bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Insomnia by Zopiclone in Older Adults Hospitalized in a Geriatric Hospital: A Retrospective Study
Authors: Lebreton Helena , Ladjouzi Nadia , Raveloson Hendriniaina , Lopez-Leret Diana , Schlatter Joël
Published: January 2025

Background

Insomnia is a significant public health problem that can affect up to 50% of older adults. Pharmacological treatments are commonly used such as benzodiazepines (BZD) and related Z-drug zopiclone.

Purpose

The objective of this study was to investigate the use of zopiclone under real-life clinical conditions.

Materials and Methods

A retrospective review of older patients was conducted in a French geriatric hospital. The eligible participants included patients aged 65 years and older who had received zopiclone as a hypnotic. The presence of indication, the dosage and duration of zopiclone, the reevaluation of the treatment, the reason for discontinuation, and the combination with BZD were assessed.

Results

The study included 30 subjects (mean age 84.6 ± 9.3 years), 90% of whom received zopiclone 3.5 mg and 10% zopiclone 7.5 mg. In 60% of cases, no indication of insomnia was found. At discharge, more patients received a combination of zopiclone and BZD. The drug reassessment was initiated in only nine patients.

Conclusion

The treatment of insomnia with zopiclone is usually prescribed for long-term periods in older adults with less need for reevaluation. More long-term data on side effects and therapeutic efficacy are needed in routine clinical practice.
Epidemiology of Cancer in the Fiji Islands: 2010 to 2018
Authors: Naidu Carol Kartika , Wiseman Nicola , Nand Devina , Harris Neil
Published: January 2025

Cancer is a global public health concern with increasing incidence and mortality rates, particularly in low- and middle-income countries (LMICs) like the Pacific Island Countries and Territories (PICTs). Among the PICTs, Fiji faces a growing burden of cancer. This study aimed to analyze cancer incidence and mortality data in Fiji from 2010 to 2018 to identify trends and provide an update on the current cancer-related statistics in the Fiji Islands. The top three cancer incidence rates among women were breast, cervical, and endometrial cancer, whereas prostate, liver, and lung cancer were the most prevalent among men. Notably, the central division had higher cancer incidence rates, whereas the northern division had a disproportionately higher mortality rate. Factors contributing to these trends may include lifestyle behaviors, limited access to health care in certain regions, and low awareness. Although this study has limitations due to data quality, it emphasizes the need for targeted interventions, accurate data reporting, and improved cancer treatment delivery to reduce the burden of cancer in Fiji.
Prognosis after one- and two-stage revision surgery for periprosthetic joint infection: A systematic review and meta-analysis
Authors: Sun Yiyuan , Liu Menghao , Xiao Dan , Li Qi , Xiong Huan , Luo Xue , Zhu Boyu , Fu Weili
Published: January 2025

Objective

Revision surgeries for periprosthetic joint infections (PJIs) in arthroplasty can follow either one- or two-stage treatment protocols. Previous studies have reported similar reinfection rates and reductions in complication rates for both treatment options. However, the literature on the selection of one protocol is still controversial. Thus, our aim was to compare the outcomes, including reinfections, complications, reoperations, and mortality, associated with one- and two-stage revision surgeries for PJI via a systematic review and meta-analysis of comparative studies.

Methods

Comparative studies were identified through searches in PubMed, EMBASE, the Web of Science, and the Cochrane Library as of November 2023. RevMan version 5.3 was used for the analyses. The included studies directly compared one-stage revisions with two-stage revisions for PJI. The primary outcomes included reinfection, complications, reoperation, and mortality.

Results

Sixteen cohort studies (fifteen retrospective and one prospective) were included in the systematic review. All studies comprising 2039 patients were included in the meta-analysis. Fourteen studies reported reinfection patient risk postrevision; when pooled via random effects models, 10.02% of patients in the one-stage group and 14.75% of patients in the two-stage group were reinfected, indicating low heterogeneity (risk ratio = 0.69; 95% CI = 0.50 – 0.94, I2 = 0%). A pooled analysis of ten studies reported complications between the two groups. Compared with the two-stage group, the one-stage group was associated with significantly fewer complications (risk ratio = 0.76; 95% CI = 0.63 – 0.91, I2 = 27%). The meta-analysis revealed no significant difference in reoperation events between the 1st-stage and 2nd-stage groups in nine studies (risk ratio = 0.77; 95% CI = 0.59 – 1.01, I2 = 20%) or in mortality in ten studies (risk ratio = 0.93; 95% CI = 0.49 – 1.78, I2 = 0%).

