bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing the bernstein collocation approach: chebyshev-gauss-lobatto nodes in singular perturbation
Authors: Beniwal Kirti , Kumar Vivek
Published: February 2025

This research provides a numerical comparison of the performance of the variational method and the Bernstein collocation method (BCM) using equispaced nodes and Chebyshev-Gauss-Lobatto Nodes with respect to solving singularly perturbed equations that involve both linear and nonlinear problems. These problems provide major numerical approximation challenges because of their boundary layers and steep gradients. The BCM with Chebyshev nodes was found to perform more accurately than the variational method and the equispaced node configuration through a thorough error assessment that takes into account both maximum absolute error and root mean square error. For instance, for a perturbation parameter ϵ = 0.0001, the BCM with chebyshev nodes shows maximum errors as 2.803 × 10−11, compared to 7.862 × 10−8 for equispaced nodes and 5.267 × 10−6 for variational method. Additionally, the condition number of the matrices in the BCM with Chebyshev nodes is consistently smaller, demonstrating improved numerical stability. This makes the BCM with Chebyshev nodes an extremely useful tool for handling the complexity of singular perturbations in terms of providing substantial improvements in accuracy and computational reliability over traditional methods.
Effect of drain region doping on performance of a vertical dual-gate JLFET
Authors: Garg Aanchal , Gola Deepti , Singh Balraj , Singh Yashvir
Published: February 2025

This work presents the subthreshold performance comparison of two variants of vertical SOI double gate junctionless FET (DG-JLFET). In the proposed structure, a channel is formed between the two vertical gates placed in respective trenches. The first DG-JLFET structure has identical moderately doped drain and channel regions. However, the second DG-JLFET structure has heavily doped drain but moderately doped channel, referred as accumulation-mode DG-JLFET (ADG-JLFET). ATLAS
TM
TCAD device simulator has been utilized to obtain the switching performance parameters for both the device structures. The DG-JLFET achieves a 3.17% improvement in subthreshold slope (SS) and a 116% improvement in drain-induced barrier lowering (DIBL) compared to the ADG-JLFET. These improvements directly contribute to the DG-JLFET’s superior overall subthreshold performance, demonstrating its advantage over the ADG-JLFET.
Comparative study of green and chemically synthesized CdO NPs: study of their photocatalytic dye degradation under sunlight irradiation
Authors: Shahzad Muhammad , Ishaque Muhammad Zahid , Iqbal Hina , Zaman Yasir , Siddique Abu Bakar , Zaman Hira
Published: February 2025

The 21st century is plagued with environmental problems, of which water pollution is one of the biggest challenges. The textile and pharmaceutical industries are major contributors to azo dye pollution in water reservoirs, for which wastewater purification is crucial. In this regard, the CdO NPs-based efficient photocatalysts have been proposed in current research work. The synthesis of CdO NPs has been reported by hydrothermal, coprecipitation, and green approaches. The synthesized CdO NPs have been characterized by advanced techniques, like UV-visible and FTIR spectroscopy, PXRD, FESEM, EDX and zeta potential analysis. The optical bandgap of the CdO NPs was optimized by studying the calcination effect on UV-visible spectra of samples. A blue shift of the SPR peak corresponding to an increase in bandgap energy was observed after calcination of samples. XRD analysis indicated FCC structure of all synthesized CdO NPs with crystallite size in the range of 11.5 -16.5 nm for chemical and green synthesis which is calculated by Debye–Scherrer’s formula. FESEM images revealed the spherical nature of CdO NPs. The photocatalytic potential of CdO NPs synthesized by hydrothermal, coprecipitation and green method has been accessed to degrade methylene blue (MB) dye effectively. Melia Azdaratch Extract based synthesized CdO NPs showed highest photocatalytic activity to degrade MB dye in 90 min.
Biophysical response of a coastal woodland to extreme water deficit during a year of record-breaking heat
Authors: Moore Caitlin E , Thompson Sally E , Beringer Jason , Cooper Wesley , Gelsinari Simone , Nguyen Hoang Long , Wang Huanhuan , Xie Qiaoyun , Silberstein Richard P
Published: February 2025

Global terrestrial and ocean surface temperatures continue to reach record levels, resulting in heat waves, drought, and prolonged heat stress experienced by vegetation in many regions. In 2023–2024, coastal terrestrial ecosystems in Western Australia were particularly affected, experiencing their driest and hottest summer since observations began in the early 1900s. Banksia woodlands are a threatened ecological community in this region that are endangered by the cumulative impacts of climate change, clearing and changing groundwater regimes, the last of which is strongly influenced by the dual use of groundwater resources by the ecosystem and by the ∼2 million people in the city of Perth. Within the banksia woodlands is a Terrestrial Ecosystem Research Network (TERN) long-term ecological observatory that has been measuring ecosystem phenology, groundwater levels and carbon, water and energy fluxes since 2011. The 11-year site records confirm 2023 rainfall was the lowest in the record. Groundwater monitoring showed an ∼1 m drop in 2023–2024 alone, in addition to a long-term reduction of ∼4 m in water table depth since observations began in 1977. The resulting extreme water deficits manifested in reduced ecosystem evapotranspiration and altered carbon flux dynamics. Phenocam imagery revealed the consequences of this water deficit at the site level through visible canopy dieback and shifts in vegetation greenness indices. Vegetation indices from remote sensing products showed widespread vegetation stress across the ecosystem range. Continued monitoring at local and regional scales with these combined methodologies will determine (a) how well the Banksia ecosystems are able to recover from this extreme climate event and (b) the ramifications for the carbon and water cycle of the region. This ecosystem is a sentinel of climate change, providing early insight into how ecosystem-climate interactions are altering globally.
Investigative study on energy solutions systems for cereals milling in Sub-Saharan rural areas based on an optimal design using multi-objective NSGA-II
Authors: Zieba Falama Ruben , Sun Yanxia
Published: February 2025

