bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges and Recommendations for Improving Cancer Research and Practice in Nigeria: A Qualitative Study With Multi-Stakeholders in Oncology Research and Practice
Authors: Oluwasanu Mojisola M , Adejumo Prisca O , Sun Yijia , Onwuka Chidera , Ntekim Atara , Awolude Olutosin A , Aniagwu Toyin I , Kotila Olayinka A , Brown Biobele J , Ogbole Godwin I , Dzekem Bonaventure S , Ajani Olufadekemi , Huo Dezheng , Babalola Chinedum P , Ojengbede Oladosu , Hammad Nazik , Olopade Olufunmilayo I
Published: November 2024

Background

Cancers, with increasing incidence and mortality rates, constitute a leading public health problem in Nigeria. As the burden of cancer in Nigeria increases, research and quality service delivery remain critical strategies for improved cancer control across the continuum of care. This study contextualizes the challenges and gaps in oncology research and practice in Nigeria, and presents recommendations to address the gaps.

Methods

This qualitative study was conducted among interprofessional and interdisciplinary stakeholders in oncology healthcare practice and research in academic settings, between July and September 2021. Key-informant interviews were held with six stakeholders and leaders in nursing, pharmacy, and medicine across the six geopolitical zones of Nigeria, and twenty-four in-depth interviews with early- or mid-career researchers or healthcare professionals involved in cancer prevention and treatment were conducted. The data were analyzed using a deductive thematic analysis approach and coded using the NVIVO 12 software.

Results

Five sub-themes were identified as major challenges to oncology research, including poor funding, excessive workload, interprofessional rivalry, weak collaboration, and denial of cancer diagnosis by patients. Challenges identified for oncology practice were poor governance and financing, high costs of oncology treatments, poor public awareness of cancer, workforce shortage, and interprofessional conflicts. Recommended strategies for addressing these challenges were improved financing of oncology research and practice by government and relevant stakeholders, increasing interest of medical, nursing, and pharmaceutical students in oncology research through curricula-based approach and mentorship, increased oncology workforce, and improved intra- and inter-professional collaboration.

Conclusion

These data highlight the challenges and barriers in oncology practice and research in Nigeria, and underscore the urgent need for increased investments in infrastructure to provide interdisciplinary and interprofessional research training for high-quality care. Only then can Nigeria effectively tackle the current and impending cancer burden in the country.
Effect of Chronic Consumption of Fluoridated Water on Sciatic Nerve Conduction Velocity in Male Wistar Rats
Authors: Enríquez-Sánchez Fernanda Marlen , López-Vázquez Miguel Ángel , Olvera-Cortés María Esther , Valdez-Jiménez Liliana , Villalobos-Gutiérrez Paola Trinidad , Pérez-Vega María Isabel
Published: November 2024

The long-term effect of fluoridated water consumption during development on the velocity of nerve impulse conduction in the sciatic nerve of rats was assessed. Thirty male Wistar rats, 21 days old, were randomly assigned to five groups. Three groups were given fluoridated water ad libitum (as the only source) at different concentrations (10, 100, and 150 ppm), designated as groups F10, F100, and F150, respectively. The study included a control group (C) that received fluoridated water at the maximum level established by the World Health Organization (1.5 ppm of fluorides) and another group that received deionized water (DW). The animals were treated until they reached 90 days of age. Electrophysiological recordings were performed on the rats’ sciatic nerves to determine nerve conduction velocity, and blood plasma was extracted for fluoride concentration analysis. The study found that the F150 group had a lower nerve impulse conduction velocity in the sciatic nerve compared to the C group ( P = 0.0015). Additionally, there was a negative correlation between the concentration of fluorides in plasma and the nerve conduction velocity (r = −0.5132, P = 0.0037). These findings indicate that chronic consumption of high concentrations of fluoride leads to a decrease in nerve conduction velocity. This, in conjunction with potential alterations in the central nervous system, may explain the deficits in learning and memory tests that have been documented in numerous studies evaluating individuals exposed to fluoride consumption. These results provide valuable information for understanding the effects and action mechanisms of fluoride in exposed individuals.
Societal Attitudes Toward Service Robots: Adore, Abhor, Ignore, or Unsure?
Authors: Yoganathan Vignesh , Osburg Victoria-Sophie , Fronzetti Colladon Andrea , Charles Vincent , Toporowski Waldemar
Published: November 2024

Societal or population-level attitudes are aggregated patterns of different individual attitudes, representing collective general predispositions. As service robots become ubiquitous, understanding attitudes towards them at the population (vs. individual) level enables firms to expand robot services to a broad (vs. niche) market. Targeting population-level attitudes would benefit service firms because: (1) they are more persistent, thus, stronger predictors of behavioral patterns and (2) this approach is less reliant on personal data, whereas individualized services are vulnerable to AI-related privacy risks. As for service theory, ignoring broad unobserved differences in attitudes produces biased conclusions, and our systematic review of previous research highlights a poor understanding of potential heterogeneity in attitudes toward service robots. We present five diverse studies (S1–S5), utilizing multinational and “real world” data (Ntotal = 89,541; years: 2012–2024). Results reveal a stable structure comprising four distinct attitude profiles (S1–S5): positive (“adore”), negative (“abhor”), indifferent (“ignore”), and ambivalent (“unsure”). The psychological need for interacting with service staff, and for autonomy and relatedness in technology use, function as attitude profile antecedents (S2). Importantly, the attitude profiles predict differences in post-interaction discomfort and anxiety (S3), satisfaction ratings and service evaluations (S4), and perceived sociability and uncanniness based on a robot’s humanlikeness (S5).
Seeing Personhood in Machines: Conceptualizing Anthropomorphism of Social Robots
Authors: Chi Oscar Hengxuan , Chi Christina G. , Gursoy Dogan
Published: November 2024

