bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Intracranial Sarcoma, DICER1-Mutant, With Prominent Chondroid Differentiation: Case Report and Summary of Reported Patients in Literature
Authors: Karia Kinnari , Eschbacher Kathryn L.
Published: January 2025

Primary intracranial sarcoma, DICER1-mutant, included as a new diagnostic entity in the 2021 WHO Classification of Central Nervous System Tumors, is a rare, but aggressive neoplasm generally identified in the supratentorial forebrain. The prognostic implications of these uncommon tumors and optimal treatment strategy remain unclear. A 19-year-old woman was found unresponsive after reporting a severe headache. CT demonstrated an intra-axial, mass-like hemorrhage in the left temporal lobe which was subsequently resected. A review of the electronic medical record, histologic characterization by hematoxylin and eosin-stained sections and a targeted panel of immunohistochemical stains, and molecular characterization was pursued. The tumor was pleomorphic and demonstrated varying cellularity. The tumor cells had hyperchromatic nuclei with a spindled to round appearance. Numerous mitoses, interspersed islands of mature hyaline cartilage, and scattered eosinophilic globules associated with cells with marked nuclear atypia were noted. The tumor cells were positive for desmin, myogenin, and SMSA (focal) and negative for other lineage markers, suggestive of a mesenchymal neoplasm with myogenic differentiation. Next-generation sequencing revealed DICER1 (E1705K and P1805fs) and KRAS (Q61H) variants; the composite methylation profile prompted a final diagnosis of primary intracranial sarcoma, DICER1-mutant. This lesion underscores the histologic and immunophenotypic variability of these rare tumors. Notable features include prominent cartilaginous islands, retained H3K27me3 expression, prominent expression of desmin, and the presence of the unique DICER1 P1805fs variant, which has not previously been reported in this tumor type. We compile the molecular and immunohistochemical findings of all primary intracranial sarcomas, DICER1-mutant to date.
Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients
Authors: Gonzalez-Ochoa Alejandro J , Szolnoky Gyozo , Hernandez-Ibarra Ana G , Fareed Jawed
Published: January 2025

Introduction

Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19.

Methods

We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint.

Results

Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, P = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, P = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, P = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels.

Conclusions

Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.
Assessing Road Safety Impacts of Policy Actions in Finland 2004-2021
Authors: Pöllänen Markus , Katko Tapio S.
Published: January 2025

Road safety has progressed positively in many countries, one example being Finland where several major road safety policies were introduced in the 1970s. In Finland, the highest number of road fatalities (1156) was seen in 1972, while in 2003 the number was 379 and, in 2021, 225. This study presents the assessed impacts of 49 key policy actions and decisions related to traffic safety in Finland based on road safety experts’ views, with special focus on years 2004 to 2021, and 1970 to 2003 as background. During the first decade of this millennium, road fatalities reduced but, in the 2010s, safety did not develop as was targeted. Based on experts’ views, the policies during 2010s included controversial policy actions that aimed at reducing road users’ costs instead of going for road safety gains. Policies supporting safe road user behavior, speeds, vehicles and roads need to be further promoted.
Equity-Related Ethical Questions in Evaluation Practice: Examples From Interviews With Evaluators in New England, U.S.
Authors: Gates Emily F. , Li Ruoying (Amy)
Published: January 2025

Amid calls for evaluations to advance equity, there are ongoing debates, varied guidance, and limited empirical research on how evaluators practically attend to equity in their work. This article identifies ethical questions—about the right thing to do when there are multiple options—that arise when evaluators attend to equity and factors that influence how evaluators interpret and address these questions. Our identification of questions and factors comes from a qualitative analysis of semi-structured individual interviews with 21 evaluators based in New England, U.S., predominantly White women representing multiple practice areas. Ethical questions address evaluators’ expertise, negotiation with funders, methodological norms, use of data about disparities, and influence of evaluators’ worldviews in cross-cultural settings. The ways evaluators navigate these questions are influenced by their workplace, professional roles, interpersonal relationships, power differences, and available time. Findings pose implications for evaluator training and future directions for research on equity and ethics.
Toward Resilient Maternal, Neonatal and Child Health Care: A Qualitative Study Involving Afghan Refugee Women in Pakistan
Authors: Shafiq Yasir , Muhammad Ameer , Kumar Kantesh , Wajid Ali Zabin , Noor Saba , Suhag Zamir Hussain , Tahir Rehman , Jan Abdullah , Ragazzoni Luca , Barone-Adesi Francesco , Valente Martina
Published: January 2025

Background:

Afghan refugees in Pakistan, particularly in Quetta, Balochistan, encounter formidable barriers in accessing maternal, newborn, and child health (MNCH) services. These challenges have been intensified by the COVID-19 pandemic and entrenched systemic health inequities.