Sub-Saharan rural areas mostly use cereals diesel milling because of lack of electricity. However diesel engine operation is very polluting. Using an alternative energy source for cereals milling could be beneficial both environmentally and economically. In this regard, a comparative analysis based on a multi-objective NSGA-II is carried out between diesel and electric milling of cereals. Different electrical energy sources including photovoltaic solar energy are proposed and investigated. The concept of cost of mechanical energy (COME) is introduced for the economic comparison between diesel and electric milling. The obtained results have shown that for 0% DPSP (Deficit of power supply probability), the COME of PV/Batt/EM, Grid/EM, DG/EM, and DE systems, are respectively 0.2455 $ kWh−1, 0.1905 $ kWh−1, 0.5649 $ kWh−1 and 0.4982 $ kWh−1. The corresponding cost of electrical energy (COEE) of PV/Batt, Grid and DG systems, are respectively 0.2051$ kWh−1, 0.158 $ kWh−1, and 0.4785 $ kWh−1. The cost of milling (COM) for the optimal systems designed are 0.0106 $ kg−1, 0.0091 $ kg−1, 0.0194 $ kg−1, and 0.0175 $ kg−1, respectively for PV/Batt/EM, Grid/EM, DG/EM, and DE systems. However, when the PV solar energy losses are sold, then the COME, the COEE, and the COM of the PV milling system become respectively 0.1854 $ kWh−1, 0.1215 $ kWh−1, and 0.0079 $ kWh−1. The calculated CO2 emissions (CO2e) per year of PV/Batt/EM, Grid/EM, DG/EM, and DE systems, are respectively 3191 kgCO2e, 6906.8 kgCO2e, 14484 kgCO2e, and 8963.8 kgCO2e. The outcomes of this study show that, the electric milling based PV energy could be the best techno-economic and environmental option to adopt in grid and non-grid connected rural areas.
ELGS-YOLO: small object detection method of power switchgear images based on multi-scale feature fusion
Authors: Liang Wanyong , Zhang Yufei , Jiang Yong , Zhou Lintao , Wang Shuai , Yao Lina
Published: February 2025

To address the challenges of difficult detection of small targets and limited computational resources prevalent in power switchgear. This paper presents an enhanced switchgear detection model, ELGS-YOLOv8, which addresses the limitations of existing models. First, ELGS-YOLOv8 employs a lightweight Efficient Mutil Scal Conv (EMSC) in the backbone network. This module reduces the number of parameters and computation of the model while improving the extraction of feature information. In addition, the local-global information extraction and fusion module (LGEF) for small targets has been proposed to further improve the detection capability of the indicator. The module integrates local information extraction module(LIEM)and local-global information fusion module (LGFM) at the neck, which are used to improve the extraction and fusion of feature information, respectively. Finally, a lightweight detection head based on the Separated and Enhancement Attention Module (LSEAM) is designed to reduce the model complexity while further improve the model’s detection performance in complex scenes. Experimental results show that the improved ELGS-YOLOv8 model achieves 90.4% in mAP@0.5, with a model size reduction of 15% and an increase in AP

s
by 7.7%, meeting the real-time and accuracy requirements for on-site deployment. Therefore, the improved strategy provides a more reliable and efficient solution for switchgear detection in substation inspections.
Optimizing light extraction from non-planar site-controlled pyramidal quantum dot system: comparative modeling of three fabricable geometries
Authors: Colavecchi Luca , Juska Gediminas , Pelucchi Emanuele
Published: February 2025

This work explores three different fabrication methods to improve light extraction efficiency of site-controlled pyramidal GaAs quantum dot (QD) system. In the theoretically analyzed structures (mimicking the as-obtained experimentally), we focus on the effects of geometry on light emission intensity, far-field profiles, and Purcell enhancement. The three methods include a back-etched approach, which exposes the pyramid’s apex, a pillar fabrication process, and a ‘mirrored’ pyramid technique. Simulation results suggest that all three techniques have the potential to improve light extraction from as grown structures, with the pillar method offering the highest extraction efficiency (43% for a numerical aperture of 0.999) and the back-etched configuration exhibiting a strong Purcell enhancement effect. The mirrored pyramid method is also of interest, as it provides a promising alternative to the back-etched approach, potentially simplifying the integration of electrical contacts for tuning QD properties. Ultimately, we emphasize the importance of precise control over the fabrication process to optimize the performance of this QD system for future applications in quantum information processing.
‘The Kingdom of Mealies’
Authors: Tischler Julia
Published: February 2025

