bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Prognosis of Patellar Tendinopathy (Jumper’s Knee) in Young, Elite Volleyball Players: Tendon Changes 11 Years After Baseline
Authors: Visnes Håvard , Bache-Mathiesen Lena Kristin , Yamaguchi Tetsuo , Gilhuus Hans Petter , Algaard Knut Robert Hector , Hisdal Erling , Bahr Roald
Published: October 2024

Background:

The long-term prognosis of jumper's knee and whether structural changes in the patellar tendon persist is unknown.

Purpose:

To investigate whether limitations in knee function and structural changes persisted beyond the athletic career of young elite volleyball players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Volleyball players (mean ± SD age, 18 ± 0.8 years) enrolled in 2006-2011 in a prospective cohort study were invited in 2020-2022 to a follow-up study. Participants rated their knee function with the Victorian Institute of Sport Assessment–Patellar Tendon (VISA-P) score (baseline and follow-up) and the International Knee Documentation Committee (IKDC) score (follow-up) and reported if jumper's knee had influenced their decision to retire from sport. Tendon thickness and structural changes were assessed with ultrasound (baseline) and magnetic resonance imaging (MRI) (follow-up) of both patellar tendons.

Results:

We included 138 of 143 former athletes (97%) 11.4 ± 1.6 years after their baseline examination. At baseline, 37 persons (52 knees) had developed jumper's knee. At follow-up, participants reported lower knee function scores in knees diagnosed with jumper's knee at baseline than healthy knees (VISA-P scores: jumper's knee, 81 [95% CI, 70-92]; healthy, 90 [95% CI, 86-94]; P < .001; IKDC scores: jumper's knee, 82 [95% CI, 75-89]; healthy, 92 [95% CI, 91-95]; P < .001). Jumper's knee problems directly caused 7 of the 37 athletes (19%) with jumper's knee at baseline to retire from competitive volleyball. Of the 138 players included, 97 (70%) completed a bilateral MRI examination (194 knees). At follow-up, 38 of the 54 abnormal tendons (70%) had no structural changes ( P < .001 vs baseline) while 22 of the 140 normal tendons (16%) had developed structural changes. Clinical symptoms were not correlated with tendon structure at follow-up (VISA-P scores for normal tendons: 85 [95% CI, 73-87]; abnormal: 89 [95% CI, 85-92]; P = .48).

Conclusion:

Jumper’s knee is not a self-limiting condition; volleyball players who had developed jumper's knee during adolescence reported persistent reductions in knee function 11 years later, leading one-fifth to retire from competitive volleyball. Although approximately 70% of tendons with structural changes at baseline were normal at follow-up, there was no clear relationship between structure and function.
Widowhood Shock, Family Reconstruction, and Mild Cognitive Impairment Among Older Adults: A Prospective Cohort Study
Authors: Zhu Xiaohan , Tang Huameng , Wang Mingxing , Yuan Dianqi , Guo Chao
Published: October 2024

Mild cognitive impairment (MCI), especially among widowed older adults, is increasingly urging public concern. This study aimed to investigate the association of widowhood, remarriage, and widowed life characteristics with the MCI risk among Chinese older adults. With an average age of 86.49 ± 10.20, a sample of 5377 participants aged between 65 and 116 was collected from four waves of the Chinese Longitudinal Healthy Longevity Survey between 2008 and 2018. Cox proportional hazards models and restricted cubic spline models were employed to estimate and plot the associations. Results showed that widowhood is associated with an increasing MCI risk, which could not be alleviated by remarriage. This negative impact was pronounced among women and those at older age. The association of living alone duration after widowhood and MCI onset displayed an inverse U-shape, with a peak risk at the 10th year. These findings have practical implications for pointing out the most vulnerable groups to MCI.
Agape—The Melody of the Teaching Church
Authors: Stanford Robert L.
Published: October 2024

This article is addressed to the teaching Church—the local church, Christian universities, and colleges, as well as parachurch or Christian-based ministries. Organized around an exegesis of 1 Timothy 1:5, the article promotes agape-love as a goal of discipleship. Agape, an evidence of Christian maturity exerts considerable impact on the methods and objectives of the ministry of discipleship. Consequently, the disciple-maker will utilize various learning and teaching modes which benefit their student-disciples.
Cancer Caregiver Anxiety Over Time: The Influence of Palliative Care
Authors: Siminoff Laura A , Wilson-Genderson Maureen , Chwistek Marcin , Thomson Maria D
Published: October 2024