Methods:

This qualitative study, conducted from February to April 2023, aimed to assess the obstacles within health systems and community environments that hinder MNCH service access among Afghan refugees. The study involved 20 key informants through in-depth interviews and focus group discussions, including Afghan refugee women, community elders, health workers, and representatives from non-governmental organizations and government agencies. The research focused on experiences during the initial four waves of the COVID-19 pandemic (2020-2021), utilizing a conceptual framework integrating Health Emergency Disaster Risk Management (Health-EDRM) with primary health care.

Findings:

The study identified significant systemic barriers to accessing MNCH services, such as insufficient funding, inadequate health infrastructure, and discriminatory practices within the healthcare workforce. Additionally, community-level obstacles were prominent, including cultural and language differences, geographical isolation, and economic constraints. The integration of Health-EDRM into local health systems was minimal, with many stakeholders either needing to be made aware of or unengaged with the framework.

Conclusion:

The findings highlight a critical need for comprehensive policy reforms, infrastructure enhancement, and community-centered approaches to address Afghan refugees’ health needs effectively. Strengthening the integration of health-EDRM into health systems is crucial for enhancing resilience and ensuring continuous care during health emergencies. The study calls for concerted efforts to implement culturally sensitive health interventions that include disaster risk management components to improve MNCH outcomes among Afghan refugees in crisis-affected settings. Addressing systemic and community-level barriers makes creating a more resilient and equitable health system for vulnerable populations possible.
Exploring the lived experiences of parents living with cystic fibrosis: A qualitative study
Authors: Jacob Anne , Hubert Dominique , Brain Cléa , Grenet Dominique , Flahault Cécile
Published: January 2025

Because of the lengthening of their life-expectancy, more people with cystic fibrosis (CF) now pursue parenthood. To explore the experience of parenting while having CF, 18 French parents with CF were interviewed (including 12 mothers and 9 participants with a lung transplant). A thematic analysis of the interview transcripts was conducted. Within the domain of parenthood, seven themes were found: Journey to Parenthood; Experience of Parenthood; Daily Life; Administrative and Financial Aspects; Interaction of CF with Children’s Lives; The Spouse; The Children. This paper documents the positive aspects of parenthood, and the logistical and emotional challenges faced by participants and how they adjust to them. Notably, this paper highlights the struggle of most participants to become parents, the sensitive period of lung transplant surgery for the family, what children are told about CF, and how children’s lives are coloured by a sense of normality and worries for their sick parent.
The association between family resilience and psychological well-being during the COVID-19 pandemic: A three-level meta-analysis
Authors: Li Rui , Wu Donghong , Zhu Lin , Mi Tingni , Jia Siyao , Ren Zhihong
Published: January 2025

Despite numerous studies observing a positive correlation between family resilience and psychological well-being during the COVID-19 pandemic, the strength of this association varied considerably in previous research. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderators of the association between family resilience and psychological well-being during the COVID-19 pandemic. Seventeen studies (65 effect sizes, 14,511 participants) were reviewed using a systematic literature search and the PRISMA approach. A three-level meta-analysis revealed a significant positive correlation ( r = 0.504, p < 0.001) between family resilience and psychological well-being during the COVID-19 pandemic. Notably, education level significantly moderated this relationship, along with the type of psychological well-being and the measures used for assessment. These findings highlight the critical role of family resilience in enhancing psychological well-being and emphasize the importance of considering educational factors in designing interventions to improve psychological outcomes during pandemics.
Rethinking the ‘wellness influencer’: Medical doctors, lifestyle expertise and the question of credentials
Authors: O’Neill Rachel
Published: January 2025

Medical doctors are central to existing networks for wellness content on Instagram in and beyond the UK, yet remain overlooked within scholarship concerned with this terrain. Taking a case study approach, this article examines three such figures prominent in the UK context. In doing so, it challenges existing conceptualisations of the ‘wellness influencer’ and argues for an expanded understanding of the category, one that does not assume its representatives are ‘lay’ persons without recognised expertise in health and well-being. The analysis developed demonstrates that credentials cannot resolve the problems associated to wellness influencing as a genre and, as such, the entry of medical doctors to the ranks of social media celebrity may not be the ‘fix’ it is often imagined to be. Ultimately, I argue that medically qualified wellness influencers extend doctors’ role in the ‘regulation of lifestyle’, and make the case for attending to their ideological operations.
All but naive: Patrolling epistemic territories in radio phone-ins
Authors: Versteeg Wytske , te Molder Hedwig , van Burgsteden Lotte
Published: January 2025

