bluuebunny/crossref_metadata_2025 huggingface dataset:
Nitrofurantoin Versus Comparators in the Treatment of Cystitis due to Extended-Spectrum β-Lactamase–Producing Enterobacterales: A Multicenter Cohort Study
Authors: Thabit Abrar K. , Al Sulaiman Khalid , Alfaraj Lulwa , Radwan Sarah A. , Almadfaa Layan O. , Mokhtar Raneen H. , Alowais Shuroug A. , Bin Saleh Khalid , Eljaaly Khalid , Alzahrani Abdulmajeed A. , Alshehri Abdulaziz J. , Alofi Fadwa S. , Aljuhani Ohoud
Published: February 2025

Background:

The increasing prevalence of extended-spectrum β-lactamase (ESBL)–producing bacteria has limited treatment options for cystitis. The recommendation of nitrofurantoin for treatment is based solely on in vitro studies.

Objective:

We aimed to evaluate the effectiveness of nitrofurantoin versus comparators in treating cystitis due to ESBL-producing Enterobacterales in the clinical setting.

Methods:

This was a multicenter retrospective cohort study of afebrile adults with symptomatic cystitis and a urine culture of ≥105 CFU/mL of ESBL-producing organism susceptible to nitrofurantoin and comparator antibiotics. Patients were categorized based on treatment (nitrofurantoin vs comparator). Clinical cure was the primary endpoint. Reinfection and relapse were secondary endpoints.

Results:

Of 225 patients, 66 received nitrofurantoin and 159 received a comparator. Carbapenems were the most used comparator (57.2%). Clinical cure rates were not significantly different between the groups in crude (77.3% vs 86.2%; P = 0.101) and regression analyses (adjusted odds ratio [aOR], 0.82; 95% CI, 0.34-1.99). Of 35.4% of nitrofurantoin patients and 66.0% comparators group patients who had follow-up cultures, lower odds of relapse and reinfection were observed with nitrofurantoin, though not statistically significant (aOR, 0.28; 95% CI, 0.07-1.18 and aOR, 0.43 with 95% CI of 0.13-1.43, respectively). However, the inpatient setting was significantly associated with higher odds of relapse (aOR, 8.83; 95% CI, 1.07-72.74; P = 0.043).

Conclusion and relevance:

Nitrofurantoin was as effective as comparators in treating cystitis due to ESBL-producing Enterobacterales. The inpatient setting was associated with higher odds of relapse. Further larger research trials are needed to validate these findings.
A Comparison of Outcomes of Standard Weight-Based and Capped Doses of Albumin for Spontaneous Bacterial Peritonitis
Authors: Huang Lily , Marcotte Avery , Murray Taryn S. , Barkes Jordan , Clayton Alissa
Published: February 2025

Background:

Albumin is recommended in the management of patients with spontaneous bacterial peritonitis (SBP) to reduce rates of renal injury and mortality. Current guideline recommendations suggest an intravenous albumin dosing regimen of 1.5 g/kg on day 1 and 1 g/kg on day 3, although a maximum dosing strategy is not well-defined.

Objective:

The purpose of this study was to evaluate differences in renal injury for patients with SBP treated with a capped dose less than or equal to 100 g vs a weight-based dose greater than 100 g.

Methods:

A retrospective analysis was conducted at a single academic medical center for patients with a diagnosis of cirrhosis treated with albumin for SBP. The primary outcome examined rates of acute renal injury at 5 days between patients treated with capped dose vs weight-based doses of intravenous albumin. Secondary outcomes included resolution of SBP by day 5, death by day 5, death by day 30, and change in serum creatinine from day 0 to day 5.

Results:

In total, 258 patient encounters were analyzed, with 154 included in this study. There were 70 encounters encompassing the capped dose and 84 in the non-capped. Acute renal injury at day 5 was observed in 10% (n = 7) of the capped dosed group and 6% (n = 5) of the non-capped group ( P = 0.381).

Conclusion and Relevance:

This study did not show a significant difference in outcomes associated with a capped albumin dose at 100 g for SBP. Application of these data may aid in reducing health system and patient costs.
A Pilot Randomized Controlled Trial Evaluating Peer Recovery Coaches for Addiction Recovery Among Indigenous Americans
Authors: Guenzel Nicholas , Zimmerman Lani , Watanabe-Galloway Shinobu , Dai Hongying Daisy , Qiu Fang , McChargue Dennis
Published: February 2025

Background:

Peer recovery coaches (PRCs) have experienced addiction and are trained to help others in recovery. Indigenous American (IA) adult PRCs may fill gaps of culturally specific support in addiction.

Aims:

The aims were to: (1) evaluate the feasibility of implementing a PRC intervention compared to an attention control group recovering from a substance use disorder, (2) compare PRC and attention control groups on relapses and secondary outcomes, and (3) measure PRC strategies.

Methods:

In this feasibility trial, we recruited a total of 120 adult IAs with substance use disorders. Ninety participants were randomized to the PRC group which received support from a PRC and 30 to the attention control group which received support from a research nurse. Both groups received weekly support for 12 weeks. Participants completed surveys weekly during the 12-week intervention and then monthly for 3 months.