Objectives: To explore anxiety experienced by caregivers providing home-based, end-of-life care to patients with cancer. We examined the relationship between caregiver anxiety and receipt of palliative care by the patient. Methods: A case series of terminal cancer patient-caregiver dyads (n = 223) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 12 months or until patient death. Data collected included qualitative, quantitative, and observational data; this analysis utilizes the quantitative data. Longitudinal Latent Growth Models were used to characterize the heterogeneity of primary caregiver anxiety over time. The influence of palliative care on caregiver anxiety over time was assessed. Characteristics associated with membership in the trajectory groups rendered from those models are presented. Results: The majority of caregivers were female (73.9%), white (54.9%), and patient spouses (45.3%). Three classes of caregivers were identified based on their anxiety scores over time (low, elevated, and high). The 2 groups who had elevated and high anxiety had significant increases in anxiety over time. Controlling for patient receipt of palliative care attenuated those increases. Caregivers with the lowest level of anxiety were more likely to be Black, report fewer symptoms of depression or caregiver burden and higher self-rated physical health. Caregivers who were younger reported higher anxiety. Conclusions: Our analysis detected 3 distinct cancer caregiver groups reporting low, elevated, and very high levels of anxiety. Caregivers with elevated or high anxiety also demonstrated increasing anxiety overtime; however increases were attenuated with patient receipt of palliative care. For cancer caregivers with elevated and high levels of anxiety, palliative care buffers further deterioration of their mental health.
Neuroborreliosis Presenting as Urinary Retention: Case Report
Authors: Ribeiro Mário , Lopes Sofia , Silva Helena , Matos Antonio , Rodrigues Marlene
Published: October 2024

Lyme disease is a tick-borne infectious disease caused by the spirochete Borrelia burgdorferi. Voiding dysfunction is a rare manifestation of neuroborreliosis with only a few cases reported. Here we describe a case of a 6-year-old male child with an acute urinary retention, paraparesis, and voiding difficulty in whom neuroborreliosis was diagnosed through serologic tests for antibodies, Western blot testing confirmation and intrathecal antibody synthesis. Magnetic resonance imaging (MRI) of the spine led to the diagnosis of acute transverse myelitis and a urodynamic study demonstrated detrusor areflexia. He received a 4-week course of intravenous ceftriaxone (2 g/d). The patient has recovered from the paraparesis but still suffers from a neurogenic bladder.
Is Physical Intimate Partner Violence a Risk Factor for Physical Child Maltreatment in a Nationally Representative Sample of Finnish School Children?
Authors: Mielityinen Laura Annika , Ellonen Noora , Fagerlund Monica
Published: October 2024

Previous studies have found a high co-occurrence between intimate partner violence and child maltreatment. However, little is known about the nuanced association between physical intimate partner violence (pIPV) and physical child maltreatment (pCM) in countries where corporal punishment is prohibited by law. Furthermore, there is a lack of information on the co-occurrence from children’s perspectives and nationally representative surveys. The main objective of this study was to examine the connection between pIPV and pCM in a nationally representative sample of 12 to 13 and 15- to 16-year-old Finnish children ( N = 6,825) after controlling for other known risk factors. The χ2 test and the logistic regression model were used. Around 47.3% of the children who had been exposed to pIPV had also experienced pCM during the past year, whereas 6.7% of those who had not been exposed to pIPV reported pCM. Children exposed to pIPV were almost three times more likely to experience pCM than children who were not exposed to pIPV. The connection remained statistically significant after controlling for other risk factors. Prevention and early identification of pIPV might reduce pCM in families. Targeted prevention efforts and interventions aimed at physical family violence are necessary to reduce its occurrence and mitigate the impact of abuse on children and families.
Fuzzy flexible job shop dynamic scheduling considering machine remaining processing capacity
Authors: Guo Chen , Luo Wenyong , Zhang Wei
Published: October 2024

Dynamic fuzzy flexible job shop scheduling (DFFJSP) is significant in the medical equipment industry. Generally the dynamic flexible job shop scheduling problem considers a single dynamic factor or ignores resources such as machine itself also plays a huge role in dealing dynamic issues. Thus fuzzy processing time and machine breakdowns are considered in this paper. In order to copy with two problems mentioned above, the model of DFFJSP containing two objectives of makespan and energy consumption is established. To solve this problem, the remaining processing capacity of broken machine is applied to weaken the impacts of machine breakdowns and a multi-objective evolutionary algorithm (NG-WOA) is proposed, which integrating NSGA-II and whale optimal algorithm (WOA). Furthermore, the joining of variable neighborhood search makes NG-WOA skip the local optimum solution in time. Through experiments, the validity of remaining processing capacity is verified in rescheduling scheme. Then NG-WOA algorithm is proven can find better solutions when compared with other two algorithms according to the distribution of pareto forefront solutions in benchmark examples. The results of this paper show that the remaining processing capacity has greater advantages in guaranteeing the stability of dynamic scheduling problems, because the machine’s processing capacity can be utilized fully compared to previous strategies for fault disturbances.
Holocene aeolian-fluvial interactions patterns and their response to climate changes in the Paiku Co basin, Southern Tibetan Plateau
Authors: Yuan Wenjie , Zheng Yinghua , Yan Ping , Ding Zhiyong , Wang Xiaoxu , Zhang Xiao , Gao Yating , Chu Jiaqi , Fan Hua , Liu Yingna
Published: October 2024

