bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Diced Cartilage for Management of Internal Mammary Vessel Exposure Sites in Autologous Breast Reconstruction
Authors: Dornseifer Ulf , Truong My L. , Grumbrecht Stephan , Pfeiler Peter P. , Haide Uli D. , Moog Philipp , Kimelman Michael 
Published: January 2025

Background:
Exposure of internal mammary vessels in autologous breast reconstruction often requires removal of a rib cartilage segment, which can lead to breast contour deformity. This study evaluated the use of diced cartilage (DC) to counteract substance loss in the microvascular anastomosis area.

Methods:
This retrospective, single-center cohort study included all breast reconstructions in which DC was used from October 2021 to June 2023. Reconstructions using DC were subdivided based on previous breast radiotherapy (DC versus DC with prior breast radiotherapy [DCR]). The control group consisted of an equal number of consecutive reconstructions performed before the use of DC. The effect of DC on breast contour was investigated using magnetic resonance imaging (>6 months postoperative) and photographic documentation (6-month follow-up).

Results:
DC was used in 114 of 173 included reconstructions (DC, n = 55; DCR, n = 59; control, n = 59). Magnetic resonance imaging analysis revealed less soft tissue sinking into resection zones in both DC groups (DC 0.2 ± 1.3 mm versus control 6.0 ± 1.6 mm, P = 0.002; DCR 0.4 ± 1.6 mm versus control 6.0 ± 1.6 mm, P < 0.003). Previous irradiation did not affect DC stability. The photographs indicated that there were no deformities after DC use, but deformities occurred in 13.6% of patients in the control group (P < 0.05). Flap failure did not occur in any group.

Conclusions:
DC is a safe procedure that prevents contour deformities associated with rib cartilage removal in breast reconstruction, regardless of prior breast irradiation.
New therapies to treat cardiac amyloidosis
Authors: Nguyen Olives , Kamna Daniel , Masri Ahmad 
Published: January 2025

Purpose of review
Review advancements in therapies for transthyretin (ATTR-CM) and immunoglobulin light chain (AL-CM) cardiac amyloidosis.

Recent findings
In ATTR-CM, tafamidis remains the cornerstone therapy, with Food and Drug Administration (FDA) approval for over 5 years. Acoramidis, another transthyretin stabilizer, has very recently been FDA-approved following positive results in the ATTRibute-CM trial. Vutrisiran, a transthyretin gene silencer, demonstrated efficacy in the HELIOS-B trial and awaits FDA review. Eplontersen's CARDIO-TTRansform trial, the largest ATTR-CM study to date, is expected to report by late 2025. Innovative approaches such as NTLA-2001 (a CRISPR-Cas9 therapy) and fibril depleters like ALXN2220 and coramitug are advancing in clinical trials. In AL-CM, daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD) has established itself as the standard of care. Novel antiplasma cell therapies include CAR-T cells and bispecific antibodies (teclistimab) and fibril depleters. Birtamimab improved survival in advanced AL-CM during the VITAL trial and is under investigation in AFFIRM-AL. Anselamimab is in phase III CARES trials, whereas AT-02 undergoes early-phase testing for ATTR-CM and AL-CM.

Summary
The therapeutic landscape for ATTR-CM and AL-CM is rapidly evolving, driven by novel therapies targeting diverse mechanisms. Ongoing clinical trials promise to further refine the standard of care and improve outcomes for patients with cardiac amyloidosis.
Patient Perspectives Regarding Chaperone Use During Pelvic Physical Therapy Vaginal Examination and Treatment
Authors: Austin Mary M. , Arnold Nora , Teasley L. , Roemmich Ryan T. 
Published: January 2025

Purpose:
This study examines patient perceptions of their experience with having a chaperone present for vaginal examination during a pelvic physical therapy initial evaluation.

Methods:
Quantitative survey results from 102 eligible participants seen in outpatient pelvic physical therapy between November 2021 and December 2023 are presented. A paper survey using a visual analog scale was provided to participants following the initial pelvic physical therapy visit, rating the degree to which it made them feel more comfortable having a chaperone, their preference to not to have a chaperone, and their preference to have a choice of having a chaperone.