Results:

The two groups had similar quantities of alcohol consumed, days of alcohol use, and days of drug use except that the PRC group had fewer days of alcohol use in the first 3 weeks of the intervention phase (2.05 vs. 3.5 days, p = .04). “Support and advocacy” was the most common PRC intervention. PRCs were widely accepted by individuals who completed the program, receiving positive feedback from 79% of participants.

Conclusion:

This pilot demonstrated that racially concordant PRC services likely have high acceptability among IA populations. Future studies may draw on these findings by having trained IA coaches recruit and work with individuals in-person to assist with retention.
EXPRESS: Is the Risk of Heart Failure Increased in Patients with Inflammatory Bowel Disease? A Meta-Analysis
Authors: Goyal Aman , Tariq Muhammad Daoud , Hurjkaliani Sonia , Maryyum Adeena , Thakkar Kamya , Thakur Tanya , Dahiya Dushyant Singh
Published: February 2025

This systematic review and meta-analysis examined the association between inflammatory bowel disease (IBD) and heart failure (HF), with further subgroup analysis for Crohn's Disease (CD) and Ulcerative Colitis (UC). A thorough analysis of five observational studies involving 430,016 IBD patients revealed a trends towards an increase, albeit statistically non-significant, risk of HF in IBD patients (RR: 1.28, 95% CI: 0.67-2.42, p=0.45, I2=100%). However, CD patients (RR=1.30, 95% CI=1.15-1.46, p<0.0001, I2=6%) exhibited a significantly higher risk of HF compared to UC patients (RR=1.43, 95% CI=0.81-2.52, p=0.21, I2=77%). These findings emphasize the importance of cardiovascular monitoring in IBD management, particularly for CD patients. The study also highlights the need for future research involving larger cohorts and randomized controlled trials to better understand the relationship between IBD and HF.
C. G. Jung’s Concept of “Manic Mood” From 1904: An Early Contribution to the Disorder of the Adult Form of ADHD?
Authors: Müller Steffen , Strauß Maria , Steinberg Holger
Published: February 2025

Background:

Adult ADHD has increasingly become a focus in adult psychiatry. Despite well-established diagnostic criteria and specific therapeutic approaches, contemporary discussions often dismiss ADHD as a “fad.” This study examines Carl Gustav Jung’s 1904 concept of “manic mood” and its potential alignment with the modern understanding of ADHD in adults.

Objective:

The aim of this paper is to investigate and discuss whether Jung’s concept of “manic mood” can be considered part of the intellectual history of adult ADHD.

Method:

Jung’s concept of “manic mood” is analyzed and presented using the literary-historical method of “close reading,” placing the analysis within the context of the early 20th-century discussion of “chronic-manic concepts.” This analysis is compared with the current diagnostic criteria for adult ADHD.

Results and Conclusion:

Jung’s concept of “manic mood,” described in 1904, has clear parallels to diagnostic criteria used for adult ADHD. It is conceivable that the patients presented by Jung would be diagnosed with adult ADHD today. Jung’s work fits into the discussion of “chronic-manic concepts” of the early 20th century and thus makes a relevant original contribution to the nosological-diagnostic classification of forms in the spectrum of ADHD-affective disorders-personality disorders. The parallel between Jung’s disease construct of “manic mood” and the current view of ADHD supports our hypothesis that the adult form of ADHD represents a consistent disease phenomenon and should therefore not be degraded as a “fad.”
Forming the Self: Self-Representation and Reality TV Form
Authors: Levy Yael
Published: February 2025

This article examines the ways in which reality television form and textuality offer openings for participants’ self-representation, regardless of how they are initially characterized by edited dialogue and performance. The tension between production interests, commercial interests, and the self-reflexive desires of participants positions the reality participant in constant negotiation between narrative and performance, agency and commodification. Nevertheless, as this article seeks to establish, the genre’s formal conventions—focusing on the confessional, the reunion, and format rules—allow for textual creases through which participants’ selves gain agency. Examining shows such as The Circle, The Real Housewives, Love Is Blind, Temptation Island, Are You the One?, and Sister Wives, the analyses show how reality TV form, despite being highly produced and controlled, may nonetheless facilitate participants’ reflexive, even resistant self-representation.
How Do Black Lives Matter to Hollywood? Marketing Black Trauma and Joy on Streaming Platforms
Authors: Escoffery Aymar Jean , Cooley Jamie
Published: February 2025

In the wake of the Black Lives Matter protests of 2020, streaming TV platforms responded by releasing playlists curating Black-focused films and series. This begs the question: how do Black lives matter on their own platforms? What kinds of stories are they marketing? By analyzing the trailers on these collections, we found that streaming platforms reduce Black storytelling to their hardship or trauma. Stories of trauma or struggle are more likely to include joy if they focus on famous or successful people. Stories of joy or complex everyday lives are clearly underrepresented and occur as frequently as stories that do not center Black people at all (despite their inclusion on Black-focused playlists). This study critiques and adds nuance to conversations about how the platforms can construct and enact harmful narratives about the Black experience.
Knowledge and practices of emergency contraception use and associated factors among female undergraduate students in Northern Uganda: A cross-sectional study
Authors: Acen Barbra Kelly , Obonyo Isaac , Ocen Tonny , Arebo Benedict , Auma Anna Grace , Beja Humphrey
Published: February 2025

Background:

Emergency contraception (EC) can prevent up to 95% of unplanned pregnancies if used correctly. Despite efforts to enhance its accessibility, cost and cultural stigmas persist as formidable barriers.