This study conceptualizes and develops a multi-dimensional Scale of Social Robot Anthropomorphism (SSRA). Through a rigorous scale development procedure that consists of a battery of qualitative (interviews and focus group) and quantitative approaches (online and field studies), four dimensions of social robot anthropomorphism are identified, namely, human-like appearance, social intelligence, emotional capacity, and self-understanding. The scale is found to be valid and reliable by testing its convergent, discriminant, and nomological validities, utilizing data collected from over 1,000 participants. The theoretical and managerial contributions are discussed, and future research recommendations are provided.
Harnessing nanostructures and fiber architecture: A synergistic leap in shape memory polymer composites
Authors: Gupta Ritesh , Tiwari Nilesh , Kumar Krishna , Pandel Upender
Published: November 2024

This research investigates the synergistic effects of carbon fiber orientation and nanostructure reinforcement across 21 configurations of shape memory polymer composites. It examines uni-directional (UD), bi-directional Twill (BDT), and bi-directional Plain (BDP) fiber architectures, along with varying concentrations of MWCNT and GnP at 0.4%, 0.6%, and 0.8%. The fabrication process involves initially preparing nanostructure-modified epoxy nanocomposites through ultrasonication followed by hand layup techniques to fabricate three-phase shape memory polymer composites. Optimal tensile performance is observed in GnP-modified UD composites at a 0.6 wt% concentration, achieving a tensile strength of 728.32 MPa and a modulus of 71.29 GPa. Furthermore, enhancements in thermomechanical and shape memory properties are noted in GnP-modified BDT composites and are further improved in GnP-modified BDP composite configurations. GnP-modified composites outperform MWCNT ones due to GnP’s sheet structure aligning parallel to the load and its larger surface area, which facilitate enhanced interaction with the matrix. These improvements, supported by FESEM analysis, highlight enhanced interfacial bonding and result in high shape recovery ratios, with all configurations exceeding 90%, despite polymer modification.
Effects of the Mental Health Law on Peruvian Primary Care Physicians: A Cross-Sectional Study on Knowledge of Major Depressive Disorder
Authors: Flores-Cohaila Javier A , Garcia-Portocarrero Peter , Saldaña-Amaya Deysi A , Herrera-Escobar Fabricio , Guivar-Cajusol Josue Y , Villarreal-Trujillo Henry Ricardo , Copaja-Corzo Cesar , Miranda-Chavez Brayan
Published: November 2024

Objective:

The objective was to evaluate the level of knowledge of primary care physicians in Lambayeque, Peru, regarding the diagnosis and treatment of Major Depressive Disorder.

Methods:

A cross-sectional analytical study was conducted among 106 primary care physicians in Lambayeque, Peru. Data were collected using a validated questionnaire assessing Major Depressive Disorder diagnosis and treatment knowledge. Physicians’ knowledge levels were categorized as inadequate, adequate, or excellent. Poisson regression models were employed to identify factors associated with adequate knowledge.

Results:

The response rate was 81.21%. Only 36.79% of physicians demonstrated adequate knowledge, with none achieving excellent knowledge. The median score was 6 (IQR: 5-7). Mental health training, which may reflect the new law’s implementation, was significantly associated with higher knowledge levels (PR: 2.42, 95% CI: 1.02 to 5.10). Other factors were not significantly associated with knowledge levels.

Conclusions:

The proportion of primary care physicians with adequate Major Depressive Disorder knowledge has doubled since 2014, indicating a positive effect of the mental health law. However, to increase this number, continuous professional development programs are needed.
How Community Health Workers can Address Tobacco Dependence of High-Risk patients: A Qualitative Analysis of the Unique Training Needs of Community Health Workers
Authors: Huard Clarissa , Villacis Alvarez Enrique , Veluz-Wilkins Anna , Garcia Sierra Andres Mauricio , Tan Marcia
Published: November 2024

Introduction

Communities with low socioeconomic status have disproportionately high rates of tobacco use, and community health workers (CHWs) have an increasing role in delivering tobacco cessation interventions. However, existing tobacco cessation trainings are not appropriate for the CHW model of care. The aim of this study was to identify training needs of CHWs to develop a tailored tobacco cessation curriculum to help them effectively serve their high-risk patients. Incorporating results of a previously conducted needs assessment survey, we developed a preliminary outline of a tobacco cessation training curriculum that was specific to the CHW experience.

Methods

Participants (N = 14) discussed their impressions of (a) the training content, (b) the unique needs of patients seen by CHWs, and (c) tailoring to the CHW care model. We conducted virtual qualitative interviews and focus groups with stakeholders (i.e., managers/directors of CHW programs) and CHWs, respectively, to obtain feedback on training, as well as a sample 2-hour training schedule and curriculum. Two independent coders analyzed the data using the Framework method.