Conclusions

Among the available observational studies, the meta-analysis revealed a lower incidence of reinfection and complications in the one-stage group than in the two-stage group, but there were no significant differences in reoperation events or mortalities.
The power of the right to an effective remedy to horizontalize DirectivesComment on Case C-715/20, X (Absence de motif de résiliation), 20 February 2024
Authors: Robin-Olivier Sophie
Published: January 2025

This note provides insight into the innovative use of the right to an effective remedy in the case X (Absence de motif de résiliation), which enables the horizontal application of the equal treatment provision contained in Directive 1999/70 on fixed-term work. After recalling the weaknesses of the protection of precarious workers under Directive 1999/70, especially when the Directive has not been correctly implemented by a Member State, and is thus deprived of horizontal direct effect, it focuses on the power of the right to an effective remedy, illustrated by the decision, and suggests that this decision can be the catalyst for a significant extension of the horizontal effect of Directives.
The Impact of a Global Mobility Program: The Lenses of ‘Future Self ’ and ‘Realised Self’
Authors: Harbon Lesley , Liu Chang
Published: January 2025

This article reports on the case of returnees from a student global mobility program, their recollections of motivation to apply to participate and their perceptions of the impact of that mobility experience 25 years later. The article outlines the original goals of the program, describing the scope and nature of the international experiences for the pre-service teachers from the state of Tasmania, Australia and the province of West Sumatra, Indonesia. Qualitative data from individual interviews with 14 of the 22 returnees 25 years after the exchange are presented. Our conclusions point to the students realising their achievement of intended benefits of the exchange, seen through ‘future self’ and ‘realised self’ lenses. We also present an extended definition of one particular benefit of student global mobility, termed ‘cultural appreciation’, allowing the conceptual understanding of this particular documented benefit of internationalisation of the university curriculum to be broadened.
Assessment of a semiquantitative scoring system for mild-to-moderate gill lesions in Atlantic salmon reared in recirculating aquaculture systems in Norway
Authors: Amlie Thomas , Dalum Alf , Stormoen Marit , Evensen Øystein
Published: January 2025

Compromised gill health is a critical cause of forfeited welfare in Atlantic salmon farming. Detecting and quantifying the early onset of gill disease is important to reveal initial inflicting stimuli. We collected gill samples of 45 Atlantic salmon from 2 commercial recirculating aquaculture systems (RASs) spanning fry-to-market-size fish with no clinical signs of gill disease. Gill samples were assessed histologically by 3 independent raters with different levels of experience. Semiquantitative scoring for 7 types of gill changes was carried out for 10 filaments per gill (450 filaments total) over 3 rounds on anonymized samples. Scores were summarized for each type of gill change. The assumed clinical relevance for each change was transformed into a category score, followed by an assessment of agreement within (intra) and between (inter) raters. A generalized linear model estimated the difference in score levels between raters. For each rater, intra-rater agreement was high for 6 gill changes and moderate for 1 gill change. Inter-rater agreement was moderate to almost-perfect, except for 2 gill changes; generalized linear model regression revealed systematic differences in score usage between the raters. Our scoring protocol worked satisfactorily for mucous cell amount, lamellar clubbing, lamellar hypertrophy and/or hyperplasia, and aneurysms, despite different levels of expertise in histologic evaluation. Intra-rater agreement was consistent, but differences existed for interlamellar hypercellularity, lamellar inflammation, and degeneration. Scoring subclinical gill changes is a challenge, and our scoring system for mild-to-moderate lesions may enable early intervention to limit the detrimental effects of poor gill health in RAS farming.
Intoxication of sheep by Astragalus arequipensis in northwestern Argentina
Authors: Marin Raul E. , Gardner Dale , Cook Daniel , Armien Anibal G. , Fortunato Renée H. , Riet-Correa Franklin , Uzal Francisco A.
Published: January 2025

Spontaneous intoxication by Astragalus arequipensis was diagnosed in a flock of 300 sheep in Jujuy province, northwestern Argentina, that grazed an area heavily invaded by this plant. The main clinical signs were intention tremors, ataxia, and progressive loss of condition. Autopsy of 2 affected animals revealed loss of body condition. The main microscopic changes were fine cytoplasmic vacuolation of cells in the cerebrum, cerebellum, thyroid and adrenal glands, kidney, liver, pancreas, urinary bladder, and lymph nodes, and swollen axons in the cerebellum. Ultrastructurally, the cytoplasmic vacuoles consisted of dilated secondary lysosomes. Composite leaf and stem samples of A. arequipensis analyzed by high-performance liquid chromatography contained 0.05% swainsonine. The diagnosis of intoxication by A. arequipensis was made based on the clinical history and signs; gross, microscopic, and ultrastructural changes; and detection of swainsonine in the plant.
Canine cystic astrocytomas: 7 cases
Authors: Reyes Vicente A. Avila , Miller Andrew D. , de Lahunta Alexander , Summers Brian A. , Rissi Daniel R.
Published: January 2025

Tumoral macrocysts (grossly observable cysts) are common in human pilocytic astrocytomas but are rarely reported in canine astrocytomas. Here we describe 7 canine astrocytomas with macrocysts. The median age of affected patients was 9.6 y, and 2 dogs were brachycephalic. Clinical signs reported in 6 cases included head tilt (4 cases), falling (4 cases), and ataxia (3 cases). Gross changes consisted of well (5 cases) or poorly demarcated (2 cases), tan-to-pale-yellow masses with distinct, 2–10-mm fluid-filled cysts that expanded the cerebellum (4 cases) or telencephalon (3 cases). Histology and immunohistochemistry revealed low-grade astrocytoma in 6 cases and high-grade astrocytoma in 1 case. Neoplastic cells were elongate, formed bundles embedded in an eosinophilic fibrillary stroma, and had oval-to-elongate nuclei. Gemistocytic differentiation was common (4 cases). Cystic areas were lined by neoplastic astrocytes and were either apparently empty or contained scant, eosinophilic, proteinaceous material and a few neoplastic astrocytes, foamy macrophages, and occasionally other leukocytes. The mitotic activity was absent or low across cases. Cytoplasmic immunolabeling for glial fibrillary acidic protein was detected in 6 cases. Our findings indicate that canine cystic astrocytomas are rare (our cases span several decades) and are located mainly, but not exclusively, in the cerebellum.
Claim Suppression of Occupational Injuries and Illnesses Among Precariously Employed Immigrant Workers in Ontario
Authors: Premji Stephanie , Begum Momtaz , Laila Kishower
Published: January 2025

