bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of pulmonary function between sleeve lobectomy and standard lobectomy
Authors: Kuroda Sanae , Nishikubo Megumi , Haga Nanase , Nishioka Yuki , Shimizu Nahoko , Nishio Wataru
Published: February 2025

Background

The extent of anastomotic stenosis after sleeve lobectomy (SL) remains unclear, and there are limited reports on postoperative pulmonary function. This study aimed to compare postoperative pulmonary function between SL and standard lobectomy (STL) and to evaluate anastomotic stenosis in SL.

Methods

This study included 44 SL patients and 825 STL patients from 2012 to 2023. Post- or preoperative forced expiratory volume in 1 s (FEV1.0) values (FEV1.0 preservation rate) were analyzed and compared between the SL and STL groups. The lobe expanded rate values, calculated using volumes of the lung lobe(s) distal to the bronchial anastomosis in the SL group and the corresponding lobe(s) in the STL group, measured using three-dimensional computed tomography (3D-CT), were analyzed and compared. In the SL group, the surface area of the lumen at the site corresponding to the bronchial anastomosis was measured on 3D-CT, and the postoperative/preoperative value (bronchus stenosis rate) was calculated.

Results

The SL and STL groups significantly differed in terms of the FEV1.0 preservation rate (84.6% vs. 87.7%, p = 0.180); however, the lobe expanded rate was significantly lower in the SL group (119.1% vs. 134.6% p = 0.009). The average bronchus stenosis rate was 64.3%, with no significant difference between wedge and circumferential bronchial resection groups (63.4% vs. 66.4%, p = 0.730).

Conclusion

The volume of the lung lobe(s) distal to the bronchial anastomosis after SL was lower than that after STL. However, this did not affect postoperative pulmonary function. The type of bronchoplasty did not influence the development of anastomotic stenosis.
Determinants of Chatbot adoption among older adults: An extended TAM approach using PLS-SEM
Authors: Wu Chia-Chen , Chen Chin-Tsu , Huang Kuo-Chen , Chou Yi-Ying
Published: February 2025

This study investigates factors influencing chatbot adoption among older adults by extending the Technology Acceptance Model (TAM) with computer anxiety (CANX) and self-efficacy (CSE) to address demographic-specific barriers. Data from 150 participants in Taoyuan City, who engaged with two chatbots for information services, were analyzed using partial least squares structural equation modeling. Results show that perceived ease of use (PEOU) positively influences both perceived usefulness (PU) and attitude (ATT), with PU being the strongest predictor of behavioral intention (BI), followed by ATT and PEOU. CSE was found to enhance PEOU, while CANX negatively affected it. Explaining 69.3% of BI variance, the findings validate TAM’s relevance for older adults and emphasize the significance of addressing psychological barriers in technology adoption. The findings underscore the need for chatbot interfaces that prioritize accessibility and cater to the specific needs of elderly users. Additionally, they highlight the importance of designing chatbots that provide functional benefits while addressing psychological barriers to engagement among older adults.
Primary umbilical endometriosis: clinical aspects and long-term follow-up of five cases
Authors: Li MengHui , Zhang KunNing , Liu ChongDong
Published: February 2025

Umbilical endometriosis (UE) is a rare condition. We have documented the clinical characteristics, management strategies, and follow-up results for five cases treated at our hospital between 1998 and 2020, with patients aged between 31 and 44 years. Patients typically presented with umbilical swelling. In all cases, surgical removal was effective and no complications were reported. Two patients had concurrent ovarian endometriosis and one adenomyosis. No umbilical recurrence was recorded during follow-up. We believe that these findings offer valuable insights for the management of this patient population. Clinical management strategies for this disease should be tailored to each patient and carried out collaboratively by both general and gynaecological physicians.
Combined Correction of Coronal and Rotational Deformities of the Femur With Distal Femoral Osteotomy Using Patient-Specific Instrumentation
Authors: Neopoulos Georgios , Jud Lukas , Vlachopoulos Lazaros , Fucentese Sandro F.
Published: February 2025

Background:

Distal femoral osteotomy (DFO) can be used to simultaneously correct coronal and rotational deformities. Patient-specific instruments (PSIs) are known to be helpful in such complex osteotomies, but data on surgical accuracy for the combined correction of coronal and rotational deformities of the femur are missing.

Purpose:

To investigate the radiological results of DFO for simultaneous correction of coronal and rotational deformities using PSIs.

Study Design:

Case series; Level of evidence, 3.

Methods:

All included patients underwent DFO (34 patients, 36 knees) using PSIs for combined correction of coronal and rotational deformities. The hip-knee-ankle angle (HKA) was measured in weightbearing long-leg radiographs, and the femoral torsion was assessed using computed tomography scans, both pre- and postoperatively. The achieved corrections of HKA and femoral torsion were determined for each knee, and surgical accuracy was calculated.

