Browse publications by year: 2025

  1. Bőthe B, Tóth-Király I, Popova N, Nagy L, Koós M, Demetrovics Z, et al.
    J Behav Addict, 2025 Feb 13.
    PMID: 39945767 DOI: 10.1556/2006.2024.00054
    BACKGROUND AND AIMS: The Moral Incongruence Model of Pornography Use proposes that pornography-use-related problems may be present due to problematic pornography use (PPU) and/or moral disapproval (MD) of pornography use. Despite some supporting empirical evidence, no study has tested the presence of different pornography-use profiles based on individuals' behavioral dysregulation (i.e., PPU) and moral values concerning pornography use. The generalizability of previous findings to diverse populations has also been limited given the scarcity of studies conducted outside of Western countries.

    METHODS: Using data from the International Sex Survey (42 countries, N = 66,994; Mage = 32.16 years, SD = 12.27), we conducted latent profile analysis to identify pornography-use profiles based on individuals' frequency of use, MD, and PPU. The profiles were compared along a wide range of pornography-use-related, sexuality-related, and psychological correlates.

    RESULTS: Six pornography-use profiles were identified, including two increased risk groups (i.e., Increased risk of PPU without MD and Increased risk of PPU with some MD). Several factors differentiated between the increased risk vs. no/low risk profiles (e.g., relatedness satisfaction) as well as between the two increased risk profiles (e.g., religiosity). Apart from behavioral dysregulation, moral values concerning pornography use played an important role in distinguishing pornography-use profiles and demonstrated the importance of inquiring about MD when working with individuals with pornography-use-related problems.

    CONCLUSION: Findings also support recent calls for better-integrated sex therapy and sexual medicine perspectives into pornography-use-related problems research and care.

  2. Gewirtz-Meydan A, Feder H, Nagy L, Koós M, Kraus SW, Demetrovics Z, et al.
    J Behav Addict, 2025 Feb 12.
    PMID: 39945771 DOI: 10.1556/2006.2024.00040
    BACKGROUND AND AIMS: Despite a growing body of research on pornography use among women, there is a lack of understanding of the problematic versus non-problematic nature. The current study aimed to investigate the relationship between women's motivations for pornography use and sexual wellbeing using a cross-sectional, self-report survey design among participants from 42 countries.

    METHODS: The total sample included 82,243 participants, of whom 46,874 (57.0%) identified as women and were analyzed. The participants' age averaged at M = 29.67 years, with a standard deviation of SD = 10.11. Participants were asked to complete a questionnaire assessing their motivations for pornography use, as well as measures of sexual functioning, sexual desire, and sexual satisfaction.

    RESULTS: Study results suggest that across cultures, women's motivations for pornography use are associated with their sexual wellbeing. Specifically, when women reported using pornography for their own pleasure or sexual curiosity, it was associated with fewer sexual functioning problems and higher sexual desire. Conversely, when women reported using pornography due to a lack of sexual satisfaction in their relationships, it was associated with more sexual functioning problems.

    DISCUSSION AND CONCLUSIONS: These findings highlight the need to consider the multifaceted nature of pornography use among women, including the usage motives, to fully understand associations with sexual wellbeing. Additionally, the study emphasizes the importance of conducting further research utilizing longitudinal designs, to establish the directionality between pornography use motivations and sexual wellbeing among women.