Objective:

This study assessed the knowledge and practices of EC use and determined the associated factors among the female undergraduate students of Northern Uganda.

Design:

This was a descriptive, institutional-based cross-sectional study conducted among the female undergraduate students of Lira University in Northern Uganda.

Methods:

Data were collected from 328 female undergraduates who were surveyed using self-administered questionnaires after obtaining informed consent from them. Data were analyzed using Statistical Package for Social Sciences (SPSS) and presented as frequencies and percentages, and binary and multiple logistic regressions were used to determine the association between the outcome variable and the independent variables. Results were presented as odds ratios with 95% confidence intervals, and associations were considered statistically significant at p ⩽ 0.05.

Results:

The response proportion was 328/334 (98%). Majority of the participants were 18–23 years old (233/328; 71.0%), had a consistent sexual partner (221/328; 67.4%), and unmarried (206/328; 62.8%). Almost all the participants (315/328; 96%) had heard about EC, where 150/328 (45.7%) learned about EC from health professionals and 135/328 (41.2%) learned about EC from family members and friends. The most well-known brand of EC was Postinor-2 (Levonorgestrel), as reported by 130/328(39.6%) participants. Of the study participants, 200/328 (61.0%) were knowledgeable about the correct timing of EC. Regarding practices of EC use, 214/328 (65.2%) used EC, of whom 122/214 (57.0%) acquired EC from the pharmacy, and most of the participants who had used EC used Postinor-2 (92/214; 43.0%). Of those who used EC, 175/214 (81.8%) used it to prevent unplanned pregnancy, and 182/214 (85.0%) participants used it with the correct timing. The factors that were associated with EC use were being a student who was studying at the Faculty of Health Sciences (adjusted odds ratio (AOR): 4.27, CI: 1.61, 10.09, p ⩽ 0.003) and the absence of a consistent current sexual partner (AOR: 8.63, CI: 4.49, 16.59, p ⩽ 0.00).

Conclusion:

Participants showed good EC knowledge and usage, but gaps persist. Factors like being a student who was studying at the Faculty of Health Sciences, and lack of a consistent current sexual partner correlated with EC use. Consistent education efforts are needed to address knowledge gaps, focusing on diverse EC forms, reliable information, and affordability.

Registration:

Not applicable.
Perioperative management of the patient on cannabis and cannabinoids: A review
Authors: Scheuermann Maria , Hans Guy , Wildemeersch Davina
Published: February 2025

Background:

The rise in global cannabis use has led anaesthetists to encounter an increasing number of patients on cannabis and cannabinoids. With cannabis influencing the perioperative period, anaesthetists will face associated challenges managing these patients.

Objective:

This review aims to summarise this literature on perioperative care for patients with long-term cannabis consumption or cannabis use disorder.

Methods:

This review was conducted based on the PRISMA 2020 statement. A literature search was performed using Medline and Cochrane library databases to identify relevant reports published from 2003 to 2023. This search yielded 209 records. After screening, 17 articles were included.

Results:

Preoperative screening of patients for chronic cannabis use or cannabis use disorder can be valuable, due to the increased risk of postoperative myocardial infarction, more postoperative pain and opioid use. Moreover, regarding respiratory management, anaesthetists should prepare to manage bronchospasm and consider adjustments in ventilation. During the perioperative period, attention should be paid to potential interactions between anticoagulant medications and cannabinoids.
ChatGPT Achieves Only Fair Agreement with ACFAS Expert Panelist Clinical Consensus Statements
Authors: Casciato Dominick J. , Calhoun Joshua
Published: February 2025

Introduction

As artificial intelligence (AI) becomes increasingly integrated into medicine and surgery, its applications are expanding rapidly—from aiding clinical documentation to providing patient information. However, its role in medical decision-making remains uncertain. This study evaluates an AI language model’s alignment with clinical consensus statements in foot and ankle surgery.

Methods

Clinical consensus statements from the American College of Foot and Ankle Surgeons (ACFAS; 2015-2022) were collected and rated by ChatGPT-o1 as being inappropriate, neither appropriate nor inappropriate, and appropriate. Ten repetitions of the statements were entered into ChatGPT-o1 in a random order, and the model was prompted to assign a corresponding rating. The AI-generated scores were compared to the expert panel’s ratings, and intra-rater analysis was performed.

Results

The analysis of 9 clinical consensus documents and 129 statements revealed an overall Cohen’s kappa of 0.29 (95% CI: 0.12, 0.46), indicating fair alignment between expert panelists and ChatGPT. Overall, ankle arthritis and heel pain showed the highest concordance at 100%, while flatfoot exhibited the lowest agreement at 25%, reflecting variability between ChatGPT and expert panelists. Among the ChatGPT ratings, Cohen’s kappa values ranged from 0.41 to 0.92, highlighting variability in internal reliability across topics.