Results:

HKA and femoral torsion changed significantly from preoperatively to postoperatively (from 2.4° ± 3.6° vs 0.1° ± 1.8° [ P < .001] and 31.2° ± 17.2° vs 18.7° ± 7.4° [ P < .001]). The difference from planned to achieved correction was statistically greater for HKA (–2.9° ± 3.8° vs –2.3° ± 3.5°; P = .018) than for femoral torsion (–12.4° ± 11.8° vs –12.3° ± 12.2°; P = .771), which did not reach significance. The accuracies of HKA and femoral torsion correction were 1.1° ± 1° and 2.4° ± 1.9°, respectively.

Conclusion:

Coronal and rotational deformities of the femur can accurately be corrected simultaneously by a DFO, utilizing PSIs. High accuracy was achieved for the correction of both coronal and rotational deformities, with absolute mean differences from planned to achieved correction of 1.1° and 2.4°, respectively.
Performance evaluation of boron-based particles as filler for thermoplastic polyester elastomer
Authors: Gul Okan , Karsli N. Gamze , Gul Cihat , Durmus Ali , Yilmaz Taner
Published: February 2025

The objective of this study is to enhance the fundamental structural characteristics of thermoplastic polyester elastomer (TPEE) material. For this purpose, two distinct boron-based particles, namely boric acid (BA) and hexagonal boron nitride (hBN), were utilised as reinforcing materials. The production of boron-based particle-reinforced TPEE matrix composites was achieved through the process of extrusion and injection molding. The investigation of the wear behavior of the composites was conducted through the implementation of adhesive wear tests, while the mechanical properties were analyzed through the execution of tensile and three-point bending tests. Furthermore, the thermal properties were examined through the utilization of differential scanning calorimetry and thermogravimetric analysis. The findings of the study indicate that the coefficient of friction values of the TPEE decreased with the addition of both BA and hBN. The incorporation of both BA and hBN into TPEE, as well as an increase in the weight ratio of these particles, resulted in a notable enhancement in tensile strength, elastic modulus and flexural stress at yield values. The addition of BA to TPEE resulted in an increase in the crystallization of the TPEE matrix, while the addition of hBN to TPEE led to a reduction in the crystallization of the TPEE matrix. The incorporation of both BA and hBN elevated the decomposition temperatures of the TPEE, thereby enhancing its thermal stability. However, hBN demonstrated superior performance compared to BA, potentially due to its lower particle size distribution. Nevertheless, it was concluded that, depending on the intended application of the end product, both types of particles can be effectively utilized to enhance the performance of TPEE.
Social Class and Career Decision Self-Efficacy: Roles of Career Social Support and Birthplace
Authors: Zhang Lulu , Wang Xiaofang , Wang Jiajia , Zhang Wei , Fan Weiqiao
Published: February 2025

While previous research has shown that social class is positively correlated with career decision self-efficacy (CDSE), how this relationship develops is unclear. This study tested the mediating effect of career social support on the link between subjective social class and CDSE and the moderating role of birthplace in the mediation model. A survey was completed among 388 Chinese college students. The results revealed that subjective social class could positively predict CDSE via career social support. For urban students, subjective social class was positively related to career social support, and it was indirectly related to CDSE via career social support. For rural students, subjective social class was positively related to CDSE. Finally, the implications for career education and counseling in Chinese college students are discussed.
An efficient and high-quality scheme for cone-beam CT reconstruction from sparse-view dat
Authors: Zhang Shunli , Tuo Mingxiu , Jin Siyu , Gu Yikuan
Published: February 2025

Computed tomography (CT) is capable of generating detailed cross-sectional images of the scanned objects non-destructively. So far, CT has become an increasingly vital tool for 3D modelling of cultural relics. Compressed sensing (CS)-based CT reconstruction algorithms, such as the algebraic reconstruction technique (ART) regularized by total variation (TV), enable accurate reconstructions from sparse-view data, which consequently reduces both scanning time and costs. However, the implementation of the ART-TV is considerably slow, particularly in cone-beam reconstruction. In this paper, we propose an efficient and high-quality scheme for cone-beam CT reconstruction based on the traditional ART-TV algorithm. Our scheme employs Joseph's projection method for the computation of the system matrix. By exploiting the geometric symmetry of the cone-beam rays, we are able to compute the weight coefficients of the system matrix for two symmetric rays simultaneously. We then employ multi-threading technology to speed up the reconstruction of ART, and utilize graphics processing units (GPUs) to accelerate the TV minimization. Experimental results demonstrate that, for a typical reconstruction of a 512 × 512 × 512 volume from 60 views of 512 × 512 projection images, our scheme achieves a speedup of 14 × compared to a single-threaded CPU implementation. Furthermore, high-quality reconstructions of ART-TV are obtained by using Joseph's projection compared with that using traditional Siddon's projection.
Artificial intelligence based BCI using SSVEP signals with single channel EEG
Authors: Kanagaluru Venkatesh , M Sasikala
Published: February 2025

Background

Brain–Computer Interfaces (BCIs) enable direct communication between the brain and external devices. Steady-state visual-evoked potentials (SSVEPs) are particularly useful in BCIs because of their rapid communication capabilities and minimal calibration requirements. Although SSVEP-based BCIs are highly effective, traditional classification methods face challenges in maintaining high accuracy with minimal EEG channels, especially in real-world applications. There is a growing need for improved classification techniques to enhance performance and efficiency.

