Long-term Effectiveness Research Articles

Is Liver Transplantation Alone an Effective Treatment for Homozygotic Familial Hypercholesterolemia in Children?

To examine the long-term results and treatment effectiveness of liver transplantation (LT) in the treatment of homozygous familial hypercholesterolemia (HoFH) in children and adolescents. Patients who underwent LT due to HoFH between 2007 and 2023 were included in the study. The patients' demographic data, clinical findings, preoperative and postoperative laboratory examinations, transplantation complications, and postoperative disease courses were evaluated. There were five boys with an average age of 6.2 (median: 6, range 4-10) years in the study. The average total cholesterol level of the patients before transplantation was 923 (median: 950, range: 780-1002) mg/dL and the average LDL-cholesterol level was 864 (median: 852, range: 770-957) mg/dL. No patients died of transplant-related complications. After an average follow-up of 9.2 (median: 9, range: 1.5-16) years, the average total cholesterol level of the patients was 197 (median: 164, range: 137-359) mg/dL, and the average LDL-cholesterol level was 138 (median: 92, range: 85-313) mg/dL. Four (80%) patients developed atherosclerotic cardiovascular disease during follow-up, and two (40%) died of this cause. LT in the treatment of HoFH did not help our patients reach the target LDL-cholesterol level after transplantation and did not prevent the development of cardiovascular disease. Therefore, LT alone is not curative in the treatment of HoFH.

Microbial symbiotic electrobioconversion of carbon dioxide to biopolymer (poly (3-hydroxybutyrate)) via single-step microbial electrosynthesis cell

This study proposes an novel single-stage microbial electrosynthesis system (MES) that bioelectrochemically converts CO2 into poly(3-hydroxybutyrate) (PHB). This innovative approach utilizes a symbiotic co-culture of electroactive acetogenic bacteria and PHB-accumulating bacteria within a single reactor, bypassing the need for separate acetate production and extraction. Systematic optimization of key operational parameters, including applied voltage, carbon source, and cathode material, was conducted to maximize PHB production. Results demonstrate that using a voltage of 2.5 V yielded a 7.14-fold increase in PHB content compared to open circuit conditions. Furthermore, functionalizing the cathode with a conductive and hydrophilic PEDOT: PSS polymer coating significantly enhanced the system’s performance, resulting in a 1.5-fold increase in both acetate and PHB production compared to unmodified carbon felt electrodes. The long-term stability and effectiveness of the co-culture system were validated through comprehensive microbial and metagenomic analyses. Results revealed a significant enrichment of CO2-utilizing electrotrophs within the cathode biofilm, including Acetobacterium and Clostridium. Concurrently, a 4 to 14-fold increase in the relative abundance of PHB-biosynthesizing bacteria, such as Pseudomonas, Rhodobacter and Caulobacter was observed in the planktonic phase. This study offers a promising pathway towards a circular bioeconomy by enabling the valorization of CO2 into valuable bio-based products via single-stage MES, utilizing a symbiotic co-culture.

The ETNA-AF Europe registry: 4-year data of edoxaban use in atrial fibrillation in the Italian real world compared to the European cohort

The prospective, single-arm, observational, phase 4 ETNA-AF Europe study collected real-world data about safety, effectiveness and therapeutic adherence in European patients with non-valvular atrial fibrillation newly prescribed with edoxaban and followed up for 4 years. Overall, 13 164 patients were included in the full-analysis set, which means that they had at least one documentation after baseline at 4 years. The current paper reports about the 3329 Italian patients out of the whole European population. In the Italian cohort, median age was 76.0 (69.0-82.0) years, with 57.4% of the patients being ≥75 years old. The CHA2DS2-VASc score was >4 in 586 (18.1%) patients. At baseline, 670 (20.8%) patients were classified as frail by the investigators. Edoxaban 30 mg/day was prescribed to 1013 (31.8%) patients: these were older, with more comorbidities and a lower estimated creatinine clearance compared with those receiving 60 mg/day. All-cause mortality was 4.1%/year and there were very low yearly rates of bleeding and thromboembolic events: major bleeding, 0.9%; intracranial hemorrhage, 0.2%; ischemic stroke, 0.3%; systemic embolism, <0.1%. These events were more frequent in patients ≥75 years or in patients with renal impairment or treated with edoxaban 30 mg/day. Advancing age was not associated with an increased incidence of intracranial bleeding. These findings confirm the favorable long-term safety and effectiveness profile of edoxaban in non-valvular atrial fibrillation patients treated in routine clinical care in Italy.