Results:
Survey results show, 53.9% of the women surveyed reported feeling more comfortable having a chaperone present for their vaginal exam, 34.3% reported a preference not to have a chaperone present, and 68.6% indicated a preference to have a choice of whether or not a chaperone was present, regardless of age and treatment diagnosis.

Discussion:
A majority of pelvic physical therapy patients prefer a choice to decide if a chaperone is present or not for a vaginal exam, and over half were more comfortable having a chaperone present, regardless of age and treatment indication in a setting with a mandatory chaperone policy. These findings support the use of an opt-out chaperone policy in which a chaperone is planned and provided for at every vaginal exam, allowing the patient to decline use of a chaperone.
How Trauma-Informed Care Is Perceived and Delivered by Pelvic Health Physical Therapists
Authors: Bridgeman Michelle , Snyder Kailey , Peterson Julie 
Published: January 2025

Background:
Traumatic experiences may lead to emotional distress and can affect pelvic floor muscle function. Many healthcare professionals do not feel comfortable practicing trauma-informed care (TIC), and with the high prevalence of women reporting traumatic events, it is imperative that pelvic health providers confidently deliver TIC. The purpose of this study was to qualitatively investigate how trauma-informed practices are currently being implemented by pelvic health physical therapists and whether formal guidelines for TIC would be beneficial.

Methods:
Subject recruitment included licensed pelvic health physical therapists (n=13). Semi-structured interviews were completed to assess perceptions of the TIC principles developed by the Substance Abuse and Mental Health Services Administration. Interview findings were analyzed using qualitative analysis software, and a direct content analysis was performed.

Results:
Themes for safety included ensuring a private space, setting session expectations, and providing the right to refuse care. Themes for trustworthiness and transparency included patient-provider connection, and verbal and nonverbal communication. Themes for collaboration and mutuality included shared decision making and providing options to fit patient needs. Themes for empowerment, voice, and choice included patient autonomy, patient making the final decision on treatment, and ensuring the patient feels in control of the session. Lastly, themes for cultural, historical, and gender issues included use of gender-neutral terminology/pronouns and continuing education. Participants reported they would like more information on TIC approaches and felt guidelines would be helpful.

Discussion:
Several trauma-informed practices are implemented by pelvic health physical therapists; however, participants desired further education to enhance their TIC practices.
Prevalence and Impact of Urinary Incontinence and Other Pelvic Floor Symptoms in Female Aerialists
Authors: Winder Brooke , Heineman Heather , Scherb Emily 
Published: January 2025

Purpose:
Urinary incontinence (UI) is a common issue in female athletes and is known to impact quality of life and sports performance negatively. UI and related pelvic floor issues in circus artists have not been specifically investigated, despite their high-impact demands. The purpose of this study was to assess the prevalence and impact of UI and other symptoms of pelvic floor dysfunction in female aerialist circus artists.

Methods:
An observational study was performed by developing and distributing an anonymous online survey via e-mail and social media. The survey included the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) as well as questions related to circus training, urogenital health history, common UI risk factors, potential stressors to the pelvic floor, experiences of anal incontinence (AI), and symptoms consistent with pelvic organ prolapse (POP).

Results:
The survey was completed by 452 female aerialist circus artists (mean age; 33.97 ± 8.67, mean hours of weekly training; 8.78 ± 7.83). 46.0% of participants reported experiencing UI, with stress UI more prevalent than urge UI. The mean ICIQ-UI SF score was 5.54 ± 2.97, and the mean score for impact on everyday life was 1.87 ± 1.97 for those with UI. 55.9% of respondents reported pain with intercourse, and 16.4% reported POP-related symptoms. UI was significantly associated with age > 40, pregnancy, parity, POP-related symptoms, history of falling onto the tailbone, and history of sudden or uncontrolled impact to the pelvis.

