bluuebunny/crossref_metadata_2025 huggingface dataset:
They Asked Me If I Wanted to Grow: The Self-Directed, Lifelong Learning of Middle Managers in the Banking Industry
Authors: Ray Daniel K. , Nelson Timothy R.
Published: February 2025

The purpose of this study was to describe the lived experiences of middle managers in the banking industry practicing self-directed, lifelong learning. The theory guiding this study is Deci and Ryan’s self-determination theory and its relationship with lifelong learning. This study aimed to answer the following question: What are the lived experiences of middle managers in the banking industry practicing heutagogy to develop lifelong learning skills? Data collected from individual interviews, focus groups, and journal prompts were synthesized using inductive coding to identify patterns and connections in the resulting data. Following an in-depth analysis of the collected data, five major themes emerged. Learning and employment growth, lifelong learning and adaptation, organizational implementation of learning, referrals and career advancement, and personal growth through experience and accomplishment offer a valuable perspective into middle managers’ experiences in the banking industry practicing self-directed learning. These themes provide insight into the various aspects of their personal and professional growth journey. The study concludes by discussing the implications and findings for future research.
Using Anti-Racist School Counseling Practices and Multi-Tiered Systems of Supports as Alternatives to Punitive Disciplinary Practices for Black Males
Authors: Pincus Robert , Kurz Charity A. , Rock Wendy D. , Hines Erik M.
Published: February 2025

Black male students are suspended and expelled from school at three times the number of White students, even though they are a smaller population. This conceptual article reviews how school counselors can support Black male students through an anti-racist lens, using culturally responsive multi-tiered system of supports (MTSS) interventions in relation to behavioral issues to reverse punishment trends. We report on several appropriate, evidence-based Tier 1, Tier 2, and Tier 3 interventions that school counselors have been successful using with Black males. This article stresses the importance of using culturally responsive interventions with Black male students.
Variation in Surgical Technique for Medial Patellofemoral Ligament Reconstruction in Skeletally Immature Patients: Data From the JUPITER Prospective Multicenter Study Group
Authors: Heyworth Benton E. , Hidalgo Perea Sofia , Green Daniel W. , Veerkamp Matthew W. , Wall Eric J. , Wilson Philip L. , Ellis Henry B. , Chipman Danielle E. ,   JUPITER Study Group, Shubin Stein Beth E. , Parikh Shital N. , Brady Jacqueline , Fabricant Peter , Farr Jack , Koh Jason , Kramer Dennis , Magnussen Robert , Milewski Matthew , Redler Lauren , Strickland Sabrina , Tompkins Marc , Yanke Adam , Yen Yi-Meng
Published: February 2025

Background:

Management approaches and surgical techniques for patellofemoral instability (PFI) continue to lack clear clinical guidelines and indications. Medial patellofemoral ligament reconstruction (MPFLR) is the most frequently used surgical procedure; however, variation in technique remains significant, particularly in skeletally immature patients.

Purpose/Hypothesis:

The purpose of this study was to examine variations in MPFLR technique in skeletally immature patients as represented by 20 orthopaedic surgeons with different experience levels and specialty training backgrounds who perform a high volume of PFI surgery in this age group. The hypothesis was that variation would be high.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Operative records of skeletally immature patients who underwent a primary, single-stage MPFLR between 2016 and 2021 within the JUPITER (JUstifying Patellar Instability Treatment by Results) cohort, a multicenter prospective study involving 13 tertiary care academic centers, were analyzed, including demographic information, injury data, and surgical technique details.

Results:

Of the 305 surgical PFI cases in skeletally immature patients, 245 knees (46% female, 54% male; mean age, 13.6 ± 1.8 years; range, 5.1-19.0 years) met inclusion criteria. High variation was identified in MPFLR tendon graft type (59% allograft, 41% autograft), patellar fixation (62% suture anchor, 32% patellar bone bridge/tunnel), and femoral fixation (76% interference/tenodesis screw, 23% suture anchor). All cases (100%) used fluoroscopic guidance and physeal-sparing principles, with femoral implant placement distal to the distal femoral physis. High variation was seen in adjunctive procedures, including lateral retinacular release or lengthening (22%), osteochondral fracture treatment (13% overall; 53% of which underwent loose body removal, 44% fixation, and 3% osteochondral allograft implantation), concomitant hemi-epiphysiodesis for genu valgum (9%), and patellar tendon medialization (Grammont procedure, 2%).