THE PARTIAL EXTRACTION THERAPIES:ROOT MEDIATED RIDGE PRESERVATION IN RESTORATIVE AND IMPLANT DENTISTRY

Crestal bone loss, a decrease in the edentulous ridges width, and a decrease in the height of the interdental papillae are all possible outcomes of extraction. It is commonly known that alveolar bone volume decreases following tooth extraction. Following tooth extraction, the bundle bone-periodontal ligament complex [BB-PDL complex] is lost, which results in the loss of alveolar bone and ridge shape. Compared to the palatal and lingual cortical plates, the buccal cortical plate is thinner and has four times as much residual ridge resorption. Numerous methods for preserving ridges have been suggested in the literature. By preserving the buccal bone-periodontal complexs vascular supply, partial extraction procedures have been shown to stop buccal bone loss. Techniques such as root submergence, socket shield, proximal socket shield, and pontic shield are examples of partial extraction therapy. This method maintains the ridge contour and the loss of alveolar bone. To replicate the future pontic, the coronal root is hollowed out and the tooth is decoronated at the level of the bone crest using the root submergence procedure. When planning a pontic location underneath a traditional fixed partial denture, the root submergence approach is recommended. The tooth root is divided into the palatal and facial portions longitudinally in the socket shield procedure. The long-shank dental bur has a little concavity in the facial root. Pontic shielding entails the same preparation as extraction socket grafting using a slow-resorbing bone replacement. By preserving the periodontal ligament and the blood vessels that are connected to it, these procedures highlight the long-term effectiveness of implants and are anticipated to produce better aesthetic results. Thus, by stopping the buccal bones natural bone resorption and the soft tissues that cover it from contracting. The review of several partial extraction therapy approaches is the main focus of this article.

Effectiveness of long-acting buprenorphine - A systematic review.

To analyse the evidence of the effectiveness of long-acting injection buprenorphine (LAI-B) in the management of opioid use disorder (OUD). Databases were searched for studies reporting on the effectiveness of LAI-B for the treatment of OUD. Risk of bias was assessed, and a narrative synthesis of data was presented. The study adhered to PRISMA guidelines and was registered with PROSPERO (CRD42023396033). Eighteen studies were included in the final review: two double-blind randomised control trials, two open-label randomised control trials, two retrospective cohort studies, one non-controlled pilot study, and eleven observational studies. In comparative trials, LAI-B was superior to placebo and superior or non-inferior to treatment as usual. LAI-B was positively associated with improvements in abstinence rates and patient-centred outcomes. There was limited data on the long-term effects of continuous LAI-B prescription. LAI-B is an effective treatment for OUD with advantages over existing forms of treatment. Patients reported high levels of medication satisfaction and there were no significant safety concerns. This review highlights the need for future research on long-term effectiveness outcomes, with participants of more varied demographics and psychiatric comorbidity, which is more reflective of the OUD population seen in community clinical settings.

Machine learning prediction for prognosis and long-term effectiveness for transcatheter ventricular septal defect closure: a 5-year single center experience