Objective

The aim of this research is to improve the classification of SSVEP signals using machine-learning algorithms. This involves extracting dominant frequency features from SSVEP data and applying classifiers such as Decision Tree (DT), Linear Discriminant Analysis (LDA), and Support Vector Machine (SVM) to achieve high accuracy while reducing the number of EEG channels required, making the method practical for BCI applications.

Methods

SSVEP data were collected from the Benchmark Dataset at Tsinghua BCI Lab using 64 EEG channels per subject. The Oz channel was selected as the dominant channel for analysis. Wavelet decomposition (db4) was used to extract frequency features in the range 7.8 Hz to 15.6 Hz. The frequency of the maximum amplitude within a 5-s window was extracted as the key feature, and machine learning models (DT, LDA, and SVM) were applied to classify these features.

Results

The proposed method achieved a high classification accuracy, with 95.8% for DT and 96.7% for both LDA and SVM. These results show significant improvement over existing methods, indicating the potential of this approach for BCI applications.

Conclusion

This study demonstrates that SSVEP classification using machine-learning models improves accuracy and efficiency. The use of wavelet decomposition for feature extraction and machine learning for classification offers a robust method for SSVEP-based BCIs. This method is promising for assistive technologies and other BCI applications.
Surface analysis of industrial gate of a die-casting process mould retired from manufacturing site
Authors: Karthikeyan Palani , Pramanik Sumit
Published: February 2025

Due to high heating and cooling casting cycles, the gate part, a crucial part of the mould, suffers from different casting problems. Therefore in the present study, an industrial gate surface of mould retired from a pressure die-casting industry after 60,000 casting cycles has thoroughly been analysed before and after being subjected to a novel enhancement heat treatment (EHT) by oil quenching technique. Here, the surface of different gate parts such as the die-block, runner, gate and casting area, of the industrial gate (IG) of a mould was precisely characterized by x-ray diffraction (XRD), by Fourier transforms infrared (FTIR) spectroscopy, microstructures, density, nanoindentation, hardness and magnetic measurement. This study predicted microstructures for the EHT samples. The novel EHT significantly recovered the mechanical and physical properties of the retired IG mould, particularly the nanohardness at die-block (from 6.83 to 12.89 GPa), gate (from 7.03 to 7.10 GPa) and casting (from 5.77 to 6.74 GPa) regions. After EHT, the internal stresses of the die material decreased and thus, its magnetic coercivity enhanced up to 223%. Therefore, the present study would help the mould manufacturer in predicting the mould’s life and condition during production.
Systematic literature review of intravenous immunoglobulin use in non-renal and non-hematologic systemic lupus erytehmatosus
Authors: Primo-Gabriel Cristina , García-Gómez Carmen , Calvo-Alén Jaime
Published: February 2025

Objective: Intravenous immunoglobulins (IVIG) are an established treatment in several immune-mediated diseases such as dermatomyositis or Kawasaki disease and they have been used in distinct clinical scenarios in systemic lupus erythematosus (SLE). However, in this latter disease no clear evidence besides hematological or renal involvement supports its use. The aim of the present study is to establish evidence for the treatment of non-renal non-hematological lupus with IVIG.

Methods: We have carried out a systematic literature review following PRYSMA principles on the use of this treatment in SLE patients with no renal no hematologic manifestations.

Results: We found 35 articles which were split into two subtypes, those with individualized data (29) and those with grouped data. Overall, 198 lupus patients treated with IVIGs [178 (90%) women and 20 (10%) men] were included. In 167 (84.3%) a clinical response was obtained [62 (31.3%) complete and 105 (53%) a partial one]. Adverse events were reported in 40 patients (20.2%), most of them mild with only 2 (1%) severe. According to individualized data, all cases with respiratory problems (5), 82.4% of those with cardiac involvement (18) and 53.8% of those with neuropsychiatric manifestations (18) achieved a complete response as more outstanding results.

Conclusions: After reviewing the experience of the use of IVIGs in extra-renal and extra-hematologic SLE patients, this treatment is demonstrated to be useful in refractory cases, especially in pulmonary, cardiac or neuropsychiatric complications with a good safety profile.
Care leaders’ moral distress in older adult care: A scoping review
Authors: Ahokas Fanny , Silén Marit , Höglund Anna T. , Hemberg Jessica
Published: February 2025

Moral distress among nurses is well researched and well documented, but there is limited research on the moral distress experienced by care leaders, who serve as intermediaries between patient care nurses and higher levels of administration. Healthcare professionals experience moral distress daily in the context of older adult care. The aim of this scoping review was to evaluate recent literature on moral distress in older adult care with the goal of revealing how care leaders’ experiences of moral distress in older adult care have been conceptualized in earlier studies. The research questions were: How is the concept of moral distress as experienced by care leaders in older adult care defined in the existing literature? How is the concept of moral distress conceptualized in the literature? The research has been conducted in accordance with the guidelines set forth by the Finnish National Advisory Board on Research Ethics TENK. We saw that consensus on how moral distress is defined is lacking. Care leaders in older adult care experience substantial moral distress, which could be linked to the duality of their leadership role. Moral distress can be caused by a complex interplay of individual and structural factors and the challenging complex moral issues inherent to older adult care. Moral distress could impact care leaders’ emotional health, job performance, overall job satisfaction and result in higher turnover rates, absenteeism, decreased quality of patient care, and increased organizational costs. Addressing moral distress on the individual, team, and organizational levels is crucial for enhancing care leaders’ well-being and improving the overall quality of care for older adults. A focus on the identification of strategies whereby care leaders can be supported, exploration of the long-term effects of moral distress on healthcare professionals in general, and the organizational outcomes associated with moral distress should be included in future research.
Managing Reusable Resources With Usage Time Limits
Authors: Legros Benjamin , van Leeuwaarden Johan SH , Fransoo Jan C
Published: February 2025

