bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular disease and bipolar disorder: A review of pathophysiology and treatment implications
Authors: Chaudhari Mayuresh , Mendez Luis , Olvera Rene L. , Seshadri Sudha , Teixeira Antonio L.
Published: January 2025

Objective

Despite the well-established increased risk of cardiovascular mortality in individuals with bipolar disorder (BD), prevention and treatment of cardiovascular risk factors and diseases have been largely overlooked in this population. This manuscript reviews the pathophysiological basis of the connection between BD and cardiovascular diseases, highlighting their shared mechanisms, reciprocal interactions, and relevant prevention and treatment strategies.

Methods

For this narrative review, a search was carried out on PubMed using the keywords bipolar disorder, cardiovascular diseases, and cardiovascular risk factors.

Results

The increased frequency of cardiovascular morbidity in BD can be attributed to overlapping biological and psychosocial mechanisms. These mechanisms are complex and involve both direct effects of BD and indirect effects mediated by lifestyle and pharmacological factors. Cardiovascular diseases also significantly exacerbate the clinical course of BD and increase morbidity and healthcare costs; thus, their effective management can improve psychiatric outcomes and vice versa. However, patients with BD frequently encounter healthcare barriers.

Conclusion

Awareness initiatives and research on integrated care are needed to determine the best strategies for improving cardiovascular and psychiatric outcomes in individuals with BD.
Eating to live well—Or worse? The role of vegan and vegetarian diets in mental health
Authors: Dobersek Urska , Lavie Carl J , Archer Edward
Published: January 2025

Background

Over the past two decades, there has been an increase in the prevalence of psychological conditions, such as depression, anxiety, disordered eating, and body image disturbances. In concert with this trend, there was a substantial rise in the advocacy and practice of restrictive dietary patterns, such as veganism and vegetarianism. These parallel developments suggest a relation between diet and mental health, but to date, research has failed to offer clear answers on whether these associations are causal, coincidental, or more complex than superficial analyses suggest.

Aim

Given this context, the purpose of this commentary is to offer a consilient perspective on the role of vegan and vegetarian diets in mental health.

Methods

We performed a broad qualitative synthesis of the current literature on diet and mental health from sociologic and psychologic perspectives.

Results

Several empirically supported hypotheses were presented with equivocal support.

Conclusion

The current evidence suggests that if a nutritionally adequate diet is consumed, the avoidance/consumption of meat and other animal foods will have no significant effects on physical and mental health.
Maternal plasma urocortin level as a biomarker of preterm birth: a prospective cohort study in Sulaimaniyah city in Iraq
Authors: Nasir Sallama Kamel
Published: January 2025

Objective

To evaluate the value of the urocortin (UCN) level to predict preterm delivery in women with threatened preterm labour.

Methods

This prospective cohort study included 96 women with a singleton pregnancy between 28 and 34 weeks of gestation who were admitted with threatened preterm labour. The participants were monitored until delivery. The UCN level was compared between those with preterm and with full-term deliveries.

Results

The mean UCN level was higher for preterm deliveries (96 ± 24.34 pg/mL) than for full-term deliveries (62.62 ± 23.63 pg/mL). A UCN cutoff level of 92 pg/mL had 20% sensitivity, 100% specificity, 100% positive predictive value, and 10% negative predictive value. Thus, 17.7% of women had a UCN level ≥ 92 pg/mL, and all delivered preterm. Among the 82.3% of women who had a UCN level < 92 pg/mL, 88.6% delivered preterm, and 11.4% delivered at full term. Moreover, 88.2% of women who had a UCN level ≥ 92 pg/mL delivered within 7 days and only 11.8% delivered after 7 days. However, 58.2% of women with a UCN level < 92 pg/mL delivered within 7 days and 41.8% delivered after 7 days.

Conclusion

A UCN cutoff level of ≥92 pg/mL predicts preterm delivery within 7 days of admission.
Investigating the effect of hot preforming combined with superplastic forming on thickness distribution and forming time of Ti-6Al-4V alloy using finite element analysis
Authors: Alavi Seyyed Amirhossein , Afshari Mahmoud , Afshari Hossein , Samadi Mohammad Reza , Abbaas H. , Abualigah Laith
Published: January 2025

The present work focuses on the development of a new superplastic forming (SPF) that utilizes hot preforming to improve thickness distribution and decrease forming time. For this purpose, finite element analysis (FEA) was employed as an efficient tool to indicate feasibility of the new method by designing the appropriate die geometry. The experimental tests were performed to find the tensile properties of Ti-6Al-4V alloy at different temperatures and angles. Detailed FEA technique was employed to model the SPF process by a constitutive model that considers both microstructural features and geometrical instabilities. The variations of the forming time and distribution of thickness due to the variation of the forming parameters such as strain rate and friction coefficient were studied to compare the results with the results of hot preforming combined with SPF process. The obtained results from FEA showed that this new method can provide a good thickness distribution, so that the thickness variation reduced from 44% to about 21% and the forming time considerably reduced from 1100 to 610 s.
Trochlear Morphological Changes in Skeletally Immature Patients Across Consecutive MRI Studies
Authors: Orellana Kevin J. , Lee Julianna , Yang Daniel , Kell David , Nguyen Jie , Lawrence J. Todd , Williams Brendan A.
Published: January 2025

Background:

Trochlear dysplasia is a consistent risk factor for recurrent patellofemoral instability (PFI), but there is limited understanding of how the trochlea develops during growth. The aim of this study was to evaluate serial magnetic resonance imaging (MRI) studies performed in skeletally immature patients with and without PFI to characterize changes in trochlear anatomy over time.