Results

Two overarching themes emerged: the need for strategies to (a) personalize treatment to each high-risk patient and (b) increase and maintain patient motivation. CHWs also reported the need for specific language to engage patients who were not ready to quit.

Conclusion

A tailored training might focus on motivational interviewing, including how to personalize treatment to the patient’s experiences, and role-playing scenarios with scenes on how to flexibly support patients who are overburdened and unmotivated.
Exploring the relationship between polycystic ovarian syndrome, testosterone, and multiple sclerosis in women: A nationwide cohort study and genome-wide cross-trait analysis
Authors: Jiang Yuan , Cesta Carolyn E , Liu Qianwen , Kingwell Elaine , Stridh Pernilla , Shchetynsky Klementy , Olsson Tomas , Kockum Ingrid , Stener-Victorin Elisabet , Jiang Xia , Manouchehrinia Ali
Published: November 2024

Background:

Women have a higher risk of developing multiple sclerosis (MS), potentially due to hormonal factors. Elevated testosterone levels, common in polycystic ovary syndrome (PCOS), might influence MS risk.

Objective:

To investigate the relationship between PCOS, as a proxy for elevated testosterone levels, and MS risk through phenotypic and genomic analysis.

Methods:

Cox regression models analysed the association between PCOS and MS risk. The genome-wide cross-trait analysis examined the genetic architecture.

Results:

In a Swedish cohort of 1,374,529 women, 77 (0.3%) with PCOS and 3,654 (0.3%) without PCOS were diagnosed with MS. After adjusting for birth year and obesity, no association was found between PCOS and MS ( HR = 0.91, 95% CI = 0.72–1.15), which was confirmed by Mendelian randomization analysis, where genetically predicted PCOS propensity, sex hormone-binding globulin (SHBG), or testosterone levels did not causally affect MS risk (all p-values > 0.05). By exploring horizontal pleiotropy, we identified shared genetic regions and 19 independent pleiotropic SNPs for SHBG with MS and 11 for testosterone with MS.

Conclusion:

We did not find evidence for a causal role of PCOS, as a proxy of elevated testosterone, in reducing the risk of MS in women. The shared genetic loci between testosterone, SHBG, and MS provide biological insights.
McArdle sign and neck flexion-induced change in central motor conduction in multiple sclerosis
Authors: Hoffman E Matthew , Brown Lucille , Jolliffe Evan , Sechi Elia , Harmsen William S , Schilaty Nathan D , Weinshenker Brian G
Published: November 2024

Background:

Rapidly reversible weakness with neck flexion (McArdle sign) is common in patients with multiple sclerosis (MS). The pathophysiology is unknown.

Objective:

To evaluate changes in central motor conduction time (CMCT) in patients with and without McArdle sign.

Methods:

We measured McArdle sign with a torque cell and CMCT with neck flexed and extended in patients with MS, other causes of myelopathy, and healthy controls.

Results:

CMCT was prolonged with neck flexion disproportionately in those with MS-associated myelopathy (MSAM) with prominent McArdle sign compared to MS patients with lesser degrees of McArdle sign, and to controls.

Conclusion:

McArdle sign may result from stretch-induced slowing of conduction due to demyelination.
Study on the deformation of hybrid BFRP-steel reinforced concrete beams considering crack development
Authors: Sun Yunlou , Sun Zeyang , Fu Jinyu , Cai Xiaoning , Wu Gang
Published: November 2024

Hybrid fiber-reinforced polymer (FRP)-steel reinforced concrete (RC) beams exhibit various flexural failure modes depending on different equal-stiffness reinforcement ratios, the post-yield stiffness ratio, and the bond-slip behavior. This study first develops a model for the tensile behavior of hybrid Basalt FRP (BFRP) -steel reinforced concrete chords, considering the modified Bertero-Popov-Eligehausen (mBPE) bond-slip model. The rationality of the tensile stiffening model was validated through comparisons with existing experimental tests on the axial tension of chords. Subsequently, a beam deformation correction calculation method considering ‘rigid-rotation’ was proposed. The corrected theoretical calculation of the beam’s peak load shows an error of 5.0% compared to the experimental value, while modified ultimate deformation exhibits an error of 4.7%. As the bond weakens, the theory proposed in this paper is more suitable for predicting the deformation capacity of hybrid reinforced beams. ACI 440.1R-15 underestimate deformations by approximately 77.8%, limiting the normative evaluation of deformation calculations for hybrid reinforced concrete beams considering bond slip. Finally, the influence of bond-slip parameters ( τm, sm and [Formula: see text]) and reinforcement configurations (equal stiffness reinforcement ratio, steel/BFRP reinforcement ratio, and post-yield stiffness ratio) on beam deformation and crack width was investigated. The results indicate that the peak bond strength is a key parameter affecting crack width and deformation of the beam. The exponential rise segment parameter α and the slip sm corresponding to peak bond strength mainly influence the load level corresponding to cracking.
Temporal characterization of NOx and its relationship with O3 at a riverine site of Foshan
Authors: He Yuanping , Pan Yingyu , Chen Ruhai , Fan Shaojia , Yu Chuck Wah Francis
Published: November 2024