Aeolian-fluvial processes are crucial in shaping landforms. Despite the advancements in understanding the sedimentary processes of aeolian-fluvial interactions, the sedimentary patterns of these interactions are complex in spatiotemporal scale, and the records of Holocene small-scale aeolian-fluvial interaction sedimentary is insufficient, especially in the Tibetan Plateau region. Therefore, this study focuses on analyzing the sedimentary patterns of aeolian-fluvial interactions and their response to climate change in the Paiku Co basin of the southern Tibetan Plateau (TP). Through the examination of aeolian-fluvial sequences, Optically Stimulated Luminescence (OSL) dating is utilized to establish a chronological framework. Furthermore, proxy indices are explored to identify potential sediment models and their reactions to climate change. The findings indicate that fluvial activity predominated during a relatively warm and wet period around 5.1–4.6 ka, while thicker aeolian sands accumulated extensively during 4.6–4.1 ka as the climate transitioned to cold and dry conditions. On a millennial scale, the aeolian-fluvial interaction sedimentation is characterized by alternating deposition of clay layers and medium to fine sand. This sedimentation pattern is predominantly influenced by climate change. Overall, the findings shed light on the complex coupling between aeolian and fluvial processes in response to past climate changes, which has important implications for understanding the landscape evolution and environmental changes in this sensitive high-altitude region.
Testing tree-ring cellulose δ18O with water isotopes for Holocene lake δ18O interpretations in the central Rocky Mountains USA
Authors: Anderson Lesleigh , Mast Alisa , Brice Becky , Berkelhammer Max
Published: October 2024

Stable isotopes of water preserved in geologic archives, primarily as oxygen (δ18O), have proven critical for documenting Earth’s climatic and hydrologic systems past and present. However, timescale differences of water isotope inputs to proxy systems and the signal embedded in long paleorecords often confound translation to observed hydroclimatic metrics. Here, a unique 20-year dataset of meteorology, hydrology, and the isotopic composition of weekly meteoric and surface water samples (δ18O, δ2H) are combined with paleoclimate δ18O data from tree-ring cellulose and lake carbonate to better understand proxy signals of Upper Colorado river basin drought. Annual tree-ring cellulose δ18O from Picea engelmannii growing within a glacier-fed creek and a spring discharge area were used to derive annual source water δ18O using a cellulose source-water isotope model. Comparisons with the monitoring record indicates that tree-ring cellulose δ18O tracks variations in wet and dry hydroclimatic extremes. Source water isotopes are shown to reflect the hydroclimate of the current year and some number of previous years as an effective moisture-discharge proxy rather than a precipitation isotope proxy. Results contextualize Holocene lake carbonate δ18O data. The contemporary-to-paleo comparison identifies changes in seasonal precipitation extremes during recent millennia and several earlier arid and monsoon-dominated Holocene periods that exceed the arid maximum of the calibration period.
A general consonance principle for closure tests based on p-values
Authors: Zehetmayer Sonja , Koenig Franz , Posch Martin
Published: October 2024

The closure principle is a powerful approach to constructing efficient testing procedures controlling the familywise error rate in the strong sense. For small numbers of hypotheses and the setting of independent elementary [Formula: see text]-values we consider closed tests where each intersection hypothesis is tested with a [Formula: see text]-value combination test. Examples of such combination tests are the Fisher combination test, the Stouffer test, the Omnibus test, the truncated test, or the Wilson test. Some of these tests, such as the Fisher combination, the Stouffer, or the Omnibus test, are not consonant and rejection of the global null hypothesis does not always lead to rejection of at least one elementary null hypothesis. We develop a general principle to uniformly improve closed tests based on [Formula: see text]-value combination tests by modifying the rejection regions such that the new procedure becomes consonant. For the Fisher combination test and the Stouffer test, we show by simulations that this improvement can lead to a substantial increase in power.
Comparison of statistical methods for the analysis of patient-reported outcomes in randomised controlled trials: A simulation study
Authors: Qian Yirui , Walters Stephen J , Jacques Richard M , Flight Laura
Published: October 2024

Patient-reported outcomes (PROs) that aim to measure patients’ subjective attitudes towards their health or health-related conditions in various fields have been increasingly used in randomised controlled trials (RCTs). PRO data is likely to be bounded, discrete, and skewed. Although various statistical methods are available for the analysis of PROs in RCT settings, there is no consensus on what statistical methods are the most appropriate for use. This study aims to use simulation methods to compare the performance (in terms of bias, empirical standard error, coverage of the confidence interval, Type I error, and power) of three different statistical methods, multiple linear regression (MLR), Tobit regression (Tobit), and median regression (Median), to estimate a range of predefined treatment effects for a PRO in a two-arm balanced RCT. We assumed there was an underlying latent continuous outcome that the PRO was measuring, but the actual scores observed were equally spaced and discrete. This study found that MLR was associated with little bias of the estimated treatment effect, small standard errors, and appropriate coverage of the confidence interval under most scenarios. Tobit performed worse than MLR for analysing PROs with a small number of levels, but it had better performance when analysing PROs with more discrete values. Median showed extremely large bias and errors, associated with low power and coverage for most scenarios especially when the number of possible discrete values was small. We recommend MLR as a simple and universal statistical method for the analysis of PROs in RCT settings.
Joint regression analysis of clustered current status data with latent variables
Authors: Feng Yanqin , Wu Sijie , Ding Jieli
Published: October 2024

