bluuebunny/crossref_metadata_2025 huggingface dataset:
Who tells your story: Narration in Hamilton: An American Musical
Authors: Muro Alicia
Published: February 2025

The aim of this paper is to analyse Lin-Manuel Miranda’s Hamilton: An American Musical in terms of its approaches to storytelling and narration. A selection of songs will be analysed focusing on their narrative traits and the figure of the narrator, including its (un)reliability. It will be argued that the songs in Hamilton can be classified depending on their approaches to storytelling, including examples of narration to the audience, confessional monologues, epistolary narration, or scenes based on dialogue/conversations. An analysis of who tells Hamilton’s story will be relevant to understand the whole show, for it is also concerned with issues of legacy and remembrance.
Adaptations in the workplace as a labor inclusion strategy for people with physical disabilities: an integrative review
Authors: Urrejola-Contreras Gabriela Paz , Pérez Miguel A. , Herrera-Miranda Felipe , López Bernardita , Gary Zambra Boris , Hernández Pérez Karla
Published: February 2025

Background

Based on the International Classification of Functioning, disability entails a problem in participation, and work activity is a pillar for inclusion. The success of labor inclusion will depend on the labor adaptations that are adopted. Discrimination in the workplace remains one of the biggest obstacles to effective inclusion.

Objective

Analyzing the evidence associated with workplace adaptations as an inclusion strategy for people with physical disabilities

Methods

Literature published between 2012 and 2023 in English and Spanish. The databases were examined: Science Direct, Scopus, Taylor & Francis and free search and 10 articles were included to prepare this integrative review. The methodological quality followed the recommendations of the Equator network.

Results

Most of the changes were organizational and accessibility related to flexible hours, the adoption of teleworking, the availability of elevators, preferential parking and adaptations in bathrooms. The main shortcomings reported were limitations in evaluating jobs, productivity costs and effectiveness of adjustments, redesigning tasks and managing disability in the work environment.

Conclusions

Although there are international efforts aimed at improving the inclusion of people with disabilities in the workplace, the results are asymmetrical between accessibility and support. The development of reasonable accommodations in the workplace in pursuit of employment rights is still in its early stages.
Exploring task completion times and text performance in pedestrians in single and dual-tasking: Comparative analysis of laboratory and outdoor environments
Authors: Girgin Nuray , Okudan Begum , Çelebi Sadık Emre , Dündar Selim
Published: February 2025

Background: Increased cell phone use causes individuals to divide their attentional resources between dual tasks in daily life. It is emphasized that this divided attention negatively affects task performance and makes pedestrian cell phone use an increasing safety concern. There is a lack of research on how dual tasks involving cell phone use affect pedestrian movements in laboratory and real-world settings and the time saved by text messaging while walking. Objectıve: The main purpose of this study is to investigate how dual-tasking affects pedestrians by analyzing task completion time and texting performance, as well as investigating potential gender differences. Methods: 119 students were included in the study. Expanded-Timed Up and Go Test was applied as a single task 1. As a single task 2; text messaging was used on a mobile phone. Dual-task was defined as performing both tasks simultaneously. All evaluations were recorded both in the laboratory and outdoor environment. Results: Between all parameters, task completion times showed a significant difference in favor of dual-task in both environments ( p ≤ 0.05). There was no significant difference in texting performance when comparing the results of two environments ( p ≥ 0.05). Performing texting and walking tasks simultaneously resulted in approximately 43–45% time savings. Conclusıons: However, dual-task increases events such as falling or hitting other pedestrians. We recommend that pedestrians do not endanger their health and the health of other pedestrians to save more or less time.
Association of gender-based discrimination and burnout among faculty in an urban academic medical center
Authors: Peccoralo Lauren A. , de Guillebon Eleonore , Clifton Elizabeth , He Celestine , Kaplan Sabrina , Deshpande Richa , Kaplan Carly , Pietrzak Robert H. , Charney Dennis , Ripp Jonathan A.
Published: February 2025

Background

Burnout in physician and scientist faculty threatens professional satisfaction, mental health, and work quality while impacting women more than men. Women experience gender mistreatment more often than men, which may impact burnout.

Objective

To determine the differences in burnout, discrimination and harassment by gender, and whether these variables were associated with burnout in physician and scientist faculty.

Methods

An anonymous cross-sectional survey from November 2018 through February 2019 was conducted in physician and scientist faculty at a large urban hospital. Survey instruments included MaslachBurnout Inventory-2, gender-based discrimination and harassment questions, and demographic and professional characteristics.

Results

Of 4156 faculty, 1497 (36%) provided gender identification and were included in analyses. Women experienced burnout at higher rates than men (30.9% vs. 23.3%, p = 0.002). Women also experienced gender discrimination and gender harassment at 11 (25.0% vs 2.3%, p < 0.001) and 5.7 (13.0% vs 2.3%, p < 0.001) times the rate of men, respectively. In a multivariable analysis, gender-based discrimination and harassment was associated with burnout among women (OR 1.65, p = 0.035) and overall (OR 1.65, p = 0.017), but not among men. In men, those aged 40–60 experienced increased burnout compared to those aged >60 (OR 2.67, p = 0.017). For all participants, burnout was associated with depression symptoms, poor work life integration, and lower leadership scores.