Conclusion

ChatGPT achieved overall fair agreement and demonstrated variable consistency when repetitively rating ACFAS expert panel clinical practice guidelines representing a variety of topics. These data reflect the need for further study of the causes, impacts, and solutions for this disparity between intelligence and human intelligence.

Level of Evidence:

Level IV: Retrospective cohort study
The Impact of Remittance on Financial Development in the Recipient Countries: A Comparison Between Highly- and Low-skilled Migrants
Authors: Forhad Abdur Rahman , Alam Gazi Mahabubul
Published: February 2025

With a long history, studies have investigated how remittances affect development. In doing so, a few studies have looked at the impact of remittances on the recipient countries’ financial development. This comparative study aims to address the lack of a specific study that would identify the impact of remittances from highly- and low-skilled groups on financial development. The instrument variable approach (IV) was used in this investigation. Findings were mostly produced using secondary data from the World Development Indicators, while primary data was also used to support the talks. According to research, remittances typically improve recipient nations’ financial development. We also point out, nevertheless, that remittances from migrants with comparatively low levels of education have significantly boosted financial inclusion in the host nations. Both inshore and offshore laws and regulations for overseas employment and investment possibilities would be loosened—an implication—to guarantee a larger and longer-term impact of remittances from both groups on financial growth.
Promoting Adherence to a Yoga Intervention for Veterans With Chronic Low Back Pain
Authors: Gonzalez Carol , Chang Douglas G. , Rutledge Thomas , Groessl Erik J.
Published: February 2025

Background

Research demonstrates that yoga can be effective for improving chronic low back pain (cLBP) among military veterans and non-veterans. Attendance of yoga interventions is necessary to obtain benefits, yet yoga class attendance can be a challenge both within and outside of research, especially for persons who lack resources.

Objective

Our objective was to describe efforts to boost attendance within a randomized trial of yoga for cLBP, and to examine factors related to attendance.

Methods

A previous trial of yoga for cLBP among military veterans randomly assigned participants to 2x weekly yoga for 12 weeks, or delayed treatment. After the second of 6 intervention cohorts, efforts were made to improve participant attendance. Attendance and reasons for missing yoga sessions were tracked using sign-in logs and phone calls. Regression analysis was used to examine factors related to attendance.

Results

After efforts to boost attendance, mean attendance increased from 10.2/24 sessions, (42% attending at least half of sessions), to 13.3/24 sessions, (df (1,74), t = −1.44; P = 0.15) (59% attending half of the sessions). The most common reasons for non-attendance were transportation, financial problems, other health issues, and work or school conflicts. Living status and back pain-related disability at baseline were significantly associated with attendance ( P= < .001 and P = .038 respectively). When including all participants, yoga session attendance was significantly associated with reduced pain severity ( P = 0.01).

Conclusions

Efforts to boost attendance appeared meaningful but the changes were not statistically significant. Attendance rate in later cohorts were comparable to those in other studies. Reasons provided for non-attendance by participants, and the regression results suggest that resources such as transportation, a stable living situation, and disability levels at baseline were related to attendance rates for this in-person intervention. Remotely delivered yoga may address some of these barriers but hybrid interventions that bring in-person yoga closer to participants may be the best option.
A Longitudinal Observational Study of a Powder-Based Supplement for a Future Synbiotic Trial in Breastfed Children From South Africa
Authors: Shivakoti Rupak , Laughton Barbara , Shafiq Mehr , Schoeman Elisma , Glashoff Richard H. , Barnabas Shaun , Fry Samantha , Leu Cheng-Shiun , Wang Shuang , Bode Lars , Aldrovandi Grace , Kuhn Louise , Slogrove Amy L.
Published: February 2025

This study investigates the feasibility and acceptability of a powder-based supplement for breastfeeding HIV-exposed uninfected children to inform a larger trial (MIGH-T MO study). Ten mothers living with HIV and their children (6 weeks-20 months) at Tygerberg Hospital, Cape Town, South Africa, participated. The children received a daily supplement of potato maltodextrin mixed with expressed breast milk for 4 weeks, serving as a placebo control for the upcoming trial. Outcomes assessed included feasibility, acceptability, adherence, and health effects, evaluated at enrollment, during weekly calls, and at the 4-week visit. High acceptability was indicated by full enrollment of eligible participants, though there was some loss to follow-up (n = 3). Among the remaining participants, no major feasibility issues were found regarding procedures, product administration, adherence, tolerance, or health assessments. The study concludes that powder-based supplements are feasible and acceptable for breastfeeding HEU children, supporting the potential for larger studies using similar supplements.
Differences in sleep EEG coherence and spindle metrics in toddlers with and without receptive/expressive language delay: a prospective observational study
Authors: Hong Xinyi , Farmer Cristan , Kozhemiako Nataliia , Holmes Gregory L. , Thompson Lauren , Manwaring Stacy , Thurm Audrey , Buckley Ashura
Published: February 2025

Background

Changes in brain connectivity during development are thought to reflect organizational and maturational processes that correspond to skill acquisition in domains like motor, language, and cognition. This theory is supported by findings in typically developing children as well as observations of abnormal connectivity among children with neurodevelopmental differences. However, few coherence studies have capitalized on the potential of sleep electroencephalogram (EEG) to examine the developing brain, especially among very young children for whom formal neurodevelopmental diagnosis is not yet possible. Sleep microarchitecture in young children may offer key insights into neurophysiological abnormalities associated with neurodevelopmental trajectories and potentially aid in early detection and intervention. In this study, we explored sleep EEG coherence and sleep spindles in typically developing toddlers and toddlers at increased risk of later neurodevelopmental diagnoses.