Conclusion:

Despite the presence of open physes, which generally limits PFI surgical technique options, variation in multiple aspects of MPFLR was high among this cohort of 20 high-volume surgeons.
Evaluating Donor-Recipient Sex Mismatch in Anterior Cruciate Ligament Reconstruction With Allograft: Outcomes at 2 Years Postoperatively
Authors: Crutchfield Connor R. , Lowenstein Natalie A. , Leite Chilan B.G. , Lattermann Christian , Matzkin Elizabeth G.
Published: February 2025

Background:

Female patients tend to suffer a greater risk of reinjury and worse patient-reported outcome measures (PROMs) after anterior cruciate ligament reconstruction (ACLR) than male patients, regardless of the graft type used.

Purpose/Hypothesis:

This study explored the role of donor-recipient sex mismatching to help explain these sex-based disparities in outcomes after ACLR with an allograft. The hypothesis was that allograft donor-recipient sex mismatch would adversely affect surgical outcomes at a 2-year follow-up, with male-to-female graft donations yielding the lowest rates of success.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent primary ACLR with an allograft between 2012 and 2022 were eligible for recruitment. The following PROMs were collected from baseline through a 2-year follow-up: Knee injury and Osteoarthritis Outcome Score subscales, Marx activity rating scale, visual analog scale for pain, and Veterans RAND 12-Item Health Survey. Demographic and graft-specific variables were also collected. Sex- matched cases were compared with sex- mismatched cases and an identical subgroup analysis was performed for female patients only.

Results:

Of the 112 included patients (N = 70 women), 59 (52.7%) were sex mismatched. The mean patient age was 40.7 ± 10.9 years, and the mean body mass index was 26.8 ± 4.7 kg/m2. Most reconstructions (89.3%) used a semitendinosus tendon graft, with a mean implanted graft diameter of 9.7 ± 0.5 mm (quadrupled). Of the mismatched cases, 96.6% involved a male allograft donated to female recipients. Overall, the matched group demonstrated higher PROM scores across all time points compared with the mismatched group, although statistical significance was only reached for the Marx score at baseline ( P = .012) and 1 year postoperatively ( P = .022). In the female-only subgroup analysis, a larger graft diameter was measured in the mismatched cases (receiving male allografts) compared with the matched female cases (9.7 ± 0.6 vs 9.2 ± 0.4 mm, respectively; P = .002). Moreover, the mismatched cases tended to report better postoperative PROM scores, although this trend was not statistically significant.

Conclusion:

The study findings indicated that male donors provided larger allografts than female donors, and that donor-recipient allograft sex matching did not contribute significantly to ACLR outcomes. Other factors may be more important to outcomes in female patients.
The Role of Isolated Lateral Extra-Articular Tenodesis in Managing Residual Pivot Shift After Primary Anterior Cruciate Ligament Reconstruction and a New Medial Meniscal Tear
Authors: Hoffer Alexander J. , Brinkman Joseph C. , Tummala Sailesh V. , Economopoulos Sofia C. , Economopoulos Kostas J.
Published: February 2025

Background:

Persistent mildly abnormal knee kinematics after anterior cruciate ligament (ACL) reconstruction (ACLR) is an ongoing clinical problem.

Purpose:

To compare the clinical outcomes of revision ACLR (rACLR), rACLR and lateral extra-articular tenodesis (LET), or isolated LET in patients with a grade ≥2 pivot shift after ACLR with an intact or partially torn graft and a new, symptomatic medial meniscal tear.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review of all patients with a new, symptomatic medial meniscal tear diagnosed after a primary ACLR was performed. Patients were included if they demonstrated a grade ≥2 pivot shift on physical examination with an intact or partially torn ACL graft. Exclusion criteria included complete graft rupture. The senior author’s management evolved in a practice change design from rACLR to rACLR with LET, to isolated LET over the study period. The primary outcomes were the International Knee Documentation Committee (IKDC), Lysholm, and Tegner patient-reported outcomes (PROs) at 2 years postoperatively.