Conclusion

Burnout is prevalent in both men and women physicians and scientists, but correlates vary by gender. Findings suggest that interventions to reduce burnout should account for gender differences, target leadership behaviors and address gender bias and mistreatment.
Design and validation of a novel ergonomic backpack
Authors: Bouve Lyndsey K. , DiAngelo Denis J.
Published: February 2025

Background

BP are the most common means for carrying items and are used by a large population but transporting heavy loads (over extended periods of time) can lead to a variety of health-related problems. An ergonomic backpack (EBP) was designed as a potential solution to reduce the incidence of injuries associated with heavy backpack weight.

Objective

The objective of this study was to design a novel ergonomic offloading backpack that reduced loads on the shoulder and spine compared to a traditional modern day backpack (BP).

Methods

Strap tension and shoulder loads were measured in a common two strap style commuter BP and the EBP during quiet (vertical) stance conditions for five weight increments (0 kg to 11 kg) to confirm the offloading capabilities of the EBP. Portable luggage scales were attached directly to the shoulder straps and configured to measure strap tension. Load sensors placed underneath the shoulder straps provided an estimate of the total force acting on the shoulders and transferred to the spine.

Results

The EBP had a large effect size and significant reduction ( p < 0.05) in shoulder loads compared to a traditional BP for all bag weight conditions. Similarly, the EBP had a large effect size in reducing strap tension compared to the traditional modern day two strap BP.

Conclusion

A newly designed EBP was effective at transferring a significantly large portion of the shoulder and spine loads to the pelvic region.
Attitudes of nurses toward artificial intelligence: A multicenter comparison
Authors: Kaplan Mehmet , Uçar Mehmet
Published: February 2025

Background

Artificial intelligence (AI) is transforming medical practices with rapidly developing technologies and the innovative solutions it provides. In order for this transformation to be successfully integrated into healthcare services, healthcare professionals must have positive attitudes towards this technology.

Objective

The present study was conducted with the aim of comparing the attitudes of nurses working in different provinces towards artificial intelligence.

Methods

The study was planned in a descriptive cross-sectional design. The study population consisted of 1453 nurses working in 3 state hospitals (inpatient hospitals providing secondary health care services) located in the city centers of Muş, Bingöl and Adıyaman provinces in eastern Turkey. While the sample size was 698 nurses in total, the study was completed with 737 nurses. The data were collected through the Introductory Information Form and the General Attitudes toward Artificial Intelligence Scale (GAAIS). ANOVA test and multiple regression were used to analyse the data.

Results

It was found that the nurses had highly positive attitudes towards artificial intelligence. When the nurses’ scores from the Positive GAAIS sub-dimension were compared, it was determined that there was a significant difference (p < 0.05) between the provinces. A statistically significant difference (p < 0.01) was found between the provinces in the Negative GAAIS sub-dimension, as well. Demographic characteristics were found to be effective on both Positive GAAIS and Negative GAAIS.

Conclusions

Although there were differences between the provinces, the nurses generally had positive attitudes towards artificial intelligence technologies. The majority of the participants continue to use artificial intelligence technologies although they state that artificial intelligence will replace humans in the future. Longitudinal studies on the factors affecting attitudes towards artificial intelligence are recommended.
The effect of game-based exercises on upper extremity muscle strength, tactile gnosia, and functionality: A randomized controlled study
Authors: Kilicoglu Emine Arslan , Unuvar Bayram Sonmez
Published: February 2025

Background

Upper extremity rehabilitation often involves exercises aimed at improving muscle strength, tactile gnosia, and functionality. Game-based exercises (GBE) have emerged as a novel approach to rehabilitation, offering engaging activities that may enhance patient motivation and compliance.

Objective

This randomized controlled study aimed to investigate the effect of GBE on upper extremity muscle strength, tactile gnosia, and functionality.

Methods

Participants were randomly assigned to either GBE group (n = 20) or control group (CG) (n = 20). The GBE group engaged in game-based exercises twice a week for six weeks, while the CG received no intervention. Upper extremity muscle strength was assessed using a Jamar Hand Dynamometer for grip strength and a Hydraulic Pinch Gauge for pinch strength assessments. Tactile gnosia was assessed using the Static Two-Point Discrimination (2PD) Threshold test. Functionality was assessed using the Nine-Hole Peg Test (9HPT).

Results

The GBE group showed a significant increase in grip strength (p < .001) and pinch strength (p < .001) compared to baseline, while no significant changes were observed in the CG. Additionally, the GBE group demonstrated a significant improvement in tactile gnosia as assessed by the 2PD test (p < .001). Furthermore, a significant improvement in functionality, as indicated by decreased 9HPT completion times, was observed in the GBE Group (p < .001).

Conclusions

Game-based exercises have a positive effect on upper extremity muscle strength, tactile gnosia, and functionality. These findings suggest that incorporating GBE into rehabilitation programs may be beneficial for individuals seeking to improve upper extremity function. Further research with larger sample sizes and longer durations is recommended to validate these findings and explore their long-term effects.
Nursing students’ pain management self-efficacy and attitudes toward pain assessment
Authors: Gülnar Emel , Bıyık Bayram Şule , Çalışkan Nurcan
Published: February 2025

Background

How well nurses assess pain depends on their knowledge, behavior, attitude, self-efficacy, and clinical decision-making skills.