  3. Putra AI, Khan MN, Kamaruddin N, Khairuddin RFR, Al-Obaidi JR, Flores BJ, et al.
    Plant Cell Rep, 2025 Feb 13;44(3):54.
    PMID: 39945834 DOI: 10.1007/s00299-025-03443-8
    Proteomics has revealed complex immune responses in fruits, leading to the identification of potential disease biomarkers and resistance mechanisms. Fruit diseases caused by fungal and bacterial pathogens present critical challenges to global food security by reducing fruit shelf life and quality. This review explores the molecular dynamics of fruit-pathogen interactions using advanced proteomic techniques. These approaches include mass spectrometry-based identification, gel-based, and gel-free strategies, tailored to the unique compositions of fruit tissues for accurate protein extraction and identification. Proteomic studies reveal pathogen-induced changes in fruit proteomes, including the upregulation of defence-related proteins and suppression of metabolic pathways crucial for pathogen survival. Case studies on tomatoes, apples, and bananas highlight specific pathogen-responsive proteins, such as PR proteins and enzymes involved in ROS scavenging, which play roles in disease resistance mechanisms. The review further demonstrates the utility of proteomic data in identifying early disease biomarkers, guiding genetic improvements for disease resistance, and optimizing pathogen control measures. Integrating proteomic insights with transcriptomics and metabolomics provides a multidimensional understanding of fruit-pathogen interactions, paving the way for innovative solutions in agriculture. Future research should prioritize multi-omics approaches and field-level validations to translate laboratory findings into practical applications. The advancements discussed underscore the transformative role of proteomics in improving food security and sustainability amid challenges posed by climate change and increasing global food demand.
    MeSH terms: Plant Proteins/genetics; Plant Proteins/metabolism; Stress, Physiological; Malus/genetics; Malus/metabolism; Malus/microbiology; Host-Pathogen Interactions*
  4. Ibrahim MH, Jaafar S
    Environ Monit Assess, 2025 Feb 13;197(3):291.
    PMID: 39945881 DOI: 10.1007/s10661-025-13749-5
    Acacia invasion has shown a negative impact on the water resources of forest streams. Therefore, studies need to be conducted demonstrating the importance of managing invasive species to preserve stream and forest ecosystems. This study investigates the effects of Acacia invasion on the water quality of Kerangas forest streams in Brunei. Water samples were collected from an Acacia-invaded (IN) stream and a non-invaded (NIN) stream during the dry season at three locations along each stream. Water properties, including pH, conductivity, salinity, total dissolved solids (TDS), phosphate, nitrate, ammonia, and nitrite, were analyzed using in situ and laboratory methods. The results showed that Acacia invasion significantly increased pH (from 4.01 to 5.68), nitrate (by 256%), and phosphate (by 250%) levels, while reducing conductivity (by 208%) and salinity (by 20%) compared to non-invaded streams. These findings suggest that Acacia invasion alters water chemistry, potentially posing risks to aquatic ecosystems. Effective management strategies, such as controlling Acacia spread and restoring native vegetation, are essential to mitigate these impacts and preserve forest water resources.
    MeSH terms: Acacia*; Environmental Monitoring*; Nitrates/analysis; Phosphates/analysis; Water Pollutants, Chemical/analysis; Ecosystem; Salinity; Introduced Species*; Water Quality*; Forests*
  5. Usman M, Alam A, Zainab Z, Khan M, Tüzün B, Ayaz M, et al.
    Chem Biodivers, 2025 Feb 13.
    PMID: 39946148 DOI: 10.1002/cbdv.202403385
    This work is based on the synthesis of new ether derivatives bearing benzothiazole scaffold through multi-step reaction process. Initially, benzothiazole was prepared by refluxing 4-hydroxybenzaldehyde with amino thiophenol having sodium metabisulfite in DMF; subsequently the product was further refluxed with different substituted benzyl and alkyl bromide in acetone to get ether hybrids of benzothiazole in good yields. Structurally, these compounds were confirmed by means of 1H, 13C-NMR and mass spectrometry and evaluated for in vitro thymidine phosphorylase inhibitory activity. In the series, seven compounds attributed excellent inhibition against thymidine phosphorylase enzyme better than the standard. Similarly, three compounds showed good activity while two compounds were found inactive. Moreover, all these compounds showed no toxicity to normal human fibroblast cell line (BJ Cell Line). In addition, Gaussian calculations were performed on the 6-31++g(d,p) basis set to examine the 13 synthesized compounds at the B3LYP, HF, and M062X levels. Additionally, molecular docking calculations were performed on thymidine phosphorylase enzyme proteins (PDB IDs: 4EAD, 2WK6, and 4LHM), and ADME/T calculations were performed to investigate the effects and responses of these compounds in human metabolism.