Results:

A total of 47 patients, with 16 in the rACLR group, 12 in the rACLR and LET group, and 19 in the isolated LET group were included. Baseline characteristics between groups were similar. At 2 years, the rACLR group IKDC score was 86.1 ± 6.6 and was lower than the rACLR and LET group (91.9 ± 4.4; P = .009; 95% CI, –10.4 to −1.2) and the isolated LET group scores (91.7 ± 3.0; P = .004; 95% CI, –9.7 to −1.6). The Lysholm score was lower in the rACLR group (85.8 ± 6.3) when compared with the rACLR and LET group (91.8 ± 4.6; P = .03; 95% CI, –11.8 to −0.39). There was no difference in any Tegner scores at 2 years ( P = .09).

Conclusion:

In patients with grade ≥2 pivot shift after an ACLR with an intact or partially torn graft and a new, symptomatic medial meniscal tear, the addition of an LET with or without rACLR led to improved PROs compared with an isolated rACLR. An isolated LET in this patient population should be considered an acceptable treatment option.
Failure Rate of Meniscal Repair With ACL Reconstruction Among Professional Athletes: A Study of 196 Patients From the SANTI Study Group With a Mean Follow-up of 96 Months
Authors: An Jae-Sung , Lahsika Mohammed , Nlandu Alice , Giurazza Giancarlo , Chamoux Julien , Uso Marc Barrera , Cardarelli Silvia , Vieira Thais Dutra , Sonnery-Cottet Bertrand
Published: February 2025

Background:

There is still controversy regarding the ideal management method for meniscal tears combined with anterior cruciate ligament (ACL) injury, especially for professional athletes.

Purposes:

To (1) describe the incidence of secondary meniscectomy in professional athletes after undergoing meniscal repair concomitant to primary ACL reconstruction (ACLR) and (2) identify the associated risk factors for repair failure of the medial meniscus (MM) and/or lateral meniscus (LM) in this population at long-term follow-up.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a retrospective comparative study. Included were professional athletes who underwent arthroscopic primary ACLR and repair of MM and/or LM tears between January 2013 and December 2022and who had ≥2 years of follow-up. Risk factors associated with secondary meniscectomy were analyzed using a Cox proportional hazards model.

Results:

Out of 230 professional athletes (mean ± SD age, 23.3 ± 5.0 years; mean Tegner score, 9.3 ± 1.0) who underwent primary ACLR, 196 patients (85.2%) also had meniscal repair. The most common type of graft used was hamstring tendon (74%), and 74% of patients underwent a concomitant lateral extra-articular procedure. Among the 196 patients with meniscal lesions, 37% had LM lesions, 29% had MM lesions, and 34% had both LM and MM lesions. LM tears were repaired in 92.8% of cases, while 7.2% were left in situ. The most common type of repair for LM tears was the all-inside technique. MM tears were repaired in 97.6% of cases, with 2.4% left alone. The most common type of repair for MM tears was the suture hook technique, and no meniscectomies were performed. At a mean follow-up of 95.8 ± 45.1 months, 26 patients (13.3%) underwent a secondary meniscectomy: 7 (5.0%) for LM and 19 (15.4%) for MM. A Cox model revealed no significant risk factors associated with secondary lateral or medial meniscectomy.

Conclusion:

At long-term follow-up, the meniscal repair failure rate in this population of patients who underwent primary ACLR was 13.2% overall, 5% for LM tears and 15.4% for MM tears. No risk factors for secondary meniscectomy were found.
Arthroscopic Anchor Placement During Shoulder Anterior Labral Repair in the Beach-Chair Versus the Lateral Decubitus Position: An Imaging Analysis
Authors: Jones Steven D. , Lencioni Alex , Elrick Bryant P. , Baldini Todd , Bravman Jonathan T. , McCarty Eric C. , Seidl Adam , Frank Rachel M.
Published: February 2025

Background:

Arthroscopic shoulder capsuloligamentous repair can be performed in the beach-chair (BC) or lateral decubitus (LD) position. Patient positioning may influence anchor placement. Limited research exists evaluating these 2 positioning techniques, specifically with respect to anchor position and trajectory.

Purpose/Hypothesis:

The purpose of this study was to perform a cadaveric imaging analysis of arthroscopic anterior shoulder stabilization in the LD and BC positions. It was hypothesized that repairs performed in the LD position would demonstrate more accurate anterior inferior anchor positioning.

Study Design:

Controlled laboratory study.