Objective

This paper investigated nursing students’ pain management self-efficacy and attitudes toward pain assessment.

Methods

This descriptive study was conducted in three public universities in Türkiye between March and June 2023. The sample consisted of 484 nursing students. Data were collected using a personal information form, the Attitude Towards Pain Assessment Scale (ATPAS), and the Pain Management Self-Efficacy Questionnaire (PMSEQ).

Results

Participants had a mean PMSEQ and ATPAS score of 72.03 ± 17.13 and 59.61 ± 8.66, respectively. Fourth graders had significantly higher mean PMSEQ and ATPAS scores than other grades. Participants who had received training in pain management before had significantly higher mean PMSEQ and ATPAS scores than those who had not. Participants who always encountered patients in pain had significantly higher mean PMSEQ and ATPAS scores than those who did not. Participants who used pain scales had significantly higher mean PMSEQ and ATPAS scores than those who did not. Participants who always assessed pain had significantly higher mean PMSEQ and ATPAS scores than those who did not. Participants who believed pain assessment was absolutely necessary had significantly higher mean PMSEQ and ATPAS scores than those who did not. There was a weak positive correlation between PMSEQ and ATPAS scores.

Conclusion

Nursing students have compatible pain assessment self-efficacy and positive attitudes toward pain assessment. As nursing students become more capable of assessing pain, they develop more positive attitudes toward it.
The neck flexion angle increases with difficulty of tasks performed on a smartphone
Authors: Arii Hironori , Tazawa Masayuki , Ibe Yoko , Nakao Yumiko , Toyama Risa , Miyashita Keisuke , Wada Naoki
Published: February 2025

Background

In recent years, smartphones have become popular worldwide and are used in daily life. Consequently, the musculoskeletal discomfort associated with smartphone use has become a problem. Neck pain, also known as text neck syndrome, develops due to neck flexion posture.

Objective

The present study determined how the neck flexion angle increases with the difficulty of a task performed on a smartphone. This study also assessed the factors associated with the neck flexion angle while using a smartphone.

Methods

Subjects were 24 healthy adults. Using the VICON motion analysis system, neck flexion angles while using a smartphone were measured under three conditions: normal standing (control), standing while watching a video (watching), and standing while typing (typing).

Results

The neck flexion angles (mean ± standard deviation) were 0.71 ± 7.05° for the control, 26.02 ± 6.28° for watching, and 30.52 ± 7.83° for typing, indicating a significant difference (p < 0.001). Significant differences were also observed between the control-watching, control-typing, and watching-typing conditions (p < 0.001). A correlation was found between average daily smartphone usage time and the neck flexion angle of typing (r = 0.531, p = 0.008).

Conclusions

The neck flexion angle increased with the difficulty of the task performed on the smartphone. People with a longer average daily smartphone usage time were more likely to adopt a neck flexion posture while using their smartphones than those with a shorter average usage.
The effects of workplace violence and work-to- family conflict on job engagement of nurses: A multilevel longitudinal research
Authors: Mehtap Özge , Kökalan Özgür
Published: February 2025

Background

Workplace violence in hospitals has been a longstanding concern, and in recent years, it has been on the rise. This research specifically examines this issue as it pertains to nurses. The violence they encounter and the work-family conflict (WFC) resulting from the difficulties in their work environment both play roles in diminishing their work engagement.

Objective

The aim of this study is to reveal the impact of workplace violence (WV) and WFC on the work engagement (WE) of nurses by conducting a longitudinal research design.

Methods

Convenience sampling was used. The study includes 52 nurses working in a private hospital in the province of Kocaeli. Participants were required to fill out daily-level surveys at the conclusion of each workday for continuous period of 5 days. A daily short form of Utrecht Employment Engagement Scale (UWES), daily Work to Family Conflict Scale developed by Netemeyer, Boles & McMurrian in 1996, and Workplace Violence Scale was developed by Chen et al. in 2004 were used to form questionnarie. Cronbach's alpha score for scales across 5 consecutive days ranged from .70 to 0.76. All scales were accepted as reliable.

Result

Correlation results showed that WV and WFC had a significant relation with WE. It is also seen that there is a positive association between WV and WFC. WV and WFC are supported to negatively affect WE of nurses

Conclusion

Health care institutions should develop practices that will reduce workplace violence and eliminate the causes of workplace violence.
Psychosocial impact and rehabilitation strategies for basketball-related injuries: SEM-PLS analysis
Authors: Yao Zhihong , Al-Hashimy Hisham Noori Hussain , Yao Jinfang
Published: February 2025

Background

This study explores the psychosocial impact of sports-related injuries on elite basketball players and their search for psychological and counselling support.

Objective

The objective is to examine how injuries affect athletes’ mental well-being, their attitudes toward received support, and their use of psychological interventions.

Methods

A phenomenological approach, analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM), was applied to data from 253 elite Turkish basketball players, including active and retired athletes. A structured questionnaire was administered to gather the data.