Discussion:
The prevalence of UI in female aerialists is similar to that in other high-level female athletes.
Based on the prevalence of pelvic floor symptoms, healthcare professionals working with circus artists should consider regularly screening for symptoms of pelvic floor dysfunction.
Radiation in the Bronchoscopy Suite
Authors: Tsai Wilson S. , Haywood Erin , Li Xinhua , Rosenbaum Jeremy , Lindsey Brenna 
Published: January 2025

Background:
This study aimed to quantify radiation doses during navigational bronchoscopy procedures, comparing them with reported cohorts and evaluating the LungVision (Body Vision Medical Inc.) system’s efficacy in dose reduction.

Methods:
This retrospective observational study included 52 consecutive navigational bronchoscopy cases, categorized into 4 imaging groups based on the C-arm: Cios Spin (Siemens Healthineers), or OEC 9900 (GE HealthCare); and the 3D tomographic imaging algorithm: Cios Spin’s onboard imaging, or LungVision’s AI-driven imaging. Patient and lesion data, outcomes, and radiation indices were collected. Existing literature on 3D image guidance for bronchoscopic lung nodules was reviewed to compare reported radiation doses.

Results:
Combining LungVision with Cios Spin significantly reduced radiation dose in all cases compared with using Cios Spin alone: Cumulative air kerma (Ka,r) reduced from 238.7 to 119.1 mGy (P=0.03), and air kerma-area product (KAP) decreased from 28.19 to 15.09 Gy·cm2 (P=0.03). For biopsy cases, LungVision led to notable dose reductions: Ka,r of 279 to 129.1 mGy, and KAP of 30.70 to 16.27 Gy·cm2. LungVision notably reduced radiation indices in 7 paired spins, isolating the 3D imaging algorithm as the sole variable with the same Cios Spin C-arm. A literature review provides additional context on radiation for bronchoscopic biopsies.

Conclusion:
Following the “as low as reasonably achievable” (ALARA) principle minimizes ionizing radiation exposure, benefiting patients and operators. Physicians should compare baseline radiation levels with the literature and adopt dose-reduction techniques. LungVision’s lower dose indices render it effective for real-time 3D imaging during navigational bronchoscopy while reducing radiation dose.
Assessing patient-reported outcomes in primary sclerosing cholangitis: an update
Authors: Evon Donna M. , Reeve Bryce B. 
Published: January 2025

Purpose of review
Patient-reported outcome (PRO) measures validated in primary sclerosing cholangitis (PSC) are needed for clinical trials. This review describes the recent US Food & Drug Administration (FDA) Patient-Focused Drug Development (PFDD) guidelines, existing PRO measures used in PSC studies, and the design of PSC-specific symptom measures adherent with the guidelines.

Recent findings
FDA released updated guidance reflecting best practices for the design and evaluation of clinical outcome assessments (including PROs) and the design of trial endpoints. Two recent systematic reviews (2018, 2020) identified multiple PRO measures used in PSC studies, with two additional measures published since. Of these, four were developed in samples inclusive of PSC patients and six have been psychometrically evaluated in PSC. Published evidence to sufficiently support alignment with the recent guidance is sparse. We review the design of three symptom measures for PSC to illustrate alignment with FDA guidance, including qualitative and quantitative studies to provide evidence for their validity for use in adult PSC trials.

Summary
Investigators planning to use PRO measures as study endpoints for PSC need to be adherent with the recent FDA guidelines and build the evidence base to support the measure as fit-for-purpose as an endpoint for clinical trials.
Cardiac fibrosis inhibitor CTPR390 prevents structural and morphological changes in collagen and fibroblasts of engineered human connective tissue
Authors: Maestro David , Palanca Ana , Soto Helena , Llarena I , DeGrave Alisa Nicole , Guedes Gabriela , de Oliveira Guilherme Henrique , Conceição André Luiz Coelho , Mieites Verónica , Icardo Jose M. , Sanchez-Cano Carlos , Conde Olga M. , Lutz Susanne , Cortajarena Aitziber L. , Villar Ana V. 
Published: January 2025