Methods:

Nine matched pairs of cadaveric shoulders (18 total shoulders) were used. Specimens underwent arthroscopic anterior inferior labral repair using 3 suture anchors placed in the 3:30, 4:30, and 5:30 positions. Repairs were performed by 2 fellowship-trained orthopaedic surgeons each trained in a respective technique. Specimens then underwent computed tomography analysis to evaluate anchor position and trajectories. Target anchor location was determined using a 3-dimensional computed tomography glenoid model, using ImageJ software, with the clockface overlaid onto the glenoid. The 3-o’clock position was set at 0° for reference, with the 3:30, 4:30, and 5:30 anchor positions set at −15°, −45°, and −75°, respectively. One-tailed t tests were used to compare anchor position deviation with target ideals.

Results:

Inferior anchor (5:30) placement was found to be more accurate in the LD position, while superior anchor (3:30) placement was found to be more accurate in the BC position. Specifically, the LD group did not demonstrate statistically significant deviation from the target ideal (−75°) for the 5:30 anchor. The true deviance for the LD group from the 5:30 target angle was between −78.6° and −58.5° ( P = .178), while the BC group did not demonstrate statistically significant deviation for the target ideal (−15°) for the 3:30 anchor. The true deviance from the target angle was between −37.9° and 1.79° ( P = .732). Both groups demonstrated adequate anchor trajectories.

Conclusion:

Both positioning techniques remain safe and efficacious. The LD position may offer improved inferior anchor placement, and the BC position may offer improved superior anchor placement. Additional studies are warranted to further elucidate the advantages and disadvantages of each position.

Clinical Relevance:

Knowledge pertaining to the accuracy of anchor placement based on patient positioning and anchor location may aid surgeons in choosing operating positions to potentially optimize anchor placement during arthroscopic anterior shoulder stabilization surgery.
Biomechanical Risk Factors for Increased Anterior Cruciate Ligament Loading and Injury: A Systematic Review
Authors: Belkhelladi Malachy , Cierson Tanya , Martineau Paul A.
Published: February 2025

Background:

Understanding the biomechanical risk factors for noncontact anterior cruciate ligament (ACL) injury can inform machine learning models, aid in prevention strategies, and guide rehabilitation protocols, reducing the incidence and burden of these injuries in both athletes and the general population.

Purpose:

To determine the biomechanical risk factors associated with noncontact ACL injury and increased knee loading.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Randomized, cohort, case-control, and cross-sectional studies identifying noncontact biomechanical risk factors for ACL injuries published before May 2023 were included in this review. Excluded were studies focused on contact ACL injuries, those focused on biomechanical risk factors postinjury, and those not published in the English language. The authors highlighted biomechanical risk factors not extensively covered in previous reviews, including the toe-in position, increased contralateral pelvic hike, increased hip internal rotation angle, and specific ankle angles. A quantitative overview of the included studies was conducted, highlighting the frequency of each biomechanical factor reported as potentially related to ACL injury or loading risk.

Results:

A total of 28 studies (2819 athletes) were selected for analysis. The majority of these studies (22/28) were cross-sectional, primarily assessing ACL load indirectly via knee valgus moment or ground-reaction forces, while case-control and cohort studies focused on ACL injury incidence. Overall, 83% (5/6) of the studies assessing upper body biomechanics found that trunk flexion/extension and perturbations affect ACL loading risk. Of studies assessing hip biomechanics, 83% (10/12) showed increased ACL loading or injury risk with increased hip abduction/internal rotation angles. For the foot and ankle, increased toe-in/toe-out landing in 67% of studies (2/3) demonstrated higher stress on the ACL. Knee biomechanics were associated with increased ACL loading in 100% of the respective studies (5/5), with decreased knee flexion angles leading to increased loading.

Conclusion:

The data demonstrated that factors associated with increased medial knee alignment, sagittal alignment of the trunk, and decreased lateral trunk flexion reduced both knee loading and ACL injury risk. Targeted prevention and detection strategies addressing high-risk biomechanics may reduce injury incidence, underscoring the need for further research to optimize intervention programs.
Mental health and the COVID-19 pandemic in Europe: A focus on the self-employed
Authors: Gerogiannis Ilias , Capecchi Stefania , Curtarelli Maurizio
Published: February 2025

Self-employed workers worldwide encountered significant mental health challenges during the COVID-19 pandemic. Nevertheless, it remains unclear whether the pandemic has affected the mental health of the self-employed more significantly than employees. To address this question, we analyzed data from more than 4,000 self-employed individuals across the 27 European Union (EU) member states. We found that the pandemic had a more significant impact on the mental health of the self-employed in the EU, especially those working in the health and education sectors and countries with the highest stringency measures. Our findings also reveal that the pandemic has prompted self-employed individuals, particularly self-employed women, to be more open to talking about their mental health challenges at work, suggesting a shift in their perception of mental health stigma. This study highlights an opportunity and a need for EU policymakers to introduce targeted measures to support the self-employed in building back better in the post-COVID-19 world.