Hypothesis:

PFI leads to progressive worsening of trochlear dysplasia over time.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective case-control study was conducted on pediatric patients (<18 years of age) with and without a diagnosis of PFI who had multiple ipsilateral MRI studies of the knee at least 6 months apart. Inclusion criteria were patients with open distal femoral physes at the initial MRI study and no intervening surgery between MRI studies. All patients with PFI were included, and 30 patients without PFI were identified for comparison. MRI scans were retrospectively reviewed to evaluate trochlear morphology using the Dejour and Oswestry-Bristol classifications and to measure the sulcus angle, trochlear depth index, medial condylar trochlear offset, and lateral trochlear inclination (LTI). Univariate and bivariate statistics were performed to evaluate differences in morphology between MRI studies and between groups.

Results:

A total of 128 patients were identified (98 in the PFI group, 30 in the non-PFI group) with a mean age of 12.3 ± 2.4 years and mean time between MRI studies of 2.3 ± 1.5 years (range, 0.5-6.5 years). Among patients with PFI, rates of moderate to severe (Dejour grades B-D and Oswestry-Bristol classification flat or convex) trochlear dysplasia increased from the initial to most recent imaging study (67% vs 89%; P < .001), and statistically significantly more dysplastic LTI and sulcus angle were observed on follow-up ( P < .05). Among the non-PFI group, the percentage of patients with normal trochlear morphology increased from 53% to 87% ( P < .001), and less dysplastic measures of trochlear depth index, LTI, and sulcus angle were seen on follow-up imaging ( P < .05). When comparing rates of change, trochlear metrics changed toward a more shallow and dysplastic direction in the PFI cohort and toward a deeper and less dysplastic direction in the non-PFI group.

Conclusion:

Skeletally immature patients with untreated PFI have trochlear dysplasia that progressively worsens over time. Conversely, those without PFI have trochlear characteristics that appear to normalize with growth.
The pattern of cytokine profile in children received extracorporeal blood purification
Authors: Hui Wun Fung , Chan Renee Wan Yi , Wong Chun Kwok , Cheung Wing Lum , Ku Shu Wing , Hon Kam Lun
Published: January 2025

We reported the cytokine profile in children <18 years old who received extracorporeal blood purification (EBP) for sepsis, rhabdomyolysis, hyperbilirubinaemia, acute respiratory distress syndrome or cytokine storm, and determined the factors affecting the cytokine removal kinetics. Plasma levels of 38 types of cytokine/chemokine were measured at pre-EBP, 12 and 24 h after initiating EBP. Altogether there were 11 eligible episodes admitted between April 2021 and December 2023. 72.7% were male with a median (25th, 75th percentile) age of 8.7 (5.4, 15.7) years old. The overall mortality rate was 45.5% but there was no EBP-associated mortality. EBP modalities included Cytosorb® haemoadsorption (63.6%) and Oxiris® haemodiafiltration (36.4%). Thirty-seven (97.4%) cytokines exhibited a concentration reduction following EBP, and 60.5% achieved a ≥50% concentration reduction. The median removal ratio was 35.0 (21.0, 53.7)% at 12 h and 55.0 (42.1, 83.1)% at 24 h. Survivors showed a significantly higher number of cytokines with ⩾50% removal ratio at 24 h (28 vs 7, p = 0.017) and better removal ratio of anti-inflammatory cytokines at 12 h (67.9% vs 0%, p = 0.030). A higher pre-EBP cytokine concentration and higher blood flow rate were significantly associated with better removal in 16 (42.1%) and 32 (84.2%) cytokines respectively. Our study demonstrated that both devices can safely and effectively reduce the cytokine and chemokine levels in critically ill children with various conditions.
Testing psychiatrists to diagnose schizophrenia: Crisis, consensus, and computers in post-war psychiatry
Authors: Freeborn Alfred
Published: January 2025