In this paper, we analysed Dutch and British radio phone-in conversations on ADHD and vaccination between radio hosts and callers, focusing on how interactants dispute the authority of both scientific and experiential claims to expertise. We found that interactants never challenged the authority of science and experience as such, but resisted their normative relevance. When callers offered expertise in the form of personal experience, hosts challenged its relevance for the overhearing audience by treating the experience as mere belief. When callers offered expertise in the form of scientific knowledge, hosts carefully patrolled the boundaries of ‘real’ science and who may speak for it. We discuss how our findings can explain the frequent contestation of factual sources in semi-public exchanges and offer a new perspective on the supposed diminished authority of scientific knowledge.
The SAMgram: a novel local enhancement and targeted extraction strategy for weak bearing fault characteristics
Authors: Jiang Zuhua , Zhang Kun , Zhang Xiangfeng , Ma Chaoyong , Xu Yonggang
Published: January 2025

Envelope analysis is one of the most commonly used methods in rolling bearing fault diagnosis. However, when a signal contains heavy noise, even if an appropriate frequency band is selected, the fault information can still be overwhelmed. Unlike traditional use of spectral amplitude modulation, a novel SAMgram is proposed in this article for the enhancement and extraction of weak bearing fault characteristics in a signal, where local spectral amplitude modulation (LSAM) is performed to highlight bearing fault components and improve the proportion of fault information. Meanwhile, a targeted indicator called normalized harmonic kurtosis is proposed to select an optimal modified filtered signal automatically by quantifying repetitive transient characteristics. To extend LSAM to practical applications, two spectrum segmentation strategies are provided based on scanning spectrum and trend component, named the scanning SAMgram and adaptive SAMgram, respectively, which aim at determining the optimal modified filtered signal for demodulation by searching for the combinations of frequency bands and magnitude orders. A simulated signal of bearing compound faults and experimental signals of bearing outer ring and inner ring faults indicate that the proposed method can not only select a frequency band related to bearing defect to eliminate interference of invalid components but also highlight fault characteristics in the selected frequency band and weaken the disturbance of noise, which is superior over traditional envelope analysis-based methods and more applicable for fault diagnosis of rolling bearings under complex environments.
Political Parties and Forms of Citizens’ Involvement in Decision-Making: A Special Section
Authors: Gherghina Sergiu
Published: January 2025

This is the introductory article to a special section that discusses the relationship between political parties and the different forms of citizens’ involvement in decision-making, that is, participatory forms, referendums, and deliberative practices. The three articles in this special issue seek to answer two specific questions, respectively, (1) regarding how ideology relates to some of these forms of involvement and (2) why politicians do not act on the recommendations resulting from such forms. They focus on Spain, Switzerland, and Iceland and bring both theoretical and empirical contributions to the existing knowledge. Their findings are that ideology matters for the use of participatory practices but does not influence the non-implementation of outcomes from deliberative practices. The policy model rarely explains parties’ positioning in referendums, but there is flexibility and moderation during campaigns, and parties are more oriented towards participatory institutions at the local level than towards deliberative practices at the national level.
Exploring Sexual Harassment in Agriculture From a Socio-Ecological Perspective: A Scoping Review
Authors: Early Jody Oomen , Gordon-Dseagu Vanessa Lani , Breckwich Vásquez Victoria , Prado Kimberly , Drury Dennise
Published: January 2025

Workplace sexual harassment (WSH) and other forms of sexual violence are pervasive in the agricultural sector, yet remain overlooked as critical occupational health and safety concerns. In this scoping review, the social-ecological model was used as a framework to examine contributing and protective factors in the literature that inform WSH interventions, policy, and research. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols, the authors searched eight databases using Boolean terms related to “sexual harassment” and “agriculture.” Articles that were peer-reviewed, empirical, and nonempirical, published in English, available as full-text, and pertaining to agriculture were included in the sample. A total of 93 articles were found, and 20 met inclusion criteria. Results showed most studies were qualitative and exploratory. A number of contributing factors were discussed in the literature, including: harmful gender beliefs and myths, gender inequity and inequality, hierarchical workplace structures, poverty, precarious immigration status, language barriers, permissive workplace climate, fear of retaliation, a need for culturally responsive workplace training, and lack of clear anti-harassment workplace policies. There is also a lack of legal protections for agricultural workers at the state and federal levels, highlighting the need for advocacy and policy reform. The socio-ecological model (SEM) offers a comprehensive approach to understanding and addressing WSH across the spectrum of prevention. More empirical and longitudinal studies are needed to strengthen the evidence base for developing comprehensive solutions to WSH that address the many barriers and risks that agricultural workers face.
Local electromagnetic shielding for thyroid: A study on shielding efficacy and specific absorption rate
Authors: Lin Jiajin , Liu Xiaocao , Li Jing
Published: January 2025