Clustered current status data frequently occur in many fields of survival studies. Some potential factors related to the hazards of interest cannot be directly observed but are characterized through multiple correlated observable surrogates. In this article, we propose a joint modeling method for regression analysis of clustered current status data with latent variables and potentially informative cluster sizes. The proposed models consist of a factor analysis model to characterize latent variables through their multiple surrogates and an additive hazards frailty model to investigate covariate effects on the failure time and incorporate intra-cluster correlations. We develop an estimation procedure that combines the expectation-maximization algorithm and the weighted estimating equations. The consistency and asymptotic normality of the proposed estimators are established. The finite-sample performance of the proposed method is assessed via a series of simulation studies. This procedure is applied to analyze clustered current status data from the National Toxicology Program on a tumorigenicity study given by the United States Department of Health and Human Services.
Nurses’ adherence to ethical principles – A qualitative study
Authors: Wong Valery , Hassan Norasyikin , Wong Yoke Ping , Chua Sophia Yen Nee , Abdul Rahman Shaliza , Mohamad Mas Linda , Lim Siriwan
Published: October 2024

Background

Nursing is regulated by a set of professional standards. Whilst many forms of ethics apply to nursing, the biomedical ethical framework is common, involving autonomy, beneficence, non-maleficence and justice. In healthcare, nurses often encounter ethical dilemmas that require them to navigate conflicting ethical principles. However, how nurses adhere to these principles in such situations is unclear.

Research Aim

To explore how registered nurses adhere to ethical principles when dealing with ethical dilemmas at work.

Research Design

A qualitative descriptive study design.

Participants and Research Context

Between August and December 2023, 21 registered nurses were recruited from a teaching hospital through purposive sampling. Data were collected through semi-structured in-person interviews or online video conferencing. Braun and Clarke’s thematic analysis approach was employed to analyse the data.

Ethical Considerations

Interview participation was voluntary. Written consent was obtained before participation. Participants’ real identities were replaced with pseudonyms. This study was approved by the SingHealth Centralised Institutional Review Board.

Findings

The data analysis developed four major themes and 15 subthemes. The four major themes are “Addressing the dilemma,” “Contemplating the principles and consequences,” “Coordinating for well-informed, ethical decision,” and “Self-reflecting and finding consolation.”

Conclusion

This study explains how nurses navigate and uphold ethical principles when caring for patients to the best of their ability. Fully adhering to ethical principles can be challenging for caring for actively dying patients. Further research can expound on nurses’ experiences and adherence to ethical principles in complex clinical cases.
Blue Carbon as a Potent Strategy in the Pathway to Achieve Net Zero
Authors: Gandhi Ekta , Francis Ann , Husain Hishmi Jamil
Published: October 2024

Climate change and its various impacts, including extreme weather events, have recently been recognized as urgent threats to the ecosystems. The Blue Economy, as defined by the World Bank, involves the use of ocean resources to promote sustainable economic propriety, livelihood improvement and job creation while ensuring health of ocean ecosystems. Notably, investing in blue carbon, which encompasses ecosystems like mangroves, tidal and salt marshes, seagrasses can serve as a powerful tool in combatting climate change. Investing in innovative solutions to reduce carbon emissions and funding initiatives to create and expand carbon sinks worldwide are essential components of this endeavour. While technological innovations are a focus, nature-based solutions, particularly the preservation and reclamation of blue carbon ecosystems, can offer an expedient, sustainable and less expensive approach. This research article aims to establish the significance of investing in blue carbon initiatives. In this line, this study proposes that implementing blue carbon initiatives under the voluntary carbon markets would be a key strategy towards achieving the net-zero pathway.
Sample Size Planning in the Design of Two-Level Randomized Cost-Effectiveness Trials
Authors: Li Wei , Dong Nianbo , Maynard Rebecca , Kelcey Benjamin , Spybrook Jessaca , Xu Yue
Published: October 2024

This study introduces recent advances in statistical power analysis methods and tools for designing and analyzing randomized cost-effectiveness trials (RCETs) to evaluate the causal effects and costs of social work interventions. The article focuses on two-level designs, where, for example, students are nested within schools, with interventions applied either at the school level (cluster design) or student level (multisite design). We explore three statistical modeling strategies—random-effects, constant-effects, and fixed-effects models—to assess the cost-effectiveness of interventions, and we develop corresponding power analysis methods and tools. Power is influenced by effect size, sample sizes, and design parameters. We developed a user-friendly tool, PowerUp!-CEA, to aid researchers in planning RCETs. When designing RCETs, it is crucial to consider cost variance, its nested effects, and the covariance between effectiveness and cost data, as neglecting these factors may lead to underestimated power.
The Relationship Between Acculturative Stress, Integration Strategy, Parenting Self-Efficacy, and Multicultural Youth's Perceived Parental Support in South Korea
Authors: Park Cheolwoo , Bayne Hannah B.
Published: October 2024