This article offers a new reading of the US–UK Diagnostic Project (1965–75), a series of influential collaborative studies that tested the ability of psychiatrists on either side of the Atlantic to diagnose schizophrenia, exploring its historical origins, significance, and legacy. Using archival materials to trace the contest between two of the key players in the Diagnostic Project, Aubrey Lewis and Morton Kramer, it explores how the methodological allegiance between biostatistics and clinical psychiatry was forged in a decade in which psychiatry was undergoing a public crisis. The article unpacks how the place of diagnosis in psychiatry was fundamentally transformed through this important and overlooked collaboration, in which computational methods were strategically used to steer post-war psychiatry from crisis to consensus.
Research of fault diagnosis and prediction based on Bayesian networks and time series model for meta-action
Authors: Gu Minghui , Li Yulong , Wang Yujiang , Wen Shutao , Li Junfa , Liu Baoyuan
Published: January 2025

Nowadays, electromechanical products have complex structures and a higher incidence of failures. However, traditional fault prediction methods lack accuracy, causing maintenance delays. To address this, a precise fault diagnosis and prediction model based on BN (Bayesian Network) and time series, grounded in MA (Meta-Action) theory, is proposed in this research. Firstly, the FMA (Function-Motion-Action) method decomposes electromechanical products into simpler MA and MAU (Meta-action Unit), reflecting the quality characteristics of the entire product. Next, the BN model is constructed with MA and fault phenomenon as nodes, enabling the diagnosis of faulty MA. Meanwhile, the vibration signal is saved as the standard time series and the database is established. Thirdly, to compare the similarity between different time series, a time series model is constructed. A distance dissimilarity matrix is established by calculating the ED (Euclidean distance) between abnormal and standard time series. The DTW (Dynamic Time Warping) algorithm is applied to compute the warping cost between signals and identify the optimal warping path. Early warnings are issued based on the cumulative costs along each optimal path, focusing on the fault mode and faulty MA with the lowest cumulative cost. Finally, experimental analysis is conducted on the CNC (Computer Numerical Control) rotary table of a specific domestic machining center model, A comparative study using multiple methods showed that the fault prediction accuracy of the proposed method reached 90.51%, demonstrating the model’s ability to effectively predict various fault types. Besides, the macro-mean recall reached 0.896, highlighting the model’s strong performance in multi-fault classification with unbalanced data and reduced sensitivity to sample size. These results confirmed the superiority of the method proposed in this research. Furthermore, the method is applicable to other electromechanical products with structures similar to CNC machine tools.
Caregivers’ Perspectives on Supporting Sexual and Gender-Diverse Youth in Adolescent Relationship Abuse Prevention
Authors: Mickievicz Erin , Laubacher Callie , Alston Coley , Burnett Johanna , Simpson Alicyn , Sickler Lynz , O’Connor Brian , Mahler Jesse , Amodei Joseph , Miller Elizabeth , Shaw Daniel , Coulter Robert W. S. , Ragavan Maya I.
Published: January 2025

Adolescent relationship abuse (ARA) has significant sequelae and is more prevalent among sexual and gender-diverse youth (SGDY). Increased parental involvement and communication has been linked to decreased prevalence of ARA and associated health risks. Parents of SGDY may have unique needs and experiences regarding communicating with their children about ARA, yet little research has examined this area. This study explored caregivers’ current practices around supporting their SGDY in healthy relationship formation and ARA prevention; caregivers’ perceptions about ARA among SGDY; and their recommendations for developing ARA prevention-focused interventions for caregivers of SGDY. We conducted 24 semi-structured interviews with caregivers of SGDY aged 12 to 19. Transcripts were analyzed using thematic analysis. Some participants reported having positive, open communication with their SGDY about dating, while others struggled to understand and respond to the unique risks of ARA experienced by their adolescent. Caregivers discussed ways systemic discrimination affects SGDY experiences of relationships and ARA, and distinct dating challenges for gender-diverse youth. When considering caregiver-focused ARA prevention, participants supported a program including ARA education, communication skills building, and caregiver affirmation. Participants encouraged the use of digital and in-person mediums, experienced and relatable facilitators, and SGDY involvement. Caregivers of SGDY had significant strengths and challenges when engaging and communicating with their child around dating and ARA prevention. Caregivers at varying stages of acceptance and understanding believed they could benefit from a comprehensive and inclusive education program on SGDY ARA experiences and how they can support their child in preventing ARA.
Action and affect: Ritual dynamics in Jackson Pollock's creative process
Authors: Julliard Raphael
Published: January 2025

This article proposes to use ritual anthropology to model the creative process in modern Western art, illustrated by the longitudinal case study of North American artist Jackson Pollock. First, the article applies Alfred Gell's model, where artists are either “passive” spectators or “active” creators, and signals the need for a more detailed description of the transition between these states. Drawing from the dynamics of affects as drivers for action in Jeanne Favret-Saada's ethnography of rural sorcery, the article proposes a resolution for this shift. This new model emphasizes that, for Pollock, artworks are used to experience a specific affect, the pursuit of which guides his creative process, both for individual artworks and the development of his entire body of work. The conclusion briefly explores how the model applies to another visual art practice and alternative models from psychology to further emphasize the centrality of affects in the creative process.
Exploring issues related to disappearing rural areas in the UAE: In search of the critical role of social workers
Authors: Gad Salah , Egorova Zhanna , Youssef Enaam
Published: January 2025

This study aims to identify and quantitatively assess the challenges faced by residents of disappearing rural areas, which present significant obstacles for social workers, and to outline potential solutions using the example of the United Arab Emirates (UAE). For this purpose, interviews were conducted with social workers ( n = 112), and questionnaires were administered to residents of disappearing rural areas ( n = 101) and prosperous villages ( n = 121).