Results

The results show that while athletes seek individual psychological support, they often feel neglected by their clubs, leading to insecurity and helplessness. Many report dissatisfaction with the mental health services provided by their organisations.

Conclusions

The study recommends integrating sports psychologists and counsellors within clubs, promoting mental health awareness, and forming interdisciplinary teams to address this. Holistic sports education programs that foster psychological resilience and emotional regulation are also advised. Further research is needed to assess the long-term effects of interventions and the role of organizational support on athletes’ mental well-being.
Trend analysis of occupational accidents during 2013–2020 based on various characteristics in Turkey
Authors: Isik Volkan , Isikhan Selen Yilmaz
Published: February 2025

Background

This study analyzes the role of factors such as gender, age, and work experience on occupational accidents and the sectoral variations in Turkey with official statistics.

Objective

The specific aim of this study is to provide an epidemiological basis for gender, age, sector, and professional experience-specific work-related accident prevention programs.

Methods

Turkish Social Security Institution's official secondary dataset was considered for 2013 and later because of a change in the official calculation method of the Institution in 2013. Trend analysis was used by using the Mann-Kendall Test to determine the trend in occupational accidents based on time and work experience (month-year).

Results

In the eight sectors considered between 2013 and 2020, including construction, manufacturing, transport, mining, communication, health, electricity, and agriculture, 82% of injured workers were men, with the most accidents occurring in the 25–34 age group (33%). Manufacturing had the highest number of accidents (58.5%), followed by construction (19.4%). Occupational diseases were most common in manufacturing, affecting 73% of men and 63% of women. Accidents occurred mainly in men aged 25–34 (34.2%) and women aged 35–44 (29.3%). Occupational diseases showed a positive, statistically significant trend as work experience increased (p < 0.05). A positive and statistically significant trend was detected in occupational accidents from 2013 to 2020 (Tau = 0.786, p = 0.009).

Conclusions

In countries like Turkey, where informal employment obscures occupational accidents, trend analysis helps increase their visibility. However, discovering that gender, age, and work experience are key factors in sector-specific accidents is crucial for improving safety and developing prevention programs.
Exploring safety risk factors temporal combination path of metro construction projects: A temporal qualitative comparative analysis in China
Authors: Wu Xiuyu , Dong Shaoqing , Li Yuan
Published: February 2025

Background

The diverse safety risk factors and their complex correlations in metro construction projects are important reasons for frequent safety accidents. However, existing studies have not yet explained fully the relationship among safety risk factors from the perspective of the sequence of factors.

Objective

The main objective of this study is to explore the temporal combination path of safety risk factors of metro construction projects.

Methods

The data are 80 metro safety accidents collected manually from the websites of government departments where the accidents occurred covering 18 provinces in China from 2007 to 2023. Grounded theory analysis was used to extract safety risk factors from accident reports, and temporal qualitative comparative analysis (TQCA) was used to explore the temporal combination path of safety risk factors.

Results

There are two kinds of temporal combination paths of safety risk factors for severe safety accidents, i.e., “environmental risk - equipment risk- management risk” and “management risk - environmental risk - equipment risk - worker operational risk”. While there are five kinds of temporal combination paths of safety risk factors for general safety accidents, namely “management risk - equipment risk”, “management risk - worker operational risk”, “worker operational risk - management risk”, “equipment risk - management risk - worker operational risk”, “environmental risk - management risk - worker operational risk”.

Conclusions

There is a typical temporal combination path of safety risk factors in metro construction safety accidents. These findings suggest that safety accidents can be effectively prevented by cutting off the path of safety risk factors.
Psychosocial demands of subordinate work in delivery platform companies: Control procedures and effects on the health of delivery workers
Authors: Siqueira Janaína Santos de , Lima Francisco de Paula Antunes , Pena Paulo Gilvane Lopes , Diniz Eugênio Paceli Hatem , Werneck Guilherme Loureiro , Fernandes Rita de Cássia Pereira
Published: February 2025

Background

The management of precarious work of delivery workers (DW) by delivery platform companies (DPC) incorporates technologies that deepen the subordination of this workforce. The demands placed on DW to carry out their tasks can compromise their health.

Objective

To analyze the contradictory demands of work subordinated to DPC and their repercussions on health, as opposed to the regulation strategies adopted by DW to prevent illnesses and accidents.

Methods

A situated analysis of the activity of DW was carried out based on the assumptions of Ergonomic Work Analysis in Salvador, Bahia, Brazil, in 2022. General and systematic observations were carried out, emphasizing the tasks of waiting for and receiving delivery orders and collecting goods, as well as self-confrontation interviews with DW.

Results

DPC are new spaces for the exploitation and precariousness of work, still operating without regulation. DPC use technology to restrict decision-making and intensify work. This increases insecurity by reducing the spaces for regulation in the face of the unpredictability of street work and the pressure of low remuneration. Consequently, there are psychosocial and physical demands associated with work accidents and illness.

Conclusion

Expanding the autonomy of these workers in terms of managing their own work and eliminating mechanisms that promote its intensification are measures required to prevent accidents and illness.
Assessment of mental workload states in monitors using functional near-infrared spectroscopy
Authors: Wang Yuzhen , Yu Ruifeng , Shi Tongyu
Published: February 2025

Background

As technology develops rapidly and complex systems become more widespread, the study of mental workload (MWL) for monitors has become increasingly important.