Employers sometimes hinder the appropriate reporting of claims to workers' compensation, a phenomenon termed claim suppression. While the magnitude of claim suppression is difficult to quantify, various reports have identified it as a significant concern. In response, several Canadian jurisdictions, such as Ontario in 2015, introduced legislation addressing claim suppression. This article first discusses the legislative and policy context that influences claim suppression in Ontario, including concerns concerning the scope, interpretation, and enforcement of the law. It then presents qualitative findings from a community-based study with members of the Toronto Bangladeshi immigrant community that documented varied forms of employer claim suppression in precarious work, as well as facilitators of claim suppression within the workers' compensation and health care systems. Our findings and those of other research suggest that the scope of claim suppression is broader than that contemplated by the legislation. Our article proposes recommendations for the conceptualization of claim suppression and for legislation, policies, practices, and interventions that are grounded in workers' lived experiences.
Actual Roles of Occupational Therapists in Palliative and Hospice Care: A Scoping Review
Authors: Güney Yılmaz Güleser , Yücel Hülya , Gintiliene Milda
Published: January 2025

Background

This study reviewed the role of occupational therapist’s in palliative and hospice care over the past 20 years.

Methods

A scoping review following Arksey and O'Malley’s five stages was undertaken using PubMed, OTseeker, Scopus, Elsevier, Cochrane Library-Medline, CINAHL, PsychInfo, Web of Science and Google Scholar.

Results

A total of 41 articles were reviewed. The most publications occurred in 2010, 2011, 2015, and 2023. The majority of the studies (48.7%) were of qualitative design. Various roles of occupational therapists have been defined in palliative care: discovering occupational meaning in the last periods of life and supporting occupational participation, management of persistent physical and psychological symptoms, especially pain and fatigue, improving or supporting the quality of life for individuals under palliative care, supporting mental well-being, supporting social participation, use of adaptive technologies, providing individuals with confidence and comfort. Occupational therapists also have various duties in maintaining palliative-hospice care at home include evaluating the individual at home and supporting home care and rehabilitation after discharge. Interventions for caregivers or supporting caregivers who have lost their roles, occupations or jobs in the care process are also among the roles of occupational therapists.

Conclusion

Occupational therapy within the context of palliative care aims to assist individuals in attaining their highest level of independence in important occupations. Occupational therapists play a crucial role in coordinating and facilitating safe transitions from the hospital to home, aiming to improve the overall quality of life and reduce hospital stays.
Design and assessment of a musculoskeletal injury prevention programme for wind players
Authors: Rodríguez-Gude Clara , Taboada-Iglesias Yaiza , Pino-Juste Margarita
Published: January 2025

Background

The cervical and mandibular regions are main areas of occurrence of pain in wind players.

Objective

The aim of this study was to describe the design and to find out the level of satisfaction of a specific exercise programme for cervical and mandibular musculature and mobility in wind players.

Methods

The programme was divided into two phases: the first one of education and the second one of implementation. The exercises included were divided into warm-up exercises (including cervical and jaw muscle mobility and activation, as well as postural awareness) and cool-down exercises (stretching and relaxing the main muscles in these areas). The programme was 12 weeks long. Participants were wind musician students.

Results

Twenty-seven students completed the pre- and post-intervention assessment, of which 13 completed the exercises. Considering the total sample, the described difficulty was low and satisfaction was high. The musicians who performed the programme indicated a high importance in instrumental practice and injury prevention, as well as ease of implementation.

Conclusions

Satisfaction with the exercise programme has been high. The fact that it is short, easy to perform and can be done by everyone makes it a quick and simple programme for everyone to do.
Exploring the professional wellbeing of Grade 2 occupational therapists employed in public health inpatient settings in Victoria, Australia: A mixed-methods study
Authors: Rayner Emily , Brown Ted , Hewitt Alana , Lunt Alison , McKeever Janice , Thorpe Matthew , Leong Annette , Douglas Fiona
Published: January 2025

Background

Patient outcomes and the organisational success of healthcare institutions are largely influenced by the wellbeing of its staff. Occupational therapy is the fastest growing allied health profession in Australia. Current empirical literature, however, has not investigated the professional wellbeing amongst this group.

Objective

This study explored the professional wellbeing of Victorian bed-based, Grade 2 occupational therapists regarding their professional identity, job satisfaction, turnover intention, work engagement and experiences of work-related burnout.

Method

Thirty-two Grade 2 occupational therapists completed an online survey involving demographics and measures of burnout, job satisfaction, professional identity, turnover intention, and job demands and resources. Eight participants were interviewed to further explore these concepts. Quantitative data were analyzed using Spearman's correlations and linear regression modelling. Qualitative data were analyzed thematically.