Abstract Background Transcatheter therapy, with minimal invasiveness and rapid recovery advantages, has emerged as the primary choice for treating perimembranous ventricular septal defect. However, patients receiving transcatheter occlusion may confront conduction abnormalities due to the occluder's proximity to the cardiac conduction bundle during implantation. Few have assessed the risks of postoperative conduction block (CB) via robust machine learning models. Purpose The purpose of this study was to evaluate our long-term follow up results of pmVSD occlusion and establish a prediction model to identify risk predictors of conduction abnormalities via robust machine learning methods. Methods Five methods including logistic regression with a stepwise selection of variables, lasso regularization; random forest; gradient descent boosting (GBM); and support vector machine, were used to train models for predicting risks of late-onset and persistent conduction block through 5 years of follow-up and were validated using 5-fold cross-validation. Receiver-operating characteristic curves and Brier scores were utilized to evaluate model discrimination and calibration, respectively. The top prediction variables were identified by using the best performing models, using the relative influence score of each variable in 5-fold cross-validation. Results The GBM model performed the best with an AUC of 0.82 (95% confidence interval [CI]: 0.75 to 0.89) for predicting late-onset CB (Brier score: 0.0204), and 0.70 (95% CI: 0.62 to 0.78) for persistent CB (Brier score: 0.0003) over entire study period. Conduction block on admission, advanced age and aortic regurgitation before discharge were strongly associated with late-onset CB, whereas decreased left ventricular ejection fraction, enlarged left ventricle end diastolic diameter at 1-month follow-up were the most significant predictors of persistent CB. Conclusions These models predict the risks of temporary and persistent postoperative conduction block in patients with pmVSD occlusion and shed light on preventing long-term complications.Study FlowchartCentral Illustration

Using advanced computing to improve outcome monitoring in substance use disorder treatment in Alaska

Abstract Issue In Alaska, crime associated with substance misuse is a massive public health and safety concern costing over $2.3 billion annually. Government officials make substantial investments to address this challenge but have little ability to monitor the long-term effectiveness of these interventions. Treatment providers are also stifled by minimal feedback regarding their lasting impact. While government databases exist that contain relevant information related to long-term treatment outcomes, low knowledge transfer continues to occur between these big data systems and treatment providers. Description To determine if emerging database technology can effectively monitor long-term recidivism outcomes, a prototype was implemented by Alaska’s leading treatment provider, Set Free Alaska. The Recidivism Tracking Interface is an innovative database system that strategically connects treatment records with the criminal justice system database. While maintaining high confidentiality and security standards, the first-of-its-kind interface assessed long-term recidivism outcomes of Set Free Alaska’s former clients from 2010 to 2023. Results Of those who successfully completed treatment (n = 970), only 12.06% were convicted of a new crime with an average of 1,167 days between discharge and new criminal charges. The current recidivism rate in Alaska is 66.3%. In addition to recidivism outcomes, the interface also revealed data incredibly useful for informing treatment services and relapse prevention practices. The Recidivism Tracking Interface effectively demonstrated that advanced computing systems can be utilized to monitor long-term outcomes in a manner that was previously unavailable to treatment providers. Lessons In the age of advanced cloud computing and generative AI, treatment providers around the world and their government partners can overcome current knowledge transfer barriers to monitor long-term outcomes in a manner that is automated, inexpensive, and easy to use. Key messages • Advanced computing offers new opportunities to improve long-term outcome monitoring. • Expanding secure access to relevant government databases can ultimately improve treatment outcomes and advance outcome-based funding models.

Harnessing Virtual Reality: Improving Social Skills in Adults with Autism Spectrum Disorder

Background and Objectives: Autism Spectrum Disorder (ASD) involves challenges in social communication and daily functioning. Emerging research highlights that virtual reality (VR) interventions can significantly improve social skills in adults with ASD by providing immersive, controlled practice environments. This systematic review will assess the effectiveness of VR-based interventions for improving social skills in adults with ASD. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases without any search time range. This review was registered on Open OSF (n) P4SM5. Results: Recent studies show that VR interventions significantly enhance job interview skills, social abilities, and practical tasks in adults with ASD, with improvements in confidence, social understanding, and everyday skills. VR has been shown to be user-friendly and effective in providing immersive, adaptable training experiences. Conclusions: The review highlights VR’s promising role in improving social skills, job interview abilities, and daily functioning in adults with ASD. It emphasizes the need for broader studies, standardized interventions, and exploration of VR’s integration with other therapies to enhance long-term effectiveness and address comorbidities like anxiety and depression.