Methods

We investigated EEG coherence and sleep spindles in 16 toddlers with receptive and expressive language delay (LangD) and 39 typically developing (TD) toddlers. Participants were aged 12–22 months at baseline, and 34 (LangD, n=11; TD, n=23) participants were evaluated again at 36 months of age.

Results

Average EEG coherence was stronger in the LangD group than the TD group, with differences most prominent during slow-wave sleep. Some age-related increases in coherence were observed, but these did not differ between groups. Sleep spindle density, duration, and frequency changed between baseline and follow-up for both groups, with the LangD group demonstrating a smaller magnitude of change than the TD group. The direction of change was frequency band-dependent for both groups.

Conclusions

These findings indicate that atypical sleep EEG connectivity and sleep spindle development can be detected in toddlers at risk of later neurodevelopmental diagnoses.

Trial registration

https://clinicaltrials.gov/study/NCT01339767; Registration date: 4/20/2011.
Genome-wide identification and analysis of the UBA2 gene family in wheat (Triticum aestivum L.)
Authors: Li Juan , Cui Chunge , Han Fengying , Liu Jin
Published: February 2025

Background

RNA-binding proteins (RBPs) participate in multiple aspects of RNA metabolism, which in turn regulates gene expression, thereby involving in organism growth and development. The UBA2 family, one of the subfamilies of RBPs, has been identified in several plant species. However, few researches have been performed to investigate the role of UBA2 in wheat (Triticum aestivum).

Results

In this study, we identified eleven TaUBA2s and divided them into three groups according to their domain characteristics. Phylogenetic analysis was conducted to forecast functional similarities among Arabidopsis, rice, maize and wheat UBA2 genes. Members within the same subfamily of TaUBA2 are relatively conserved in terms of protein structure, motifs, and gene structure. Chromosomal location and synteny analysis suggested that the segmental duplication events played important roles during TaUBA2s evolution. The cis-acting element analysis showed that TaUBA2s were involved in hormone response, development, light response, metabolism, and response to environmental stress. Furthermore, TaUBA2C contains two RNA recognition motifs (RRMs), and the first RRM is responsible for the nuclear speckle formation of TaUBA2C, whereas the two RRMs are necessary for its biological function.

Conclusions

Taken together, our study provides a comprehensive analysis of the TaUBA2 family in wheat and lays the foundation for the future functional investigations of TaUBA2s in wheat growth, development and stress responses.
Genome-wide association analysis reveals the function of DgSAUR71 in plant height improvement
Authors: Xu Xiaoheng , Feng Guangyan , Li Peng , Yu Shuai , Hao Feixiang , Nie Gang , Huang Linkai , Zhang Xinquan
Published: February 2025

Background

Orchardgrass (Dactylis glomerata L.) is one of the four most economically important forage grasses cultivated globally and serves as an excellent perennial forage with high ecological value. Plant height is a key determinant of both biomass and grain yield. While numerous genes regulating plant height have been identified in annual crops, no such genes have been reported for orchardgrass.

Results

In this study, we analyzed the relationship between plant height and biomass yield in a natural population of 264 orchardgrass genotypes and found that a plant height of 90–110 cm contributed to the maximum biomass yield. Genome-wide association analysis (GWAS) identified 23 candidate loci associated with plant height, corresponding to 62 candidate genes. Among these, DgSAUR71, a member of the small auxin-up RNA (SAUR) gene family, emerged as a novel candidate gene associated with plant height. Functional analysis revealed that DgSAUR71 slightly reduced plant height in rice (Oryza sativa L.) and was involved in regulating plant height in orchardgrass.

Conclusions

This study demonstrates that plant height is an important contributor for optimizing biomass yield in orchardgrass, with an optimal range identified. DgSAUR71 was identified as a gene associated with plant height through GWAS and shown to negatively regulate plant height. These findings provide new insights into plant height regulation in orchardgrass and contribute to advancing crop height diversification research.
Evolution of morphological traits of Dendrobium sensu lato (Orchidaceae)—an attempt to resolve phylogenetic relationships in nominal and morphologically convergent sections
Authors: Burzacka-Hinz Aleksandra , Dudek Magdalena , Olędrzyńska Natalia , Naczk Aleksandra M. , Szlachetko Dariusz L.
Published: February 2025

Background

Dendrobium is a large genus within the Orchidaceae family, containing over 1,600 species. Most are sympodial epiphytes. These species are distributed throughout southern, eastern, and southeastern Asia, the Pacific Islands, Australia, New Guinea, and New Zealand. Infrageneric classification of this group is challenging, largely because of the large number of taxa, the wide geographic range, and the considerable morphological diversity. The primary objective of our research was to analyze the genus Dendrobium (focusing primarily on the nominal section) using DNA sequences and to integrate these findings with morphological data.