Results

A significant positive correlation was found between professional identity and job satisfaction (ρ = .516, p = .002), and a significant negative correlation was observed between professional identity and two burnout subscales: disengagement (ρ = −.533, p = .001) and exhaustion (ρ = −.507, p = .002). A regression model accounted for 39.2% of the variance of participants’ professional identity ( p = .002). Notable qualitative findings included the contributors to and preventers of staff turnover, implications of working in a discharge-driven environment, and importance of various coping strategies to mitigate the pressures of competing job demands.

Conclusion

This research contributes to the growing understanding of professional wellbeing amongst Grade 2 occupational therapists working in hospital environments, and the factors that contribute to and hinder their wellbeing.
Analysis of factors impacting inter-body fusion cage subsidence following an oblique lateral interbody fusion (OLIF) stand-alone procedure
Authors: Chang Sheng , Xiang Hong-Fei , Wei Jia-Hao , Liu Yong
Published: January 2025

Background

Lumbar oblique lateral interbody fusion (OLIF stand-alone) procedures have become a common treatment for various spinal conditions, including spinal stenosis and spondylolisthesis. However, cage subsidence following OLIF stand-alone procedures is a significant concern that can compromise the surgical outcomes.

Objective

To investigate the occurrence of cage subsidence following OLIF procedures and identify the relevant factors influencing cage subsidence.

Method

A retrospective analysis was conducted on 86 patients who underwent elective OLIF stand-alone procedures at the Affiliated People's Hospital of Qingdao University between 2019 and 2023. Patients were categorized into two groups based on disc height (DH) subsidence: cage non-subsidence group (< 2 mm) and cage subsidence group (> 2 mm). General and imaging data were collected pre-surgery, post-surgery, and at six months follow-up. Single-factor analysis identified factors influencing cage subsidence, followed by multi-factor regression analysis on these variables to determine their impact.

Results

When the degree of DH subsidence in the last follow-up (M6) was evaluated, among the 86 patients (102 segments), 26 patients (25.49%) fulfilled the criteria for cage subsidence. Factors with clinical and statistical significance in the single-factor analysis were incorporated into the multi-factor analysis, and it was found that the mean CT value of the concerned segment, multifidus area, and severe multifidus atrophy were relevant risk factors for cage subsidence; the protective factors for cage subsidence were degree III zygapophyseal joint degeneration, posterior cage position, and end-plate inflammation sclerosis (P < 0.05).

Conclusion

Surgeons should be cautious in preoperatively identifying patients at risk of cage subsidence, particularly those with a low mean CT value of the concerned segment or severe multifidus atrophy. During surgery, selecting a cage of adequate length to span the epiphyseal ring and align with the original DH can help protect paravertebral muscles from iatrogenic injury and reduce the risk of cage subsidence.
Gait analysis in patients with cerebral infarction and intracerebral hemorrhage walking with a body weight-supported walker
Authors: Koshisaki Hiroo , Tanabe Shigeo , Nagai Shota , Kawakami Kenji , Sakurai Hiroaki
Published: January 2025

Background

There is increasing recognition of the effectiveness of body weight-supported (BWS) walkers for stroke patients with hemiplegia. However, it is unclear whether the effectiveness of BWS walkers is because of the walker alone or the combined effect of the walker and body weight support.

Objective

We aimed to determine whether there are differences between normal, walker, and BWS walker gaits in patients after cerebral infarction (CI) and intracerebral hemorrhage (ICH).

Methods

Twenty-one stroke patients with hemiplegia underwent trials under three gait conditions: normal, walker, and BWS walker gait. Spatiotemporal parameters and joint kinematics during walking were calculated using a three-dimensional motion analyzer. We further examined differences in effects depending on CI and ICH.

Results

Speed and cadence improved in the walker gait and BWS gait groups compared with the normal gait group. In addition, the percentage of the stance and swing phases was improved in BWS walker gait compared to normal gait. Both patients with CI and those with ICH showed similar trends in gait parameters by BWS Walker.

Conclusions

These results suggest that using a BWS walker improves walking in stroke patients with hemiplegia in terms of gait parameter, and is a useful tool for gait training.
An Exploratory Analysis of Early Care Differences and Risk of Post-Maxillary Advancement VPI in Individuals With Cleft Palate
Authors: Kinter Sara , Kapadia Hitesh , Susarla Srinivas
Published: January 2025

Objective

To investigate whether differences in early cleft care increase risk of velopharyngeal insufficiency (VPI) after maxillary advancement.

Design

Retrospective cohort study.

Setting

Large pediatric tertiary care hospital.

Patients/Participants

Adolescents and young adults (AYAs) with cleft palate (∓cleft lip) who underwent maxillary advancement between 2008 and 2019.

Interventions/Comparisons

Initial palate repair at a different institution (early care elsewhere, ECE) versus care at a single institution (consistent care, CC).

Main Outcome Measures

Post-maxillary advancement VPI.

Results

One-hundred seventy-eight AYAs underwent maxillary advancement, 74 in the ECE group and 104 in the CC group. The ECE group was more likely to be internationally adopted (34% versus 4%), to have a history of VPI surgery (54% versus 32%) and to be older at time of palate repair (mean 25 versus 16 months). Of anatomical measures, only velar length differed, with the ECE group tending to have a shorter velum (mean 26 mm versus 28 mm). Proportional odds regression revealed increased odds of post-operative VPI in the ECE group (OR 1.46, 95% CI 0.75-2.85) relative to the CC group. This relationship was stronger among those with bilateral cleft lip and palate (OR 3.29, 95% CI 0.86-13.52). For patients with history of prior VPI surgery, the odds of post-operative VPI in the ECE group was more than 3 times that in the CC group (OR 3.06, 95% CI 1.08-9.16).