Over the past decades, ethnically and racially diverse populations have constantly increased in South Korea. In their acculturation, a number of multicultural families encounter acculturative stress, which can negatively influence their individual as well as relational well-being. Therefore, the present study aimed to investigate the association between acculturative stress of multicultural parents ( n = 2,249) and parental support perceived by multicultural youth ( n = 2,271) in South Korea. Additionally, the authors examined the potential mediating effect of parental self-efficacy moderated by parental acculturation on the association between parental acculturative stress and perceived parental support. Moderated mediation analysis was conducted to test the association between multicultural mothers’ acculturative stress and their youth's perceived level of parental support with the mediating effect of multicultural mothers’ parenting self-efficacy level moderated by integration strategy. The moderation analysis identified a significant buffering effect of achieving an integrated level of acculturation on multicultural parents’ acculturative stress and parenting self-efficacy. In addition, parenting self-efficacy significantly mediated the link between multicultural parents’ acculturative stress and multicultural youth's perceived level of parental support. Implications and future directions for mental health professionals, educators, and researchers were discussed.
Association of exposure to nonpersistent endocrine disruptors with sex hormones and metabolic health in US females
Authors: Dubey Pallavi , Reddy Sireesha Y. , Thangavel Chinthana , Hardy Ghislain , Dwivedi Alok Kumar
Published: October 2024

Endocrine disruptive chemicals (EDCs) are considered as the potential attributes for the increasing trend in obesity and metabolic syndrome (MS) through disruption of sex hormones, particularly in women. We evaluated the association of understudied EDC compounds with total testosterone (TT), sex hormone-binding globulin (SHBG), obesity, and MS. A population-based cross-sectional study was conducted using the National Health and Nutrition Examination Survey datasets collected during the years 2013–2016. Women of age ≥15 years with urinary measurements of nonpersistent EDCs, including bisphenol, triclosan, triclocarban, dichlorophenol, and paraben compounds were included in this study. Data were analyzed using the modified Poisson models to estimate the adjusted relative risk (RR) and 95% confidence interval (CI). The associations were also validated by considering TT and SHBG concentrations as the outcomes. The study included 1974 women with 11% high TT, 10.5% low SHBG, 40% obesity, and 46.2% MS. A medium to high exposure to bisphenol-A (RR = 1.64; 95% CI: 1.14, 2.35, p = 0.009), bisphenol-F (RR = 1.83; 95% CI: 1.35, 2.49, p < 0.001), bisphenol-S (RR = 1.83; 95% CI: 1.35, 2.49, p = 0.041) and 2, 4- dichlorophenol (RR = 1.61; 95% CI: 1.06, 2.45, p = 0.026) were associated with low SHBG but not with high TT. In addition, high exposure to triclosan was also inversely associated with SHBG concentrations (regression coefficient = −0.09; 95% CI: −0.15, −0.02, p = 0.013). However, these EDCs were found to be associated with SHBG, obesity, and MS according to menopausal status. High exposure to certain nonpersistent EDCs was associated with low SHBG, obesity, and MS according to menopausal status.
Streamlining Complex Intervention Evaluation Through Participatory Systems Mapping and Contribution Analysis: A Comprehensive Framework for Actionable Complexity Evaluation
Authors: Bouyousfi Salah Eddine , Ouedraogo Miché
Published: October 2024

The use of complexity-based evaluation methods remains relatively underexplored in the field of evaluation. While increasingly employed to assess complex interventions, Contribution Analysis (CA) continues to suffer from a lack of operationalization. In this article, we propose enhancing the implementation of CA by leveraging Participatory Systems Mapping as a tool to delineate and scrutinize contribution narratives. The research has a dual objective. It aims to experiment with the recently introduced Participatory Systems Mapping method in the field of evaluation while providing a tool for examining contribution narratives. The combination of CA and Participatory Systems Mapping was tested by evaluating a youth employability project. This approach enabled a collaborative and in-depth examination of impact stories and alternative explanations. It proved valuable not only in managing the complexity of the intervention but also in strengthening the implementation of CA.
Teacher-led strategies for maximizing learning outcomes in higher education / Estrategias dirigidas por el profesorado para maximizar los resultados de aprendizaje en Educación Superior
Authors: Ramos-Alvarez Manuel Miguel , Luque-Agulló Gloria
Published: October 2024

A number of challenges have arisen in educational policies for higher education (HE) contexts in the last decades, leading to a shift from teacher- to learner-oriented methodologies. However, there is a dearth of studies revising effective teacher-led strategies aimed at maximizing learning outcomes in HE, since learners may still need teachers’ support in organizing their acquisition process. Consequently, adopting this instructional perspective, this paper has examined how teachers’ methodology can be (re)designed to promote successful learning in HE by means of strategies aimed at scaffolding content, language, design of tasks and output. A systematic list of effective instructional strategies is developed in this paper, overlooking those techniques that, despite their frequent use, have not proved to be highly beneficial for promoting learning outcomes. When students become expert learners, a shift from instructional to discovery or learner-based methodologies may occur.
Uncovering the Therapeutic Target and Molecular Mechanism of Upadacitinib on Sjogren’s Syndrome
Authors: Yang Youguo , Liu Yuan , Li Xiaofen , Zeng Yongping , He Weiqian , Zhou Juan
Published: October 2024

Objective:

Upadacitinib, a selective Janus associated kinase 1 (JAK-1) inhibitor, can be prescribed particularly for the clinical treatment with Crohn’s disease or rheumatoid arthritis. It is clinically observed that upadacitinib has been found with potential therapeutic effectiveness on Sjogren’s syndrome (SS). However, the anti-SS targets and mechanisms involved in upadacitinib treatment remain uninvestigated.