Results

UPGMA morphological analysis and SIMPER analysis, considering 14 characters, showed that characters such as the placement of the inflorescence, the pseudobulbs from which the inflorescence grows, the surface of the lip, and the number of lobes on the lip are the distinguishing characters of the taxa within Dendrobium sensu lato.The nominal section, Stachyobium, and Formosae (species-rich) are more morphologically variable and exhibit a wide range of variability, in contrast to sections with fewer species. The reconstruction of the ancestral states of Dendrobium sensu lato showed that most of the characters examined arose independently several times during evolution. The only exception is dorsiventrally compressed leaves, a character that arose only once. In addition, the nominal section is not monophyletic and is not entirely consistent with morphology, and species of Holochrysa, Breviflores and Stuposa are closely related.

Conclusion

We conclude that convergent evolution likely occurred among Dendrobium sensu lato representatives, and that many floral traits may have resulted from adaptations to pollinators. This has led to numerous classification problems within the genus. We have not received a clear answer to the question of how to classify species across the genus. Therefore, in this study, we focused primarily on the nominal section.
Integrating fractional-order SEI1I2I3QCR model with awareness and non-pharmaceutical interventions for optimal COVID-19 pandemic
Authors: Refaie Ali Ahmed , Rehman Daniyal Ur , Khan Najeeb Alam , Ayaz Muhammad , Ara Asmat , Khan M. Ijaz
Published: February 2025

Infectious diseases like COVID-19 continue to pose critical challenges globally, underscoring the need for effective control strategies that go beyond traditional vaccinations and treatments. This study introduces an advanced SEI1I2I3QCR model, uniquely incorporating fractional-order delay differential equations to account for latency periods and dynamic transmission patterns of COVID-19, improving accuracy in capturing disease progression and peak oscillations. Stability analyses of the model reveal the critical role of delay and fractional order parameters in managing disease dynamics. Additionally, we applied optimal control theory to simulate non-pharmaceutical interventions, such as quarantine and awareness campaigns, demonstrating a notable reduction in infection rates. Numerical simulations align the model closely with real-world COVID-19 data from China, validating its utility in guiding pandemic response strategies. Our findings emphasize the significance of integrating time-delay factors and fractional calculus in epidemic modeling, offering a novel framework for pandemic management through targeted, cost-effective control measures.
An evaluation of Scottish green health prescriptions using the APEASE criteria
Authors: Howlett Neil , Freethy Imogen , Harding Sian , Wagner Adam P. , Miners Lisa , Anne-Greco Honey , Lamming Laura , Lloyd Nigel , Brown Katherine E.
Published: February 2025

Background

Time spent in green space such as parks and forests can have positive effects on physical and mental health. Green Health Partnerships were set up in Scotland to promote use of green space for health improvement. One of the main mechanisms to achieve this was the setup of Green Health Prescriptions (GHPr). This study evaluates three GHPrs in different localities across a range of feasibility elements, and the funding and resourcing associated with implementation.

Methods

Interviews were conducted across service user, referrer, link worker, and activity provider groups across Dundee, Highland, and North Ayrshire. Interviews were deductively analysed using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Spillover effects, Equity) criteria. Data within each APEASE domain was then inductively coded producing more reflexive sub-themes. Data on funding and resources associated with delivering each programme was also collected to provide further context to the APEASE criteria.

Results

All stakeholder groups generally found the concept of using green spaces and the GHPr acceptable, and, although service users perceived that staff were often good communicators, there were times where awareness of and knowledge about the GHPr were lacking. There were reported improvements across a wide range of physical and mental health, and social outcomes for service users. The GHPr was also considered affordable in terms of the green health activity sessions. A key issue for staff across practicability, acceptability, and with monitoring equity, was the lack of underpinning IT infrastructure for referrals, communication with link workers, and data capture to reflect on service user progress. As implemented in Dundee, progression through the GHPr, after initial referral, took on average 195 min, at a cost of £64 per service user.

Conclusions

This evaluation highlighted the potential benefits for service users that can be realised through a GHPr. However, a lack of supportive systems to capture referral information, communicate between professionals, and document service user progress limits a more robust and extensive evaluation of the current GHPr model.

Evaluation registration

Research Registry identifier: researchregistry9069, registration date: 25/04/23.
Development of a patient assessment to meet the needs of patients suffering from advanced non-oncological diseases – the KOPAL trial
Authors: Marx Gabriella , Mallon Tina , Stanze Henrikje , Zimansky Manuel , Schneider Nils , Nauck Friedemann , Scherer Martin , Pohontsch Nadine
Published: February 2025

Background

Patients suffering from progressive non-oncologic chronic diseases are primarily treated in primary care. Early integration of palliative care (PC) can improve patients’ quality of life and reduce burdensome physical symptoms. To guide interprofessional counselling between GPs and specialist palliative home care teams, we developed an aide memoire for patients diagnosed with advanced non-oncological chronic diseases, the KOPAL conversation guide, as part of the KOPAL trial. The aim of this study was to ensure the conversation guide covers all relevant care aspects in order to reveal individual gaps and needs in healthcare.