Conclusions

VPI after maxillary advancement is more likely among individuals who received early cleft care elsewhere compared to those who underwent all cleft operations at a single center.
Perioperative Outcomes of Spring-Assisted Cranioplasty, Distraction Osteogenesis Versus Conventional Expansion in Craniosynostosis: A Systematic Review and Meta-Analysis
Authors: Putri Indri Lakhsmi , Hasanah Rizka Uswatun , Aisyah Imaniar Fitri , Pramanasari Rachmaniar , Dyah Kencono Wungu Citrawati
Published: January 2025

Objectives

This study compares perioperative outcomes between spring-assisted cranioplasty (SAC), distraction osteogenesis (DO) and conventional expansion in craniosynostosis surgery.

Design

Systematic review and meta-analysis.

Setting

Retrospective and prospective cohort.

Patients and Participants

A comprehensive electronic search was conducted using PubMed/Medline, Scopus, Science Direct, EBSCO, Web of Science, and Cochrane Library, alongside Gray literature sources (SSRN, Scopus preprint, and MedRxiv). Publication bias was assessed and study quality was evaluated using the Newcastle Ottawa Scales (NOS).

Interventions

SAC or DO.

Main Outcome Measures

Blood loss and blood transfusion.

Results

Thirteen studies were included, with 7 studies comparing DO versus conventional and 6 comparing SAC vs conventional. All studies met eligibility criteria for meta-analysis, with study quality ranged from good to very good. Compared to conventional, the SAC or DO significantly reduced blood loss (MD = −190.42 mL), and blood transfusion (MD = −227.22). Additionally, SAC and DO shorten operative time (MD = −94.38 min), anesthesia duration (MD = −114.81 min), hospital stay (MD = −0.68 days), and ICU stay (MD = −1.00 days). Long-term follow-up showed a lower reoperation rate (OR = 0.20), but no significant change in cranial index at 10 years (MD = 0.06, P = .74).

Conclusions

SAC or DO result in lower perioperative complications, overall shorter durations, and reduced reoperation rates compared to conventional expansion. Standardized postoperative outcome reports are useful to classify the severity of complications and guide the future long-term treatment strategies for craniosynostosis surgery.
Primary Visceral Ewing Sarcoma (Gastric and Bladder) with KIT Expression: A Report of Two Patients and a Differential Diagnostic Approach
Authors: Chaachou-Charradi Anas , Bagué Silvia , Medina Carmen Medina , Lavernia Javier , Claramunt Reyes , Guerrero José A. López , Navarro Samuel , Llombart-Bosch Antonio , Williamson Sean R. , Machado Isidro
Published: January 2025

Extra-skeletal Ewing sarcoma is a rare tumor, most commonly occurring in the paravertebral region, extremities, retroperitoneum, and very rarely in visceral locations. We present two primary visceral Ewing sarcomas confirmed at the molecular level: one located in the stomach and the other in the bladder. Both tumors demonstrated strong and diffuse membranous CD99 expression, accompanied by variable KIT immunoreactivity. Additionally, we provide a review of the literature on primary gastric and bladder ES, including an analysis of differential diagnoses for gastric and bladder tumors exhibiting CD99 and KIT expression.
Factors Contributing to Late Breast Cancer Diagnosis at the Brazzaville University Hospital in 2020, Congo: A Cross-Sectional Analytic Study
Authors: Ilboudo Michel , Woromogo Sylvain Honoré , Kaboré Dagnagnéwendé Dieudonné , Zerbo Nina Assanatou Jumelle , Nkoua Mbon Jean Bernard
Published: January 2025

Objectives

Breast cancer is leading the cancer incidence and mortality ranks worldwide. Currently, breast cancer represents 30.1% of all cancers occurring in women in Congo. In sub-Saharan Africa, breast cancer is diagnosed delayed in 70% of cases. The purpose of this work is to study the epidemiological aspects of patients with late diagnosis of breast cancer at the Brazzaville University Hospital, Congo.

Methods

We carried out a cross-sectional analytic study in the medical oncology service of the University Hospital of Brazzaville. We used systematic, exhaustive sampling. Logistic regression was used for data analysis, and P values ≤5% were considered significant.

Results

Data for 182 patients were collected. Delay in diagnosis represented 91.21% of cases. Delay in diagnosis was significantly associated with lack of finance ( P = 0.011) and with breast cancer stages greater than 2 ( P < 0.001), but the proximity to the center was suggestive. Multivariate analysis revealed an association between diagnostic delay and proximity to the center ( P = 0.025) as well as with breast cancer stages greater than 2 ( P < 0.001).