Materials and methods:

Thus, this study was designed to identify therapeutic targets and mechanisms of upadacitinib for treating SS through conducting network pharmacology and molecular docking analyses.

Results:

In total, we identified 298 upadacitinib-related target genes, 1339 SS-related targets before collecting 56 overlapped target genes and 12 hub target genes. Upadacitinib largely exerted the critical biological processes including regulation of microenvironment homeostasis, inflammatory response, and cell apoptosis, and largely acted on pivotal molecular mechanisms including hypoxia-inducible factor 1 (HIF-1) signaling pathway, apoptosis pathway, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, or Th17 cell differentiation pathway. Molecular docking data suggested that upadacitinib exhibited the high affinities with signal transducer and activator of transcription 3 (STAT3), HIF1A, poly(ADP-ribose) polymerase 1 (PARP1) target proteins, in which the structural interactions between upadacitinib and STAT3, HIF1A, PARP1 showed potential therapeutic activities against SS.

Conclusion:

In conclusion, upadacitinib possesses the bright anti-inflammatory and anti-apoptotic activities on SS, and this study can provide a theoretical basis for clinical therapy of SS using upadacitinib.
Incorporating iterative continuation tasks into EFL writing courses
Authors: Wei Ran , Ma Dini
Published: October 2024

This study explored how the iterative continuation task can be incorporated into a writing course in a setting for English as a foreign language (EFL). It investigated the effectiveness of the iterative continuation task in influencing senior high school students’ writing performance and their writing attitudes. Eighty-four year-one students from a China’s provincial senior high school participated in the study. They were divided into two groups: an experimental group and a control group, each consisting of 42 students. The experimental group was subjected to six turns of reading–writing continuation tasks, whereas the control group continued with the previous practice of a single turn of reading–writing continuation tasks. Data were collected from writing tests and questionnaires. The results show that the iterative continuation task helped improve students’ writing performance in lexis and grammar rather than organization and content and it also had a positive impact on changing students’ writing attitude, especially on the dimensions of writing perception and writing process. The iterative continuation task has been proved to be a facilitative pedagogical approach for language development in EFL senior high school contexts.
L2 anxiety, proficiency, and communication across the classroom, non-classroom, and digital settings: Insights from Ethiopian preparatory schools
Authors: Welesilassie Merih Welay , Nikolov Marianne
Published: October 2024

Research into second or foreign language (L2) learning has demonstrated that L2 anxiety, perceived proficiency, and L2 willingness to communicate (L2WTC) profoundly impact language learning outcomes. However, the complex interplay between these variables has yet to be fully explored, as these factors are dynamic and context-specific and can vary across different learners and learning environments. The study, therefore, utilized a cross-sectional quantitative survey research design to scrutinize the causal relationships between L2 anxiety, English proficiency, and L2WTC of 609 Ethiopian preparatory school students. The model for the L2WTC, both inside and outside the classroom, has been expanded to include an additional sub-scale known as the L2WTC in a digital setting. Moreover, in contrast to the commonly recognized debilitative-focused L2 anxiety, the construct of L2 anxiety has been divided into facilitative and debilitative anxiety. This method allows us to measure not only the presence or absence of anxiety but also evaluate if anxiety helps or hinders the L2 learning experience. A self-assessment proficiency measure was also developed specifically for Ethiopian high school students. The study treated facilitative and debilitative anxiety as independent variables while considering English proficiency and L2WTC in the classroom, outside the classroom, and in digital settings as dependent variables. English proficiency was also used as an independent variable to predict L2WTC in these three settings. Our proposed model, including these variables, was tested using structural equation modelling (SEM). According to the descriptive analysis, the mean scores of L2WTC in the three settings were generally low, ranging from 2.30 to 2.84. Debilitative anxiety casts a shadow on the positive aspects of anxiety. The English proficiency was also too low. According to SEM, debilitative anxiety displayed a statistically significant negative impact on L2WTC inside and outside the classroom, in digital settings, and English proficiency. In contrast, facilitative anxiety was found to positively contribute to L2WTC outside the classroom, in digital settings, and in English proficiency. English proficiency made a statistically significant and positive contribution to L2WTC within and outside the classroom and in digital contexts. L2WTC inside the classroom positively contributed to L2WTC outside the classrooms and in digital contexts. We systematically compared the findings with existing studies in the discussion and elucidated the pedagogical implications, limitations, and potential future research avenues. The outcomes of our study have the potential to significantly contribute to the advancement of theoretical and empirical knowledge about improving English education, learning, and communication not only in Ethiopia but also in similar contexts of English as a foreign language (EFL).
Deep learning-based approach for identifying vortex-induced vibrations in stay cables
Authors: Guo Jian , Mao Renjie , Ma Kaijiang , Chen Daijie
Published: October 2024