Nitrogen dioxide (NO2) is a crucial precursor of tropospheric O3. This study undertakes continuous measurements of nitric oxide (NO), nitrogen dioxide (NO2) and ozone (O3) at Shishan Port (SSP), a riverine site in Foshan, China. Oxides of nitrogen (NOx = NO + NO2) exhibit a distinct seasonality, with high concentrations in winter and low concentrations in summer. The daily average concentration of NOx is 30.5 ppb, with high concentrations in the evening and morning and low concentrations in the afternoon. The variation of the total oxidant (Ox = O3 + NO2) with the levels of NOx was examined to infer the atmospheric sources of Ox as the sum of a local contribution dependent on NOx and a regional contribution independent of NOx. The local contribution predominates during low wind speed and calm weather in winter. The case analysis of a typical NO2 pollution episode affirms that the increase of NO2 at night in SSP is significantly influenced by the exhaust emissions of passing ships, atmospheric diffusion conditions and the O3 concentration generated during the day. Due to the chemical coupling of NOx and O3, along with regional transport, the levels of NOx and O3 are inextricably linked yet complicated.
Desirable design: What aesthetics are important to young people when designing a mental health app?
Authors: Garrido Sandra , Doran Barbara , Oliver Eliza , Boydell Katherine
Published: November 2024

Objectives: Smartphone apps can be highly effective in supporting young people experiencing mood disorders, but an appealing visual design is a key predictor of engagement with such apps. However, there has been little research about the interaction between visual design, mood and wellbeing in young people using a mental health app. This study aimed to explore young people’s perspectives on colour and visual design in the development of a music-based app for mood management. Methods: Workshops were conducted with 24 participants (aged 13-25 years) with data analysis following a general inductive approach. Results: Results indicated that colour could impact wellbeing in both positive and negative ways. Participants favoured a subtle use of colour within sophisticated, dark palettes and were influenced by a complex interplay of common semiotic values, experiences with other apps, and mood. Conclusions: These findings highlight the highly contextual nature of the relationship between colour and mood, emphasising the importance of co-design in app development.
From bliss to burden: An ethnographic inquiry into how social, material and individual obstacles to digital well-being shape everyday life
Authors: Van Bruyssel Sara , De Wolf Ralf , Vanden Abeele Mariek
Published: November 2024

Drawing from a two-year ethnography with sixteen adults in Flanders and Brussels, Belgium, this study disentangles the social, material, and individual obstacles experienced in day-to-day life that hinder and foster digital well-being. Findings show how these obstacles are interrelated, laying bare the tensions that cut across social relations, digital devices, and spaces. Moreover, (gendered) responsibilities and social relations impact whether someone can, or even desires, to overcome obstacles to digital well-being. We thus observed a “constrained agency” that limited individual efforts in feeling digitally well. Emphasizing the relational characteristics of connected everyday life, the study argues that identifying where agency is constrained can make visible the layers and tensions in people’s experiences with digital media use. To put this into practice, we echo the call for a re-imagination of digitized everyday life that questions underlying inequalities and privileges, seeing a need for individual and collective strategies that can foster sustainable digital well-being.
Rage Against the Machine: Exploring Violence and Emotion in Conspiracy Narratives on Parler
Authors: Wischerath Darja , Piwek Lukasz , Roscoe Jonathan F. , Davidson Brittany I.
Published: November 2024

The mainstreaming of conspiracy narratives has been associated with a rise in violent offline harms, from harassment, vandalism of communications infrastructure, assault, and in its most extreme form, terrorist attacks. Group-level emotions of anger, contempt, and disgust have been proposed as a pathway to legitimizing violence. Here, we examine expressions of anger, contempt, and disgust as well as violence, threat, hate, planning, grievance, and paranoia within various conspiracy narratives on Parler. We found significant differences between conspiracy narratives for all measures and narratives associated with higher levels of offline violence showing greater levels of expression.
The Outcomes of the Voice Use Reduction Program on Voice Quality and Vocal Fatigue in Occupational Voice Users
Authors: Vermeulen Rouxjeanne , Toit Maria du , van Lierde Kristiane , Graham Marien A. , van der Linde Jeannie
Published: November 2024

The study aimed to describe the outcomes of the voice use reduction (VUR) program on voice quality and vocal fatigue (VF) in occupational voice users (OVUs). A within-subject, quasi-experimental, pre-test, post-test research design was performed on 30 OVUs. Perceptual and acoustic outcome measures were employed pre-and post-implementation of the VUR, including the GRBASI 4-point rating scale, jitter, shimmer, fundamental frequency ( F0), harmonic-to-noise ratio (HNR), maximum phonation time (MPT), frequency min and max, intensity min and max, the dysphonia severity index (DSI), and the vocal fatigue index (VFI). The pre-and post-test outcomes revealed significant ( p < .001) decreases in perceptual G (Grade of hoarseness), R (Roughness), A (Asthenia), S (Strain), and I (Instability). Perceptual normality in these areas increased significantly ( p < .001). Acoustic measures revealed significant ( p < .05) decreases in Jitter%, Intensity (dB) Min, and DSI scores as well as significant ( p < .05) increases in MPT /a/, /s/, and /z/, Frequency (Hz) Max, and F0 (Hz) Max, indicating improved voice quality at post-test. The VUR program positively affected and improved OVUs’ perception of VF in the areas of tiredness of voice and physical discomfort. OVUs strongly perceive improvement of VF symptoms with rest regardless of the current level of VF they are experiencing. When approaching OVUs, clinicians are encouraged to use a combination of direct voice therapy and vocal hygiene accompanied by VUR to help develop healthier use of the voice, facilitate healing, and prevent further/future injury or disorder.
From Policy to Practice: Data Sharing Challenges and Opportunities for Mixed Methods Research in the Era of U.S. Open Science Initiatives
Authors: Hagiwara Nao , Gallo Joseph J.
Published: November 2024