Objective

To explore the signaling features of functional near-infrared spectroscopy (fNIRS) in different MWL states.

Methods

Twenty participants performed the N-back task and fNIRS data were collected to measure changes in blood oxygenation levels in the prefrontal cortex. Additionally, performance metrics and NASA Task Load Index (NASA-TLX) questionnaire results were recorded.

Results

NASA-TLX scores increased progressively from 0-back ( M = 8.750) to 1-back ( M = 34.792), 2-back ( M = 52.292), and 3-back ( M = 75.625). Significant differences were observed in oxygenated hemoglobin (HbO) concentrations ( F3, 57 = 10.557, p < 0.001) across these tasks. HbO increased from 0-back ( M = -0.008) to 1-back ( M = -0.002) and 2-back ( M = -0.001), but decreased to 3-back ( M = -0.002). Channels CH16, CH17, and CH18, located in the left dorsolateral prefrontal cortex (DLPFC), were significantly activated in the 1-back, 2-back, and 3-back conditions. CH1 and CH2, which are located in the right DLPFC, showed significant activation in both the 2-back and 3-back tasks.

Conclusions

Our results showed that different levels of the N-back tasks triggered different MWL states. Significant differences in HbO concentrations and activated channels were observed across tasks with varying MWLs. HbO followed an “inverted U” pattern, increasing as the MWL shifted from underload to normal, and subsequently decreasing as it reached overload. Additionally, the left DLPFC was activated earlier than the right DLPFC, with the latter gradually engaging as the MWL increased. This study provides valuable insights into the assessment of MWL states.
Low back activity confidence scale: Cross-cultural adaptation, reliability, and validity of the Turkish version in individuals with non-specific low back pain
Authors: Arikan Halime , Çoban Tuğçe
Published: February 2025

Background

The Low Back Activity Confidence Scale (LoBACS) was developed to evaluate self-efficacy in individuals with low back pain (LBP).

Objective

This study aimed to assess the psychometric properties of Turkish version of LoBACS in individuals with non-specific LBP.

Methods

The study included 105 participants (66 female, 39 male) with a mean age of 40.94 ± 14.65 years. The cultural adaptation and psychometric evaluation of LoBACS followed international standards and COSMIN guidelines. Reliability was assessed using the Cronbach's α and Intraclass Correlation Coefficient (ICC). Structural validity was tested with Confirmatory Factor Analysis (CFA). Pearson correlation analysis examined the relationships between LoBACS and the Waddell Disability Index (WDI), Modified Oswestry Disability Index (MODI), Roland Morris Disability Questionnaire (RMDQ), International Physical Activity Questionnaire (IPAQ), Short Form-36 (SF-36), Fear Avoidance Beliefs Questionnaire (FABQ), and Visual Analog Scale (VAS).

Results

The Turkish version of LoBACS showed high reliability (ICC = 0.850, Cronbach's α = 0.919). CFA and fit indices supported its validity. Correlations between LoBACS and other measures ranged from −0.192 to 0.542. No floor or ceiling effects were noted.

Conclusion

The Turkish version of LoBACS is a reliable and valid tool for assessing self-efficacy in individuals with non-specific LBP, suitable for both research and clinical settings.
Incidence and Factors Associated With Nonunion following Naviculocuneiform Joint Arthrodesis
Authors: Kim Jaeyoung , Sadlowski Max , Vier David , Reddy Veerabhadra , Royer Christian , Brodsky James , Zide Jacob
Published: February 2025

Background:

Nonunion following naviculocuneiform (NC) joint arthrodesis is a well-recognized complication. Most studies reporting nonunion rates involve a limited number of cases or focus on a single disease entity. Moreover, there is variation between studies with regard to the number of articular facets included in the arthrodesis as well as the fixation construct used, with no clear evidence indicating how these factors influence union. This study, using the largest cohort to date, aims to investigate the nonunion rate following NC joint arthrodesis and to identify demographic and surgical factors associated with nonunion.

Methods:

One hundred ten feet in 100 patients who underwent NC joint arthrodesis between 2016 and 2023 at a single institution were retrospectively identified. The indications for surgery included osteoarthritis (n = 89), deformity (n = 10, flatfoot or cavus), and rheumatoid arthritis (n = 11). Charcot arthropathy was excluded. Nonunions were defined by radiographic review and were further categorized as symptomatic or asymptomatic. Demographic and surgical factors, including isolated medial NC facet vs multiple NC facet arthrodesis, fixation construct, concurrent arthrodesis of other joints, and type of bone graft used, were included in the regression analysis to determine their association with nonunion.

Results:

The overall nonunion rate was 27.3% (30/110 cases), with 15.5% (17 cases) presenting as symptomatic nonunions. There were no significant differences in the nonunion rates among different indications for NC arthrodesis ( P = .9404). A statistically significant difference in nonunion rates was observed between patients undergoing isolated medial facet arthrodesis (38.2%) and those undergoing multiple facet arthrodesis (16.4%, P = .0102). After performing multivariate analysis adjusted for potential confounders, age (OR 1.08, 95% CI: 1.0-1.16, P = .0456), diabetes (OR 12.70, 95% CI: 1.24-130.3, P = .0324), and isolated medial NC facet arthrodesis (OR 17.48, 95% CI: 3.23-94.54, P = .0009) were significantly associated with nonunion. No significant association with nonunion was identified based on the type of bone graft, fixation construct, or whether concurrent arthrodesis of adjacent foot joints was performed.