AbstractCardiac fibrosis is a key characteristic of heart failure, with no effective treatment available. Using three-dimensional human models and cutting-edge biotechnology to evaluate new therapies offers a significant advancement. CTPR390, an experimental anti-fibrotic inhibitor targeting Hsp90, has shown success in animal models, but remains unexplored in human cardiac models. This study evaluated a cardiac three-dimensional engineered connective tissue (ECT) model treated with CTPR390, focusing on changes in the extracellular matrix and fibroblasts. Results showed that CTPR390 prevented architectural changes in TGFβ1-activated ECT, preserving tissue perimeter, collagen fibers alignment while reducing percentage of structured areas and degree of collagen structuration. Additionally, the treatment reduced cell area of elongated fibroblasts under tension, without changes in the internal rounded cells devoid of tension. Fibroblast recruitment to tension areas was diminished, showing biomechanical behavior similar to control ECT. This treatment also lowered the gene and protein expression of key pro-fibrotic markers. For the first time, advanced biotechnology was employed to detect the detailed structure of tissue fibrosis reduction after administering CTPR390, representing a significant advancement toward clinical application for cardiac fibrosis treatment.Graphical Abstract
ERGA-BGE genome ofPinctada radiata(Leach, 1814): one of the first Lessepsian migrants
Authors: Vasileiadou Katerina , Manousaki Tereza , Dailianis Thanos , Skouradakis Grigorios , Vernadou Emmanouela , Karakasi Danae , Böhne Astrid , Monteiro Rita , Fernández Rosa , Escudero Nuria ,   Genoscope Sequencing Team, Moussy Alice , Cruaud Corinne , Labadie Karine , Demirdjian Lola , Istace Benjamin , Couloux Arnaud , Wincker Patrick , Oliveira Pedro H. , Aury Jean-Marc , Haggerty Leanne , Martin Fergal , Bortoluzzi Chiara 
Published: January 2025

AbstractPinctada radiata, commonly known as the Gulf pearl oyster, is a species of pearl oyster found primarily in the warm waters of the Red Sea, the Persian Gulf, and parts of the Indian Ocean.Pinctada radiatacontributes to marine ecosystems by filtering water, which helps maintain water quality and supports other marine life. This species is the first bivalve Lessepsian migrant, having migrated from the Red Sea to the Mediterranean Sea via the Suez Canal. The reference genome ofPinctada radiatacould help identify genes enabling adaptation to varying temperatures and salinities, facilitating survival in diverse and newly colonized habitats allowing comparisons with other bivalves to uncover shared and unique genetic adaptations. Additionally, the genome could support targeted management practices and conservation initiatives, such as habitat restoration and selective breeding, ensuring the long-term sustainability ofP. radiata. The entirety of the genome sequence was assembled into 14 contiguous chromosomal pseudomolecules. This chromosome-level assembly encompasses 0.93 Gb, composed of 220 contigs and 44 scaffolds, with contig and scaffold N50 values of 8.1 Mb and 63.8 Mb, respectively.
Development of a comprehensive sustainability performance index for takaful operators: integrating Maqasid Al-Shariah and stakeholder perspectives
Authors: Mohd Zain Fahru Azwa , Wan Abdullah Wan Amalina , Muhamad Nasir Muhamad Nasyat , Hassan Mohd. Faharizan 
Published: January 2025

Purpose
This study aims to develop a comprehensive sustainability performance index tailored for Takaful operators. It integrates Maqasid Al-Shariah’s principles with key stakeholders’ expectations, ensuring a holistic evaluation of sustainability practices.

Design/methodology/approach
The index is formulated through a multi-step process, beginning with a thorough literature review to identify pertinent economic, social, environmental and religious indicators. Using a Multi-Attribute Utility Theory approach, the process incorporates expert consultations, stakeholder workshops and the analytical hierarchy process. The framework amalgamates diverse sustainability attributes, focusing on regulatory compliance, financial performance, customer satisfaction, workplace environment and community engagement. The final index is tested with data from various Takaful operators to validate its reliability and robustness.

Findings
The newly developed index effectively captures the multifaceted aspects of sustainability specific to Takaful operators, offering a balanced assessment across economic, social, environmental and religious dimensions. Findings suggest that while Takaful operators excel in community welfare and ethical compliance areas, there are notable gaps in integrating environmental and social governance factors. The index successfully highlights these gaps, providing a structured framework to enhance the sustainability practices of Takaful operators. Initial applications of the index reveal significant variability in sustainability performance among Takaful operators, pointing to areas needing improvement.