  6. Greco I, Beaudrot L, Sutherland C, Tenan S, Hsieh C, Gorczynski D, et al.
    PLoS Biol, 2025 Feb;23(2):e3002976.
    PMID: 39946310 DOI: 10.1371/journal.pbio.3002976
    Tropical forests hold most of Earth's biodiversity and a higher concentration of threatened mammals than other biomes. As a result, some mammal species persist almost exclusively in protected areas, often within extensively transformed and heavily populated landscapes. Other species depend on remaining remote forested areas with sparse human populations. However, it remains unclear how mammalian communities in tropical forests respond to anthropogenic pressures in the broader landscape in which they are embedded. As governments commit to increasing the extent of global protected areas to prevent further biodiversity loss, identifying the landscape-level conditions supporting wildlife has become essential. Here, we assessed the relationship between mammal communities and anthropogenic threats in the broader landscape. We simultaneously modeled species richness and community occupancy as complementary metrics of community structure, using a state-of-the-art community model parameterized with a standardized pan-tropical data set of 239 mammal species from 37 forests across 3 continents. Forest loss and fragmentation within a 50-km buffer were associated with reduced occupancy in monitored communities, while species richness was unaffected by them. In contrast, landscape-scale human density was associated with reduced mammal richness but not occupancy, suggesting that sensitive species have been extirpated, while remaining taxa are relatively unaffected. Taken together, these results provide evidence of extinction filtering within tropical forests triggered by anthropogenic pressure occurring in the broader landscape. Therefore, existing and new reserves may not achieve the desired biodiversity outcomes without concurrent investment in addressing landscape-scale threats.
    MeSH terms: Animals; Humans; Human Activities; Population Dynamics; Tropical Climate*; Ecosystem; Biodiversity*; Forests*
  7. Abdul Razak SF, Yogarayan S, Ali Bukar U, Sayeed MS
    PLoS One, 2025;20(2):e0318996.
    PMID: 39946332 DOI: 10.1371/journal.pone.0318996
    Flash floods are severe disaster that have caused enormous damage to people, property, and the environment. Despite the conventional emphasis on technical and engineering solutions in controlling flash flood disasters, this study investigates the understudied issue of user-centric cultural viewpoints, inspired by Grid-Group Cultural Theory, and their potential impact on crisis management. The study collected 351 responses, primarily targeting adults in flood-prone areas using convenience sampling method with the goal of exploring cultural bias for feature identification of in-vehicle flash flood app. Accordingly, the research investigates the participants responses using quantitative approach which includes descriptive statistics, exploratory factor analysis, average factor, and rank scoring analysis to uncover critical user-centric cultural traits that might improve preparedness, response, and recovery activities during flash flood disasters. The findings of the study identified distinct cultural biases that impact perceptions and preferences regarding features of an in-vehicle flash flood app. By integrating Grid-Group Cultural Theory as a framework for analysis, the study highlights the importance of incorporating diverse cultural perspectives into flash flood management strategies. The result emphasizes the need to apply a holistic approach that integrates people's knowledge and practices with technical solutions. Recommendations of features for future development of in-vehicle flash flood app is provided based on each cultural bias aligned with the theory to build more resilient communities in the face of flash flood occurrences.
    MeSH terms: Adult; Culture; Disaster Planning/methods; Disasters; Female; Humans; Male; Floods*; Mobile Applications
  8. Ismail H, Huam ZS, Yew SQ, Ahmad H, David CCH, Baharudin MH, et al.
    PLoS One, 2025;20(2):e0314763.
    PMID: 39946348 DOI: 10.1371/journal.pone.0314763
    INTRODUCTION: Sickness absenteeism among the nurses in Malaysia is not fully understood. Complicated with the increase in workload and mental stress during the COVID-19 pandemic and the manifestation of long COVID-19 symptoms, there is a need for an updated insight on the prevalence and the risk factors of sickness absenteeism among nurses in Malaysia. As such, we designed a study protocol that assess the prevalence and risk factors of sickness absenteeism among nurses in Malaysia in the post-COVID-19 pandemic era.