Chapter 1 traces the emergence of an agricultural education infrastructure in the Transkei and the Ciskei. It focuses on the Black agricultural producers who spearheaded the progressive farming movement, invoking the notion of science-based planning in order to offset the reserves’ socio-economic destabilization caused by rapid industrialization and urbanization. By the 1920s, well over one hundred agricultural demonstrators were ‘preaching the gospel’ of improved methods throughout the Transkei and Ciskei while the agricultural schools trained future farmers and demonstrators, attracting far more applicants than they could accommodate. Demonstration caravans toured the Transkei, offering lectures and demonstrations to several thousand people. Numerous so-called Native Farmers’ Associations organized African smallholders to cooperate. In an increasingly hostile political and economic climate, Black farmers promoted independent farming as a possible alternative to a life in which Blacks were subjects of white mining and agrarian capital. African progressive farmers’ visions were steeped in Cape liberal thought, with its emphasis on acculturation, middle-class respectability, education, and Christianity rather than racial categorizations. Although Cape liberalism was waning at the time, it still opened up opportunities for the minority of formally educated aspiring Black farmers to obtain support from sections of the Cape’s paternalistic administrative and missionary establishment.
From ‘Progress’ to ‘Rehabilitation’
Authors: Tischler Julia
Published: February 2025

Chapter 3 discusses the ways in which white officials and experts seized the notion of emancipatory farming, turning it on its head. From the late nineteenth century, specific groups of ‘friends of the natives’—including missionaries, liberal intellectuals, and Cape officials—were highly influential in shaping discourses and policies around the ‘agrarian question’. Their staunch support of agricultural education in the reserves—against the pushback of many white farmers—reflected these reformers’ intellectual investment in an early, relatively flexible and paternalistic variant of segregationist thought. From the late 1920s onwards, however, the national Native Affairs Department (NAD) increasingly intervened in the Cape, overriding the province’s long tradition of relative local autonomy. Meanwhile, many graduates of the agricultural schools saw their professional ambitions thwarted, while the demonstration service promoted a model of farming that most of its addressees were unable to put into practice. Such setbacks, in addition to heightened concerns over soil erosion and malnutrition, were grist to the mill of NAD officials who wanted to discard the hitherto gradualist approaches to rural development in favour of restrictive and compulsive measures. NAD-style agricultural education was no longer about an individual’s progress and access to the league of ‘civilized’ farmers but rather a means of segregation and discrimination intended to safeguard the system of circular migration through which white-owned mines and farms benefitted from cheap African labour.
Women Farmers and Farmers’ Wives
Authors: Tischler Julia
Published: February 2025

Chapter 10 examines rural domestic training for white women. Combining inspiration from the Canadian and American domestic science movements with the Afrikaner nationalist volksmoeder (‘mother of the people’) ideal, the authorities highlighted women’s duties of motherhood focused on the nation and cast domesticity as a corrective to the supposedly degenerative effects of female wage labour. White women eagerly sought out rural education services but, at the same time, transgressed Victorian notions of separate spheres that divided ‘male’ productive work from ‘female’ consumption. Teachers and students at the private Boschetto Agricultural College, the only agricultural college for women in the southern hemisphere, sought recognition as female farmers rather than as merely farmers’ wives. Nevertheless, government interventions to oppose women’s independent farming are indicative of how the rise of commercial farming devalued female contributions to agricultural production in South Africa and elsewhere.
Connectome-based prediction of future episodic memory performance for individual amnestic mild cognitive impairment patients
Authors: Zhang Zhengsheng , Wang Mengxue , Lu Tong , Shi Yachen , Xie Chunming , Ren Qingguo , Wang Zan
Published: February 2025

The amnestic mild cognitive impairment progression to probable Alzheimer’s disease is a continuous phenomenon. Here we conduct a cohort study and apply machine learning to generate a model of predicting episodic memory development for individual amnestic mild cognitive impairment patient that incorporates whole-brain functional connectivity. Fifty amnestic mild cognitive impairment patients completed baseline and 3-year follow-up visits including episodic memory assessments (e.g. Rey Auditory Verbal Learning Test Delayed Recall) and resting-state functional MRI scanning. Using a multivariate analytical method known as relevance vector regression, we found that the baseline whole-brain functional connectivity features failed to predict the baseline Rey Auditory Verbal Learning Test Delayed Recall scores (r = 0.17, P = 0.082). Nonetheless, the baseline whole-brain functional connectivity pattern could predict the longitudinal Rey Auditory Verbal Learning Test Delayed Recall score with statistically significant accuracy (r = 0.50, P < 0.001). The connectivity that contributed most to the prediction (i.e. the top 1% connectivity) included within-default mode connections, within-limbic connections and the connections between default mode and limbic systems. More importantly, these connections with the highest absolute contribution weight mainly displayed long anatomical distances (i.e. Euclidean distance >75 mm). These ‘neural fingerprints’ may be appropriate biomarkers for amnestic mild cognitive impairment patients to optimize individual patient management and longitudinal evaluation in a timely fashion.
A systematic review and meta-analysis of treatments and outcomes of primary localized cutaneous amyloidosis
Authors: Wang Qin-Xiao , Ye Qian , Zhou Kai-Yi , Luo Si-Yu , Fang Sheng
Published: February 2025

Background

Primary localized cutaneous amyloidosis (PLCA) is a skin-limited disorder characterized histologically by amyloid deposition in the papillary dermis. This study aimed to review current treatment strategies and provide an updated perspective on the treatment of PLCA.