Research limitations/implications
The development of the index is limited by the availability and quality of data from Takaful operators. Future research should aim to improve data collection methods and expand the index’s application to a broader range of operators.

Practical implications
Takaful operators can use the index as a transparent and objective tool to evaluate and improve their sustainability practices, facilitating better decision-making and strategic planning towards achieving sustainable development goals.

Social implications
By incorporating Maqasid Al-Shariah and stakeholder perspectives, the index promotes socially responsible and ethically sound business practices within the Takaful industry, aligning with broader societal values and expectations.

Originality/value
This paper introduces the first comprehensive sustainability performance index specifically designed for Takaful operators, integrating religious principles with conventional sustainability metrics. The index provides substantial value for researchers, practitioners and policymakers dedicated to enhancing sustainability in the Islamic finance sector.
Can China Destabilize US Government Debt? The Biggest Threat Comes from within
Authors: Arnal Judith 
Published: January 2025

ABSTRACTChina is the second‐largest foreign holder of US government debt, after Japan. As of May 2024, China‐based investors held $768.3 billion worth of US government debt. In recent years, however, Chinese investors have been reducing their holdings of US government debt. Despite the large figure, Chinese holdings represent only 9.6% of total foreign holdings, and less than 3% of total US public debt held by the public. This significantly reduces China's potential destabilizing power, especially since Chinese investors cannot entirely do without US government debt, widely used as collateral in financial transactions. However, this does not mean that the US is free from financial tensions. Surprisingly, these tensions would not be inflicted by any geopolitical adversary but rather by the US' own economic policies. Poor fiscal governance, combined with a high public debt ratio, large public deficits projected for the coming years, an economic strategy reliant on expansionary fiscal policies, and trade policies centered on tariffs, risks increasing the US' cost of borrowing in the short term. If the United States continues down this path of fiscal imbalances, a fiscal crisis could arise in the medium term, with significant implications for the international financial system. When it comes to financial stability in the United States, the biggest threat comes from within.
Effects of the Trophic Ecology of Exotic Game Birds on Mascarenes Biodiversity: The Case of Francolinus pondicerianus in Mauritius
Authors: Herpin Ugo , Gauchet Lucie , Strasberg Dominique , Zuel Nicolas 
Published: January 2025

ABSTRACTGame bird species were introduced to several insular systems during the 18th and 19th centuries. The Mascarenes are a relevant example of such introductions, including the grey francolin (Francolinus pondicerianus). In the case of Mauritius and Réunion Island, although this bird has been present for more than 300 years, limited information is available concerning its behavioural adaptations in insular systems, especially regarding its feeding behaviour. The first aim of this study was to describe the diet of the grey francolin, a well‐established game‐bird species in the Mascarenes. From this novel information, we also wish to discuss how the grey francolin can be positioned in insular food chains, and thus, its potential impact on the biodiversity of Mauritius and Réunion Island. We provide an analysis of 9115 food items, including both insects and seeds harvested from stomach contents of 13 grey francolin. The birds were harvested in Mauritius, from two distinct zones, and their stomach contents were sorted and identified using binocular magnifiers. The results revealed a total diversity of 20 seed species and 23 insect species, with a majority of exotic species. Solanum sp., Amaranthus sp. and Chamaesyce hirta were the dominant seeds, whereas insect food items were widely dominated by ant species (Pheidole megacephala, Solenopsis geminata). Important variability was observed in the composition of stomach contents, resulting in relevant amplitudes of species‐diversity indicators and the animal‐versus‐plant ratio, throughout the 13 birds. Furthermore, the amount of certain food items was particularly high for one stomach content, whereas their global occurrence among the 13 birds was rather low, suggesting that the grey francolin has a versatile and opportunistic diet. Despite the lack of monitoring of food availability or diversity, the variation in stomach contents suggests that the diets of these generalist birds are dependent on the availability of resources in the environment.