    MATERIALS AND METHODS: This is a correlational cross-sectional study. The sociodemographic and clinical questionnaire, sickness absenteeism questionnaire, job characteristics questionnaire, Demand-Control-Support Questionnaire (DCSQ), Work-Related Strain Inventory (WRSI), Work and Family Conflict Scale (WAFCS), the COVID-19-related workplace worries questionnaire, as well as the Depression, Anxiety, and Stress (DASS-21) questionnaire will be randomly distributed to 166 nurses from October 2024 to May 2025.

    DISCUSSION: While physical illnesses, psychological disorders, job-related factors, and sociodemographic factors have been identified as risk factors to sickness absenteeism among healthcare professionals in general, the role of these risk factors in causing sickness absenteeism among the nurses remains unclear. Additionally, the increased stress and workload faced by nurses during the COVID-19 pandemic, as well as post-acute COVID-19 syndrome, may have further impacted sickness absenteeism.

    CONCLUSION: By examining the various risk factors of sickness absenteeism, especially in the post-COVID-19 pandemic era, this research will inform future targeted interventions to reduce sickness absenteeism among Malaysian nurses and its associated consequences.

    MeSH terms: Absenteeism*; Adult; Anxiety/epidemiology; Cross-Sectional Studies; Depression/epidemiology; Female; Humans; Malaysia/epidemiology; Male; Nurses/psychology; Surveys and Questionnaires; Risk Factors; Stress, Psychological/epidemiology; Prevalence; Workload/psychology; Sick Leave/statistics & numerical data; Pandemics
  9. Yeow MYH, Chong CY, Lim MK, Yee Yen Y
    PLoS One, 2025;20(2):e0314512.
    PMID: 39946354 DOI: 10.1371/journal.pone.0314512
    Software reuse is an essential practice to increase efficiency and reduce costs in software production. Software reuse practices range from reusing artifacts, libraries, components, packages, and APIs. Identifying suitable software for reuse requires pinpointing potential candidates. However, there are no objective methods in place to measure software reuse. This makes it challenging to identify highly reusable software. Software reuse research mainly addresses two hurdles: 1) identifying reusable candidates effectively and efficiently, and 2) selecting high-quality software components that improve maintainability and extensibility. This paper proposes automating software reuse prediction by leveraging machine learning (ML) algorithms, enabling future research and practitioners to better identify highly reusable software. Our approach uses cross-project code clone detection to establish the ground truth for software reuse, identifying code clones across popular GitHub projects as indicators of potential reuse candidates. Software metrics were extracted from Maven artifacts and used to train classification and regression models to predict and estimate software reuse. The average F1-score of the ML classification models is 77.19%. The best-performing model, Ridge Regression, achieved an F1-score of 79.17%. Additionally, this research aims to assist developers by identifying key metrics that significantly impact software reuse. Our findings suggest that the file-level PUA (Public Undocumented API) metric is the most important factor influencing software reuse. We also present suitable value ranges for the top five important metrics that developers can follow to create highly reusable software. Furthermore, we developed a tool that utilizes the trained models to predict the reuse potential of existing GitHub projects and rank Maven artifacts by their domain.
    MeSH terms: Machine Learning*; Algorithms; Programming Languages; Software*
  10. Ma W, Liu Y, Yi Q, Liu X, Xing W, Zhao R, et al.
    PLoS One, 2025;20(2):e0317839.
    PMID: 39946390 DOI: 10.1371/journal.pone.0317839
    Table tennis is one of the most popular sports in the world, and it plays a positive role in the overall development of people's physical and mental health. This study develops an AI table tennis coaching system using a Multimodal Large Language Model with a table tennis knowledge base, aiming to provide precise training guidance and match strategies for table tennis beginners.

    METHOD: By using visual recognition technology, motion capture technology, and advanced multimodal large language models with a comprehensive professional table tennis knowledge base, the system accurately identifies common errors made by beginners and provides targeted training guidance.

    RESULT: The AI Table Tennis Coaching System demonstrates high accuracy in identifying mistakes made by beginner players, particularly in recognizing arm-related errors and racket-related errors, with accuracies reaching 73% and 82% respectively.