Zwitterionic Polymers for Biomedical Applications: Antimicrobial and Antifouling Strategies toward Implantable Medical Devices and Drug Delivery.

Poly(ethylene glycol) (PEG) is extensively utilized in biomedical applications due to its biocompatibility; however, its thermal instability and susceptibility to oxidative degradation significantly constrain its long-term effectiveness. Zwitterionic polymers, characterized by their distinctive structure, enhanced stability, and superior biocompatibility, offer a more advantageous alternative. These polymers exhibit super hydrophilicity, resist nonspecific protein adsorption, and maintain stability in biological environments due to their charge-neutral ionic nature. Zwitterionic polymers enhance anticancer drug delivery by precisely targeting tumor cells and facilitating an efficient drug release. Their inherent antifouling properties and prolonged circulation within the bloodstream render them highly suitable for redox-sensitive drug carriers, thereby augmenting the antitumor efficacy. Moreover, zwitterionic polymers markedly mitigate biofouling in implants, biosensors, and wound dressings, thereby improving both their functionality and their therapeutic outcomes. These advantages arise from the formation of robust hydration layers, which significantly enhance the hemocompatibility and inhibit the adhesion of proteins, platelets, and bacteria. Zwitterionic polymers, including sulfobetaine (SB), phosphorylcholine (PC), and carboxybetaine (CB), are increasingly employed in blood-contacting devices and as effective coating materials for implantable devices. This mini-review paper aims to explore the recent diverse biomedical applications of zwitterionic polymers and highlight their advantageous properties compared with unmodified polymers. We will cover their use in drug delivery systems, tumor targeting nanocarriers, antibiofouling and antibacterial activities in implantable devices, tissue engineering, and diagnostic devices, demonstrating how their unique properties can translate into different applications. Through this exploration, this Perspective will display the potential of zwitterionic polymers as innovative polymer materials in the field of biomedical engineering and beyond.

Long-term Effectiveness and Safety of Risankizumab in Patients with Crohn’s Disease from a Large Tertiary Center

Background and AimsRisankizumab is a selective IL23 inhibitor approved for the treatment of Crohn’s disease (CD). We report a large long-term real-world experience with risankizumab in CD. MethodsWe performed a prospective monitoring of clinical outcomes in patients in our center who started treatment with risankizumab. Patients with active luminal disease who had at least 12 weeks of follow-up were included in the effectiveness analysis. Harvey-Bradshaw Index (HBI) as well as C-reactive protein (CRP) and fecal calprotectin (FCP) were used to monitor disease activity. Primary outcomes were clinical remission and steroid-free clinical remission rates at weeks 12, 26, and 52. Univariate analysis followed by a multivariate analysis using a logistic regression model was performed to identify predictors of steroid-free clinical remission at one year. All patients who started treatment with risankizumab for any indication were included in the safety analysis. Results134 patients were included in the effectiveness analysis. 70 (52%) were ustekinumab-experienced. Clinical remission rates were 69%, 64%, and 54% at weeks 12, 26, and 52, respectively. Steroid-free clinical remission rates at 12, 26, and 52 weeks were 58%, 58%, and 50% respectively. Remission rates in ustekinumab-experienced patients were not statistically lower compared to naïve patients, and in a multivariate analysis, prior ustekinumab treatment was not associated with lower odds of achieving steroid-free clinical remission at one year. Adverse effects were assessed in 243 patients and were consistent with previous literature. ConclusionsThis large real-world experience with risankizumab with long-term follow-up demonstrates effectiveness and safety in patients with CD; there was comparable effectiveness in ustekinumab-naïve and ustekinumab-experienced patients.

The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal-Fetal Attachment in Primigravida Women.

To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal-fetal attachment in primigravida women. A multi-site cross-sectional research design study. This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal-Fetal Attachment Scale (MFAS-HU-20). The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal-fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal-fetal attachment tends to decrease. The correlations range from -0.263 to -0.426, all significant at p < 0.001. The emotional impact of climate change can adversely affect the bonding process between mother and fetus. Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers. The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women. The research adhered to that is STROBE. Public contributions by women in community health centers.