The “Year of Open Science” initiative, spearheaded by the White House in 2023, catalyzed the adoption of national open science policies across U.S. Federal Government agencies, but open science is an international movement. This paper elucidates the evolving landscape of open science policies, particularly focusing on the Data Management and Sharing Plans by agencies like NIH, NSF, and CDC. While quantitative research (and qualitative research to some degree) has received considerable attention in data sharing, this paper highlights the underexplored terrain of mixed methods research. Through detailed analysis and examples, it advocates for tailored guidelines and collaborative efforts to bridge the gap in data sharing practices, emphasizing the unique challenges and opportunities inherent in mixed methods research.
Advancing Behavioral Mapping a Step Forward: Meeting Urban Planning’s Objectives
Authors: Shilon Mor , Eizenberg Efrat
Published: November 2024

Amidst major urbanization and technologization processes, scholars have been seeking innovative concepts and methods for studying urban environments and settings. Behavioral mapping was developed in the 1970s by environmental psychologists. However, despite its potential to address new challenges, the method remains relatively underdeveloped in the field of urban planning. This paper juxtaposes the new objectives of urban planning with the qualities of behavioral mapping to discuss the method’s relevance for studying dynamic urban environments. Drawing on case studies of complex urban settings of different scales (a community park and a hospital), we offer a systematic analysis of applying behavioral mapping in urban planning and conclude about the use of the methods and its potential to address contemporary challenges faced by urban planners.
What’s Love Got to do With it? Introducing bell hooksian Love Typologies to Qualitative Inquiry in Educational Research
Authors: Washington LaShawn Faith
Published: November 2024

Many Black women scholars, like bell hooks, have been subjected to academic capitalist white supremacist patriarchal values that minimizes and invalidates the epistemologies, theories, methods, and knowledge production processes of Black women. Thus, as a means to move past antiquated theorization and knowledge production practices, I proposed a pathway forward by introducing a “bell hooksian approach” to higher educational research that is based on four “hooksian love typologies” (love as an active choice, revolutionary self-love, familial, and romantic) rooted in the scholarship of Black feminist theorist bell hooks. This framework helps to better understand and research the multifaceted conceptualizations of love that can assist and better support Black women and women of color on college campuses and in the academy more generally. Lastly, asserting that notions of love is a central aspect of Black life, I made recommendations for researchers and practitioners on how to utilize a love-centered hooksian approach within qualitative inquiry.
Comparison of dissolution profiles of brand name and generic drugs of mycophenolate mofetil in the presence of concomitant drugs
Authors: Takizawa Yusuke , Kanatani Shiori , Oishi Kanon , Ohashi Ryuto , Kurita Takuro , Nakajima Takanori
Published: November 2024

Generic drugs have become popular because they reduce medical costs. However, switching from a brand name drug to a generic drug of mycophenolate mofetil (MMF) in immunosuppressive therapy after kidney transplantation resulted in an insufficient increase in its blood concentration in some cases. Immunosuppressive therapy after transplantation typically involves a multidrug strategy. Therefore, changes in efficacy due to switching to a generic drug of MMF may be due to its combination with other drugs. Since the first barrier to the absorption of an orally administered formulation is dissolution, the present study examined the effects of prednisolone (PDN) and tacrolimus (TAC), which are used in immunosuppressive therapy, on the dissolution behavior of MMF. A dissolution experiment was performed in the 1st liquid for dissolution testing (pH 1.2), McIlvaine buffer (pH 4.0), and a 2nd liquid for dissolution testing (pH 6.8) under the single condition of the brand name drug and two generic drugs of MMF as well as under combined conditions with PDN and TAC. Although the initial dissolution rate of MMF differed between the brand name and generic drugs, no significant difference was observed in the final dissolution rate. Furthermore, the f2 value, which evaluates the equivalence of dissolution behavior, was within the standard range. In the 2nd liquid for dissolution testing (pH 6.8), the dissolution rate and ratio slightly decreased under the combined condition with PDN or TAC; however, in comparisons with the single conditions, the f2 value was within the standard range. Therefore, a reduced blood concentration due to switching to a generic drug of MMF may not be due to a change in dissolution behavior.
On the interchangeability of presentation order for cause and effect: Experimental tests of cue and outcome-density effects
Authors: Shankar Sahana , Byrom Nicola , van Tilburg Wijnand A P , Rakow Tim
Published: November 2024