Methods

We searched the PubMed, EMBASE and Cochrane Library databases for eligible studies. Cohort studies were meta-analyzed using a random effects model to evaluate the outcomes of different treatments, while case reports and case series were evaluated using the Mann-Whitney U test.

Results

Overall, 117 studies (535 patients) were included. Surgery favoured nodular amyloidosis (NA), with statistically significant differences for the other therapies. For the non-NA group, 62 case-level studies (79 patients) and 20 cohort studies (418 patients) were analyzed separately. Although there were no statistically significant differences between therapies in the case-level studies, biological agents and JAK inhibitors may be a promising treatment for refractory lesions. Of the cohort studies, the partial response (PR) rate was 100.0%, 100.0%, 97.5%, 96.9%, and 94.4% of transcutaneous electrical nerve stimulation, micro-needling, laser therapies, topical therapies, and systemic immunosuppressants; the complete response (CR) rate was 22.2% and 2.5% of surgical interventions and laser therapies.

Conclusion

This study suggest that surgery is the most effective option for NA and laser therapy is recommended for non-NA patients. Biologic agents and JAK inhibitors may be promising treatment options for lesions that do not respond to conventional therapies.
VPS13D mutations affect mitochondrial homeostasis and locomotion in Caenorhabditis elegans
Authors: Yin Xiaomeng , Wang Ruoxi , Thackeray Andrea , Baehrecke Eric H , Alkema Mark J
Published: February 2025

Mitochondria control cellular metabolism, serve as hubs for signaling and organelle communication, and are important for the health and survival of cells. VPS13D encodes a cytoplasmic lipid transfer protein that regulates mitochondrial morphology, mitochondria and endoplasmic reticulum contact, and quality control of mitochondria. VPS13D mutations have been reported in patients displaying ataxic and spastic gait disorders with variable age of onset. Here, we used CRISPR/Cas9 gene editing to create VPS13D-related spinocerebellar ataxia-4 missense mutations and C-terminal deletion in VPS13D's ortholog vps-13D in Caenorhabditis elegans. Consistent with SCAR4 patient movement disorders and mitochondrial dysfunction, vps-13D mutant worms exhibit locomotion defects and abnormal mitochondrial morphology. Importantly, animals with a vps-13D deletion or a N3017I missense mutation exhibited an increase in mitochondrial unfolded protein response. The cellular and behavioral changes caused by VPS13D mutations in C. elegans advance the development of animal models that are needed to study SCAR4 pathogenesis.
From the 4Ms to a Disability-Friendly Healthcare System
Authors: Moro Teresa , McGinley Jacqueline , Ewald Bonnie
Published: February 2025

There are approximately 3,922 Age-Friendly Health Systems (AFHS) sites in the United States (US). These systems promote better healthcare for adults age 65 and older by implementing the following four elements, referred to as the “4Ms”, into care provision: 1) What Matters; 2) Medication; 3) Mentation; and 4) Mobility. There are no equivalent parameters to ensure high-quality care for adults with disabilities. This is problematic because many individuals with disabilities experience conditions associated with aging well before their 65th birthday. For example, adults with Down syndrome are more likely to develop earlier onset dementia and many will be diagnosed with Alzheimer’s disease in their early 50s. While AFHS are of critical importance, by focusing solely on adults over age 65, we are missing an opportunity to improve the health and well-being of people with disabilities. Many adults living with disabilities would likely benefit from providers deliberately and thoughtfully addressing what matters, medication, mentation, and mobility. In this paper, we posit that implementing the 4Ms framework with younger adults with disabilities has the potential to both enhance compliance with the ADA and lay the ground work for making an equitable, disability-friendly health system a reality.
Disseminated Ureaplasma urealyticum infection and hyperammonemic encephalopathy in a patient with Activated PI3K- delta syndrome 2 (APDS2)
Authors: Lai Yi Wye , Lin Ray Junhao , Maiwald Matthias , Lim Gareth Zigui , Pooja Rao , Koh Tse Hsien , Puah Ser Hon , Tan Teck Choon , Howe Hwee Siew , Lim Xin Rong
Published: February 2025

Hyperammonemia syndrome (HS) from Ureaplasma infection is typically reported in post-transplant recipients, particularly lung transplant. We describe a young female with activated PI3K-delta syndrome (APDS) 2 who presented with HS from disseminated Ureaplasma urealyticum infection with septic arthritis. We also performed a literature review of Ureaplasma-associated HS in non-transplant patients.
We Drove to the Moon: Ensuring Methadone Access in Rural Kentucky through Peer Transportation
Authors: Fallin-Bennett Amanda , Moffitt Trevor , Walsh Sharon L. , Lofwall Michelle , Miles Jennifer , Underwood Clinton , Combs Kayla , Fanucchi Laura C.
Published: February 2025