Effectiveness of laser therapy among patients with open-angle glaucoma: a systematic review and meta-analysis study.

This study aims to evaluate the efficacy of selective laser trabeculoplasty in improving the intraocular pressure in patients diagnosed with open-angle glaucoma. A comprehensive search was performed across electronic databases, including PubMed, Scopus, and Web of Science, until June 2024, using keywords related to "selective laser trabeculoplasty" and "open-angle glaucoma." Studies were chosen based on set eligibility criteria. Data extraction was carried out by two independent reviewers, and statistical analyses were performed using a random-effects model to calculate the pooled mean differences in IOP reduction and overall success rates. The initial search yielded 3111 articles, with 23 studies included in the systematic review and 22 in the meta-analysis. The pooled MD in IOP reduction between the SLT and control groups was -1.44 mm Hg (95% CI: -2.19 to -0.70, p < 0.01). Subgroup analyses revealed a MD of -0.76 mm Hg (95% CI: -1.31 to -0.21, p < 0.01) when comparing SLT to medication, and -0.42 mm Hg (95% CI: -0.64 to -0.19, p < 0.01) when comparing 180-degree SLT to 360-degree SLT. The pooled success rate favored SLT with an odds ratio (OR) of 0.71 (95% CI: 0.51 to 0.99, p = 0.05). There was significant heterogeneity among the studies (I² = 71%). SLT is effective in lowering IOP in OAG patients, demonstrating significant efficacy compared to medication and different SLT protocols. The findings underscore SLT's potential as a reliable treatment option. However, the observed heterogeneity underscores the necessity for standardized protocols in future research to improve comparability and verify SLT's long-term effectiveness.

Vaccination against RSV infections - update and perspective

Almost 60 years after a disastrous clinical vaccine trial in children, which resulted in enhanced disease and even deaths, the world of RSV vaccination is currently undergoing a dramatic positive change and development, closely linked to advances in new vaccine technologies. Three licensed safe and highly efficacious vaccines, Abrysvo, Arexvy and mRESVIA, reduce the incidence of RSV lower respiratory disease by 80% in people older than 60 years of age. Questions regarding long-term protection and effectiveness in specific risk groups with chronic medical conditions remain, and furthermore, innovative and safe concepts to actively vaccinate pregnant women and infants to prevent severe RSV infections - also in these high-risk populations - are eagerly awaited.Passive vaccination with the long-acting monoclonal antibody Nirsevimab for prevention of severe disease in the first RSV season of infants is a major innovation in global health and the importance and benefits of reducing the number of intramuscular injections for high-risk children is immense. In the coming years, results of numerous pediatric candidate RSV vaccine studies are expected, although particular caution seems advisable for historical reasons. In summary, the field of RSV vaccination has been revolutionized in the last 2 years and we will see further significant progress soon.

Digital Transformation in the Health Product Supply Chain: A Framework for Analysis

ABSTRACT Well-functioning supply chains for medicines and other health products are vital for a health system’s goals of ensuring access, quality, and efficiency. However, in several countries the performance of government-run supply chains for health products remains subpar. The widespread adoption of digital technology presents new opportunities for enhancing the performance of the health product supply chain. This paper aims to provide a practical and systematic analysis of digital initiatives within health product supply chains. It provides examples of successful digital interventions in each of the Enable, Plan, Source, and Deliver categories of the Supply Chain Operations Reference model. The examples provide clear evidence that the use of digital technology in the health supply chain can improve access and affordability; in some instances, use of digital technology can lead to faster health product adoption and alter the overall architecture of decision making. While many digital interventions in the public sector supply chain target the collection of data and its analysis and use for reporting, the long-term effectiveness of digital solutions hinges on their ability to enhance the agency of supply chain actors. A thorough and systematic inquiry about the logic model of how a particular digital solution enhances agency and improves accountability is essential at the outset. In developing roadmaps to prioritize and sequence digital solutions in health supply chains, governments should start by asking where lack of information is the primary constraint impeding supply chain performance.