JEL CLASSIFICATIONS: I31, L26
Oral Microbiome and Dental Caries in Kenyan Children and Adolescents Living with HIV
Authors: Wang Y. , Matangkasombut O. , Kemoli A.M. , John-Stewart G. , Benki-Nugent S. , Slyker J. , Aldrovandi G.M. , Seminario A.L.
Published: February 2025

Objective:

This cross-sectional study evaluates the association between the oral microbiome and the presence of untreated dental caries among Kenyan children and adolescents living with HIV (CALHIV).

Methods:

We collected 83 oral swab samples from CALHIV receiving medical care at Kenyatta National Hospital. We used the 16S rRNA sequencing technique on oral swab samples to profile bacterial composition. Only CALHIV with results of oral microbiome and dental examinations simultaneously were included in the further analysis. We compared the alpha and beta diversity of the oral microbiome between individuals with and without dental caries. Log-ratio LASSO regression with 2-stage estimation, 10-fold cross-validation, and adjustment for the false discovery rate was applied to select the best features that can predict caries status at the phylum level.

Results:

Of the 70 participants with both oral health data and oral microbiome data available, 66% had dental caries. The group with dental caries had higher Chao 1 alpha diversity (P = 0.046) but not beta diversity. Log-ratio LASSO regression had a higher ratio of paired features proteobacteria/SR1 (P = 0.0067), Euryarchaeota/SR1 (P = 0.0074), Acidobacteria/SR1 (P = 0.0079), and Fusobacteria/SR1 (P = 0.0125) at the phylum level and was significantly associated with a lower prevalence of untreated dental caries. A higher abundance of SR1 together with certain bacteria was associated with a higher prevalence of untreated dental caries.

Conclusions:

This is the first study to analyze the oral microbiome of CALHIV and untreated dental caries in a cohort that had received medical care since their first years of life. While this study provides information about the paired feature selection for dental caries in CALHIV on ART using cross-validation, SR1 may interact with other bacteria to increase the prevalence of untreated dental caries. Longitudinal microbiome data and samples from multiple sites in the oral cavity will be essential for understanding and confirming these findings.

Knowledge Transfer Statement:

The results of this study can help clinicians understand how SR1 interacts with other bacteria that may increase the prevalence of untreated dental caries in children and adolescents living with HIV and on long-term antiretroviral therapy. Furthermore, these findings may provide valuable insights for future research, informing longitudinal microbiome data and sampling from various sites in the oral cavity.
Roxadustat improves diabetic myocardial injury by upregulating HIF-1α/UCP2 against oxidative stress
Authors: Fang Tingting , Ma Congcong , Yang Bingyun , Zhao Meiyu , Sun Luning , Zheng Ningning
Published: February 2025

Background

Diabetes mellitus (DM), characterized by hyperglycemia, is intricately linked with cardiovascular complications. Hyperglycemia induces oxidative stress, compromising mitochondria energy metabolism disturbances, leading to cardiomyocyte hypoxia and dysregulation of hypoxia-inducible factor-1α (HIF-1α), thereby exacerbating diabetic myocardial injury. Roxadustat (FG-4592), as an inhibitor of HIF-PHD, reduces HIF-1α degradation and regulates the transcription and function of downstream target genes. This study explores the protective effect of FG-4592 on the diabetic myocardium and further investigates the specific mechanisms responsible for this action.

Methods

We established diabetic myocardial injury mice and high glucose-induced rat cardiomyocyte models, administered FG-4592 pretreatment to clarify the protective effects and related mechanisms of FG-4592 on diabetic myocardial injury by detecting changes in oxidative stress, mitochondrial function, and related pathways.

Results

FG-4592 demonstrated cardioprotective effects in diabetic mice by regulating mitochondrial structure and function, as well as maintaining oxidative stress balance in the myocardium. It stabilized HIF-1α, activated UCP2, and enhanced the PI3K/AKT/Nrf2 pathway, reducing mitochondrial superoxide production, improving mitochondrial respiratory potential, and modulating oxidative stress markers in high glucose-induced cardiomyocytes.