Due to variations in wind speed profiles along the length of bridge stay cables, vortex-induced vibrations (VIV) exhibit multimodal characteristics, presenting challenges for VIV identification. Currently, the VIV identification is concentrated on the stable stage of VIV, lacking an available early warning system for detecting the initial developing stage of VIV. In this study, a deep learning-based approach that integrates energy distribution ratio features derived from frequency band wavelet packet decomposition to recognize VIV of stay cable was proposed. Firstly, vibration characteristics induced by vortices in cable-stayed bridges were analyzed based on field monitoring data from the bridge health monitoring system, aiming to propose suitable feature indicators for VIV identification. Secondly, using root mean square as label classification, a deep learning model was constructed, incorporating convolutional neural networks, long short-term memory networks, and attention mechanisms. Finally, four different stages in the evolution of stay cables VIV were identified utilizing field monitoring datasets to analyze the optimal parameter. Meanwhile, effective early warning recognition was achieved through the classification and recognition of confusion matrix. This study provides technical support for early warning systems and structural condition assessment concerning bridge stay cable VIV.
Post-earthquake inspection of high-speed railway viaducts with multi-scale task interaction deep learning strategy
Authors: Shu Jiangpeng , Yang Han , Liu Gaoyang , Yu Hongchuan , Ning Yingjie , Bairán Jesús-Miguel
Published: October 2024

Automated computer vision-based inspections of railway infrastructures, such as component type, damaged status, and location, have been investigated actively by resorting to task-specific deep learning models. However, task-specific models that fulfill these separate inspection tasks encountered bottlenecks in improving inference accuracy, and bring huge computational costs. Multi-task deep learning, which can fulfill these inspection tasks concurrently, has yet to be fully investigated in the context of structural inspection. In this study, a multi-scale task interaction deep learning strategy is presented towards component recognition, damage segmentation, and depth estimation for a comprehensive post-earthquake inspection of high-speed railway viaducts. Three modules for multi-scale task interaction were proposed to modify the multi-task deep neural network, taking full advantage of task commonalities at multiple scales. The proposed method was validated with a large-scale image dataset of high-speed railway viaducts. Component recognition and depth estimation were incorporated to implement multi-task learning since they have higher pattern affinities at multiple scales. Results reported that mean Intersection over Unions of testing samples of component and damage tasks were 91.2% and 72.1%, RMSE of depth estimation was 1.54 m. Compared with single-task cases, training time, inference duration, and FLOPs of the multi-task model were reduced by 23%, 30%, 27% respectively. Results showed improvement in both inference accuracy and training efficiency, substantiating the superiority of the proposed strategy.
A web-based platform for studying the impact of artificial intelligence in video capsule endoscopy
Authors: Apostolidis Georgios , Kakouri Antigoni , Dimaridis Ioannis , Vasileiou Eleni , Gerasimou Ioannis , Charisis Vasileios , Hadjidimitriou Stelios , Lazaridis Nikolaos , Germanidis Georgios , Hadjileontiadis Leontios
Published: October 2024

Objective: Integrating artificial intelligence (AI) solutions into clinical practice, particularly in the field of video capsule endoscopy (VCE), necessitates the execution of rigorous clinical studies. Methods: This work introduces a novel software platform tailored to facilitate the conduct of multi–reader multi–case clinical studies in VCE. The platform, developed as a web application, prioritizes remote accessibility to accommodate multi–center studies. Notably, considerable attention was devoted to user interface and user experience design elements to ensure a seamless and engaging interface. To evaluate the usability of the platform, a pilot study is conducted. Results: The results indicate a high level of usability and acceptance among users, providing valuable insights into the expectations and preferences of gastroenterologists navigating AI–driven VCE solutions. Conclusion: This research lays a foundation for future advancements in AI integration within clinical VCE practice.
Exploring indigenous adoptees’ stories of reconnection after adoption through the lens of the indigenous connectedness framework
Authors: Linjean Meschelle , Semanchin Jones Annette
Published: October 2024

The Indigenous Connectedness Framework (ICF) describes mechanisms that help or hinder Indigenous children’s development of family, community, environmental, intergenerational, and cultural/spiritual connectedness, or belonging, and healthy identity. It has been applied in considerations of child welfare system-involved youth and alumni and studies of Indigenous mental health, but not yet to Indigenous adoptees who may not have experienced child welfare involvement prior to adoption and are reconnecting to their origins as adults. Although various factors influence the extent of (re)connectedness, Indigenous adoptees’ reunification with biological family, community, land/place, ancestors, and culture is generally linked with increases in their senses of connectedness, or belonging, and Indigenous/Tribal identity. To gain initial insights into the suitability of the ICF to describe components of Indigenous adoptee (re)connectedness, this study used a Two-Eyed Seeing approach with Indigenous storytelling and narrative inquiry methodologies to explore experiences and perceptions of reunification with four Indigenous adults who experienced adoption by non-Indigenous families as children and were raised in non-Indigenous communities. Stories about reconnection with family, community, and land/place after adoption, as well as stories of perceived supports for, and challenges of, reunification were obtained during conversational interviews conducted via Zoom or phone and then mapped onto the ICF. Disconnectedness mechanisms, (re)connectedness mechanisms, and themes related to adoptees’ internal worlds and resilience, relational identity development, and contributions to intergenerational connectedness were revealed. Suggested pathways for social work to support (re)connectedness or belonging for Indigenous adoptees and implications for future research are provided.
Survey of data stories: Guidelines for data story authoring
Authors: Garreton Manuela , Moyano Daniela , Guerra José , Parra Denis
Published: October 2024