Studies of cue-outcome contingency learning demonstrate outcome-density effects: participants typically overestimate contingencies when the outcome event is relatively frequent. Equivalent cue-density effects occur, although these have been examined less often. Few studies have simultaneously examined both event density effects or have manipulated the presentation order of the events, limiting knowledge of whether these phenomena share underlying principles. We report three well-powered experiments to address those gaps. Participants judged the effectiveness of a medical treatment after viewing a series of pairings for two events, a cause (treatment given vs. not) and an effect (patient recovered vs. not). Experiment 1 manipulated both event densities independently. We then manipulated the presentation order for the cause and the effect, alongside a manipulation of effect density (Experiment 2a) or cause density (Experiment 2b). Experiment 1 found a large main effect of event density ([Formula: see text] = .55), which was qualified by a significant interaction between event type and density level ([Formula: see text] = .10) whereby effect density had greater impact than cause density. Experiments 2a and 2b found effects for effect density ([Formula: see text] = .60) and cause density ([Formula: see text]= .31). The effects of cause–effect presentation order were always small and non-significant. We conclude that effect-density manipulations had substantial impact on contingency judgements, and cause-density manipulations less so. Moreover, it matters little which event (cause or effect) is seen first. These findings have implications for contingency, associative, probabilistic, and causal models of contingency judgement; primarily, that people may be more sensitive to the causal status of events than to their temporal order of presentation.
Advancing stroke safety and efficacy through early tirofiban administration after intravenous thrombolysis: The multicenter, randomized, placebo-controlled, double-blind ASSET IT trial protocol
Authors: Tao Chunrong , Liu Tianlong , Sun Jun , Zhu Yuyou , Li Rui , Wang Li , Zhang Chao , Song Jianlong , Jing Xiaozhong , Nguyen Thanh N , Nogueira Raul G , Saver Jeffrey L , Hu Wei
Published: November 2024

Background:

Intravenous thrombolysis (IVT) is the cornerstone treatment for the acute ischemic stroke (AIS) within 4.5 h after onset. Current guidelines recommend administering antiplatelet medications 24 h after IVT. However, vascular reocclusion is a common occurrence after IVT. Tirofiban, a platelet glycoprotein IIb/IIIa antagonist, can help deter macrovascular reocclusion, prevent microvascular thrombosis, and enhance cerebral blood flow.

Objective:

This trial aims to assess whether early administration of tirofiban can improve clinical outcomes in patients with AIS who received IVT.

Methods and design:

The Advancing Stroke Safety and Efficacy through Early Tirofiban Administration after Intravenous Thrombolysis (ASSET IT) Trial is an investigator-initiated, randomized, placebo-controlled, double-blind, multicenter study. Up to 832 eligible patients will be consecutively randomized in a 1:1 ratio to receive either intravenous tirofiban or placebo over a period of 2 years across 38 stroke centers in China.

Outcomes:

The primary endpoint is excellent functional status at day 90, defined as a modified Rankin Score of 0–1. Primary safety endpoints include symptomatic intracerebral hemorrhage at 24 h and mortality at 90 days.

Trial registry number:

NCT06134622 (clinicaltrials.gov).
Impact of time from symptom onset to puncture, and puncture to reperfusion, in endovascular therapy in the late time window (>6 h)
Authors: Sadeler Agathe , Finitsis Stephanos , Olivot Jean-Marc , Richard Sebastien , Marnat Gaultier , Sibon Igor , Calviere Lionel , Cognard Christophe , Mazighi Mikael , Desilles Jean-Philippe , Lapergue Bertrand , Tamazyan Ruben , Zuber Mathieu , Gory Benjamin , Maïer Benjamin
Published: November 2024

Background:

Increased time from symptom onset to puncture (TSOP) and time from puncture to reperfusion (TPTR) are associated with worse outcome in ischemic stroke patients treated with endovascular therapy (EVT) in the early time window (<6 h). However, these associations are less described in the late window (>6 h), where patients may benefit from EVT because of a more favorable imaging profile (late window paradox). We sought to compare the effect of these timeframes between these two periods on efficacy and safety outcomes.

Methods:

The ETIS (Endovascular Treatment in Ischemic Stroke) registry is an ongoing, prospective, observational study in 21 centers that perform EVT in France. We included adult patients with an anterior occlusion, successfully treated by EVT (modified treatment in cerebral ischemia (mTICI) 2b–3) between January 2015 and June 2023, with a known time of stroke onset. The cohort was divided into two groups according to the TSOP (⩽6 h vs >6 h). Primary outcome was favorable outcome (modified Rankin Scale 0–2 at 90 days).

Results:

In total, 7516 patients were included, with 5936 patients being treated ⩽6 h and 1580 >6 h. In the early window, TSOP and TPTR were associated with worse outcomes at 90 days (adjusted odds ratio (aOR) = 0.68 per hour; 95% confidence interval (CI) = 0.64–0.73; p < 0.001 and aOR = 0.92 per 10-min increment; 95% CI = 0.90–0.94, p < 0.001, respectively). TSOP was not associated with worse outcomes at 90 days in the late window ( p = 0.955), but TPTR was associated with worse outcomes (aOR = 0.91 per 10-min increment; 95% CI = 0.86–0.96, p = 0.001), every 10 additional minutes in TPTR being associated with a 1.7% (95% CI = 0.6–2.7) decreased probability of favorable outcome.