In reusable resources like vehicle sharing, city parking, and hotel services, resource units are used by consecutive customers for a stochastic usage time and are made available for future customers upon return. We model such reusable resources as Erlang loss systems, where customers who find all units occupied are blocked. Customers are rational decision-makers, and their willingness to join the system depends on factors such as price, time limits, service value, and resource availability. When each customer is charged a fixed price, we examine whether it is beneficial to install time limits, which increase availability at the expense of reduced usage time. We formulate and solve a two-dimensional revenue maximization problem to optimize both the usage price and the time limit. We differentiate between on-demand resources, which are immediately reusable upon return, and reserved resources, which can only be reused after the time limit expires. With on-demand resources, setting a time limit is proven to be detrimental, making the entry price the sole tool for maximizing revenue. This conclusion remains valid when the usage time increases with the entry price. In contrast, managing reserved resources involves an interplay between time limits and entry prices. Additionally, we show that loss systems (where customers do not wait) should be managed differently from systems where customers do wait. Specifically, in systems with waiting, we prove that only the time limit should be optimized, while the entry price should capture the full market share. We prove our results by analyzing the behavior of the equilibrium arrival rate and revenue, which necessitates establishing novel properties for the blocking probability. These properties yield new sharp bounds for the blocking probability and enable us to prove the convergence of the optimized model for on-demand resources to the quality-and-efficiency-drivenregime as the number of resource units grows.
Efficacy and Safety of Anlotinib and PD-1/L1 Inhibitors as Maintenance Therapy for Extensive-Stage Small Cell Lung Cancer Patients who Have Achieved Stable-Disease After First-Line Treatment with Chemotherapy and Immunotherapy: A Retrospective Study
Authors: Peng Yi , Wu De , Tang Jing , Li Xiaobing
Published: February 2025

Objective

To develop personalized treatment strategies for maintenance therapy in patients with extensive-stage small cell lung cancer (ES-SCLC).

Materials and Methods

We analyzed data from ES-SCLC patients who achieved stable disease (SD) following initial chemotherapy combined with immunotherapy. These patients subsequently received maintenance therapy (MT) with a combination of anlotinib and PD-1/L1 inhibitors. The primary endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (AEs).

Results

Preliminary findings suggest that this regimen is highly effective, with a median PFS of 6 months and OS of 13.5 months, alongside a DCR exceeding 60%. Subgroup analysis revealed enhanced efficacy in patients with fewer than three metastatic sites and those who experienced hypertension, proteinuria, or hand-foot syndrome during MT. Mechanistic studies showed a notable increase in the proportion of CD8+ T cells in the peripheral blood post-MT, correlating with improved outcomes. These findings imply that the therapeutic effect of MT may be partly due to the direct activation of CD8+ T cells, producing a synergistic anti-tumor response. Despite the prevalence of AEs, AEs were generally manageable, underscoring anlotinib’s potential in this context.

Conclusion

The combination of anlotinib and PD-1/L1 inhibitors offers promising efficacy and manageable AEs in MT, making it a viable option for ES-SCLC patients who achieve SD post-initial therapy. These results justify further prospective studies to validate this approach.
Tackling Adultism: Solidarity, Literacies, and Parenting
Authors: Brooks Maneka Deanna
Published: February 2025

A commitment to social justice and equity should appear not only in academics’ writing but also in their personal lives. In this Insights essay, I contend with creating coherence between my research and parenting practice through my struggles with unlearning adultism. Specifically, I describe how my middle child, Junior, challenged me to live as I write within my research. As a result, this essay examines how embracing intersectional anti-adultism in my parenting practices required that I expand how I enacted literacies for challenging injustice within schooling. As such, this essay articulates three commitments for engaging in thick solidarity with youth in research and parenting. Moreover, it encourages academics to evaluate adultism in our personal lives.
Children’s socio-moral reasoning about vaccine-like behaviors
Authors: Probst Sarah , Warneken Felix
Published: February 2025