    CONCLUSION: The system operates at low costs, is easy to deploy, and offers a high cost-performance ratio, providing effective technological support for table tennis teaching and training. The AI table tennis coaching system is expected to play a significant role in enhancing training efficiency, promoting athlete skill improvement, and popularizing the sport. Future research will focus on improving the accuracy of footwork recognition in AI table tennis coaching systems and expanding their capability to provide training guidance for high-level athletes, thereby promoting the overall advancement of table tennis.

    MeSH terms: Artificial Intelligence; Female; Humans; Language; Male; Knowledge Bases; Athletic Performance/physiology; Athletes
  11. Math S, Nga JDL, Lim HF, Amin M, Pacheco-Pereira C
    PLoS One, 2025;20(2):e0318991.
    PMID: 39946493 DOI: 10.1371/journal.pone.0318991
    OBJECTIVES: To explore dental students' preparedness, experiences and confidence levels in utilizing teledentistry (TD) for patient care during the COVID-19 pandemic and to determine the dental needs and experiences of patients receiving treatment from dental students through TD.

    METHODS: Two online surveys were administered through Google Forms, incorporating both five-point Likert scales and open-ended questions alone for the student questionnaire. The patient questionnaire, available in English and Mandarin, was distributed during or after teleconsultations. Descriptive statistics were used to summarise the data.

    RESULTS: Out of 125 students, 88% (N = 110) were contacted by 318 patients. Of them, 79.1% reported no telecommunication problems, 91.8% faced no language barriers, and 87.2% encountered no technological barriers. Most students (67.3%) agreed they would need further training in TD. Low confidence levels were observed among 26.3% of students in managing crowns and bridges and among 18.2% of students in managing mucosal conditions. From the patient perspective, 76.4% contacted the students via WhatsApp Messages and 21.0% used the Voice Call mode. About 44.0% of patients enquired about the next available appointment. Their most common concern was tooth pain (15.1%) followed by denture problems (9.1%), chipped fillings (6.6%), and crowns and bridge problems (6.3%). Overall, 82% patients reported effective communication during teleconsultation, 85% were satisfied with the questioning process, and expressed satisfaction with the diagnoses provided. However, 10% of patients chose to ignore their concerns, and 5% sought assistance from medical practitioners.

    CONCLUSION: Most dental students were confident in addressing patient concerns but recognized the need for additional training for managing complex cases. Both students and patients reported positive experiences with TD, including effective communication and satisfaction. These findings highlight the importance of integrating TD training into dental curricula, addressing technical and privacy concerns, and improving patient education for secure and effective TD use in routine care.

    MeSH terms: Adult; Female; Humans; Male; Middle Aged; Surveys and Questionnaires; Telemedicine; Young Adult; Pandemics
  12. Abu Bakar MH, Othman MQ, Azeman NH, Mobarak NN, Daniyal WMEMM, Abdullah F, et al.
    PMID: 39946857 DOI: 10.1016/j.saa.2025.125872
    Applying visible-wavelength interrogation Kretschmann SPR spectroscopy technique using a polymeric ZnO-Quantum Dot PVA (pZnOQD) layer for chloride ion detection represents a significant advancement in photonic technology. This method streamlines the detection process while maintaining high sensitivity. Molecular analysis reveals subtle shifts in specific peaks of the ZnOQD spectrum after the interaction, suggesting chloride ion interaction with the active layer. Subsequent SPR analysis confirms these findings, showing wavelength shifts in SPR peaks between 630 - 660 nm across different chloride ion concentrations. This technique demonstrates exceptional sensitivity, detecting chloride ion concentrations from 1.0 to 20.0 ppm, with two distinct sensitivity ranges (1.0 - 4.0 ppm and 4.0 - 20.0 ppm) and corresponding values of 1.7221 (R2 = 0.998) and 0.627 nm/ppm (R2 = 0.992), respectively. These results are comparable, with a low detection limit of 0.3 ppm. Experimental data fitting well with the Sips model yields an R2 value of 0.995 and a binding affinity of 3.876 × 102M-1, providing valuable insights for sensor development. This integrated analysis provides a comprehensive understanding of chloride ion interactions with the pZnOQD sensing layer, paving the way for advanced optical spectroscopy using quantum dots.
  13. Wong LP, Lee HY, Alias H, Lachyan A, Nguyen DK, Seheli FN, et al.
    J Infect Public Health, 2025 Jan 30;18(4):102689.
    PMID: 39946975 DOI: 10.1016/j.jiph.2025.102689
    BACKGROUND: Intestinal parasitic infections (IPIs) remain a significant public health challenge and a neglected disease in many parts of Asia, contributing to morbidity and mortality, particularly in vulnerable populations. Despite the potential of vaccines to reduce the burden of these neglected IPIs, little is known about the public's willingness to be vaccinated against these infections.