This study assesses the shielding efficacy of local electromagnetic shield for the thyroid gland. The investigation employed a mechanical model of a thyroid shield gear, integrating it within a high-resolution three-dimensional virtual model (Duke). The simulation environment and biological electromagnetic model were constructed from 1 to 6 GHz, with the Finite-Difference Time-Domain (FDTD) algorithm. The results indicated that the specific absorption rate (SAR) values of the thyroid were significantly elevated under forward irradiation and in the L band (1–2 GHz). In addition, the local electromagnetic shield reduced the SAR values at the thyroid position, with a shielding efficiency ranging from 15 to 40 dB across the evaluated frequency range. Further, the local shielding effectiveness of the thyroid have obvious variety between frequency and polarization. However, the data also indicated a potential increase in SAR values in other tissues, notably the eyes by up to 4 dB. The study determines that local electromagnetic shields markedly reduce radiofrequency radiation to the thyroid, necessitating a balanced design approach that accounts for both protective benefits and side effects on other tissues. The method and result provide a new perspective and quantitative data for thyroid protection, which has important guiding significance for the design and practical application of electromagnetic protection products.
Not All Seizures Are Created Equal: The Sex Factor in Epilepsy
Authors: Sadri Zahra , Brewster Amy L.
Published: January 2025

[Box: see text]
The relative cerebral blood volume (rCBV) < 42% is independently associated with hemorrhagic transformation in anterior circulation large vessel occlusion
Authors: Lakhani Dhairya A , Balar Aneri B , Ali Subtain , Khan Musharaf , Salim Hamza A , Koneru Manisha , Wen Sijin , Wang Richard , Mei Janet , Hillis Argye E , Heit Jeremy J , Albers Gregory W. , Dmytriw Adam A , Faizy Tobias D , Wintermark Max , Nael Kambiz , Rai Ansaar T , Yedavalli Vivek S
Published: January 2025

Background

Pretreatment CT perfusion (CTP) marker relative cerebral blood volume (rCBV) < 42% lesion volume has recently shown to predict poor collateral status and poor 90-day functional outcome. However, there is a paucity of studies assessing its association with hemorrhagic transformation (HT). Here, we aim to assess the relationship between rCBV < 42% lesion volume with HT.

Methods

In this retrospective study, we included patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO) of anterior circulation who had successful recanalization from two comprehensive stroke centers between 9/1/2017 and 10/01/2023. Successful recanalization was defined as modified treatment in cerebral infarction (mTICI) 2b or greater. Logistic regression analysis and ROC analysis were used to assess the relationship between rCBV <42% and HT.

Results

In total, 150 patients (median age: 69 years, 58.7% female) met our inclusion criteria. On multivariable logistic regression analysis, taking into account age, sex, hypertension, hyperlipidemia, diabetes, prior stroke or transient ischemic attack, admission National Institute of Health stroke scale (NIHSS), Alberta Stroke Program Early CT Score (ASPECTS), and intravenous thrombolysis, rCBV <34% (aOR:1.01, P < .05), rCBV <38% (aOR:1.01, P < .05) and rCBV <42% (aOR:1.01, P < .05) lesion volumes were independently associated with HT. On ROC analysis rCBV < 42% (AUC = 0.61, P < .05) performed slightly better than rCBV < 38% (AUC = 0.59, P < .05) and rCBV < 34% (AUC = 0.59, P < .05) in predicting HT.

Conclusion

The rCBV <42% lesion volume is independently associated with HT in AIS-LVO patients who underwent successful recanalization.
Effects of pain in lumbosacral stenosis and lifestyle-related factors on brain-derived neurotrophic factor expression profiles
Authors: Sobański Dawid , Staszkiewicz Rafał , Sobańska Małgorzata , Strojny Damian , Grabarek Beniamin Oskar
Published: January 2025

This study investigated the role of brain-derived neurotrophic factor (BDNF) in patients with degenerative lumbar stenosis, focusing on its expression and correlation with pain intensity. The study examined 96 patients with lumbar stenosis and 85 control participants. BDNF levels in the yellow ligamentum flavum were measured using reverse transcription quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and western blot analysis. The results showed significantly higher BDNF expression at both messenger ribonucleic acid (mRNA; fold change = +1.35 ± 0.23; p < 0.05) and protein levels in patients (28.98 ± 6.40 pg/mg) compared to controls (4.56 ± 1.98 pg/mg; p < 0.05). Furthermore, BDNF levels correlated positively with pain intensity reported by patients, with higher expression observed in those experiencing more severe pain. The study also explored the influence of lifestyle factors, such as smoking and alcohol consumption, and related diseases, such as diabetes, on BDNF expression. Smoking, alcohol use, and diabetes were associated with significantly elevated BDNF levels ( p < 0.05). These findings suggest that BDNF could serve as a biomarker for pain severity in degenerative lumbar stenosis at the protein level, although this was not consistently observed at the mRNA level; this highlights the potential for BDNF-targeted therapies in managing pain. Future research should involve larger longitudinal studies to validate these findings and explore therapeutic interventions. This study underscores the importance of considering molecular and lifestyle factors in the treatment of degenerative lumbar stenosis, aiming to improve patient outcomes through comprehensive, targeted approaches.
Perceived pervasive ambiguity in the onset of COVID-19: Media dependency and social media sharing in Seoul, Tokyo, and New York
Authors: Jung Joo-Young , Kim Yong-Chan , Mai Lisi , Kwesell Allison , Lee Dokyung
Published: January 2025