Conclusion:

Only EVT procedural time is associated with unfavorable outcomes at 90 days in late window patients. These results highlight how the late window paradox may end at the start of EVT and underscore the need for timely management, particularly for the EVT, even for late window patients with a presumed more favorable imaging profile.
Re-tear following rotator cuff repair: Do functional outcomes predict success?
Authors: Angerett Nathan , Maurer Timothy , Lutz Rex , Alexander Tia , Krasney Leighann , Kelly Matthew
Published: November 2024

Purpose

The purpose of this study is to compare functional outcomes between patients who were found to have a retear on ultrasound versus those with an intact repair following arthroscopic rotator cuff repair.

Methods

Retrospective cohort study comparing functional outcomes of 84 patients who underwent arthroscopic rotator cuff repair and were found to have a retear versus those who did not experience a retear. Functional outcomes included American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test, strength and active range of motion (AROM) assessed preoperatively and postoperatively at 3 and 6 months.

Results

Patients without a retear by 6 months demonstrated greater improvements in internal rotation at 3 months (2.3° of mean change, p = 0.0356), as well as greater improvements in external rotation range of motion (8.8° of mean change, p = 0.0210) between 3 and 6 months as compared to those patients who did experience a retear. Both groups showed decreased pain scores and increased ASES scores at all points postoperatively.

Conclusions

Our study found statistically significant improvements in internal rotation at 3 months, and external rotation between 3 and 6 months in the non-retear group. No differences in functional outcomes existed between at final follow-up.
Predictors of disease outbreaks at continental-scale in the African region: Insights and predictions with geospatial artificial intelligence using earth observations and routine disease surveillance data
Authors: Pezanowski Scott , Koua Etien Luc , Okeibunor Joseph C , Gueye Abdou Salam
Published: November 2024

Objectives

Our research adopts computational techniques to analyze disease outbreaks weekly over a large geographic area while maintaining local-level analysis by incorporating relevant high-spatial resolution cultural and environmental datasets. The abundance of data about disease outbreaks gives scientists an excellent opportunity to uncover patterns in disease spread and make future predictions. However, data over a sizeable geographic area quickly outpace human cognition. Our study area covers a significant portion of the African continent (about 17,885,000 km2). The data size makes computational analysis vital to assist human decision-makers.

Methods

We first applied global and local spatial autocorrelation for malaria, cholera, meningitis, and yellow fever case counts. We then used machine learning to predict the weekly presence of these diseases in the second-level administrative district. Lastly, we used machine learning feature importance methods on the variables that affect spread.

Results

Our spatial autocorrelation results show that geographic nearness is critical but varies in effect and space. Moreover, we identified many interesting hot and cold spots and spatial outliers. The machine learning model infers a binary class of cases or none with the best F1 score of 0.96 for malaria. Machine learning feature importance uncovered critical cultural and environmental factors affecting outbreaks and variations between diseases.

Conclusions

Our study shows that data analytics and machine learning are vital to understanding and monitoring disease outbreaks locally across vast areas. The speed at which these methods produce insights can be critical during epidemics and emergencies.
Aortic Rupture in a Pediatric Patient With Influenza
Authors: Grasty Madison A. , L’Etoile Nathan , Nitsche Lindsay J. , Takeda Moe , Fisher Brian T. , Drant Stacy , Mavroudis Constantine D.
Published: November 2024

Influenza can lead to significant morbidity and mortality in children. Aortopathy tends to occur in adults during influenza season; however, aortic pathology in children with influenza is exceedingly rare. This report describes a child who experienced an aortic rupture during an influenza infection without evidence of secondary bacterial infection or connective tissue disorder.
Temporal Trends in Single- and Multiple-Sports Team Participation Among Adolescents in the United States: Analysis Using the Youth Risk Behavior Surveillance System, 1999-2019
Authors: Knell Gregory , Yockey Andrew , Brayton Riley P. , Johnson Ashleigh M. , Ellis Henry B. , Wilson Philip L.
Published: November 2024

Background:

It is unclear how levels of sport participation have changed among adolescents in the United States (US) in recent years, particularly considering evidence of increasing sport professionalization and attrition.

Purpose:

To evaluate the differences and trends in single- and multiple-team sport participation among US high school students between 1999 and 2019.

Study Design:

Descriptive epidemiology study.

Methods:

Using the Youth Risk Behavior Surveillance System of the US Centers for Disease Control and Prevention, a biannual representative survey of US high school students, data on self-reported sport participation (no participation, single team, multiple teams) within the previous year were evaluated. Differences in sport participation prevalence between 1999 and 2019 were assessed in sex strata by grade, race/ethnicity, and US region. Weighted trends using the National Center for Health Statistics Guidelines for Analysis of Trends and logistic regression models were employed for analyses.

Results:

The study sample over the 20-year period (N = 149,404) was 49.8% female; the majority were in ninth grade (27.7% female, 28.7% male), were non-Hispanic White (56.1% female, 56.8% male), and resided in the Southern US (57.6% female, 57.4% male). Among girls, 27.2% (95% CI, 25.8-28.6) reported multiple sports team participation in 1999, while 21.3% (95% CI, 20.1-22.6) reported the same in 2019. Among boys, 39.5% (95% CI, 38.4-40.7) reported multiple sports team participation in 1999 versus 29.1% (95% CI, 27.7-30.6) in 2019. Analyses of trends indicated that girls experienced increasing trends in single-sport team participation (β = 0.04, SE = 0.01, P < .001). Among boys, there were increasing trends in no sport participation (β = 0.06, SE = 0.01, P < .001), while multiple-sport team participation decreased over the 20-year period (β = −0.10, SE = 0.01, P < .001). Disparities in trends were observed among female and male groups by race/ethnicity, grade, and region.