    OBJECTIVE: This study aimed to assess the general population's knowledge, symptom experiences, and willingness to vaccinate against IPIs across six countries: Malaysia, Vietnam, India, Pakistan, and China.

    MATERIALS AND METHODS: A cross-sectional online survey was conducted between June and December 2023 across six countries in Asia region. Participants completed a self-administered online questionnaire that assessed demographic information, knowledge of IPIs, symptom experiences, and willingness to receive a vaccine against IPIs for themselves and their children. Univariate and multivariable logistic analyses were performed to determine the factors related to vaccination the willingness.

    RESULTS: A total of 5470 complete responses were received. The highest proportion of individuals willing to receive the vaccine was in India (86.1 %), followed by China (80.8 %) and Pakistan (75 %), with Vietnam having the lowest proportion at 50.1 %. For child vaccination, China had the highest willingness (83.3 %). A higher knowledge score was significantly associated with increased willingness to be vaccinated [adjusted odds ratio (aOR)= 1.91, 95 % CI: 1.70-2.15]. Additionally, a higher symptom experience score was significantly associated with greater vaccination willingness (aOR=1.71, 95 % CI: 1.50-1.94). Females residing in urban-suburban areas showed significantly higher vaccination intentions. The willingness to vaccinate children against IPIs closely mirrored the trends observed in self-vaccination willingness, with knowledge being the only factor significantly associated with the willingness to vaccinate children.

    CONCLUSION: The study underscores the importance of enhancing educational efforts regarding neglected IPIs and vaccination, particularly when vaccines are available and recommended.

  14. Wang M, Liu Y, Guo W, Kang T, Jiang Q
    Nurse Educ Pract, 2025 Feb 08;83:104288.
    PMID: 39947057 DOI: 10.1016/j.nepr.2025.104288
    AIM: This study aims to compare the effects of narrative pedagogy with traditional teaching methods on nursing education outcomes.

    BACKGROUND: Narrative pedagogy has been developed for over a decade, and while studies confirm that it can stimulate student interest, foster empathy, and enhance the integration of theoretical knowledge with practical skills in nursing care, there is still insufficient evidence to recommend its widespread adoption.

    METHODS: In November 2024, a comprehensive search was conducted across databases including PubMed, Embase, The Cochrane Library, Web of Science, OVID, Scopus, PsychInfo, CNKI, Wanfang Data, Chinese Science and Technology Periodical Database (VIP) and China Biology Medicine disc (CBM) to identify studies that met the inclusion and exclusion criteria. Relevant data were extracted, and the quality of studies was assessed prior to conducting a meta-analysis. The review protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO)(CRD42024606820).

    RESULTS: Out of an initial pool of 11748 articles, 41 studies were selected for meta-analysis after a rigorous screening process. The results indicate that narrative pedagogy significantly improves nursing students' final examination scores, practical skills, empathy, and professional identity compared with traditional teaching methods.

    CONCLUSION: Narrative pedagogy effectively enhances nursing students' final examination performance, practical skills, empathy, and professional identity. However, given the limited number and quality of the included studies, these findings should be confirmed by further high-quality research.