Methadone, a gold standard treatment for opioid use disorder, faces limited access due to federal regulations restricting its dispensing to licensed opioid treatment programs (OTPs). Transportation is a critical barrier reported by rural area residents, where the distances to OTPs are over six times farther than for urban residents. To overcome this barrier in rural Kentucky, the HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS) partnered with Voices of Hope, a local recovery community organization, to develop a peer transportation program as part of the Recovery Coach Linkage and Retention Programs. The transportation program ran from 6/2021 to 12/2022 in 8 KY HCS counties and funded peer drivers (ie, individuals in recovery) to provide transportation to medication for opioid use disorder appointments and recovery-related services. Peer drives transported 197 participants 232,700 miles; most (78.5%) were to a single OTP in rural Madison County, KY, over 550 days. The program was an innovative solution. Peer drivers had greater flexibility and a broader scope of work compared to traditional options like Medicaid-provided nonemergency medical transportation. Furthermore, peer drivers could transport participants in unconventional locations, as outlined in the presented case study, and build rapport with participants through sharing lived experience. Implementing similar, peer-based transportation programs is a novel solution to a critical need.
Will my Child Walk Funny? The Rotational Profile of Infants and Children With Classic Bladder Exstrophy
Authors: Regan Maia D. , Cardin Stefano , Defrancesco Christopher , Horn B. David
Published: February 2025

Background:

Bladder exstrophy is a rare, complex disorder that involves the urinary, reproductive, gastrointestinal, and musculoskeletal systems and is marked by an incomplete lower abdominal wall, leaving the bladder exposed to the outside world. Skeletal findings in this condition include externally rotated innominate bones. While the resulting acetabular retroversion might be expected to cause out-toeing, there is no published data on the gait parameters or rotational profile of children with classic bladder exstrophy (CBE) in isolation. This study, therefore, characterizes the rotational profile and walking age of infants and toddlers with CBE.

Methods:

Patients treated at a tertiary care pediatric hospital for CBE from January 2014 to June 2023 were retrospectively reviewed. Patient history, examination, and radiographic findings—including rotational profile and age at independent ambulation—were recorded. Patients with a diagnosis of cloacal exstrophy or epispadias without exstrophy were excluded.

Results:

Out of 46 patients meeting inclusion criteria, 17 (37%) were female and 29 (63%) were male. All underwent exstrophy repair combined with iliac osteotomies (24 anterior and 22 posterior). The anterior pelvic ring was secured with suture fixation (44/46) or threaded wires (2/46). Patients were immobilized with either a spica cast (n=41, 89%) or skin traction (n=5, 11%).

Preoperatively, hip internal and external rotation with the hip in extension averaged 43 and 78 degrees, respectively. Postoperatively, internal rotation initially decreased and then increased over time, while external rotation decreased over the same time. There was no difference in internal or external rotation between patients who had either anterior or posterior osteotomies (P=0.35, 0.09, respectively).

At 3 years of age, foot progression angle (n=21) averaged +8.7 degrees ±5.5 (range: 0 to 20 degrees) while thigh foot angle (n=30) averaged +2.8 degrees ±4.4 (range: 0 to 10 degrees). Despite most patients undergoing surgery before age 1, all patients walked independently on time at a mean age of 13±2.4 months (range: 11 to 18 mo).

Conclusions:

Infants and toddlers with CBE who undergo early reconstruction walk independently at a normal age. Their rotational profile falls within normal bounds, even though their underlying pelvic anatomy may predispose them towards an externally rotated gait.

Level of Evidence:

Level III—retrospective cohort study.
Validating the Hierarchical Nature of the AO Spine Upper Cervical Spine Injury Classification System
Authors: Narayanan Rajkishen , Dalton Jonathan , Bransford Richard , Dvorak Marcel R. , Singh Chhabra Harvinder , Joaquim Andrei F. , El-Sharkawi Mohammad , Benneker Lorin M. , Schnake Klaus , Oner Cumhur , Dandurand Charlotte , Canseco Jose A. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. ,   AO Spine Upper Cervical Spine Injury Classification System Validation Members
Published: February 2025

Study Design.

Global cross-sectional survey.

Objective.

To validate the hierarchical nature of the AO Spine Upper Cervical Spine Injury Classification (UCIC) across AO geographical regions/practice experience.

Summary of Background Data.

In order to create a universally validated scheme with prognostic value, AO Spine established an upper cervical spine injury classification involving three elements: injury morphology (region: I – occipital condyle and craniocervical junction; II – C1 ring and C1-2 joint; III – C2 and C2-3 joint), and (subtype: A - isolated bony injury; B – bony/ligamentous injury; C – displaced/translational injury), neurologic status (N0 – intact; N1 – transient deficit; N2 – radiculopathy; N3 – incomplete spinal cord injury (SCI); N4 – complete SCI, and NX – unable to examine), and case-specific modifiers (M1 – injuries at risk of nonunion; M2 – injuries at risk of instability; M3 – patient specific factors; M4 – vascular injury).

Methods.

151 AO Spine members (orthopaedic and neurosurgery) were surveyed globally regarding the severity (zero - low severity to 100 - high severity) of each UCIC variable. Primary outcomes were differences in perceived injury severity score (ISS) over various geographic/practice settings, level of experience, and subspecialty.

Results.

148 responses were received. There was an increase in median perceived severity as each anatomic region (I-III) progressed from types A to B to C. Neurologic status progressed similarly, except N1 and N2 were perceived similarly. Modifier M2 was perceived more severely than M3. There were no differences in ISS amongst levels of surgeon experience. There were small geographic differences with respondents from North and Central and South America perceiving types IC (P=0.003), IIB (P=0.003), and IIIB (P=0.003) somewhat more severely than other regions. Neurosurgeons perceived types IB (P=0.002) and IIIB (P=0.026) as more severe than orthopaedic spine surgeons.

Conclusions.