Findings

The results of the questionnaire were compared using Student's t-test, which showed statistically significant differences for UAE citizens between the components combined in the categories Loss of home ( pvalue = .01, at p < .05), Material reasons ( pvalue = .043 at p < .05), Privacy ( pvalue = .039, at p < .05), and Medical support ( pvalue = .05 at p < .05). According to the ratings provided by participants, the component that received the highest weight was Loss of home, with an average rating of 4.5 points across the sample of citizens. In contrast, noncitizens assigned equal importance to Loss of home and Medical support, with an average rating of 4.3 points for each of these components. To solve the problems identified with the help of a social worker, it is proposed to actively use modern technology to find and perform work, obtain information, and consult with doctors and psychologists through video communication, with the social worker acting as a prompting and technical assistant.

Applications

In addition to offering suggestions to social workers, this study provides important information for policymakers at different levels of government to adopt constructive social welfare reforms for residents of disappearing rural settlements.
Community multiculturalism and self-reported immigrant crime: Testing three theoretical mechanisms
Authors: Leerkes Arjen S. , Fokkema Tineke , Bening Jonathan , Bezemer Willemijn E.
Published: January 2025

There are considerable contextual differences, both between countries and municipalities, in the degree to which first- and second-generation immigrants are involved in crime. This study aims to understand such variation better, focusing on the local level. It examines whether municipal variation in self-reported crimes among Turkish- and Moroccan-Dutch men residing in 30 representative Dutch cities ( n = 902), including the four largest cities, is associated with municipal variation in multicultural attitudes, or ‘community multiculturalism’ (CM), among the native-Dutch living in these municipalities ( n = 2556). We propose and test a mechanism-based theoretical model that links Berry's acculturation theory to general strain theory, social bonding theory, and collective efficacy theory. In line with a previous study using police data, the self-reported offending incidence is indeed considerably lower in municipalities with higher CM levels than in other, demographically comparable municipalities. The empirical evidence suggests that the association between CM and immigrant crime is caused by CM promoting social control in the immigrant group, both at the individual and community levels.
Semi-Branched Endovascular Aortic Repair: A New Feature in the Treatment of Complex Aortic Aneurysms
Authors: Bilman Victor , Silverberg Daniel , Speter Chen , Halak Moshe
Published: January 2025

Purpose:

To report a case series on using a novel semi-branch feature in custom-made stent-grafts in the endovascular treatment of complex aortic aneurysms and summarize the contemporary usage of this technology.

Case series:

Four patients underwent endovascular aortic aneurysm repair (EVAR) with a custom-made semi-branch stent-graft (Semi-Branch Endovascular Aortic Aneurysm Repair [SBEVAR]). Two male patients, 75- and 76-year-old, were treated due to failed EVAR with late-type Ia endoleak, and the other two, 80- and 55-year-old male patients, due to a juxta-renal aortic abdominal aneurysm (JRAAA). In 3 cases, the celiac trunk (CT) vessel was targeted through an inner semi-branch; in the other case, all target vessels were bridged through inner semi-branches. Intra-operative technical success was accomplished in all 4 patients. Post-operative recovery was uneventful in all cases. The 30-day computed tomography angiography (CTA) follow-up for each patient showed patent target vessels, excellent apposition of the bridging stent to the semi-branch, and complete exclusion of the aneurysm.

Conclusion:

The present report and the literature review demonstrate that introducing this novel semi-branch technology for the endovascular treatment of complex aortic aneurysms is feasible and holds great potential. The encouraging outcomes in cases of JRAAA and failed EVAR with late-type Ia endoleak inspire further studies to explore additional uses of this new tool in treating aortic pathologies.