    TWEETABLE ABSTRACT: Narrative education has been used in nursing teaching for more than 15 years, but there is no evidence to show the effectiveness of narrative education in nursing students. Therefore, this study aims to conduct the first systematic review and meta-analysis of the learning effects of narrative education on nursing students. From the establishment of the database until November 2024, a systematic evaluation search was conducted on 11 databases. After careful screening process, 41 studies on narrative education of urination nursing students in China were selected for meta-analysis. The results show that narrative education is significantly better than traditional teaching methods in improving final exam scores, practical skills, humanistic care ability, empathy and professional identity. Given the limited number and quality of included studies, these findings should be confirmed by further high-quality studies.

  15. Cao X, Liu J, Zhao J, Feng S, Zhao Z
    J Sport Rehabil, 2025 Feb 13.
    PMID: 39947195 DOI: 10.1123/jsr.2024-0160
    Adolescent athletes participating in sports involving sudden directional changes, pivoting, and jumping frequently sustain anterior cruciate ligament (ACL) ruptures. ACL reconstruction (ACLR) surgery is often required, followed by a lengthy rehabilitation period. This study aims to evaluate the effectiveness of combining BOth Sides Up (BOSU) ball exercises with conventional resistance training in the recovery of joint stability and function after ACLR in adolescent athletes. Thirty adolescent athletes (ages 14-18) who underwent ACLR were randomly allocated to either the control group receiving traditional postoperative rehabilitation (n = 15) or the intervention group combining BOSU ball training with resistance exercises (n = 15). Joint stability, proprioception, strength, and functional outcomes were assessed before the procedure, as well as 3, 6, and 12 months after the operation using the KT-1000 arthrometer, Y-balance test, isokinetic dynamometry, and the ACL-Return to Sport after Injury ACL-Return to Sport after Injury (ACL-RSI) scale. The intervention group demonstrated notably better anterior-posterior knee joint stability (P < .05) than the control group at the 6-month and 12-month follow-ups after the surgery, greater reach distances in the Star Excursion Balance Test (P < .05), higher quadriceps and hamstring strength ratios (P < .05), and superior ACL-RSI scores (P < .01). Incorporating BOSU ball training with resistance exercises appears to be more effective than traditional rehabilitation alone in enhancing joint stability and neuromuscular control after ACLR in adolescent athletes. These results provide evidence supporting the incorporation of unstable surfaces into a comprehensive rehabilitation program to optimize recovery and safe return to sports.
  16. Wong WC, Lin V, Fang X, Kidd M, Lancet Commission on Transforming Primary Health Care in the Post-COVID-19 Era
    Lancet, 2025 Feb 15;405(10478):527-528.
    PMID: 39947214 DOI: 10.1016/S0140-6736(25)00198-9
  17. Cappellini MD, Viprakasit V, Georgiev P, Coates TD, Origa R, Khelif A, et al.
    Lancet Haematol, 2025 Feb 10.
    PMID: 39947215 DOI: 10.1016/S2352-3026(24)00376-4
    BACKGROUND: Treatments to reduce red blood cell (RBC) transfusion burden among patients with transfusion-dependent β-thalassaemia remain limited. Here, we report long-term follow-up data from the phase 3 BELIEVE trial of luspatercept for transfusion-dependent β-thalassaemia.

    METHODS: BELIEVE was a phase 3, randomised, double-blind, placebo-controlled study performed at 65 sites in 15 countries. The trial included adults with transfusion-dependent β-thalassaemia or haemoglobin E/β-thalassaemia and Eastern Cooperative Oncology Group score of 0-1. Patients were randomly assigned (2:1) using integrated response technology stratified by region to luspatercept (1·0-1·25 mg/kg) or placebo administered subcutaneously once every 21 days. After study unblinding, patients could receive luspatercept in the open-label extension phase (crossover allowed). The primary endpoint results (proportion of patients with reduction in transfusion burden of ≥33% and ≥2 RBC units during weeks 13-24) are described elsewhere; herein we present an update to the primary endpoint analysis consequent to late-reported transfusion events. We also report long-term efficacy (intention-to-treat population) and safety data (safety population) for patients followed up for approximately 3 years. This trial is registered on ClinicalTrials.gov (NCT02604433) and is completed.