Framing public-health behaviors as benefiting others, rather than the self, can increase behavior uptake in adults. However, there are mixed results on the effects of such messaging in a vaccination context, and it is unclear how children reason about the social and moral implications of vaccination. In this study, we present school-aged children ( N = 60) with hypothetical vaccine-like behaviors and manipulate whether they benefit the self or others, and whether they prevent low or high severity harm. We find that children readily endorse these behaviors when they prevent high severity harm, and that the beneficiary of the behavior does not impact children’s endorsement. Younger children thought vaccine-like behaviors were morally important regardless of who they protected; However, as children get older, they thought about the vaccine-like behaviors in moral terms when they protected others. We discuss potential implications for how communications about vaccination may impact children’s reasoning about others.
Personalized sleep-aid system based on multidimensional physiological features
Authors: Zhou Yafeng , Chen Fan , Li Fangfang
Published: February 2025

Amid the fast-paced modern lifestyle, a growing number of individuals face difficulties with sleep. To tackle this persistent issue, our research introduces a personalized sleep-aid system which relies on multidimensional physiological characteristics. This cutting-edge system combines advanced deep learning technologies with state-of-the-art devices for collecting physiological signals, facilitating the real-time monitoring of vital physiological indicators like heart rate and respiration. Utilizing this information, the system generates personalized music for promoting better sleep, thereby enhancing overall sleep quality. Empirical evaluations demonstrate the effectiveness of the system in improving sleep quality, displaying significant advantages across diverse PSQI dimensions. Essentially, this study introduces an innovative tool for modern society, combining physiological signal collection with deep learning to provide better sleep assistance.
Derivation and Validation of Risk Score Including Nutritional Status Among Patients With Chronic Limb-threatening Ischemia: Insight From I-PAD NAGANO Registry
Authors: Okina Yoshiteru , Ueki Yasushi , Kato Tamon , Miura Takashi , Oyama Yushi , Hashizume Naoto , Yokota Daisuke , Taki Minami , Senda Keisuke , Wakabayashi Tadamasa , Fujimori Koki , Karube Kenichi , Sakai Takahiro , Sunohara Daisuke , Nomi Hidetomo , Kanzaki Yusuke , Machida Keisuke , Kashiwagi Daisuke , Saigusa Tatsuya , Ebisawa Soichiro , Okada Ayako , Motoki Hirohiko , Kuwahara Koichiro
Published: February 2025

Purpose:

Geriatric nutritional related index (GNRI) is a simple and well-established screening method of nutritional status. We aimed to develop and validate a scoring system including GNRI to predict long-term outcomes in patients with chronic limb-threatening ischemia (CLTI) undergoing endovascular treatment (EVT).

Materials and methods:

Patients undergoing EVT for symptomatic LEAD from August 2015 to August 2016 were enrolled into the I-PAD NAGANO registry, a prospective, multicenter, observational registry. We identified predictors of amputation-free survival (AFS) at 5 years using Cox proportional hazards regression and developed a risk scoring system. The predictive performance of the risk score was assessed.

Results:

A total of 126 patients with CLTI were analyzed. Cox multivariate analysis revealed GNRI score <92 points, ≥72 years of age, hemodialysis, heart failure, and anemia to be significant predictors. We developed a 5-item risk score (I-PAD CLTI score) assigning points to each factor based on the magnitude of association with AFS at 5 years. The I-PAD CLTI score showed a c-index of 0.80 for 5-year AFS. Patients with high score (≥7 points, n=50) had an increased risk of AFS at 5 years compared with those with low score (<7 points, n=68) (26.5% vs 72.1%, p<0.001).

Conclusion:

A simple 5-item risk score including nutritional status showed reasonable discriminative and prognostic ability for long-term AFS among patients with CLTI.

Clinical Impact

The I-PAD CLTI score, a simple five-item risk score including nutritional status determined by geriatric nutritional related index, showed reasonable discriminative and prognostic ability for long-term amputation free survival among patients with chronic limb-threatening ischemia. This risk score may be useful for clinicians to accurately predict patient’s prognosis and thus identify high-risk patients who may derive the greater clinical benefit from more intensive risk modification. Further research is required to test the clinical utility of risk-score-based treatment approach to improve the prognosis of patients with chronic limb-threatening ischemia.
Performance Quality Rating Scale for Somatosensation After Stroke Version 3: Reliability, Feasibility
Authors: Wanklyn Tamara , Webster Kate E. , Carey Leeanne M.
Published: February 2025

The Performance Quality Rating Scale for Somatosensation after Stroke (PQRS-SS) guides observation of survivors of stroke performing client-selected occupations, using common operational definitions. We aimed to determine the inter- and intra-rater reliability, standard error of measurement, and feasibility (via interviews and thematic analysis) of the PQRS-SS version 3. Videos of 22 survivors of stroke with somatosensory impairment completing 38 client-selected occupations on two occasions (76 clips) were viewed by four clinicians twice, 6 weeks apart (PQRS-SS version 3). Intraclass correlation coefficients (ICC), standard error of measurement (SEM), and interview data are reported. For PQRS-SS version 3, inter-rater reliability was moderate to excellent (ICC2,1 = 0.71, ICC2,4 = 0.91) and intra-rater reliability was good (ICC3,1 = 0.76–0.87). Clinician raters reported the PQRS-SS version 3 was easy to use. The PQRS-SS version 3 is ready for use by trained, experienced clinicians and is ready for ongoing psychometric testing.
Assessing the Role of Nasal Irrigation in Chronic Otorrhea in Children With Tympanostomy Tubes
Authors: Kulasek Michal , Mercier Erika , Bergeron Mathieu
Published: February 2025

Importance

Nasal irrigation (NI) is effective in the treatment of sinonasal disease; however, its efficacy in treating otologic conditions is undetermined. Chronic otorrhea (CO) is an important complication in children with tympanostomy tubes (TT), requiring additional treatment.