Conclusions

FG-4592 exerts protective effects against diabetic myocardial injury by reducing oxidative stress. The mechanism is linked with the upregulation of HIF-1α and UCP2, which subsequently activate the PI3K/AKT/Nrf2 signaling pathway.
Nano-XRF of lung fibrotic tissue reveals unexplored Ca, Zn, S and Fe metabolism: a novel approach to chronic lung diseases
Authors: Falcones Bryan , Kahnt Maik , Johansson Ulf , Svobodová Barbora , von Wachenfelt Karin A. , Brunmark Charlott , Dellgren Göran , Elowsson Linda , Thånell Karina , Westergren-Thorsson Gunilla
Published: February 2025

Synchrotron-radiation nano-X-Ray Fluorescence (XRF) is a cutting-edge technique offering high-resolution insights into the elemental composition of biological tissues, shedding light on metabolic processes and element localization within cellular structures. In the context of Idiopathic Pulmonary Fibrosis (IPF), a debilitating lung condition associated with respiratory complications and reduced life expectancy, nano-XRF presents a promising avenue for understanding the disease’s intricate pathology. Our developed workflow enables the assessment of elemental composition in both human and rodent fibrotic tissues, providing insights on the interplay between cellular compartments in chronic lung diseases. Our findings demonstrate trace element accumulations associated with anthracosis, a feature observed in IPF. Notably, Zn and Ca clusters approximately 750 nm in size were identified exclusively in IPF samples. While their specific role remains unclear, their presence may be associated with disease-specific processes. Additionally, we observed Fe and S signal colocalization in 650-nm structures within some IPF cells. Fe-S complexes in mitochondria are known to be associated with increased ROS production, suggesting a potential connection to the disease pathology. In contrast, a bleomycin-induced fibrosis rodent model exhibits a different elemental phenotype with low Fe and increased S, Zn, and Ca. Overall, our workflow highlights the effectiveness of synchrotron-based nano-XRF mapping in analyzing the spatial distribution of trace elements within diseased tissue, offering valuable insights into the elemental aspects of IPF and related chronic lung diseases.
Preoperative liquid biopsy transcriptomic panel for risk assessment of lymph node metastasis in T1 gastric cancer
Authors: Ding Ping’an , Wu Jiaxiang , Wu Haotian , Ma Wenqian , Li Tongkun , Yang Peigang , Guo Honghai , Tian Yuan , Yang Jiaxuan , Er Limian , Gu Renjun , Zhang Lilong , Meng Ning , Li Xiaolong , Guo Zhenjiang , Meng Lingjiao , Zhao Qun
Published: February 2025

Background

The increasing incidence of early-stage T1 gastric cancer (GC) underscores the need for accurate preoperative risk stratification of lymph node metastasis (LNM). Current pathological assessments often misclassify patients, leading to unnecessary radical surgeries.

Methods

Through analysis of transcriptomic data from public databases and T1 GC tissues, we identified a 4-mRNA panel (SDS, TESMIN, NEB, and GRB14). We developed and validated a Risk Stratification Assessment (RSA) model combining this panel with clinical features using surgical specimens (training cohort: n = 218; validation cohort: n = 186), gastroscopic biopsies (n = 122), and liquid biopsies (training cohort: n = 147; validation cohort: n = 168).

Results

The RSA model demonstrated excellent predictive accuracy for LNM in surgical specimens (training AUC = 0.890, validation AUC = 0.878), gastroscopic biopsies (AUC = 0.928), and liquid biopsies (training AUC = 0.873, validation AUC = 0.852). This model significantly reduced overtreatment rates from 83.9 to 44.1% in tissue specimens and from 84.4 to 56.0% in liquid biopsies. The 4-mRNA panel showed specificity for T1 GC compared to other gastrointestinal cancers (P < 0.001).

Conclusions

We developed and validated a novel liquid biopsy-based RSA model that accurately predicts LNM in T1 GC patients. This non-invasive approach could significantly reduce unnecessary surgical interventions and optimize treatment strategies for high-risk T1 GC patients.
Acute kidney injury and outcomes in hospitalized children with autoimmune rheumatic disease
Authors: Lin Chien-Hung , Liu Wen-Sheng , Wan Chuan , Wang Hsin-Hui
Published: February 2025

Background

Autoimmune rheumatic diseases (ARDs) in children can negatively impact renal function, potentially leading to acute kidney injury (AKI). This study compares the prevalence of AKI and other adverse in-hospital outcomes among hospitalized children with ARDs.