    FINDINGS: Between May 2, 2016, and May 16, 2017, 336 patients were randomly assigned to luspatercept (n=224) or placebo (n=112). The median age of patients was 30 years (IQR 23-40); 195 (58%) were female and 141 (42%) male. As of Jan 5, 2021, the median duration of treatment in the luspatercept group was 153·6 weeks (IQR 81·0-171·0) and median study follow-up was 163·1 weeks (140·5-176·2). Due to the difference in treatment duration between the luspatercept and placebo groups, no comparative analyses between the two groups were performed after week 96. Patients in the luspatercept group showed a sustained reduction in RBC transfusion burden from baseline through week 192, with mean decreases of 6·2 RBC units (SD 5·7) during weeks 97-144 and 6·4 RBC units (4·3) during weeks 145-192. In the luspatercept group, a 33% or greater reduction in transfusion burden from baseline was observed in 173 (77%) patients over any 12-week interval and in 116 (52%) patients over any 24-week interval. The median total duration of 33% or greater transfusion burden reduction response during any period of at least 12 weeks was 586·0 days (IQR 264·0-1010·0). The most common grade 3 or worse treatment-emergent adverse events (TEAEs) among all patients who received luspatercept (n=315, including 92 patients who crossed over after study unblinding) were anaemia (nine [3%]), increased liver iron concentration (seven [2%]), and bone pain (seven [2%]); serious TEAEs occurred in 71 (23%) patients. No treatment-related deaths occurred in any group during the study.

    INTERPRETATION: These long-term results affirm luspatercept's efficacy in addressing key unmet needs of patients with transfusion-dependent β-thalassaemia with a manageable safety profile.

    FUNDING: Celgene and Acceleron Pharma.

  18. Muhammad AM, Ismail A, Chong PP, Yap WH, Muhamad A, Alitheen NB, et al.
    Int J Pharm, 2025 Feb 11;672:125339.
    PMID: 39947363 DOI: 10.1016/j.ijpharm.2025.125339
    Skin-penetrating peptides (SKPs) are emerging as a promising class of permeation enhancers that can facilitate macromolecule delivery across the skin. Although their pharmaceutical applications are under extensive study, SKPs are crucial for enhancing skin permeability, enabling larger molecules to penetrate the stratum corneum. This review explores the transformative role of SKPs in non-invasive transdermal drug delivery. Drawing from an extensive collection of literature, it provides insights into the current usage and application of SKPs as tools to enhance skin permeability and facilitate the delivery of larger molecules. Additionally, it highlights the opportunities, challenges, and future directions for SKP applications in transdermal drug delivery.
  19. Zaharani L, Vequizo MK, Amiri ZR, Johan MR, Majid WHA, Khaligh NG
    Int J Biol Macromol, 2025 Feb 11;304(Pt 2):140907.
    PMID: 39947556 DOI: 10.1016/j.ijbiomac.2025.140907
    The carboxylation of cellulose by maleic anhydride in the molten solvent-free and catalyst-free process gave a low degree of substitution (DS). The most of maleic anhydride was sublimated in its melting point and stirring became a problem. Therefore, the cellulose was functionalized with maleic anhydride for the first time by a planetary ball mill at ambient conditions in the absence of solvent and catalyst. The chemical structure, morphology and surface composition, particle size distribution, surface charge, and the degree of substitution of the functionalized cellulose were investigated. A reduction in particle size was demonstrated. The EDX analysis showed an increasing average C/O mass ratio. The zeta potential decreased from -10.2 mV for cellulose to -4.08 mV for functionalized cellulose. The DS was 3.10 ± 0.02, 3.23, and 3.24 mmol of carboxyl groups per gram of functionalized cellulose by the conductometry, back titration, and combined TG-DSC analysis, respectively. XPS C1s and O1s energies demonstrated cellulose functionalization. Moreover, TG-DTA plots demonstrated a slight decrease in the thermal stability of the functionalized cellulose. Water vaporization in a two-step process was observed for the functionalized cellulose. A glass transition and decarboxylation were detected in the DSC plot of the functionalized cellulose.
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