The AO Spine UCIC has overall excellent hierarchical progression in subtype ISS. These findings are consistent across geographic regions, spine subspecialty training and experience levels.
Pharmacogenetics of plasma dolutegravir exposure during 1-month rifapentine/isoniazid treatment of latent tuberculosis
Authors: Covington Nia , Luetkemeyer Anne F. , Imperial Marjorie Z. , Dawson Rodney , Cramer Yoninah , Rosenkranz Sue , Swindells Susan , Gelmanova Irina , Avihingsanon Anchalee , Arduino Roberto C. , Samaneka Wadzanai , Dooley Kelly E. , Savic Rada , Podany Anthony T. , Haas David W.
Published: February 2025

In Advancing Clinical Therapeutics Globally protocol A5372, a pharmacokinetic study of dolutegravir with 1-month of daily rifapentine/isoniazid, twice-daily dolutegravir offset the induction effects of rifapentine on plasma dolutegravir trough concentrations (Ctrough). Here, we characterize the impact on dolutegravir Ctrough of UGT1A1, AADAC, and NAT2 polymorphisms that affect dolutegravir, rifapentine, and isoniazid, respectively. People with HIV receiving dolutegravir-based antiretroviral therapy with an indication to treat latent tuberculosis underwent pharmacokinetic sampling during dolutegravir 50 mg once daily alone, and on day 28 of dolutegravir 50 mg twice daily with rifapentine/isoniazid. Multivariable linear regression models characterized genetic associations with dolutegravir Ctrough. Among 30 participants evaluable for genetic associations, median (Q1, Q3) day 0 dolutegravir Ctrough was 1745 (1099, 2694) ng/ml, and day 28 was 2146 (1412, 2484) ng/ml. Day 28 Ctrough was higher with UGT1A1 rs887829 TT [geometric mean ratio (GMR) = 1.65; 90% confidence interval (CI): 0.97–2.78] and CT (GMR = 1.38; 90% CI: 1.02–1.86) than with CC, and was higher with AADAC rs1803155 GG (GMR = 1.79; 90% CI: 1.09–2.93) and AG (GMR = 1.48; 90% CI: 1.14–1.90) than with AA. Median day 28 Ctrough ranged from 1205 (1063, 1897) ng/ml with 4 total UGT1A1 and AADAC risk alleles, to 3882 and 3717 ng/ml with only one risk allele. Individuals with concomitant AADAC slow metabolizer and UGT1A1 normal metabolizer genotypes may be at greater risk for clinically significant drug–drug interactions between rifapentine/isoniazid and dolutegravir.
High Rates of “Watch” and “Reserve” Class Antibiotics Used to Treat Infections in Neonates and Infants in Southeast Asia
Authors: Harrison Michelle L. , Dickson Benjamin F. R. , Villanueva-Uy Maria Esterlita T. , Dwi Putri Nina , Adrizain Riyadi , Kartina Leny , Gunaratna Gayana P. S. , Chandrasiri Nambage Shirani , Tran Hoang T. , Nguyen Huong X. , Fong Siew M. , Kasahara Erena S. , Le Chau H. M. , Soekardja Distyayu , Husada Dominicus , Hong Ng Boon , Williams Phoebe C. M.
Published: February 2025

We evaluated antibiotic prescribing practices for neonates and infants hospitalized with infections in resource-constrained healthcare settings, where antimicrobial resistance is responsible for significant neonatal morbidity and mortality. A point prevalence survey of 667 admitted infants across 10 clinical sites in Southeast Asia revealed a total of 405 antibiotics were prescribed to 218 infants, with high use of World Health Organization-classified “Watch,” “Reserve” and “Not Recommended” antibiotics.
Characteristics of Children Hospitalized for Acute COVID-19 in France From February 2020 to December 2023
Authors: Rybak Alexis , Ouldali Naïm , Werner Andreas , Casha Paul , Robert Blandine , de Pontual Loïc , Béchet Stéphane , Cahn-Sellem Fabienne , Angoulvant François , Cohen Robert , Levy Corinne ,   PANDOR study group
Published: February 2025

We describe the characteristics of children hospitalized for coronavirus disease 2019 in France with a focus on the post-BA.1 Omicron period (February 2022–December 2023). We identified 3 main groups of children: those ≤90 days old (44.8%), older children with comorbidities (22.1%) and children with multisystem inflammatory syndrome (5.2%). Low vaccination coverage in these groups suggests that this burden could be alleviated with immunization.
Completion, Safety and Tolerability of Once-Weekly Isoniazid and Rifapentine for Tuberculosis Infection by Children and Adolescents
Authors: Cruz Andrea T. , Cameron Lindsay H. , Starke Jeffrey R.
Published: February 2025

Background:

Treating patients for tuberculosis (TB) infection prevents future cases and transmission. Long treatment regimens have been associated with low completion rates. We describe a 1-decade experience with treating children and adolescents for TB infection (TBI) with 3 months of once-weekly doses of isoniazid and rifapentine (3HP).

Methods:

This was a retrospective review (2014–2024) of 2 to <21 year olds who received 3HP under directly observed therapy for TBI. We abstracted demographic data, testing methods and treatment course information. Our primary outcome was treatment completion; our secondary outcome was adverse events (AEs).