Methods

We conducted three focus groups including four patients, seven health care providers, and five stakeholders. During each group, a draft of the conversation guide was discussed, revised, and consented from the respective perspectives.

Results

The final KOPAL conversation guide contains eight key topics: living with the illness, physical, emotional, personal, and social situation, information and communication, control and autonomy, emergency management. Each topic refers to a number of related subtopics listed in each respective thematic section. The conversation should start with the introductory question referring to the patient’s current well-being. At the end, patients are asked to state their primary concern based on the conversation.

Conclusions

The KOPAL conversation guide is a broad evaluation and communication tool. It covers potential PC needs of non-oncological patients and provides a basis for interprofessional case planning, and counselling. Applying the guide may help to bridge gaps in communication between general and specialist PC professionals as well as between professionals and patients.
The burden of ischemic stroke in Eastern Europe from 1990 to 2021
Authors: Xu Jingyao , Hou Shuai , Chen Zimeng , Liu Yong , Deng Xia , Wang Chunping , Liu Shijie , Wang Yanqiang
Published: February 2025

Background and purpose

Ischemic stroke is a significant public health concern, particularly in Eastern Europe, where the burden remains high. This study aims to evaluate the trends and burden of ischemic stroke in Eastern Europe from 1990 to 2021, providing insights into epidemiological changes and informing public health strategies.

Methods

We used data from the Global Burden of Disease 2021 database to comprehensively assess regional and national ischemic stroke indicators in Eastern Europe. These indicators included the number of cases, incidence, number of deaths, mortality, disability-adjusted life years (DALYs), DALY rates, and estimated annual percentage change (EAPC). Joinpoint analysis was employed to examine sex-specific time trends in the burden of ischemic stroke across Eastern European countries. These estimates incorporated the Socio-Demographic Index (SDI).

Results

In 2021, Eastern Europe reported 490,197 cases of ischemic stroke, with an age-standardized incidence rate (ASIR) of 142.57 (95% UI: 122.12 to 164.67), exceeding the global level. The region recorded 329,291 deaths, with an age-standardized mortality rate (ASMR) of 90.99 (95% UI: 82.79 to 98.48), significantly higher than the global rate. Disability-adjusted life years (DALYs) totaled 5,713,718, with an age-standardized DALYs rate (ASDR) of 1601.20 (95% UI: 1483.51 to 1723.12). Our joinpoint regression analysis indicates that the disease burden remains notably high in Eastern Europe, despite an overall declining trend from 1990 to 2021 in ASIR and ASMR across most countries, with estimated annual percentage changes (EAPC) of -1.13 (95% CI: -1.24 to -1.02) and − 2.78 (95% CI: -3.24 to -2.32), respectively. Lithuania reported the highest incidence rate, while the Russian Federation had the highest mortality and DALY rate. Conversely, Estonia showed significant improvements in stroke indicators. Key risk factors included low temperature and smoking, contributing notably to environmental and behavioral risks.

Conclusion

Ischemic stroke continues to be a significant global health issue. Our temporal trends study results indicate that the disease burden remains notably high in Eastern Europe, particularly in Lithuania and the Russian Federation.
Dihydrolipoamide dehydrogenase deficiency in two unrelated Tunisian children
Authors: Aloulou Hajer , Charfi Fatma , Charfi Rim , Chehida Amel Ben , Boudabbous Hela , Chabchoub Imen , Lebigot Elise , Kammoun Thouraya , Maaloul Ines
Published: February 2025

Background

Dihydrolipoamide dehydrogenase deficiency (DLDD) (OMIM# 246,900) is an extremely rare inherited metabolic disorder causing neurological and/or liver impairment. The clinical manifestations are mostly characterized by severe neurological impairment in early childhood, hepatic presentations and rarely by myopathic manifestations.

Case presentations

Here, we describe two patients presenting with recurrent episodes of vomiting and liver dysfunction. DLDD was confirmed via sanger sequencing by identification of the pathogenic variant c.685G > T (p.Gly229Cys) in DLD gene at a homozygous state.

Conclusion

To our knowledge, this is the first Tunisian report of DLDD. Phenotypic spectrum of this disease is very large. Biochemical markers that predict the impairment of the pathways affected by the deficiency of E3 subunit (gluconeogenesis, tricyclic cycle and catabolism of branched chain aminoacids) are variably present. Confirmation is based on genetic study of DLD gene.
Evaluation of color stability in single-shade composite resins using spectrophotometer and cross-polarized mobile photography
Authors: Tepe Hatice , Celiksoz Ozge , Yaman Batu Can
Published: February 2025

Background

This study aimed to evaluate the long-term color stability of single-shade composite resins when exposed to simulated intraoral conditions, including staining, brushing, and thermal cycling. Additionally, the study compared the performance of spectrophotometry and cross-polarized (CP) photography in detecting color changes, focusing on their applicability for both clinical and research purposes.