Conclusion:

Sport participation over a 20-year period in the US decreased significantly for boys and increased for single-sports teams among girls. Sport specialization may be contributing some of the observed trends, though limitations in the data require additional research to confirm these hypotheses. Tailored efforts to increase sport participation among both sexes is needed.
Influence of Injury to the Kaplan Fibers and Anterolateral Ligament on Pivot-Shift Phenomenon in Adult and Adolescent Patients With Anterior Cruciate Ligament Injury: A Retrospective Cohort Study
Authors: Cui Jiaming , Cheng Songmiao , Luo Yuan , Li Qiang , Li Fu , Wang Yicheng , Ming Hong
Published: November 2024

Background:

Studies have shown that Kaplan fibers (KFs) play a role in controlling anterolateral rotatory knee laxity in anterior cruciate ligament (ACL) injury. However, recent clinical studies have suggested that KF injuries are not associated with a higher-grade pivot shift in knees with acute ACL injuries.

Purpose:

To compare the effect of KF and anterolateral ligament injury on anterolateral rotatory laxity as measured by the pivot-shift test in both adult and adolescent patients with acute ACL injury.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This study consisted of patients who experienced primary acute ACL tears between January 2019 and December 2021. The magnetic resonance imaging examinations and pivot-shift tests for these individuals were conducted within 14 days after injury. Variables associated with concomitant injury were included in a binary logistic regression model to evaluate risk factors of a high-grade pivot shift and a KF injury.

Results:

The study included 540 patients with acute ACL tears (64 adolescent patients and 476 adults). The main risk factor for a high-grade pivot shift after acute ACL injury in adults was partial or total disruption of anterolateral ligament continuity (odds ratio [OR], 2.271; 95% CI, 1.499-3.442). In adolescent patients, the main risk factor was KF injury (OR, 19.98; 95% CI, 2.367-168.669), including edema and disruption of continuity.

Conclusion:

The main risk factor for a high-grade pivot shift after acute ACL injury differs between adolescent patients and adults: the KF injury sign in adolescent patients indicates a higher-grade pivot shift.
Creating an endless visual space: An Isovist analysis of a small traditional Chinese garden
Authors: Chen Huishu , Li Yangluxi , Yang Li
Published: November 2024

Traditional Chinese private gardens, as a unique spatial typology, create a maze-like quality through the arrangement of sightlines and pathways, offering occupants a sense of perpetual circulation and boundless time. The rich experiential nature cultivated within these confined spaces, alongside the ecological worldview of “harmony between heaven and humanity,” holds significant relevance for urban landscape design and the sustainable development of urban environments. While there is ample research literature on various aspects of garden spaces, studies exploring how private gardens generate visually infinite and cyclic spatial experiences within limited areas often remain confined to intuitive analysis, lacking concrete and rational explanations. This study employs the method of Isovist Analysis to test the validity of the spatial consciousness of “Limitless vision, Endless recurrence” within the spatial layout and tour organization of traditional private gardens, using the analysis of Isovists at eight scenic spots within the Xiaocanglang Water Courtyard, as well as an examination of visual-spatial changes along both primary and secondary pathways in different tour directions. It is hoped that this research method will serve as a tool for urban designers and landscape architects to assess spatial-visual characteristics and experiences during the design phase.
Blinded by the ‘green-halo’? Equity in financing climate adaptation of urban sanitation
Authors: Hyde-Smith Leonie , Roelich Katy , Mdee Anna , Zhan Zhe , Evans Barbara
Published: November 2024

Adapting urban sanitation systems to changing climate conditions will require substantial investments. However, there is a gap in understanding the funding strategies for such adaptation measures, especially amid concerns that resilience measures might reinforce existing urban sanitation inequalities. Through cross-case document analysis and complementary key informant interviews, we examined the sanitation adaptation investments in eight cities, focusing on their funding arrangements and social and intergenerational equity implications. Debt financing of sanitation adaptation often relies on repayment through customer bills with only opaque considerations of the affordability for different socio-economic customer groups. The lack of appropriate accounting for the lifecycle costs of resilient infrastructure threatens to mortgage future generations. There is no convincing evidence that ‘greening’ of adaptation financing either shifts or redistributes the financial risk more equitably nor does it make the repayment of the investments substantially cheaper for customers. We conclude that a public sector funding approach is most appropriate to ensure social and intergenerational equity within climate-resilient sanitation systems.
Tapping into the vocal learning and rhythmic synchronization hypothesis
Authors: Theofanopoulou Constantina
Published: November 2024

In this article, I present three main points that could benefit the “vocal learning and rhythmic synchronization hypothesis”, encompassing neurogenetic mechanisms of gene expression transmission and single motor neuron function, classification of different behavioral motor phenotypes (e.g., spontaneous vs. voluntary), and other evolutionary considerations (i.e., the involvement of reward mechanisms).