Results:

Eight hundred two patients met inclusion criteria; 94.1% completed therapy. Completion rates were not associated with demographic data or testing methods. The most common reasons for not completing 3HP were AEs (23/802, 3%), moving out of the area (11, 1.4%) and pill burden (7, 0.9%). AEs resulting in failure to complete 3HP were rare. These included vomiting (15; 2 with elevated aspartate aminotransferase/alanine aminotransferase), abdominal pain (7, all with normal aspartate aminotransferase/alanine aminotransferase), rash (6), angioedema (4) and myalgias (2); 16/23 had >1 AE. Of the 23 with AEs, 20 began alternative regimens [rifampin (12), levofloxacin (5) and isoniazid (3)], and 17/20 (85%) completed TBI therapy.

Conclusions:

Over 94% of children as young as 2 years of age completed 3HP for TBI, which is remarkable considering the large pill burden and lack of child-friendly formulations available in the United States. The only factor associated with treatment completion was the presence of an AE.
Subglottic spray via epidural catheter in awake tracheal intubation: A CARE-compliant case report
Authors: Chen Chao , Chen Junheng , Chen Weiqiang , Guo Chunming , Zhan Yinzhou
Published: February 2025

Rationale:

For anticipated difficult airways, awake tracheal intubation is strongly recommended by guidelines for its high success rate and safety. The key to successful awake tracheal intubation is effective airway topicalization. Currently available topicalization techniques have corresponding drawbacks and complications. Especially for subglottic topicalization, noninvasive techniques are not effective. Subglottic spray via epidural catheter with a flexible bronchoscope provided an effective and noninvasive technique.

Patient concerns:

A 73-year-old female patient with a history of giant goiter for 9 years suffered chest tightness and shortness of breath, and a 54-year-old male patient with a neck mass and hoarseness were scheduled for thyroidectomy.

Diagnoses:

Two cases of anticipated difficult airway due to compression by a giant goiter.

Interventions:

The subglottic area was topicalized via an epidural catheter with a flexible bronchoscope, and awake tracheal intubation was successfully performed.

Outcomes:

This technique was effective in eliminating airway reactions and hemodynamic fluctuations during awake intubation and improving the intubation success rate and patient tolerance.

Lessons:

This is the first report of subglottic topicalization via an epidural catheter with a flexible bronchoscope applied in cases of awake intubation in giant goiter. The epidural catheter spray is safe and effective in awake intubation of an anticipated difficult airway, and this noninvasive technique is an alternative option to transtracheal injection.
Endoscopic diagnosis of gastric carcinoma of fundic gland type: A case report
Authors: Zhu Chen , Jiang Wen , Bian Zhaolian
Published: February 2025

Rationale:

Gastric carcinoma of fundic gland type is a new type of gastric cancer with a low incidence rate. The mechanism of gastric carcinoma of the fundic gland differs significantly from that of common adenocarcinoma. While it typically presents as a benign growth, there are cases where it can progress to malignancy. If early endoscopy fails to provide an accurate diagnosis and the treatment is inappropriate, the tumor may metastasize and spread.

Patient concerns:

A 61-year-old male, abdominal discomfort, was performed gastroscopy.

Diagnoses:

Gastroscopy revealed a raised lesion approximately 1.8 cm × 1.5 cm in size in the middle of the gastric body, with surface flushing.

Interventions:

The patient was performed endoscopic submucosal dissection.

Outcomes:

The pathology showed gastric carcinoma of fundic gland type SM2, and the cure grade was eCura B. Follow-up review was conducted after communicating with the patient. After 6 months of follow-up, the patient shows no signs of recurrence or metastasis; future observations will require ongoing monitoring. This case emphasizes the difficulties of endoscopic diagnosis, and postoperative pathology confirmed the diagnosis of gastric carcinoma of the fundic gland type.

Lessons:

Gastric carcinoma of the fundic gland type is characterized by low atypia and easy SM invasion. This case highlights the importance of using endoscopy to identify this type, and select appropriate treatment methods. Because the infiltrative characteristics differ from those of conventional early gastric cancer, selecting endoscopic submucosal dissection treatment for lesions smaller than 2 cm can reduce postoperative tumor recurrence and metastasis.
Effect of electroconvulsive therapy on depression among adolescents and its relationship with family function
Authors: Chen Kaichao , Ren Li , Yang Yahui , Liang Kaiwen , Zhou Yahan , Lv Furong , Du Lian
Published: February 2025

To explore the short-term and long-term effects of electroconvulsive therapy (ECT) on depression among adolescents and to determine the relationship between the effects of ECT and family functioning. Sixty-five adolescent inpatients with major depressive disorder (MDD) who received ECT were recruited. We assessed the severity of MDD with the Hamilton Depression Rating Scale-24 (HDRS-24) before (T0), 1–2 days after the end of ECT treatment (T1), and 3 months after the end of ECT treatment (T2). We calculated the reduction in HDRS scores at T1 (short-term effect) and T2 (long-term effect). Additionally, we examined the relationship between family functioning and the effects of ECT. The short-term response rate to ECT was 64.6%, but the long-term response rate decreased to 22.2%. HDRS scores were significantly lower at T1 and T2 than at T0 (P < .01). Independent sample t tests showed that the mean scores for the communication, roles, affective responsiveness, affective involvement, and overall functionality dimensions of the Family Assessment Device were significantly lower in the responder group than in the nonresponder group at T2 (P < .05). Forward entry binary logistic regression showed that the short-term effects of ECT were stronger among patients who were hospitalized in a psychiatric ward for the first time, and the affective involvement dimension of the Family Assessment Device was significantly negatively correlated with the long-term effects of ECT (P < .05). ECT may be an effective intervention for MDD among adolescents; however, its short-term effects are more prominent than its long-term effects. In addition, family functioning may be related to long-term responses to ECT.
Safety of Transesophageal Echocardiography With the Assistance of a Nurse Practitioner
Authors: Harashima Yuki , Okuno Taishi , Sato Yukio , Shoji Tatsuro , Osabe Kazuko , Ito Rie , Kato Aoi , Kamiyama Akiko , Motodate Noriko , Murata Risako , Oda Ryutaro , Miyahara Daisuke , Kuwata Shingo , Ishibashi Yuki , Kida Keisuke , Tanabe Yasuhiro , Izumo Masaki , Fujitani Shigeki , Akashi Yoshihiro J.
Published: February 2025