Objective

Determine potential factors of NI that put children with TT at risk of developing CO.

Study design

Case-control study.

Setting

Single tertiary level of care pediatric hospital.

Participants

Consecutive patients under the age of 18 with bilateral TT presenting between June and September 2023 were selected.

Intervention

All patients in this study used NI.

Main outcome measures

The main outcome was the development of CO, defined as 10 or more consecutive days of ear drainage despite proper treatment.

Results

Twenty consecutive patients with CO were recruited and compared to 100 consecutive controls without CO. The mean age was similar, with 22.9 ± 18.4 months for the CO group and 25.2 ± 16.4 months for the control group ( P = .59). An immediate discharge occurred more frequently in the CO group (80%) than in the control group (46%, P = .005; OR: 4.70; 95% CI: 1.5-13.5). A fast rate of administration of NI was more prevalent in the CO group (75%) compared to the control group (51%, P = .049; OR: 2.88; 95% CI: 1.0-7.6). TT insertion under local anesthesia occurred more frequently in the CO group (45%) than in the control group (22%, P = .03; OR: 2.9; 95% CI: 1.1-7.4). No statistical difference was found between groups in the frequency and volume of NI. No patients with CO used a small volume of NI (≤5 mL).

Conclusion and relevance

A fast rate of administration of NI was correlated with an increased risk of CO. Patients should be encouraged to apply gentle pressure as it could potentially prevent this complication.
A Performance-Based Adaptation Index for Automated Insulin Delivery Systems
Authors: Diaz C. Jenny L. , Colmegna Patricio , Pryor Elliot , Breton Marc D.
Published: February 2025

Background:

Automated insulin delivery (AID) algorithms can benefit from tuning of their aggressiveness to meet individual needs, as insulin requirements vary among and within users. We introduce the Performance-Based Adaptation Index (PAI), a tool designed to enable automatic adjustment of an AID system aggressiveness based on continuous glucose monitoring (CGM) metrics.

Methods:

PAI integrates two CGM-based metrics—one for hypoglycemia and another for hyperglycemia exposure—over a previous time window into a single index ([Formula: see text]). We propose two methods to compute [Formula: see text]: one based on time in range (TIR, 70-180 mg/dL), and the other on glycemic risk indices. Using [Formula: see text], we developed a multiplicative strategy to adjust the AID system’s aggressiveness, accounting for situations where [Formula: see text] cannot be reliably calculated. The feasibility of this method was assessed in-silico using the UVA/Padova Type 1 Diabetes Simulator and our full closed-loop algorithm (UVA-model predictive control (MPC)) across five scenarios: optimal tuning (baseline), conservative and aggressive tunings, and temporary and permanent changes in insulin needs. Glycemic outcomes were evaluated from the simulated glucose traces.

Results:

Negligible performance variations were observed in the baseline scenario. For the conservative scenario, adjusting [Formula: see text] improved TIR (35.1% vs 71.8%) and increased total daily insulin (32.1 U vs 41.2 U). Conversely, for the aggressive scenario, it reduced hypoglycemia exposure (TBR: 2.6% vs 1.4%) and overall insulin usage (45.6 U vs 43.0 U).

Conclusion:

In-silico results demonstrated the safety and efficacy of using PAI to automatically tune the UVA-MPC controller, achieving TIR values above 70% under fully closed-loop conditions and across various physiological states. Clinical validation of these results is warranted.
Ratio of non-protein calories to grams of amino acids and amino acid blood levels in preterm infants receiving parenteral nutrition
Authors: Huston Robert K , Clark Reese H , Chace Donald H
Published: February 2025

Background

Studies evaluating the optimal intake of amino acids for preterm infants have often not considered the effect of the non-protein calorie to grams of amino acids ratio (NPKcal:g AA) in parenteral nutrition solutions. The objectives of this study were to document the ratio in a group of preterm infants and explore any associations of the ratio to AA and acylcarnitine levels.

Methods

This was descriptive cohort study of data collected from a previously published prospective study evaluating the influence that gestational age had on amino acid and acylcarnitine profiles in preterm infants ≤31 weeks postmenstrual age. Acylcarnitine and AA levels on day of life 7 of three study groups, based upon terciles of the NPKcal:g AA, who were receiving minimal enteral feedings and an enterally fed comparison group were measured. Growth velocities and changes in z-scores were also evaluated.

Results

NPKcal:g AA terciles were: 6.3–17.6:1 (low, N = 153), 17.7–21.2:1 (mid, N = 150), and 21.3–36.2:1 (high, N = 159). Higher levels of ornithine, citrulline, blood urea nitrogen, isovalerylcarnitine + methylbutyrylcarnitine, and octenoylcarnitine were found in the low versus the high group. From day 1–42 of life, the low group had a lower head circumference (HC) growth velocity and the low and mid groups had more negative HC changes in z-scores versus the enteral group.