Conclusion:

This study demonstrates a significant rate of nonunion following NC joint arthrodesis, exceeding that previously reported. We found that the rate of nonunion significantly increased in arthrodeses involving only the medial NC facet as compared to those including multiple NC facets.
Testing the Durability of Persuasion From Moral Appeals About Renewable Energy
Authors: Gustafson Abel , Goldberg Matthew H. , Lee Sanguk , Remshard Miriam , Luttrell Andrew , Rosenthal Seth A. , Leiserowitz Anthony
Published: February 2025

Research shows that opinions rooted in moral justifications may be more stable over time. This suggests that communicators could create more durable persuasion by adding explicit moral claims (i.e., stating that the issue is a matter of right vs. wrong) to persuasive messages. Here, using animated videos about the transition from fossil fuels to renewable energy, we conducted a three-stage longitudinal experiment ( N = 4,488) to test whether messages with explicit moral claims have more durable persuasive effects than similar messages without. We replicated this test across two distinct moral dimensions: harm to innocent people and contamination of nature’s purity. Our findings show that all message versions had strong immediate persuasive effects relative to a control condition, and much of those effects remained after a 3-week period. However, there were no clear advantages—in immediate effects or in durability—from adding explicit moral claims to the messages.
The effect of Bevacizumab treatment on the incidence of hypertension in patients with ovarian cancer: a systematic review and meta-analysis
Authors: Zhang Xiaoyan , Hu Jumei , Fan Xijing , Chen Qiaoqiao , Zheng Danjun , Huang Minjuan , Xu Yuanqing
Published: February 2025

Introduction

This study aims to evaluate the effect of bevacizumab treatment on the incidence of hypertension in patients with ovarian cancer.

Methods

A comprehensive search of PubMed, Scopus, Embase, Cochrane, Web of Science, and Google Scholar databases was conducted until August 2024. We included only randomized clinical trials that compared ovarian cancer patients treated with Bevacizumab to those treated with other therapies. The primary outcome was the relative risk (RR) of developing hypertension, stratified by grade. Statistical analyses were performed using a random-effects model to account for heterogeneity between studies. Subgroup analyses were conducted based on hypertension severity (grade ≥2 and grade ≥3) and disease stage. Sensitivity analyses and publication bias assessments were also performed.

Results

A total of 11 randomized trials were included, comprising 5212 patients. The meta-analysis revealed that patients receiving Bevacizumab had a significantly higher risk of hypertension compared to controls (RR = 2.91, 95% CI: 1.65–5.16, P = 0.0002). Subgroup analysis showed that the risk of grade ≥2 hypertension was 1.68 times higher (95% CI: 0.92–3.07), and grade ≥3 hypertension was 5.10 times higher (95% CI: 2.46–10.55) in the Bevacizumab group. Sensitivity analysis confirmed the robustness of these findings, and no significant publication bias was detected.

Conclusion

Bevacizumab treatment in ovarian cancer significantly increases the risk of hypertension, particularly severe hypertension (grade ≥3). These findings underscore the need for vigilant blood pressure monitoring and management in patients receiving Bevacizumab to mitigate cardiovascular complications and optimize treatment outcomes.
Sovereign budyaan flying together: sovereign relationships across the Wiradyuri PhD journey
Authors: Russ-Smith Jessica , Green Sue , Orchard Christopher
Published: February 2025

First Nations sovereignty is core in supporting research experiences of First Nations PhD students. This article is based upon the relationality of three sovereign budyaan (birds), and the sovereign Wiradyuri (sovereign First Nations in so-called New South Wales, Australia; also spelt or referred to as Wiradjuri) cosmology, by exploring a Wiradyuri Wambuul (Macquarie River Clan of the Wiradyuri Nation in so-called New South Wales, Australia) scholar’s experiences with her two sovereign yalmambildhaany (teachers), connect with Wiradyuri concepts of teaching, speaking and Country. Yalmambildhaany guide and support the First Nations researcher to learn from Country, ancestors, buyaa (Wiradyuri cultural law) and songlines to ensure their research embodies sovereignty. This article highlights the importance of sovereign research for First Nations peoples and the need to centre First Nations cosmologies.
EXPRESS: Is trypophobia more related to disgust than to fear? Assessing the disease avoidance and ancestral fear hypotheses
Authors: Thiebaut Gaëtan , Méot Alain , Prokop Pavol , Bonin Patrick
Published: February 2025