Background:

Due to advancements in cardiovascular intervention technologies, transesophageal echocardiography (TEE) is increasingly used. In Japan, nurse practitioners are being integrated into specialized procedures, including TEE, under physician supervision to address physician shortages and improve patient safety.

Methods:

Consecutive patients undergoing TEE at our outpatient clinic from July 2022 to June 2023 were included, with baseline characteristics, procedural details, and outcomes retrospectively collected.

Results:

A total of 186 patients were included in the study. A significant decrease in blood pressure was observed in 124 patients (68.5%), with 19 patients requiring treatment through infusion loading. Desaturation (SpO2 < 90%) was observed in 105 patients (57.7%). No significant differences in hypotension or hypoxia incidence were found between elderly and younger patients or among TEE indications.

Conclusions:

TEE procedures were safely performed under the assistance of nurse practitioners, demonstrating effective management of the procedural risks associated with this diagnostic technique.
Patient perspectives on the desirability of social worker support in outpatient orthopaedic trauma clinics
Authors: Sprague Sheila , Fleming Natalie , Gonsalves Marc , Al-Asiri Jamal , Johal Herman , Williams Dale , Al-Zahrani Faisal , Gallant Jodi L. , Renaud Sara , Pusztai Kaitlyn , MacRae Sarah , Zalzal Megan , Bzovsky Sofia , Petrisor Brad
Published: February 2025

Objectives:

This study examined the benefits of a dedicated social worker in the fracture clinic setting as perceived by patients and caregivers.

Methods:

This cross-sectional survey engaged patients aged 18 and older presenting to the fracture clinic associated with a level 1 trauma center. Surveys were available in English and Arabic and included 11 questions designed to measure level of agreement with various aspects of social worker presence in the outpatient fracture clinic.

Results:

A total of 199 patients and caregivers participated in this study. Most of the participants were female (61.8%) and older than the age of 50 (57.1%). While there was nuance in the circumstances and issues participants felt were appropriate for social worker assistance, most (95.4%) found the general premise of having a dedicated social worker available in the fracture clinic to be acceptable and believed that it would be beneficial to fracture clinic patients. Participants indicated that social workers could support trauma patients with multiple issues (≥60% level of agreement across all items).

Conclusions:

Orthopaedic trauma patients and their caregivers overwhelmingly support the addition of a dedicated social worker to the fracture clinic, with a high level of agreement across demographic groups and proposed social worker interventions. The patient and caregiver population finds the fracture clinic to be an appropriate and viable setting for the mitigation of nonphysical impacts of orthopaedic trauma. These findings can inform the development of potential future additions of social services to the fracture clinic.

Level of Evidence:

Level IV.
Not all call is created equally: The impact of culture and sex on burnout related to in-house call
Authors: Coleman Jamie J. , Robinson Caitlin K. , von Hippel William , Cohen Mitchell J.
Published: February 2025

BACKGROUND

In-house call (IHC) has previously been shown to result in increased burnout in acute care surgeons (ACSs). There is wide variation, however, in the implementation and culture of work surrounding IHC across trauma centers and within the demographics of practicing ACSs. We hypothesized that local work practices and culture surrounding IHC as well as sex of ACSs would impact burnout.

METHODS

Continuous physiologic data were collected over 6 months from 224 ACSs who wore a fitness wearable. Acute care surgeons were sent daily surveys to record work, personal activities, and feelings of burnout. The Maslach Burnout Inventory was completed by ACSs at the beginning and end of the study period.

RESULTS

Forty-eight (21.5%) of ACS reported being expected to complete the usual workday after IHC, 94 (42.2%) were expected to finish work from IHC, and 81 (36.3%) were expected to leave immediately after IHC was over. Acute care surgeons expected to complete a usual workday postcall were more likely to be burned out, and IHC resulted in a greater increase in their daily feelings of burnout than among ACSs who reported working in other work cultures. Females showed higher levels of daily burnout than males but no difference in the degree to which IHC led to burnout.

CONCLUSION

In-house call results in increased burnout in all ACSs; however, IHC had a larger impact on daily feelings of burnout in ACSs expected to work without adjustments to their work schedule postcall. Although female ACSs reported higher levels of daily burnout than male ACSs, IHC increased daily feelings of burnout equally between the two sexes. Taken together, these findings necessitate caution about work expectations surrounding IHC and suggest a need for the deliberate creation of a postcall culture for ACS.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.