Conclusion

The delay in breast cancer diagnosis widely discussed in the literature remains relevant in Congo. Routine screening, the construction of a cancer center and its optimal equipment, and the subsidy of care are all critical factors for battling delayed breast cancer diagnosis in Congo.
Prostate Artery Embolization in the Setting of Prostate Cancer: Review and Opinion
Authors: Parikh Nainesh , Yamoah Kosj , Johnstone Peter , Torres-Roca Javier , Pow-Sang Julio , Fernandez Daniel , Rishi Anupam , Grass G. Daniel
Published: January 2025

Prostate Artery Embolization (PAE) is a novel minimally invasive angiographic technique that has been used effectively to treat men with lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH). However, applications of PAE for men with prostate cancer have been minimally studied. This review serves as an update on the status of PAE in men with prostate cancer, as well as a discussion of emerging indications.
Optimal fractional control applied to a single link flexible robot with disturbances and payload changes
Authors: Benftima Selma , Ben Attia Selma , Salhi Salah , Feliu Batlle Vicente
Published: January 2025

This article explores and compares the use of the linear quadratic regulator (LQR) theory to control a single-degree-of-freedom flexible link robot ( FLR) using an integer-order model and a fractional-order model. The fractional-order model is obtained from the integer-order one by introducing new “fictitious” fractional states. The LQR technique determines feedback gains to optimally control a system by considering its dynamics and cost function. Two LQR schemes are designed here: one for the integer-order model using a linear matrix inequality reformulation and the other for the fractional-order model involving analytical tuning and numerical optimization. A genetic algorithm is used to optimize the fractional-order LQR by minimizing the same cost function as the integer-order model. The resulting control system minimizes disturbances, ensuring accurate tracking, stability, and robustness in flexible robotic systems. The complete scheme integrates active disturbance rejection control ( ADRC) and Luenberger observers to estimate internal states. Simulations and experiments demonstrate that the fractional-order LQR outperforms the integer-order version in terms of energy efficiency, evaluated using total variation ( TV) and the integral absolute control signal ( IACS). Then we have shown that feeding back fictitious fractional states besides the standard integer-order ones reduces the LQR cost index and improves the robot performance.
Prevalence and predictive factors of chemotherapy-induced peripheral neuropathy in cancer patients: A cross-sectional single-center study in Pakistan
Authors: Jadoon Ismail , Yameen Muhammad Arfat
Published: January 2025

Chemotherapy-induced peripheral neuropathy is a debilitating pain condition resulting from cancer treatment and is known to be associated with a decrease in health-related quality of life. This single-center cross-sectional study, conducted at Institute of Nuclear Medicine Oncology and Radiotherapy (INOR), Abbottabad, Pakistan, assessed the prevalence and severity of chemotherapy-induced peripheral neuropathy and its impact on quality of life in cancer patients undergoing chemotherapy. Patients completed the European Organisation for Research and Treatment of Cancer QLQ–C30 and QLQ–CIPN20 questionnaires. Subscales are scored from 0 to 100, with higher scores indicating greater symptom severity. A total of 154 patients participated, with a mean age of 48.57 years (SD 14.22); 33.8% were male and 66.2% were female. The prevalence of sensory CIPN was 36.4%. The mean scores for the sensory, motor, and autonomic subscales of the QLQ–CIPN20 were 23.2 (SD 19.1), 16.6 (SD 15.8), and 14.8 (SD 17.2), respectively. CIPN symptom severity was negatively correlated with global health status/quality of life and physical, role, emotional, cognitive, and social functioning. There was no significant association with age, sex, body surface area, height, weight, or type of chemotherapeutic agent used. However, symptom severity increased with the number of treatment cycles completed (e.g., sensory, p = 0.003). CIPN was prevalent in this healthcare center and significantly impacted function and quality of life. These findings highlight the importance of developing strategies to mitigate CIPN and the need for routine screening of CIPN.
Development of Progressively Earth-Independent Medical Operations to Enable NASA Exploration Missions
Authors: Anderson Arian , Stratton Emily , Nelson Ariana , Lemery Jay , Berens Kurt , Hilmers David , Lehnhardt Kris
Published: January 2025

Introduction —The National Aeronautics and Space Administration’s (NASA's) transition from operations in low-Earth orbit to long-duration missions to the Moon and Mars necessitates the development of progressively Earth-independent medical operations (EIMO) to support crews and reduce overall mission risk. Previous work has defined and laid the foundation for EIMO, but further development of the concept is required to prepare for future exploration missions. Methods —NASA's Exploration Medical Capability element organized a series of 5 technical interchange meetings from 2023 to 2024, which included internal (NASA) and external subject-matter experts in human spaceflight, health technology, and austere medicine to create a framework for developing the technologies and procedures necessary to maintain human health and performance in a progressively Earth-independent fashion. Results —The EIMO technical interchange meetings provided a forum for a field of experts and stakeholders to better understand gaps between current approaches to medical care in low-Earth orbit and the innovations needed to maintain the health and performance of astronauts on long-duration deep-space missions. These discussions were recorded, analyzed, and collated into reports that can inform the maturation of EIMO concepts. Conclusions —Multidisciplinary input from experts with experience in human spaceflight, health technology, and austere medicine is critical when planning for long-duration exploration missions. Innovations such as probabilistic risk assessment tools, extended reality devices, and advanced clinical artificial intelligence capabilities have been identified as high-value targets that can enhance inflight medical autonomy while maintaining appropriate workload balance and crew safety. By further developing the EIMO paradigm, NASA aims to identify areas of future work, research, and collaboration to reduce overall risk on future human spaceflight missions into deep space.
Telomere Length and Symptoms of Attention Deficit and Hyperactivity Disorder in Children at 6–12 Years
Authors: Campos-Sánchez Irene , Navarrete-Muñoz Eva María , Martens Dries S. , Riaño-Galán Isolina , Lertxundi Aitana , Llop Sabrina , Guxens Mónica , Rodríguez-Dehli Cristina , Lertxundi Nerea , Soler-Blasco Raquel , Vrijheid Martine , Nawrot Tim S. , Wright John , Yang Tiffany C. , McEachan Rosie , Gützkow Kristine Bjerve , Chatzi Vaia Lida , Vafeiadi Marina , Kampouri Mariza , Grazuleviciene Regina , Andrusaityte Sandra , Lepeule Johanna , Valera-Gran Desirée
Published: January 2025