The study applies the concept of perceived pervasive ambiguity and media system dependency theory to examine how the situation surrounding the outbreak of the COVID-19 pandemic influenced people's media dependency and the likelihood of sharing information, opinions, and feelings on social media. Perceived pervasive ambiguity refers to the inherent difficulties individuals encounter in making sense of the information available to them, arising from their perceptions of societal-level unpredictability. Employing cross-national survey data collected in Seoul, Tokyo, and New York City (NYC) at strategic points of high concern for each country in February and March 2020, structural equation modeling analyses revealed that individuals with higher levels of perceived pervasive ambiguity also exhibited greater dependency on five types of media: TV, print newspapers, radio, online newspapers, and portal sites. Those with higher perceived pervasive ambiguity and dependency on print newspapers, radio, and online newspapers were more likely to share their thoughts and opinions about COVID-19 on social media. Cross-city differences based on multi-group analyses and the implications of the findings are discussed.
Unpacking the African media typology: Perspectives from journalists in Kenya, Rwanda, and Uganda
Authors: Sobel Cohen Meghan
Published: January 2025

The uniqueness of journalism cultures across African nations often highlights the inapplicability of normative, Western-centric theories. The newly proposed African media typology suggests that media systems in Africa would be best understood by thinking about them within the context of the type of individual in a leadership position in that country at a specific moment in time. This study aims to begin operationalizing the African media typology by investigating journalist perspectives about political leadership, changes in press freedom, and the role of news media in promoting or inhibiting various forms of development and democratization. Cross-national surveys of journalists in Kenya, Rwanda, and Uganda, conducted in 2019 ( N = 424 journalists: 174 in Rwanda, 148 in Uganda, and 102 in Kenya), reveal ways in which journalists’ perceptions about the role of news media as contributing to various forms of development are similar and different across varying media environments within the typology.
Polycystic kidney disease
Authors: Ansari Taha Alver , Siddiqui Zubair Ahmed
Published: January 2025

Polycystic kidney disease is a common inherited disorder that primarily follows an autosomal dominant inheritance pattern, leading to significant kidney problems. Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent form, representing the leading genetic cause of end-stage kidney disease worldwide. Characterised by clusters of fluid-filled cysts in both kidneys, ADPKD is a multisystem and progressive disease involving organs such as the heart, liver, and pancreas. Understanding ADPKD's genetic basis, clinical presentations, and progression is crucial for GPs, as early detection and appropriate management can significantly improve patient outcomes. This article provides a comprehensive overview of ADPKD for GPs, focusing on diagnosis, management, and clinical implications.
Enfortumab vedotin plus pembrolizumab for previously untreated locally advanced or metastatic urothelial carcinoma: a cost-effectiveness analysis
Authors: Zhu Youwen , Liu Kun , Zhu Hong , Li Shan , Yuan Dan
Published: January 2025

Background:

Both the antibody–drug conjugate (ADC) enfortumab vedotin (EV) and programmed death-1 inhibitor pembrolizumab have been shown to provide survival benefits in patients previously treated with locally advanced or metastatic urothelial carcinoma (la/mUC). Cost-effectiveness is necessary to consider whether the increased efficacy of the two therapies will lead to higher prices for first-line treatment of previously untreated la/mUC.

Objectives:

To guide the choice of EV plus pembrolizumab or chemotherapy for patients with previously untreated la/mUC.

Design:

The cost-effective analysis.

Methods:

A Markov model was developed to simulate the lifetime of patients with previously untreated la/mUC to assess the overall cost and efficacy of EV plus pembrolizumab and chemotherapy based on the EV-302/KEYNOTE-A39 trial. Primary outcomes included total cost, life-years (LYs), quality-adjusted LYs (QALYs), the incremental cost-effectiveness ratio (ICER), and incremental net health benefits at the USA and Chinese willingness-to-pay threshold of $150,000/QALY and $35,173/QALY, respectively. Model stability was examined through sensitivity and subgroup analyses.

Results:

EV plus pembrolizumab and chemotherapy treatment regimens were associated with 2.07–2.16 and 1.04–1.06 QALYs with corresponding costs of $288,347–$532,362 and $24,773–$267,568, respectively. ICERs in the United States and China are $267,491/QALY and $254,339/QALY, respectively. The factors that most strongly influenced model outcomes in unidirectional sensitivity analyses were patient weight and the cost of EV. To achieve greater cost-effectiveness, EV costs would need to be reduced by over 75% and 10% in the United States and China, respectively.