Clinical Impact

The inner semi-branch is a novel technology for the incorporation of the renal and mesenteric vessels during complex endovascular aortic aneurysm repair. This new feature allows the use of a branched stent graft with a shorter length of the proximal sealing zone, reducing, consequently, the aortic coverage. It efficiently treats pathologies in which fenestrations could be inappropriate because precise stent graft placement might be difficult and in which tiny diameters leave inadequate room for typical inner branches. Although encouraging findings have been reported, long-term outcomes in target vessel stability have yet to be described.
Activation of the motor system following gaze cues is determined by hand access, not hand proximity
Authors: Wang Xiaoye Michael , Chan Cassie HY , Wang Yiru , Karlinsky April , Constable Merryn D , Welsh Timothy N
Published: January 2025

The influence of gaze cues on target prioritisation (reaction times [RTs]) and movement execution (movement trajectories) differs based on the ability of the human gaze cue model to manually interact with the targets. Whereas gaze cues consistently impacted RTs, movement trajectories may only be affected when the hands of the human model had the potential to interact with the target. However, the perceived ability to interact with the targets was confounded by the proximity between the model’s hands and the targets. The current study explored if the influence of gaze cues on movement trajectories is shaped by the model’s potential to access and interact with the targets using their hands or simply the proximity of the hands. A centrally presented human model randomly gazed towards one of two peripheral target locations. Participants executed aiming movements to targets that non-predictively appeared at one location at a stimulus onset asynchrony of 100, 350, or 850 ms. In Experiment 1, the model’s hands could not directly access the targets as each was holding a tray. In Experiment 2, the hands had direct access to the targets, but their palms-downwards orientation and wrist-flexed posture rendered efficiently interacting with the targets unlikely. Although RTs showed a facilitation effect of the gaze cue in both experiments, changes in movement trajectories were only observed when the model had direct access to the target (Experiment 2). The results of the current study suggest that the gaze model’s direct hand access is necessary for the social gaze cues to influence movement execution.
Insights and trends review: Use of extended reality (xR) in hand surgery
Authors: Oyama Shintaro , Iwase Hiroaki , Yoneda Hidemasa , Yokota Hideo , Hirata Hitoshi , Yamamoto Michiro
Published: January 2025

Digital transformation through extended reality (xR)—comprising virtual, augmented, mixed, and substitutional reality—has become an integral part of the future of clinical and surgical practice. xR technologies facilitate advanced surgical planning, training, therapies and education, reshaping both personal and institutional healthcare. This paper examines the potential changes that xR has introduced into the field of hand surgery, exploring how xR enhances patient-centric care, increases medical service efficiency and revolutionizes surgical training, planning and therapeutic interventions. Key areas such as surgical assistance, telemedicine, therapies and rehabilitation, medical training and education, and improving patient understanding are highlighted. By synthesizing the current literature, this narrative review articulates the theoretical and practical implications of xR, offering insights into its transformative potential and supporting continuous educational advancement in medical practice.
Secondary metacarpal fracture after malunion of the little metacarpal
Authors: Zhang Jiangchao , Xiong Ge , Yu Deshui
Published: January 2025

Nineteen patients presenting with a secondary metacarpal fracture after a previously fractured little metacarpal were retrospectively reviewed. The new injury was more likely to be at the original fracture site in patients with shaft fractures than those with neck fractures.

Level of evidence: IV
The impact of preexisting psychiatric disorders on patient outcomes following primary total shoulder arthroplasty: A systematic review and quantitative synthesis
Authors: Sun Bryan , Thangavelu Vetri , Yakubov Rose , Sun Clare , Khan Moin , Chaudhari Sumit , Sheth Ujash
Published: January 2025

Purpose

To summarize complication rates, reoperation rates, length-of-stay (LOS), patient-reported outcome measures (PROMs), and range of motion following total shoulder arthroplasty (TSA) in patients with preexisting psychiatric disorders (PDs) compared to controls.

Methods

Three databases (MEDLINE, PubMed, and EMBASE) were searched from inception to 4 March 2024 to identify studies comparing outcomes between patients undergoing anatomic (aTSA) or reverse TSA (rTSA) with or without a preexisting psychiatric condition. The authors adhered to the preferred reporting items for systematic reviews and meta-analyses and revised assessment of multiple systematic review guidelines. Data on demographics, as well as postoperative complication rates, reoperation rates, LOS, PROMs, and range of motion were extracted from included studies. PROMs included the American Shoulder and Elbow Surgeons (ASESs) score, and visual analogue scale (VAS) pain score. Meta-analyses were conducted for outcomes reported by multiple studies, with odds ratios (ORs) and mean differences (MDs) as effect measures for continuous and dichotomous outcomes, respectively.

Results

Thirteen studies were included in this review, comprising a total of 820,831 TSA patients. The PD group (71.0% female) consisted of 150,432 patients (mean age: 67.6 ± 9.9) with a mean follow-up time of 34.1 ± 30.1 months. The control group (58.1% female) consisted of 670,399 patients (mean age: 69.4 ± 10.7) with a mean follow-up time of 39.1 ± 36.0 months. The PD group had significantly higher rates of complications and reoperation. The PD group also reported significantly lower postoperative ASES scores, higher postoperative VAS scores, and inferior postoperative abduction. There were no significant differences in postoperative LOS, forward flexion, internal rotation, or external rotation.

Conclusion

Patients with preexisting PDs may have a one-and-a-half times higher odds of postoperative complication or reoperation, as well as significantly worse postoperative pain and PROMs. Identification of at-risk individuals with preexisting psychiatric conditions and preoperative referral to a mental health specialist to optimize psychiatric conditions may benefit this patient cohort ahead of their shoulder arthroplasty procedure.