Objective:

To explore the association between telomere length (TL) and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6–12 years.

Method:

Data from 1,759 children belonging to the HELIX project cohorts and the Asturias, Gipuzkoa and Valencia cohorts of INMA project were included. TL was determined by blood sample using a PCR protocol. ADHD symptoms were described by parents using the Conners’ Parent Rating Scale-Revised: Short Form. Multiple negative binomial regression models adjusted for potential confounders were used to estimate associations.

Results:

Overall estimates showed no associations between TL and ADHD symptoms. However, we observed that a longer TL was significantly associated with a lower risk of presenting hyperactivity symptoms in children belonging to the HELIX project (IRR = 0.93, 95% CI [0.87, 0.99]; p = .022).

Conclusion:

While our study did not find a consistent association between TL and ADHD symptoms across all cohorts, the significant association found within the HELIX cohort suggests that longer TL may be linked to a lower risk of hyperactivity symptoms. Further research is needed to explore this association in more detail.
Phygital Heuristics in Tourists’ Decision-Making in Motion
Authors: Liu Xuerui , Wang Dan , Li Xiang
Published: January 2025

Decision-making in motion has become increasingly prominent during travel. However, little is known about the cognitive mechanisms underlying tourists’ trip choices; both physical and digital cues and shortcuts (i.e., phygital heuristics) behind these processes are especially nebulous. Grounded in environmental psychology, we investigate the interactions among destination environments, decision tasks, and tourists’ cognitive processes when making decisions in motion. Results are based on real-world scenarios. Our findings shed light on the role of “ecological fit” in prompting adaptive and context-specific heuristics. We contribute to existing research by explicating how the sociophysical-biopsychological environment triggers and influences decision-making in motion, shedding light on the role of phygital heuristics in tourists’ actual behavior. Managerial implications are provided regarding marketing strategies and recommendation systems.
Analysis of bending force and springback behavior of metal–polymer–metal sandwich laminates
Authors: Park Jin Sung , Chung Kyung Hwan , Kim Ji Hoon
Published: January 2025

The bending and springback behaviors of sandwich laminates are more complex than those of monolithic sheet materials because of the differences between the properties of the core and skin materials. In this study, simplified analytical and numerical models were used for analyzing the springback angle and bending force of metal-polymer-metal sandwich laminates under bending. An analytical model was used to predict springback in three-point bending. The springback angles and bending force obtained from the numerical model correlated well with the experimental results. It was found that the finite element model using solid elements in the core was advantageous for predicting the shape after bending. It was demonstrated that these models can be used to design sandwich laminates with desired flexural stiffness by appropriately choosing the volume fraction. Potential weight reduction for sandwich laminates during the air bending process was presented.
Investigation on microperforated sandwich structures with light weight and broadband sound absorption: Influences of foam filling and core configurations
Authors: Yang Jingbo , Jiang Yongfeng , Meng Han , Ma Qing , Feng Xiangchao , Gao Zhaorui , Shen Cheng , Lu Tian Jian
Published: January 2025

Structures with light weight and broadband sound absorption is of vital importance for noise control applications in engineering practice. Foams exhibit broadband but poor low frequency sound absorption, micro-perforated sandwich structures conversely possess good sound absorption at low frequencies due to resonance, the bandwidth is however limited. Micro-perforated sandwich structures with foam filling are therefore proposed in the paper to obtain wideband low-frequency sound absorption. An integrated analytical, numerical and experimental research is conducted to investigate sound absorption and lightweight characteristics of four commonly used micro-perforated sandwich structures with honeycomb (PHSP), corrugated (PCSP), N hybrid (PNHSP) and honeycomb-corrugated (PHCSP) cores. An analytical model is built to estimate sound absorption coefficient (SAC) based on the acoustic impedance theory and Johnson-Champoux-Allard model. Numerical simulation and experimental measurement methods are conducted simultaneously to validate the analytical model. The influences and underling mechanism of foam filling and filling configurations are explored, and it is found that melamine foam filling can enhance low-frequency sound absorption bandwidth of micro-perforated sandwich structures, and half-filled foam can bring in higher absorption peak values than fully filled foam due to more violent resonance. To overall evaluate both the lightweight and sound absorption performance of varied sandwich cores, a comprehensive evaluation index by the sound absorption and relative mass is developed. Results show that the PCSPs with lower half part filled foam perform best at both sound absorption and lightweight among all sandwich structures. Results of this paper can provide guidance for the application of sandwich structures.
CT Texture Analysis in Breast Cancer Patients Undergoing CT-Guided Bone Biopsy: Correlations With Histopathology
Authors: Wermelskirchen Silvio , Leonhardi Jakob , Höhn Anne-Kathrin , Osterhoff Georg , Schopow Nikolas , Briest Susanne , Denecke Timm , Meyer Hans-Jonas
Published: January 2025

Background:

Texture analysis has the potential to deliver quantitative imaging markers. Patients receiving computed tomography (CT)-guided percutaneous bone biopsies could be characterized using texture analysis derived from CT. Especially for breast cancer (BC) patients, it could be crucial to better predict the outcome of the biopsy to better reflect the immunohistochemistry status of the tumor.