Conclusion:

While first-line EV plus pembrolizumab has significant health benefits compared to chemotherapy for patients with previously untreated la/mUC, this regimen is not cost-effective at the current price in the United States or China.
Repairing the Deltoid Ligament in Ankle Fractures Is it time for a Paradigm Shift?
Authors: Van den Berg Joy , Penning Diederick , Baumbach Sebastian , Schepers Tim
Published: January 2025

Background

It remains unclear whether repairing the deltoid ligament (DL) is beneficial in acute ankle fractures. The aim of this review is to critically review the developments in deltoid ligament repair (DLR) in ankle fractures over the course of 44 years.

Method

An electronic search was conducted on the PubMed and Embase database including comparative studies evaluating the effect of performing DLR in adults suffering from a closed acute ankle fracture with suspected rupture of the DL.

Results

A total of 27 studies were retrieved, of which only one was a randomized study. A total of 1327 patients were reviewed (663 undergoing DLR and 664 receiving non-DLR treatment for an acute ankle fracture). Although earlier studies concluded that DLR holds little necessity in ankle fracture treatment if the anatomy of the ankle is restored, more recent studies support DLR due to more favorable clinical and radiographic outcomes.

Discussion

All studies agree that restoration of the ankle anatomy to its pre-fracture state is necessary to achieve the best clinical outcome. However, there is still controversy in whether to standardize DLR in ankle fracture treatment. The literature shows a clear shift toward more frequent restoration of the DL, and in light of improved surgical techniques and implants, there is a need for more rigorous studies to provide a clear indication for DLR in acute ankle fracture treatment.

Level of Evidence:

III
Lower Perceived Economic Mobility Inhibits Pro-Environmental Engagement by Increasing Cynicism
Authors: Yang Shasha , Liu Yongfang
Published: January 2025

People’s environmental protection behavior largely depends on their perception of the economic and social environment. Through six studies, this article investigates the relationship between perceived economic mobility and pro-environmental engagement. Using the World Values Survey, Study 1 ( N = 59,948) found that lower mobility is linked to lower pro-environmental intentions. Studies 2 ( N = 243) and 3 ( N = 235) manipulated mobility in real and virtual society, supporting Study 1’s findings. Study 4 ( N = 219) introduced cynicism, showing that lower mobility was associated with higher cynicism, which in turn was associated with lower pro-environmental behavior. Studies 5 ( N = 234) and 6 ( N = 294) manipulated mobility and measured cynicism as well as environmental donation, providing further evidence. Our findings expand research on perceived economic mobility, highlighting its broader impact on behavior that affects the natural environment.
Prognostic significance of MRD and its correlation with arsenic concentration in pediatric acute promyelocytic leukemia: a retrospective study by SCCLG-APL group
Authors: Fan Zhong , Yang Liang-Chun , Chen Yi-Qiao , Wan Wu-Qing , Zhou Dun-Hua , Mai Hui-Rong , Li Wan-Li , Yang Li-Hua , Lan He-Kui , Chen Hui-Qin , Guo Bi-Yun , Zhen Zi-Jun , Liu Ri-Yang , Chen Guo-Hua , Feng Xiao-Qin , Liang Cong , Wang Li-Na , Yu-Li  , Luo Jie-Si , Huang Dan-Ping , Luo Xue-Qun , Li Bin , Huang Li-Bin , Zhang Xiao-Li , Tang Yan-Lai
Published: January 2025

Background:

Treatment outcomes for acute promyelocytic leukemia (APL) have improved with all-trans-retinoic acid and arsenic trioxide, yet relapse remains a concern, especially in pediatric patients. The prognostic value of minimal residual disease (MRD) post-induction and the impact of arsenic levels during induction on MRD are not fully understood.

Objectives:

To evaluate the relationship between post-induction MRD levels and relapse-free survival (RFS) in pediatric APL patients, and to investigate the correlation between blood arsenic concentration levels during induction therapy and MRD status.

Design:

A retrospective analysis of pediatric APL patients enrolled in a clinical trial from September 2011 to July 2020.

Methods:

We assessed the relationship between RFS and post-induction MRD levels using the log-rank test. The optimal MRD cut-off was determined using the “surv_cutpoint” function in the survminer R package. Arsenic concentration levels were monitored in 16 patients on days 7 and 14 of induction therapy, and Spearman correlation was used to analyze the relationship between arsenic concentrations and MRD levels.

Results:

Among 176 pediatric APL patients, with a median follow-up of 6 years, 4 relapsed. Patients with MRD >3.1% had significantly lower RFS compared to those with MRD ⩽3.1% (94.6% vs 100%, p = 0.023). In addition, a negative correlation was found between blood arsenic concentration levels and post-induction MRD levels. Lower arsenic concentrations were associated with higher MRD levels, with significant correlations observed for trough concentrations ( R = −0.666, p = 0.005) and peak concentrations ( R = −0.499, p = 0.049) on day 7.