Materials and methods

The study employed five single-shade composite resins (Omnichroma; OMN, Zenchroma; ZNC, Vittra APS Unique; VTR, Charisma One; CHR, and Essentia Universal; ESU) and one multi-shade composite resin (Filtek Z550: FLT) for testing. The specimens were subjected to thermal cycling, staining, and brushing to simulate intraoral conditions. Color measurements were conducted using a spectrophotometer and CP photography at the initial baseline (t0) and following each subsequent procedure 10-day (t1) and 1-year simulated staining, brushing and thermal cycling (t2). Color differences (ΔE1, ΔE2) were calculated using the CIEDE2000 formula. Statistical analyses included Shapiro-Wilk for normality, ANOVA and paired t-tests for parametric data, and Kruskal-Wallis and Wilcoxon tests for non-parametric data. Method consistency was evaluated with the Intra-Class Correlation Coefficient (ICC) (p < 0.05).

Results

All composite groups demonstrated statistically significant color changes following the simulated conditions (p < 0.001). The CHR group exhibited the highest values for both ΔE1 and ΔE2, indicating the greatest degree of discoloration. The FLT and ZNC groups exhibited the lowest ΔE values across methods at various time points. A positive correlation was identified between spectrophotometer and CP photography measurements for all parameters (p < 0.001), although the correlation for ΔE1 and ΔE2 was less robust.

Conclusions

Single-shade composites display a high susceptibility to significant discoloration when subjected to simulated intraoral conditions, with CHR exhibiting the most pronounced alterations. Both spectrophotometry and CP photography were effective in assessing color stability, with CP photography offering a practical alternative for clinical settings. These findings offer insight into the aesthetic durability of single-shade composites and underscore the importance of long-term evaluations.
Exploring the knowledge, attitude, and practice of community pharmacists regarding pediatric asthma management in Guangdong Province, China: a cross-sectional survey study
Authors: Lin Guohua , Lai Meijun , Chau Chi Ian , Hu Hao , Ung Carolina Oi Lam
Published: February 2025

Background

Pediatric asthma is a common respiratory disease that significantly affects children's physical and mental health. This study aims to investigate community pharmacists' self-reported knowledge of asthma and explore their attitude and practice in providing pharmaceutical services to address the needs of pediatric asthma patients.

Methods

An online questionnaire informed by recent literature was distributed to community pharmacists in Guangdong Province, China via Qualtrics using convenience sampling and snowballing. Descriptive analysis and generalized multiple linear regression analysis were used for data analysis.

Results

Out of 579 community pharmacists who attempted this questionnaire, 473 completed it, giving a completion rate of 81.7%. Among the participants, 217 (45.9%) were female, and 319 (67.5%) aged between 31 and 50. The mean score of self-reported knowledge was 60.29 ± 6.16 out of 95 (range: 19–76); the mean score of attitude was 87.62 ± 8.37 out of 130 (range: 77–130); the mean score of practice was 18.72 ± 2.32 out of 30 (range: 6–24). Age, years of employment, highest education level, the average number of patients serving per day, and the average number of asthma patients serving per week were factors significantly associated with participants' self-reported knowledge, attitude, or practice toward pediatric asthma management (p < 0.05).

Conclusions

Many community pharmacists felt they lacked sufficient knowledge about pediatric asthma and infrequently provided pharmaceutical services to children with asthma, despite having a positive attitude towards this professional role. To enhance the pharmaceutical care for pediatric asthma patients, it is essential to develop practice guidelines and care models, and provide education and training to community pharmacists accordingly.
Machine learning-based prediction of post-induction hypotension: identifying risk factors and enhancing anesthesia management
Authors: Chen Ming , Zhang Dingyu
Published: February 2025

Background

Post-induction hypotension (PIH) increases surgical complications including myocardial injury, acute kidney injury, delirium, stroke, prolonged hospitalization, and endangerment of the patient's life. Machine learning is an effective tool to analyze large amounts of data and identify perioperative complication factors. This study aims to identify risk factors for PIH and develop predictive models to support anesthesia management.

Methods

A dataset of 5406 patients was analyzed using machine learning methods. Logistic regression, random forest, XGBoost, and neural network models were compared. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), calibration curves, and decision curve analysis (DCA).

Results

The logistic regression model achieved an AUROC of 0.74 (95% CI: 0.71–0.77), outperforming the random forest (AUROC: 0.71), XGBoost (AUROC: 0.72), and neural network (AUROC: 0.72) models. In terms of calibration, logistic regression demonstrated superior performance, as reflected by Brier Scores and calibration curves, followed by XGBoost, random forest, and neural network. Decision curve analysis indicated that the logistic regression model provided the greatest clinical utility among all models. Baseline blood pressure, age, sex, type of surgery, platelet count, and certain anesthesia-inducing drugs were identified as important features.

Conclusions

This study provides a valuable tool for personalized preoperative risk assessment and customized anesthesia management, allowing for early intervention and improved patient outcomes. Integration of machine learning models into electronic medical record systems can facilitate real-time risk assessment and prediction.