We examined fear and disgust responses in trypophobia in order to distinguish between two hypotheses concerning the origin of this phenomenon. According to the hypothesis that trypophobia stems from an ancestral fear of dangerous animals, fear predominates over disgust, whereas the opposite is true according to the disease aversion hypothesis. Currently, the question of which of the two plays a more significant role in trypophobia remains unclear. Adults had to rate on Likert scales their level of disgust and fear when presented with photographs of frightening or disgusting stimuli, trypophobia-inducing stimuli, i.e., clusters of holes, or neutral stimuli. They also had to rate the difficulty of viewing these images. Higher levels of disgust than fear were found for the trypophobic images in both the overall sample and in the participants reporting the highest levels of discomfort when viewing them. Trypophobic images had a special status for these latter participants, as they were rated more disgusting than non-trypophobic disgusting images and more frightening than non-trypophobic frightening images. Although disgust is the dominant emotion in trypophobia, fear is also not negligible.
Young People’s Experiences of Transitioning Out of Care in India: Convergence of Two Frameworks
Authors: Modi Kiran , Kalra Gurneet Kaur , Prasad Leena
Published: February 2025

Aftercare youth or care leavers are amongst the most vulnerable section of the youth population but they have immense potential and require support and guidance to become resilient and independent citizens who can give back to society. This study aims to highlight the challenges faced by care leavers due to the absence of or inadequate aftercare support during the transition, which increases care leavers’ vulnerabilities to homelessness, unemployment, substance misuse and ruptured social relationships. This research using a mixed-method approach with a descriptive research design involved the participation of 435 care leavers and 100 key informants, including government functionaries, duty-bearers and civil society practitioners. The findings stated that upon turning 18 years of age, youth transitioning out of childcare institutions to independent life in India experience many challenges, such as securing housing and identity documents; accessing education, skill development and employment opportunities; garnering psychosocial support and financial stability. It also found that continued aftercare support is necessary to foster independent living skills in these young people and enable their reintegration into mainstream society. While exploring the continuum of care approach from childcare to aftercare, the researchers developed the concept of a ‘Sphere of Aftercare’ ( Beyond 18, 2019 ), comprising eight domains of support that are considered essential for a successful transition. This article highlights some of the case studies based on the interviews conducted with the respondent care leavers during this study. It uses two frameworks for analysis, namely the ‘Sphere of Aftercare’—developed as a result of the national study along with Udayan Care’s 28 years of experience as practitioners, and second the ‘Resilience Framework’ ( Stein, 2006 )—by Professor Mike Stein for outcomes as a care leaver. The study revealed a lack of transition planning at the level of childcare institutions and functionaries and a general lack of understanding of the holistic needs of youth in aftercare throughout the eight identified domains of the ‘Sphere of Aftercare’. The study also found an absence of clarity in stakeholders about their roles; a lack of data management with regard to the number of youth leaving care, leading to inadequate budget planning; and a lack of adequate monitoring mechanisms to assess care leavers’ outcomes. In light of this study’s findings, policy reforms and ways of developing robust aftercare programmes are recommended in relation to policy, practice and law, including the introduction of an Individual Aftercare Plan, increasing budget allocation for care leavers’ aftercare support and strengthening the voices of care leavers.
Predictors and outcome of deterioration during admission in patients with cerebral venous thrombosis
Authors: Ferro Margarida , Bettencourt Sofia , Soares Mafalda , Baptista Mariana , Marques-Matos Cláudia , Fragata Isabel , Paiva Nunes Ana , Aguiar de Sousa Diana
Published: February 2025

Introduction:

Cerebral venous thrombosis (CVT) is a less common stroke subtype. While long term outcome factors have been extensively studied, short term deterioration remains poorly understood.

Patients and methods:

We conducted a 10-years retrospective analysis at a high-volume tertiary center, including consecutive patients diagnosed with CVT. The primary outcome was early deterioration (ED), defined as decrease in Glasgow Coma Scale, de novo or worsening of focal deficit, death from neurological cause, new or enlarged parenchymal lesions or subarachnoid hemorrhage during hospitalization. Multivariable logistic regression analysis was performed to identify factors associated with ED.

Results:

We included 138 patients (81.2% female, median age 42.0 years (IQR 29.3–49.0)). Forty-five (32.6%) patients had ED, with 33 (23.9%) showing clinical deterioration and 35 of 104 (33.7%) imaging worsening. Variables selected from the multivariate model for association with ED were aphasia (OR 4.63, 95% CI 1.61–13.32), motor deficits (OR 2.34, 95% CI 0.97–5.61), and parenchymal lesion (OR 3.65, 95% CI 1.38–9.67). Twenty-seven patients underwent endovascular treatment after deterioration. Patients in the ED group had worse functional outcome at discharge, 6 and 12 months ( p < 0.001).

Discussion:

One third of patients in this cohort experienced ED. Patients with aphasia, motor deficit, or parenchymal brain lesion at baseline were at higher risk. These patients performed worse at long term follow-up.