Conclusion:

Our study highlights the prognostic significance of post-induction MRD assessment in pediatric APL. We also demonstrate a negative correlation between blood arsenic concentration levels and MRD, suggesting that lower arsenic concentrations during induction therapy may contribute to a higher MRD burden. These findings may inform strategies to optimize treatment and improve outcomes in pediatric APL. Trial registration: www.clinicaltrials.gov (NCT02200978).
Characterization of children’s prospective prescription review and exploration of factors influencing the success of interventions
Authors: Wen Qiang , Yang Chuang , Deng Bangjian , Zhang Yi , Song Lin
Published: January 2025

Background:

Medication safety is crucial in clinical care. Although many hospitals have implemented prospective prescription review systems to manage medication use, the impact of these systems on pediatric patients is not yet fully understood.

Objectives:

We explore the characteristics and economic impacts of pediatric prospective prescription review and identify factors influencing intervention success rates.

Design:

This study adopted a cross-sectional design.

Methods:

Prospective prescription review tasks were compared in the outpatient of our hospital between 2021 and 2023 to assess medication rationalization rates and cost variability. Data were collected using the PASS PharmReview system, including patient information, medication indications, prescribing physicians, intervention pharmacists, prescription rationality rate, and medication costs. SPSS 26.0 software was used to compare changes in medication rationality and medication costs between the initial (2021) and stable (2023) periods and to analyze factors affecting intervention success during the stable period by the logistic regression model.

Results:

The study included 11,533,807 prospective prescription review tasks. The medication rationalization rate increased from 92.0% to 95.7% ( p < 0.05) between the initial ( n = 5,392,551) and stabilization periods ( n = 6,141,256). Outpatient medication costs per capita decreased by 3.2%, from ¥320.7 to ¥310.5. Factors influencing intervention success included the following: the greater age is negatively associated with success( p < 0.001, odds ratio (OR) = 0.98); internal medicine demonstrates a superior intervention success rate compared to the surgical department ( p < 0.001, OR = 1.37); higher physician titles were associated with lower success rates ( p < 0.001, OR = 0.59); and success increased with pharmacists of higher educational levels ( p < 0.001, OR = 1.18).

Conclusion:

Implementing a prospective prescription review system in pediatric outpatient settings improves medication rationality and reduces errors and costs, with intervention success influenced by patient age, department, physician titles, and the educational level of pharmacists.
Spelling correction with large language models to reduce measurement error in open-ended survey responses
Authors: Allamong Maxwell B. , Jeong Jongwoo , Kellstedt Paul M.
Published: January 2025

Open-ended survey questions have a long history in public opinion research and are seeing a renewed interest as computing power and tools of text analysis proliferate. A major challenge in performing text analyses on open-ended responses is that the documents—especially if transcribed or collected through web surveys—may contain measurement error in the form of misspellings which are not easily corrected in a reliable and systematic manner. This paper provides evidence that large language models (LLMs), specifically OpenAI’s GPT-4o, offer a flexible, dependable, and low-cost solution to correcting misspellings in open-ended responses. We demonstrate the efficacy of this approach with open-ended responses about the Democratic and Republican parties from the 1996–2020 American National Election Studies, where GPT is shown to correct 85%–90% of misspellings identified by human coders in a sample of responses. Following spelling correction on ∼50,000 responses, we document several consequential changes to the data. First, we show that spelling correction reduces the number of unique and single-use tokens while increasing the number of words matched to a sentiment dictionary. Then, to highlight the potential benefits and limitations of spelling correction we show improved out-of-sample prediction accuracy from a text-based machine learning classifier. Finally, we show a significantly larger degree of emotionality is captured in the spelling-corrected texts, though the size of this measure’s relationship with a known correlate in political interest remains relatively unchanged. Our findings point to LLMs as an effective tool for reducing measurement error by correcting misspellings in open-ended survey responses.
A comprehensive review of digital twin in healthcare in the scope of simulative health-monitoring
Authors: Nadeem Mubaris , Kostic Sascha , Dornhöfer Mareike , Weber Christian , Fathi Madjid
Published: January 2025

Objective

Digital twins (DTs) emerged in the wake of Industry 4.0 and the creation of cyber-physical systems, motivated by the increased availability and variability of machine and sensor data. DTs are a concept to create a digital representation of a physical entity and imitate its behavior, while feeding real-world data to the digital counterpart, thus allowing enabling digital simulations related to the real-world entity. The availability of new data sources raises the potential for developing structured approaches for prediction and analysis. Similarly, in the field of medicine and digital healthcare, the collection of patient-focused data is rising. Medical DTs, a new concept of structured, exchangeable representations of knowledge, are increasingly used for capturing personal health, targeting specific illnesses, or addressing complex healthcare scenarios in hospitals.