Conclusions

This study suggests that preterm infants may receive parenteral nutrition solutions containing inadequate energy to prevent oxidation of administered AA. The impact of inadequate non-protein caloric intake needs to be considered when evaluating growth and outcomes in nutritional studies of VLBW infants.
Consumption and reality testing: How do individuals justify the limits to their consumption efforts in the face of climate change?
Authors: Dubreuil Clement , Borraz Stephane
Published: February 2025

This article aims to understand how the individuals justify the limits to their consumption efforts regarding environmental issues. We adopt an interpretivist approach, drawing on the theoretical framework of pragmatic sociology proposed by Boltanski and Thévenot. We contribute to the literature on the green gap by identifying the justifications put forward by individuals who seek to contribute to the common good. In particular, we show how they question the measurement of carbon footprints, i.e. the reality test that is supposed to assess the virtuous nature of practices. We also contribute to the literature on convention theory in marketing by exploring the justification of consumers with regard to a reality test. Finally, we propose a number of managerial recommendations. They aim to help create tools and attractive holistic narratives to push back the limits to consumption efforts.
Care partner experience with telepresence robots in long-term care during COVID-19 pandemic
Authors: Hu Grace , Wong Joey , Ren Lily Haopu , Kleiss Sarah , Berndt Annette , Wong Lily , Hussein Ali , Ahmed Nazia , Mann Jim , Hung Lillian
Published: February 2025

Objective

As people living with dementia move into long-term care (LTC), their care partners face a difficult role change from primary caregiver to visitor, losing a significant degree of control and direct care involvement. The COVID-19 pandemic exacerbated these challenges with health risks, changing care home protocols, and government policies. To help address these challenges, this study aimed to investigate the experiences of care partners who used telepresence robots to maintain contact with and care for their loved ones during the pandemic.

Methods

This study was guided by the Collaborative Action Research (CAR) approach. Along with interdisciplinary researchers and trainees, our team included patient and family partners as co-researchers throughout the project. We conducted semi-structured interviews with 20 care partners who used the robots in five urban Canadian LTC homes between May 2021 and August 2023.

Results

Thematic analysis identified four key themes characterizing their experiences using the robot: (a) decreases care partner burden, (b) facilitates care partner–staff relationship, (c) creates relational autonomy, and (d) expands the scope of what is possible.

Conclusion

The results of the study suggest that telepresence robots can play a useful role in enhancing the caregiving experience for informal care partners in multifaceted ways. Care partners reported positive benefits of having the robot assist their virtual visits. However, further research is needed to determine the sustainability of robot implementation among diverse geographic regions and care home compositions.
“A Wandering Existence”: Social Media Practices of Chinese Youth in the Context of Platform-Swinging
Authors: Zhao Hongxun , Wang Jiahui , Hu Xurui
Published: February 2025

In the era of ubiquitous mobile internet, Chinese youth are engaging in dual pursuits of knowledge and employment through various social media platforms, showcasing unique social media practices. Via semi-structured interviews with 14 platform-swinging youth and NVivo12-assisted three-tier qualitative analysis, this study reveals the psychological mechanisms behind their “wandering” behavior. Spontaneous engagement, fulfillment of needs, resonance with peers, preservation of meaning, self-management, and intermittent swinging characterize youth’s complex wandering online activities. It further explores new dimensions of youths’ media practices, emphasizing subjective expression, identity reconstruction, boundary clarification, and visibility control. Moreover, wandering youth also encounter challenges like context collapse, losing their true selves, and self-pulling, which raises a critical question: Where will they wander?
China's National Education Conference Matters: Major Education Discursive Blueprinting in 2024
Authors: Hou (侯滟斯) Yansi
Published: February 2025

Purpose

This study aims to analyze the blueprint for China's future education development outlined in China's National Education Conference of September 2024, and to examine the role of conference speeches in shaping China's education policymaking.

Design/Approach/Methods

This study thematically analyzed both the conference speech and the related press releases.

Findings

Regarding the speech content, five key tasks outlined in the conference speeches for building a strong education system by 2035 were identified. These tasks address the public's demand for high-quality education and the needs of national development. Regarding the speech structure, the conference speeches were structured into four main parts, each serving a distinct function in shaping education policy.

Originality/Value

This study contributes to a deeper understanding of China's recent policy directions for education development. It also sheds light on the discursive blueprinting function of conference speeches in China's education policymaking process.
Efficient computation of tournament winning probabilities
Authors: Brandes Ulrik , Marmulla Gordana , Smokovic Ivana
Published: February 2025

In the run-up to any major sports tournament, winning probabilities of participants are publicized for engagement and betting purposes. These are generally based on simulating the tournament tens of thousands of times by sampling from single-match outcome models. We show that, by virtue of the tournament schedule, exact computation of winning probabilties can be substantially faster than their approximation through simulation. This notably applies to recent FIFA World Cups and is independent of the model used for individual match outcomes.
ST-elevation Myocardial Infarction and Focal Myopericarditis Due to Cardiac Mucormycosis in an Immunosuppressed Patient
Authors: Chhabria Rahul , Pawar Niraj , Gavali Vishal , Bahadur M.M.
Published: February 2025