AGILE PROJECT MANAGEMENT: ANALYZING THE EFFECTIVENESS OF AGILE METHODOLOGIES IN IT PROJECTS COMPARED TO TRADITIONAL APPROACHES

This systematic review examines the comparative effectiveness of Agile and traditional project management methodologies, focusing on their application in dynamic IT environments and well-defined industries. Utilizing the PRISMA guidelines, a total of 45 peer-reviewed studies published between 2005 and 2023 were analyzed. The review found that Agile methodologies consistently outperformed traditional approaches in dynamic settings, offering greater flexibility, faster project delivery, and higher customer satisfaction through iterative cycles and continuous stakeholder engagement. However, traditional methods, such as Waterfall, were found to be more effective in projects with fixed scopes and stringent regulatory requirements, providing better control and predictability. The review also highlights the growing adoption of hybrid project management models, which combine Agile’s adaptability with the structure of traditional methods, particularly in large or complex projects. The findings underscore the importance of selecting the appropriate methodology based on project-specific factors, with Agile excelling in fast-changing environments and traditional methods being more suitable for regulated industries. Further research is recommended to explore Agile’s applicability in non-IT sectors and the long-term effectiveness of hybrid models.

Rebooting the Adaptive Immune Response in Immunotherapy-Resistant Lung Adenocarcinoma Using a Supramolecular Albumin.

Despite the availability of immune checkpoint inhibitors (ICBs) significantly prolonging the life expectancy of some lung adenocarcinoma (LUAD) patients, their implementation and long-term effectiveness are hampered by the growing issue of acquired resistance. Herein, the bioinformatics analysis of immunotherapy-resistant LUAD patients and the system analysis of Anti-PD1-resistant mice models once again validate that the resistance-associated Wnt/β-catenin pathway offers a promising avenue for ICB sensitization. Consequently, a mild and convenient self-assembly between albumin and carnosic acid (CA), a Wnt inhibitor is employed, to develop a supramolecular albumin known as ABCA, serving as a reactivator for ICB. As anticipated, ABCA effectively suppress the Wnt/β-catenin cascade in vitro and leads to significant inhibition of cell proliferation while promoting apoptosis. Most notably, ABCA restores the anticancer efficacy of Anti-PD1 in immunotherapy-resistant LUAD orthotopic allografting mice models by reinvigorating the adaptive immune response mediated by T lymphocytes. Furthermore, ABCA exhibits minimal adverse effects during treatment and high-dose toxicity tests, underscoring its excellent potential for clinical translation. Collectively, the present work possesses the potential to provide innovative perspectives on the advancement of optimized immunotherapies targeting drug resistance, while also presenting a promising avenue for translating Wnt inhibitors into immunotherapeutic drugs for their clinical application.

The future of metronomic chemotherapy: experimental and computational approaches of drug repurposing.

Metronomic chemotherapy (MC), long-term continuous administration of anticancer drugs, is gaining attention as an alternative to the traditional maximum tolerated dose (MTD) chemotherapy. By combining MC with other treatments, the therapeutic efficacy is enhanced while minimizing toxicity. MC employs multiple mechanisms, making it a versatile approach against various cancers. However, drug resistance limits the long-term effectiveness of MC, necessitating ongoing development of anticancer drugs. Traditional drug discovery is lengthy and costly due to processes like target protein identification, virtual screening, lead optimization, and safety and efficacy evaluations. Drug repurposing (DR), which screens FDA-approved drugs for new uses, is emerging as a cost-effective alternative. Both experimental and computational methods, such as protein binding assays, in vitro cytotoxicity tests, structure-based screening, and several types of association analyses (Similarity-Based, Network-Based, and Target Gene), along with retrospective clinical analyses, are employed for virtual screening. This review covers the mechanisms of MC, its application in various cancers, DR strategies, examples of repurposed drugs, and the associated challenges and future directions.