Level of evidence

IV.
From research to case study: The Next Generation of Hotel Mystery Shoppers from the Perspective of Gen Z
Authors: Hagglund Hans , Okumus Bendegul
Published: January 2025

This case study presents results from a longitudinal mystery shopping study conducted between 2020 and 2023. Data was collected from Gen Z hospitality and tourism students aged between 18 and 25 with part-time and full-time work experience in the hospitality and tourism industry. They visited various hotels across the United States and examined 25 service standards. Our research revealed the operational performance of hotels, the dynamics of interactions between guests and employees, and the specific expectations of Gen Z. This case study provides valuable insights into the rapidly evolving hotel industry in the U.S. from the perspective of Gen Z.
Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Evaluation and Treatment of Pyogenic Spondylodiscitis of the Spine: AO Spine Knowledge Forum Trauma and Infection
Authors: Bigdon Sebastian F. , Vialle Emiliano , Dandurand Charlotte , Scherer Julian , Camino-Willhuber Gaston , Joaquim Andrei F. , Chhabra Harvinder S. , El-Sharkawi Mohammad , Bransford Richard , Fisher Charles G , Schnake Klaus J. , Schroeder Gregory D ,   The AO KF Trauma and Infection Members
Published: January 2025

Study Design

Literature Review with clinical recommendations.

Objective

To highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.

Methods

Five influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.

Results

Five studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, a novel scoring tool for standardizing treatment decision-making. Conditional recommendation to incorporate the SITE Score or SISS Score for improved treatment outcomes. Article 2: Maamari et al conducted a meta-analysis comparing imaging modalities, with conditional recommendation to consider 18F-FDG PET/CT to diagnosis PS as an adjunct to MRI which remains the gold standard. Article 3: Thavarajasingam et al demonstrated the potential survival benefit of early surgery in specific PS cases, leading to a strong recommendation for early intervention in appropriate patients. Article 4: Neuhoff et al compared conservative and surgical treatments in well-resourced settings, concluding a strong recommendation for early surgery in appropriate patients. Article 5: Bernard et al evaluated antibiotic treatment duration, with a conditional recommendation for a 6-week course in confirmed cases, based on comparable efficacy to a 12-week regimen.

Conclusions

Management of PS remains complex and varied. This perspective provides spine surgeons with evidence-based recommendations to enhance standardization and effectiveness in clinical practice.
A Case of Pulmonary Sarcoidosis With Multiple Endobronchial Polypoid Structures and Partial Airway Obstruction
Authors: Orhun Nagihan , Ekin Utku , Rajab Islam , Sanchez Jessimar , Hazari Arham , Ismail Mourad
Published: January 2025

We present a case of a 42-year-old male with sarcoidosis manifesting as endobronchial mass-like lesions, a rare and atypical presentation of the disease. Sarcoidosis typically involves the respiratory system, but its occurrence as endobronchial polyps mimicking malignancy is uncommon. The diagnosis was confirmed through bronchoscopy and biopsy, revealing non-caseating granulomas. Treatment with corticosteroids led to significant clinical improvement. This case underscores the importance of considering sarcoidosis in the differential diagnosis of endobronchial masses and the role of biopsy in confirming the diagnosis.
AI-Based Writing Assistants in Business Education: A Cross-Institutional Study on Student Perspectives
Authors: Lookadoo Kathryn , Moore Sarah , Wright Carol , Hemby Virginia , McCool Lynn B.
Published: January 2025

In a cross-institutional study, this article shares research findings about business student perceptions and experiences using an automated writing assistant program based on traditional artificial intelligence. Using a mixed-methods approach, we share student responses to Grammarly’s suggested revisions and provide insight into students’ confidence levels and correctness in workplace written communication. Finally, this study concludes with a discussion of the implications of this work related to business communication education and research, as well as possibilities for the future.
Employees’ Language Choices and Usage Pattern: A Study on Corporate India
Authors: Mohanty Seemita , Chatterjee Shraddha
Published: January 2025

Amid a multitude of languages, English is given primacy in business and commerce in India. This study examines the language choices and usage pattern in the corporate world to understand how the diverse linguistic base of employees is utilized across the workplace. Data were collected through Google Forms and in-depth interviews. Results show that English is the preferred language for all official communications. A strong command over English is crucial for job interviews and client requirements. However, employees prefer regional languages when conversing informally, and a majority also want regional languages to be a part of the formal communication process.
A comparative study of casson and Jeffrey nanofluids flowing through the radiative bidirectional stretched surface with porous media
Authors: Shehzad Sabir , Yousaf Sadia , Faiza  , Farid Rabia
Published: January 2025