Data stories are sequences of data facts connected through a meaningful narrative and combine data visualizations and storytelling to convey information effectively. They have gained popularity due to data journalism, evolving into a hybrid practice involving computer science, design, and storytelling. Creating data stories requires diverse skills however there is a lack of guidance. We found one model that identifies the process of transforming data into visual stories following three stages; explore data, make a story and tell a story. Based on this approach, we surveyed recent literature on data stories in order to classify their contributions to each of the three stages. The contribution of this review is the proposal of guidelines for authors that provide greater detail to each stage and gaps for future research. We hope that by better understanding the design process and the guidelines that emerge from it, we will enrich the quality of the data stories and thus make them more meaningful and engaging to readers.
‘No one has ever told us it will be fun’. Achieving fulfilment in medical practice
Authors: Weston Clive
Published: October 2024

Facilitating a tutorial with medical students who appeared unusually tentative and apathetic prompted me to reflect upon the intergenerational character of Medicine and consider how we might counter the pervasive pessimism that leads to demoralisation and disillusionment. Engaging in local Communities of Practice may allow clinicians, old and new, to maintain enjoyment and fulfilment in Medicine.
Functional status following pulmonary rehabilitation in people with interstitial lung disease: A systematic review and meta-analysis
Authors: Rodrigues Guilherme , Santos Rute , Pinto Rita , Oliveira Ana , Marques Alda
Published: October 2024

Background

Individuals with interstitial lung disease (ILD) often experience worsening symptoms and activity avoidance. Limited data exists on outcome measures for assessing functional status (capacity and performance), as well as on the effectiveness of pulmonary rehabilitation (PR) in improving these outcomes in ILD.

Aim

This review aimed to systematically assess the effects of PR on both functional capacity and performance in individuals with ILD.

Methods

Randomised controlled trials involving pulmonary rehabilitation (PR) in adults with ILD, which included at least an exercise training component and education and/or psychosocial support, were included. Risk of bias and quality of evidence were assessed. Mean changes from baseline and standard deviations were retrieved for each group, and a random-effects model was applied.

Results

Eight studies were included, mostly involving individuals with idiopathic pulmonary fibrosis ( n = 5). PR duration ranged from 3 to 26 weeks. Seven studies used the 6MWT to evaluate functional capacity and one also used the 30-s STS. Two studies assessed functional performance, measuring time spent in moderate physical activity with the SenseWear Armband, number of steps per day with the same device, and energy expenditure in MET-min using the international physical activity questionnaire. PR improved functional capacity (6MWT-MD 45.82 m, 95%CI [26.14; 65.50], I2 = 71.54%, p < .001; 30-s STS- PR: 3.7 ± 2.6 reps; control group: −0.4 ± 2.5 reps, p < .001) compared to usual care. Only self-reported physical activity levels increased after PR (PR: 51.4 ± 57.7MET-min; control group: 20.9 ± 37.2MET-min, p = .03).

Conclusion

PR is effective at improving functional capacity; however, functional performance is often overlooked, resulting in limited and inconclusive findings.
Nutrition and Training Recommendations for Transgender and Gender-Diverse Athletes Involved in Strength Sports and Resistance Training: A Case Series of Nine Athletes Assigned Female at Birth
Authors: Linsenmeyer Whitney , Glassman Bari , Tomasiello Nikias , Walcott Katherine
Published: October 2024

Transgender and gender diverse (TGGD) athletes have distinct nutrition and training considerations. Guidance for nutrition and sport professionals working with TGGD athletes is lacking, especially when addressing sex-specific data. The purpose of this case series was to depict nutrition and training assessment approaches and recommendations for TGGD athletes involved in strength sports or resistance training. Six types of data informed each case presentation, including: demographic, anthropometric, health history, and survey data (Eating Competence Scale, Exercise Benefits and Barriers Scale); a 3-day food and physical activity record; and an in-depth interview. Nine TGGD athletes assigned female at birth (AFAB) presented with a range of gender identities, experiences, sport involvement, and transition journeys. Most athletes consumed inadequate energy and fiber, adequate or marginally high levels of saturated fat and added sugars, and high levels of sodium. Most athletes scored low on the Eating Competence Scale and high on the Exercise Benefits and Barriers Scale. Nutrition and sports professionals can individualize the care they provide for TGGD athletes when addressing sex-specific data and help athletes ensure they are meeting their nutrient needs.