Methods

This article surveys the current state-of-the-art in applying DTs in healthcare, and how these twins are generated to support smart, personalized medicine. These concepts are applied to a DT for a simulated health-monitoring scenario.

Results

The DT use case is implemented using AnyLogic multi-agent simulation, monitoring the patient’s personal health indicators and their development.

Conclusion

The results indicate both possibilities and challenges and provide important insights for future DT implementations in healthcare. They have the potential to optimize healthcare in various ways, such as providing patient-centered health-monitoring.
Unpacking the Rejection of L2 Students Toward ChatGPT-Generated Feedback: An Explanatory Research
Authors: Chen (陈子淇) Ziqi , Wei (韦卫) Wei , Zhu (祝新华) Xinhua , Yao (姚远) Yuan
Published: January 2025

Purpose

Drawing on the Unified Theory of Acceptance and Use of Technology (UTAUT), this sequential mixed-method study explored L2 learners’ challenges in seeking corrective feedback in an AI-assisted educational environment.

Design/Approach/Methods

The data was collected from 45 university students in a Computer Science program who were encouraged to seek corrective feedback from ChatGPT for their argumentative writing report. Self-reflection data were qualitatively and quantitatively analyzed.

Findings

Findings suggested that 45.9% of the AI-generated feedback was rejected by students, with a higher rejection rate observed for content-focused feedback (58.7%) compared to form-focused feedback (41.3%). AI-generated content-focused feedback was rejected due to misalignments between expected and received feedback, anticipated high workload to respond, mismatch between feedback from AI and external references, and impeding conditions for students to engage with the feedback. Meanwhile, the rejection of form-focused feedback was largely associated with the high level of expected effort.

Originality/Value

This study is one of the few existing studies on the L2 learners’ challenges in seeking corrective feedback from generative AI systems. Notably, the study differentiates between form-focused and content-focused feedback and identifies the distinct challenges and learning opportunities that impact students’ rejection of AI feedback.
The misreadings, misinterpretations, and misrepresentations of women’s rights in African cultures: Challenging the systems of power that influence relationality and [Mis-]interpretations of women in Shona culture and beyond
Authors: Mawere Munyaradzi , Tandi Costain , Zhou Takavafira Masarira , Mapfumo Ericcson Tinashe
Published: January 2025

The tidal wave of Western feminism has swept across the globe, leaving an indelible mark upon the diverse cultures of Africa. Within this context, the feminist movement has been amplified by the pressing need to decolonise the discourses surrounding identity, rights, space, epistemology, and race, among other fundamental constructs. Regrettably, the core of this radical feminist wave has often been misread, misinterpreted, and grossly misrepresented the experiences of African women. The prevalent portrayal has been one that casts African women as second-class citizens, whose rights are disrespected and violated by their male counterparts. Grounded in the Shona culture of Zimbabwe, and as part of a broader critical examination of cultural and global studies, this paper endeavours to uncover and correct the egregious misrepresentations and misreadings of the rights and roles of the Shona woman, at least from a cultural vantage point. This paper advances the argument that Western feminism is a colonial construct, one that has been imposed upon the women of Zimbabwe by imperialist forces, with the intention of sowing anarchy within African culture and the cherished institution of the family. It concludes that the very discourse of identity necessitates a process of decolonisation and reconstruction.
Silicotuberculosis: a critical narrative review
Authors: Ehrlich Rodney , Murray Jill , Said-Hartley Qonita , Rees David
Published: January 2025

Silicotuberculosis, the combination of silicosis and pulmonary tuberculosis (TB), remains a substantial clinical and public health problem in high TB burden countries with silica-exposed workforces. The objectives of this narrative review are to propose a definition of silicotuberculosis which includes post-tuberculous lung disease, to emphasise the importance of understanding how the two diseases modify each other, and to identify as yet unanswered questions relevant to clinical practice and disease control and mitigation. The unique aetiological relationship between silica exposure and TB is now firmly established, as is the accelerated impairment and mortality imposed by TB on individuals with silicosis. However, the rich clinical, pathology and laboratory literature on combined disease from the pre-TB treatment era appears to have been largely forgotten. The close clinical and pathological appearance of the two diseases continues to pose a challenge to imaging, diagnosis and pathological description, while inconsistent evidence regarding TB treatment and TB preventive treatment prevails. Many other topics raise questions to be answered,
inter alia
: the range of phenotypes of combined disease; the rates and determinants of disease progression; the role of computed tomography in identifying and characterising combined disease; appropriate screening practice; acceptable policies of management of workers that combine risk reduction with social security; and the workplace respirable silica concentration that protects against the excess TB attributable to inhaled silica.