A comparative study of radiative Casson and Jeffrey fluids flows generated by the chemically reactive bidirectional stretched sheet is presented. Energy and mass species analysis is performed under radiative heat generation impacts. The Robin’s heat and mass conditions are imposed for the analysis of considered model. The boundary-driven equations are simplified into one independent variable equation by the implication of similarity constraints. The resulted model is tackled by the help of homotopic scheme. The results of various parameters are sketched and interpreted for both Casson and Jeffrey nanofluids. The convergence is expressed through numeric benchmarks and graphical form. The numeric evaluation of Sherwood and Nusselt number is presented against the versatile parametric values. The results showed that the higher velocity curves appeared in Casson nanofluid case as comparative to case of Jeffrey nanofluid. The temperature heat generation constraints boosted the temperature of both Casson and Jeffrey nanofluids. The incrementing trend of chemical reactive and Lewis number resulted weaker concentration profiles for Jeffrey and Casson fluids. The conducted research model has magnificent appliances in solar energy devices, chemical reactors, solar reservoirs, nuclear power plants, heat reservoirs, microwave oven, thermal radiant, thermal imaging and many others.
The Fit Older Adult with Acute Myeloid Leukemia: Clinical Challenges to Providing Evidence-Based Frontline Treatment
Authors: Abedin Sameem M , Uy Geoffrey L , Michaelis Laura C.
Published: January 2025

Recent advances in acute myeloid leukemia (AML) come from studies investigating younger (age<60 years) adults or older (age≥75 years) or less fit adults. Uncertainty exists for the management of otherwise healthy adults with AML in their 60s and 70s, which also represents a significant proportion of AML cases. We discuss current considerations in older, fit adults with AML including determination of fitness, what factors beyond fitness should be assessed, and finally what challenges and innovations lie ahead to improve outcomes for these patients.
Clinical use of measurable residual disease in adult ALL: recommendations from a panel of U.S. experts
Authors: Short Nicholas J , Aldoss Ibrahim , DeAngelo Daniel J , Konopleva Marina Y. , Leonard Jessica T. , Logan Aaron , Park Jae H. , Shah Bijal Dinesh , Stock Wendy , Jabbour Elias J.
Published: January 2025

Measurable residual disease (MRD) is a powerful predictor of clinical outcomes in acute lymphoblastic leukemia (ALL). In addition to its clear prognostic importance, MRD information is increasingly used in clinical decision algorithms to guide therapeutic interventions. While it is well-established that achievement of MRD-negative remission is an important endpoint of ALL therapy, the prognostic and therapeutic implications of MRD in an individual patient are influenced by both disease-related factors (e.g. cytomolecular risk) and assay-related factors (e.g. sensitivity, specimen source, and timing of assessment), which add complexity to MRD-guided treatment decisions. In this review, we discuss the data supporting the use of MRD assessment in adult ALL and how this information can rationally inform clinical decisions, including selection of patients for MRD-directed therapies or allogeneic hematopoietic stem cell transplantation. We also discuss important interpretative challenges related to novel high sensitivity next-generation sequencing-based MRD assays, which are becoming increasingly used in clinical practice.
A randomized, placebo-controlled, cross-over trial of ketamine in Rett syndrome
Authors: Campbell Kathleen , Neul Jeffrey L. , Lieberman David N. , Berry-Kravis Elizabeth , Benke Tim A. , Fu Cary , Percy Alan , Suter Bernhard , Morris David , Carpenter Randall L. , Marsh Eric D. , von Hehn Jana
Published: January 2025

Background

Preclinical studies and anecdotal case reports support the potential therapeutic benefit of low-dose oral ketamine as a treatment of clinical symptoms in Rett syndrome (RTT); however, no controlled studies have been conducted in RTT to evaluate safety, tolerability and efficacy.

Design

This was a sequentially initiated, dose-escalating cohort, placebo-controlled, double blind, randomized sequence, cross-over study of oral ketamine in 6–12-year-old girls with RTT to evaluate short-term safety and tolerability and explore efficacy.

Methods

Participants were randomized to either five days treatment with oral ketamine or matched placebo, followed by a nine-day wash-out period and then crossed-over to the opposite treatment. Ketamine was dosed twice daily at 0.75 mg/kg/dose (Cohort 1) or 1.5 mg/kg/dose (Cohort 2). An independent safety monitoring committee evaluated safety and approved proceeding to the next dose cohort. Caregivers, participants, outcome assessors, and study staff except pharmacists were blinded to allocation. The primary endpoint was safety and tolerability. Exploratory efficacy endpoints included change in clinician- and caregiver-rated measures of RTT features, brain activity on electroencephalography, and wearable biosensors to measure respiration, heart rate, sleep, and activity.