We describe an extremely rare case of fatal cardiac mucormycosis in a renal transplant recipient, clinically manifested by focal myopericarditis and ST-elevation myocardial infarction, due to contiguous mediastinal spread. Cardiac mucormycosis is seen in 0.2–1.2% of renal transplants and carries an unfavorable prognosis despite the timely diagnosis, intensive antifungal therapies, and surgical intervention.
FITNESS ASSESSMENT IN ACUTE MYELOID LEUKEMIA: RECOMMENDATIONS FROM AN EXPERT PANEL ON BEHALF OF EUROPEAN LEUKEMIA NET
Authors: Venditti Adriano , Palmieri Raffaele , Maurillo Luca , Röllig Christoph , Wierzbowska Agnieszka , de Leeuw David C. , Efficace Fabio , Curti Antonio , Ngai Lok Lam , Tettero Jesse M. , Adès Lionel , Almeida Antonio M , Bullinger Lars , Dennis Mike , Esteve Jordi , Ferrara Felicetto , Heuser Michael , Huls Gerwin A , Lübbert Michael , Mehta Priyanka , Montesinos Pau , Pabst Thomas , Récher Christian , Rossi Giuseppe , Russell Nigel H. , Sierra Jorge , Stauder Reinhard , Vey Norbert , Walter Roland B. , Wang Eunice S , Nier Samantha , Martins Carolina Garcez , Ossenkoppele Gert J
Published: February 2025

Fitness assessment in patients with acute myeloid leukemia (AML) is critical to deliver the right therapy to the right patient. While several scoring systems are available to aid in determining fitness, the absence of validation studies has resulted in the lack of universally accepted assessment procedures. This limitation, combined with the increasing availability of novel agents expanding the spectrum of less-intensive options, has introduced additional complexity to the fitness assessment process. In this evolving context, fitness should reflect eligibility for a specific treatment among the several available, rather than a generic binary classification of eligibility for intensive chemotherapy. Moreover, the growing emphasis on patient-centered care, further highlights the importance of integrating quality of life, patients' preferences, patients' self-reported physical and social functioning status, social support, and early integration of palliative care into the assessment framework. A modern interpretation of fitness assessment should incorporate a comprehensive evaluation that extends beyond traditional clinical and biological disease characteristics. Thus, fitness assessment in patients with AML represents only one piece of a larger puzzle, encompassing the patient's overall capacity to sustain and benefit from a specific therapeutic program.
Inhaled nitric oxide for the treatment of COVID–19: an open-label, parallel, randomised controlled trial
Authors: Friedrich Frederico , Cypel Marcelo , Michaelsen Vinicius Schenk , Brum Marcos Otávio Antunes , Ramos Fabiano , Marco Roberta , Chatkin Gustavo , Grun Lucas Kich , dos Santos Letícya Simone Melo , Santos Amanda Paz , Fernandes Morgana Thaís Carollo , Paungartner Luciana Medeiros , Maranghello Marcelo Scheffer , Lantmann Caroline , Eggers Gustavo , Sanches Gustavo Duenhas , Marinovich Daniel , Rosa Regis Goulart , Barbé-Tuana Florencia María , Jones Marcus Herbert
Published: February 2025

Background

Inhaled nitric oxide (iNO) in high concentration inhibits SARS-CoV-2 replication in epithelial cells and may prevent severe disease in hospitalized patients. To evaluate safety and efficacy of inhaled nitric oxide 160 ppm on supplemental oxygen in patients hospitalized with COVID-19.

Methods

We conducted an open-label, randomized clinical trial in hospitalized patients with COVID-19 receiving supplemental oxygen. Patients were randomly assigned to receive iNO for 6 h in addition to standard of care. The primary safety endpoint was assessed by incidence of adverse events (AEs). The secondary efficacy endpoint was the number of days free of supplemental oxygen within 15 days after randomization.

Results

Fifty-five patients were enrolled, 27 in the iNO group and 27 in the control group, and one patient was excluded. No adverse events occurred with the inhalation of NO. Number of days free of supplemental oxygen (median, IQR) was 11 (8.0 to 13.0) in the iNO group and 8 (2.5 to 10.5) in the control group; p=0.044. The iNO group had a shorter length of hospital stay, 4.5 days (3.0 to 6.3) compared to 7.0 days (6.0–10.0) in the control group; p= 0.004. Clinical score was lower in the iNO group on days 3 and 5 (p=0.010 and p=0.033). The number of patients weaned from ventilatory support on day 3 was higher in the iNO group (n=9[33%]) when compared to controls (n=1[4%]); p= 0.005. Respiratory failure and mortality did not differ between the groups.

Conclusion

The iNO treatment was well-tolerated and safe. Among adults hospitalized for COVID-19, iNO 160 ppm for 6 h increased the number of days free from supplemental oxygen, shortened the days of ventilatory support, the length of hospital stay and improved the clinical score.

Clinical trial registration:ensaiosclinicos.gov.br, Identifier: RBR-8nfx26