Aligning With SDG 5: Addressing Barriers and Fostering Female Participation in Stem Education in India

Objective: This study investigates the barriers preventing female participation in STEM (Science, Technology, Engineering, and Mathematics) education in India, aligning with SDG 5 (Gender Equality). The research aims to identify demotivation factors faced by female students and develop participant-informed recommendations to foster greater female engagement in these disciplines. Method: A qualitative approach was employed, utilizing open-ended surveys, narrative interviews, and focus groups with female students across various educational levels in India. Thematic analysis was conducted to identify patterns and themes related to the barriers and potential solutions for increasing female participation in STEM. Results: The study reveals key barriers, including cultural expectations, gender discrimination, institutional biases, lack of female role models, and social pressures, which discourage women from pursuing STEM careers. Specific challenges such as safety concerns, biased judgments, and limited mentorship opportunities were also highlighted. Based on these findings, several recommendations emerged, including policy reforms, inclusive curricula, gender sensitization programs, mentorship initiatives, and early engagement activities. Contribution: The study contributes to the understanding of gender disparities in STEM education in India by offering actionable insights for policymakers, educators, and communities. It emphasizes a multifaceted approach combining cultural change, policy reform, institutional support, and targeted interventions to foster an inclusive environment for women in STEM. This research aligns with SDG 5 by advocating for strategies that promote gender equity and empower women in traditionally male-dominated fields. Future research should focus on evaluating the long-term effectiveness of these interventions across diverse contexts and disciplines.

Measuring the Digital Maturity of Organisations in the People Care Sector

This study focuses on the organisations in the people care sector (OPCs), encompassing a broad spectrum of activities ranging from essential healthcare services to various aspects of daily living support. Sustainability in OPCs encompasses multiple dimensions aimed at ensuring the long-term viability, efficiency, and effectiveness of services provided to vulnerable populations. Given the critical role of digital technologies in enhancing the operational efficiency within such organisations and their sustainability, it becomes imperative to gauge their digital maturity levels. To establish a robust framework for assessing the digital maturity of OPCs, we identified 29 factors grouped into five clusters that encapsulate various dimensions of digital readiness that directly influence the sustainability of OPCs. We employed the SNAP methodology to ascertain the relative significance of these factors and clusters. Furthermore, each factor was articulated through the lens of digital maturity using the rubrics approach, offering a nuanced understanding of the OPCs’ digital readiness across four distinct levels. Experts from the people care sector, IT, and multi-criteria decision-making contributed invaluable input during the instrument’s development phase. Theoretical validation of the instrument involved focus group discussions with domain experts, while practical validation entailed applying the instrument to real-world case studies. The instrument enables OPCs to assess their digital maturity levels, providing valuable strategic planning and decision-making insights. Furthermore, the instrument can serve as a roadmap for identifying areas ripe for digital transformation and weak points, facilitating continuous improvement and future readiness. The quantification of the digital maturity of the OPC enables the OPCs to rank at the cluster maturity level and overall maturity level. Overall, this instrument represents a significant step towards enhancing digital maturity assessment within the OPC sector, contributing to its evolution and adaptation in the digital age, and enabling the OPCs’ sustainability.

Mind-Body Medicine in the Treatment of Depression: A Narrative Review of Efficacy, Safety and Mechanisms.

This narrative review examines the efficacy, mechanisms and safety of mind-body medicine (MBM) in the treatment of depression. We reviewed the potential effects of various MBM interventions such as yoga, tai chi, qigong, mindfulness-based interventions and nutrition on clinical and subthreshold depressive symptoms. Current studies indicate a growing interest in the use of MBM for psychiatric disorders, including depression. MBM interventions demonstrate efficacy in reducing depressive symptoms with fewer adverse effects and costs compared to pharmacological treatments. MBM has significant potential to improve mental health outcomes for depression. These interventions encourage self-care and stress management through behavioural, exercise, relaxation and nutritional approaches. While existing data are promising, further, more rigorous studies are required to confirm long-term effectiveness and to determine the role of MBM in comprehensive depression treatment strategies.