Results

Twenty-three participants enrolled (11 in Cohort 1, 12 in Cohort 2) from 3/12/2019–11/22/2021. One participant was excluded from analysis due to not meeting inclusion criteria on blinded review prior to analysis. One participant was withdrawn from the study due to an adverse event (vomiting) after the first dose of ketamine. Although planned for four dose cohorts, the trial was stopped after Cohort 2 due to enrollment challenges associated with the COVID-19 pandemic. Ketamine was safe and tolerated in both cohorts, with 1 related treatment emergent adverse event of vomiting. No difference was observed in efficacy between ketamine and placebo. Electroencephalography showed the expected increase in high frequency power with ketamine.

Conclusions

Short-term, low-dose oral ketamine was safe and well tolerated in girls with RTT. No clinical efficacy of ketamine in treating symptoms of RTT was observed with 5 days of treatment, despite electroencephalography evidence of ketamine target engagement during the first dose. Further studies are needed to evaluate safety and efficacy of higher dose and longer exposure to ketamine in RTT.

Trial registration

Registered at clinicaltrials.gov NCT03633058.
Anesthesia depth monitoring during opioid free anesthesia – a prospective observational study
Authors: Mogianos Krister , Persson Anna KM
Published: January 2025

Background

Patients undergoing general anesthesia are more frequently monitored for depth of anesthesia using processed electroencephalography. Opioid-free anesthesia is nowadays an accepted modality for general anesthesia, however it is unclear how to interpret data from processed electroencephalography when using a mixture of non-opioid anesthetic drugs. Our objective was to describe density spectral array patterns and compare processed encephalographic data indices between opioid-free and routine opioid based anesthesia.

Methods

This prospective observational cohort study was conducted on 30 adult patients undergoing laparoscopic surgery in a non-tertiary regional hospital. The patients underwent general anesthesia with three different methods and were monitored for anesthesia depth using processed encephalography and density spectral array. Primary outcome is a group-derived mean difference in patient state index and spectral edge frequency. As a secondary outcome a descriptive comparison of the spectral power, derived from the density spectral array, was done between groups.

Results

The opioid-free anesthesia group had significantly higher patient state index and spectral edge frequency compared to routine anesthesia. Density spectral array patterns were also different, most notably lacking the high power in alpha frequency spectrum seen in the other routine anesthesia methods.

Conclusions

Processed electroencephalography monitoring can be used in opioid-free anesthesia, however clinicians should expect higher values in monitoring indices. The density spectral array pattern using a common protocol for opioid-free anesthesia, with mainly sevoflurane combined with low doses of dexmedetomidine and esketamine, differs from well described opioid and GABA-ergic anesthesia methods. These findings should be further validated using other protocols for opioid-free anesthesia in order to safely monitor anesthesia depth.

Trial registration

Clinicaltrials.gov registration number NCT06227143, registration date; 26th of January 2024.
Psychological responses to acute exercise in patients with stress-induced exhaustion disorder: a cross-over randomized trial
Authors: Kling Jenny , Persson Asplund Robert , Ekblom Örjan , Blom Victoria
Published: January 2025

Background

Understanding psychological responses to acute exercise, defined as a single bout of physical exercise, in clinical populations is essential for developing tailored interventions that account for the psychological benefits and challenges of exercise. Given its effectiveness in reducing symptoms in various psychological disorders, exercise should be further explored in Exhaustion Disorder ICD-10-SE: F43.8A (ED), characterized by persistent exhaustion following long-term psychosocial stress. Currently, no studies address the psychological responses to acute exercise in ED patients.

Aims

This study aims to (1) compare the psychological responses to acute exercise between ED patients and healthy controls and (2) assess response differences between low and moderate exercise intensities.

Methods

We conducted a two-armed cross-over trial comparing ED patients (n = 30) and healthy controls (n = 30). Participants completed a 22-min exercise at low or moderate intensity on a cycle ergometer, on separate occasions, in randomized order. The primary outcome was perceived fatigue (POMS); secondary outcomes included feelings of energy, anxiety, stress, exertion, and psychological discomfort, measured before, during, and up to 24 h post-exercise. Exercise effects were assessed using repeated measures analysis of variance.

Results

ED patients reported higher levels of exertion, psychological discomfort, fatigue, anxiety, and stress but lower energy throughout the trial compared to controls. Unlike controls, the ED group showed significant fatigue and stress reductions post-exercise (p < 0.05). Additionally, ED patients showed a more elevated energy after moderate-intensity exercise compared to controls (p < 0.05). Both groups experienced anxiety reductions post-exercise, with no group interactions over time. No differences were observed between pre- and 6 or 24 h post-exercise in any variables. The only intensity effect (p < 0.05) in the ED patients was a more pronounced energy decline 30 min after moderate-intensity exercise.

Conclusions

A 22-min exercise session was perceived as more strenuous by patients with exhaustion disorder (ED) and generated greater improvements in feelings of fatigue, energy, and stress compared to healthy individuals without delayed negative effects. These findings highlight the specific psychological responses in ED to exercise and can inform intervention design tailored specifically to this population.

Trial registration

The study was retrospectively registered on 05/30/2024 at Clinical Trials.gov, with trial registration number 2022–04943-01.