Objectives:

The present study examined the relationship between texture features and outcomes in patients with BC receiving CT-guided bone biopsies.

Design:

This study is based on a retrospective analysis.

Methods:

The present study included a total of 66 patients. All patients proceeded to undergo a CT-guided percutaneous bone biopsy, using an 11-gauge coaxial needle. Clinical and imaging characteristics as well as CT texture analysis were included in the analysis. Logistic regression analysis was performed to predict negative biopsy results.

Results:

Overall, 33 patients had osteolytic metastases (50%) and 33 had osteoblastic metastases (50%). The overall positivity rate for the biopsy was 75%. The clinical model exhibited a predictive accuracy for a positive biopsy result, as indicated by an area under the curve (AUC) of 0.73 [95% confidence interval (CI) = 0.63-0.83]. Several CT texture features were different between Luminal A and Luminal B cancers; the best discrimination was reached for “WavEnHH_s-3” with a P-value of .002. When comparing triple-negative to non–triple-negative cancers, several CT texture features were different, the best discrimination achieved “S(5,5)SumVarnc” with a P-value of .01. For the Her 2 discrimination, only 3 parameters reached statistical significance, “S(4,-4)SumOfSqs” with a P-value of .01.

Conclusions:

The utilization of CT texture features may facilitate a more accurate characterization of bone metastases in patients with BC. There is the potential to predict the immunohistochemical subtype with a high degree of accuracy. The identified parameters may prove useful in clinical decision-making and could help to identify patients at risk of a negative biopsy result.
Learning beyond dialogue
Authors: Izak Michal
Published: January 2025

This article outlines the different threads in the dialogic perceptions on learning, principally published in Management Learning journal, and identifies common assumptions underpinning them. It proceeds to contextualize them methodologically and conceptually to problematize dialogic lenses on learning – rather than to critique them. It claims that shunning the instances of non-dialogic learning or overlooking the research contexts in which dialogic inquiry is not expedient risks favouring certain societal and organizational discourses at the expense of others, as well as missing out on lessons which otherwise could have been learned. It concludes with an outline of a non-dialogic perspective on management learning built on existing contributions, with a view to galvanize the conversation ongoing in this journal on positionality of any pre-configured research lenses on learning. Finally, it considers the potential risks and consequences of failing to adjust one’s research accessory in accordance with one’s object of study.
Peeling the (experiential) onion: A review of the interconnected layers of research on experiential learning in Management Learning between 2010 and 2024
Authors: Robinson Melanie A , Leigh Jennifer SA
Published: January 2025

In an essay published for the 40th anniversary issue of Management Learning, Reynolds reflected on the impact of, and reactions to, experiential learning to teach management. Fifteen years later, in honor of the journal’s 55th anniversary, we delve into the research published since that point to explore how experiential learning is invoked in Management Learning. To this end, we reviewed and coded 45 articles published between 2010 and 2024. This process pushed us to reflect on three different (often interconnected) ways in which experiential learning is examined in the journal, with articles that explore the experiential learning process, center on one or more specific dimensions of experiential learning, and attend to contextual elements that facilitate or hinder experiential learning. We also situate the methods and activities discussed across the sample within the clusters of experiential learning identified by Grain, allowing us to identify areas in which research in Management Learning overlaps with and extends the model. To close, we relate our findings to contemporary debates about experiential learning and education, both within the journal and the field, and propose future research directions.
A critical voice in academia’s wilderness: Dystopia, utopia, heterotopia
Authors: Cunliffe Ann L
Published: January 2025

Introduction to the 55th Anniversary SI.
Social support among women with infertility: Associations with psychiatric symptoms, disordered eating, and substance use
Authors: Miller-Matero Lisa R , Joseph-Mofford Genevieve EM , Vagnini Kaitlyn M , Haley Erin N , Vanderziel Alyssa M , Loree Amy M , Hecht Leah M
Published: January 2025

Though social support in the broader population is related to better psychosocial outcomes, little work has examined the relationship between social support and patient-reported outcomes among women with infertility. The purpose of this study was to investigate whether perceived social support was associated with psychiatric symptoms, disordered eating, and substance use among women with an infertility diagnosis. Individuals who received a diagnosis of female-factor infertility ( N = 188) completed measures of perceived social support, psychiatric symptoms, disordered eating, and substance use. Approximately two-thirds of participants endorsed having high levels of perceived social support (63.3%) with smaller proportions indicating moderate (28.2%) or low levels (8.5%). Compared to those with high levels of support, participants with low/moderate levels were more likely to report greater symptoms of anxiety ( p < 0.001), greater symptoms of depression ( p < 0.001), and hazardous cannabis use ( p = 0.03). Clinicians could consider screening women with infertility for level of social support.