Conclusion:

We identified predictors of ED in patients with CVT. These patients should be carefully monitored. These findings may inform the design of future clinical trials aimed at evaluating additional therapeutic interventions in the acute phase.
The Professional Becoming Political: Exploring Predictors of Engagement with Professional Activism in Portugal
Authors: Costa Ana Luísa , Vaz Henrique , Menezes Isabel
Published: February 2025

This study aims to understand what drives professional activism (PA) among professionals working in educational, social and community intervention with people in situations of vulnerability. Even though PA (e.g., advocacy, policy practice and social justice activism) is valued in literature and ethical-professional guidelines, it is not a recognised and transversal practice in the field. Furthermore, the literature exploring the subject is limited in terms of considering the commonalities inherent to different professions and areas of intervention dealing with vulnerability and studying the topic in Portugal. As such, a solid need exists to problematise and understand everyday engagement with PA, its tactical variety and what underpins the professional activist repertoire. Drawing on previous research findings, this study’s purpose was pursued through quantitative research with a group of 338 professionals working in this field. Multiple linear regression analyses allowed us to identify four models that could explain professional engagement with diverse forms of PA and suggest the influence of personal and psychological, as well as social and contextual elements. The analysis has implications for preparing professionals for political activism to realise social justice for people in situations of vulnerability.
Predictors of Functional Outcome at 1 Year After Stroke: Analysis of INTERSTROKE Data from Pakistan
Authors: Awan Safia , Wasay Mohammad , Iqbal Romaina , Ali Ali N. , Yusuf Salim , Donnell Martin O.
Published: February 2025

Background and Objective

Identification of early and long-term outcomes after stroke is important in stroke management strategies. The aim of this study was to analyse predictors of independence and functional outcome at 1 and 12 months post-stroke.

Methods

This was a prospective study of patients with first stroke who were enrolled between April 2013 and July 2015 from a single-centre tertiary care hospital in Pakistan. Patients were followed up at 1 and 12 months and assessed using the modified Rankin scale (mRs).

Results

A total of 395 patients with acute first strokes were enrolled. Stroke dependency (mRs score 3-5) was higher in our site at 1 month. At 1 month, 137 (34.6%) of the participants were independent (mRs 0-2), 54.1% ( n = 214) were dependent (mRs 3-5) and 11.1% ( n = 44) died. At 12 months, 86% ( n = 303/351) completed the follow-up. Of 303 participants, 35.3% ( n = 107) were independent (mRs 0-2), 35.6% ( n = 108) were dependent (mRs 3-5) and 29% ( n = 88) had died. Forty-eight patients (14%) were lost to follow-up. Overall mortality was 33% (132/395) in 1 year. At 12 months, no comorbidities (OR 3.26; 95% CI: 1.48-7.21) and normal level of consciousness at onset (OR 3.44; 95% CI: 1.93-6.12) were associated with greater post-stroke independence (mRs 0-2). Out of 395, 111 (28.1%) patients with no or minimal disability at 1 month (mRs 0-2), 32.4% showed worsening of disability (mRs 3-5) at 12 months.

Conclusion

At 1 year, 33% died and 36% were dependent. A large number (60%) of patients with minimal disability at 30 days worsened or died at 1 year.
Endoscopic Proximal Hamstring Repair Using a Modified Whipstitch: A Technical Note
Authors: Cotter Eric J. , Kazi Omair , Vogel Michael J. , Nho Shane J.
Published: February 2025

Background:

Tearing of the proximal hamstring tendon is a common injury in athletes for which surgical repair is being increasingly utilized. The described techniques for endoscopic repair employ a simple or mattress suture configuration. We hypothesize that the incorporation of a running modified whipstitch may allow for increased suture purchase and sturdier tendon fixation.

Indications:

Patients with partial tears, 2-tendon tears and >2 cm retraction, or 3-tendon tears refractory to conservative management are typically indicated for surgery.

Technique Description:

In the prone position, 2 portals are established in the gluteal crease. Neurologic structures such as the posterior femoral cutaneous nerve and the sciatic nerve are visualized. The ischium is decorticated, and a triple-loaded suture anchor is placed in the ischial tuberosity. Using a tissue penetrator and a suture-passing device, a modified whipstitch suture configuration is constructed to secure the torn tendons.

Results:

Overall, following endoscopic surgical repair, most patients demonstrate improvement in functional outcomes metrics and achievement of patient acceptable symptom state in >70% of cases. Return-to-sport rate between 77.3% and 95% has been described in the literature.

Discussion/Conclusion:

Open repair utilizes a running suture configuration, whereas endoscopic repair has traditionally been performed with simple or mattress constructs. A modified whipstitch, performed endoscopically, may provide the durability of open repair with decreased rates of perioperative complications associated with endoscopic repair. Further work comparing suture techniques and postoperative outcomes should be investigated.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Evolving Landscape of Ad Hoc Arbitration in China: Recent Developments in Shanghai and Proposed Revisions to the Arbitration Law
Authors: Xie Dan , Ho Weng Si
Published: February 2025

This paper examines the evolving landscape of ad hoc arbitration in China, focusing on developments in Shanghai and the proposed revisions to the Arbitration Law. It begins with a brief overview of the current legal regime governing Chinese arbitration, highlighting the dual-track system for purely domestic and foreign-related (including foreign) ad hoc arbitration. It then explores the prohibition of purely domestic ad hoc arbitration, delving into the historical and political reasons behind this stance. Next, the paper analyses recent developments in Shanghai and the proposed revisions to the Arbitration Law concerning the validity of foreign-related ad hoc arbitration. It further discusses the enforceability of foreign ad hoc arbitration awards and Chinese practices under the New York Convention. Finally, Section Five concludes the paper.