Methods

A retrospective analysis was conducted using the United States Nationwide Inpatient Sample (NIS) database from 2005 to 2020. The study included children aged 1–17 years with ARDs, categorized into inflammatory arthritis, ANCA-associated vasculitis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and other connective tissue diseases. Logistic regression assessed associations between ARD types and outcomes, including AKI, dialysis, and major adverse events.

Results

Among 13,891 children with ARDs, 8.2% developed AKI and 1.3% required dialysis. Compared to inflammatory arthritis, ANCA-associated vasculitis significantly increased the risk of AKI (aOR = 11.20, 95% CI: 8.08–15.51) and dialysis (aOR = 40.60, 95% CI: 13.54-121.71). SLE also elevated risks of AKI (aOR = 4.16, 95% CI: 3.20–5.40) and dialysis (aOR = 11.34, 95% CI: 4.15–31.01). Children with SSc had increased risks of infection/pneumonia (aOR = 2.51, 95% CI: 1.84–3.41) and sepsis (aOR = 2.13, 95% CI: 1.26–3.58).

Conclusions

Children with ARDs, especially those with ANCA-associated vasculitis and SLE, face elevated risks of AKI and dialysis. These findings underscore the importance of vigilant monitoring and tailored management in this population.
Identification of Houge type of X-linked syndromic mental retardation caused by CNKSR2 truncated variants
Authors: Chang Si-Hua , Jin Jie-Yuan , Hu Yi-Qiao , Wang Run-Yan , Xiang Rong , Wang Xia
Published: February 2025

Background

Houge type of X-linked syndromic mental retardation (MRXSHG) is a type of X-linked condition which is mainly manifested as delayed development, mental retardation, epilepsy that begins at an early age, and delayed language acquisition. MRXSHG is a serious disorder with CNKSR2 variant and at least 34 variants have been identified in MRXSHG patients. However, the genotype-phenotype correlation and variants characteristics of CNKSR2 need further investigation and improvement.

Methods

Two Chinese MRXSHG families were recruited, and their genetic causes were investigated using whole-exome sequencing (WES), Sanger sequencing, and bioinformatics analysis. To verify the impact of these variants, we used real-time PCR and minigenes consisting of exon 14, intron 14, and exon 15 from both the wild-type and the c.1658-3_1676del DNA sequences.

Results

In this study, we reported two Chinese boys with MRXSHG and described some rare MRXSHG phenotypes, such as delayed bone age, slightly widened right fissure, and an underdeveloped right temporal lobe, characterized by reduced growth and volume compared to typical development. Two novel variants in CNKSR2 (c.1658-3_1676del and c.1102G > T, p.Gly368*) were identified in these cases. Minigenes results revealed that variant c.1658-3_1676del produced an aberrant spliceosome assembly.

Conclusions

We identified two novel CNKSR2 variants in MRXSHG families, expanding the variant spectrum of CNKSR2, enriching MRXSHG-related phenotypes, and contributing to genetic counseling for MRXSHG patients.
Manufacturing and characterization of conductive threads based on twisting process for applying smartwear
Authors: Kim Hyelim , Rho Soohyeon , Jeong Wonyoung
Published: February 2025

A basic study was conducted to manufacture conductive composite threads for use in textile-type electrodes and circuits for smartwear that can be sewn, embroidered, and knitted. The two-types of poly(ethylene terephthalate(PET) filament with a circular cross-section(SD), and an oval cross-section and curved surface(DT), and the conductive yarn was selected as a silver-coated polyamide(AP). The samples were produced two-ply PET yarn as the first twist, then using AP as the second twist, and both processes were applied with 100, 200, 500, and 1,000 TPM. As the number of twists increased, the packing density of samples increased, and the bulkiness of DT was decreased. In addition, the elongation at break tended to increase as the number of twists increased, especially for samples manufactured with DT with a curved surface appeared larger. The linear resistance results increased as the number of second twists in which the conductive yarn was twisted increased. It was confirmed that the area of AP exposed to the outside was more prominent in SD-AP, resulting in decreased linear resistance. Based on the results, samples that have the excellent mechanical and electrical performance were selected to manufacture textile-type electrodes that embedded leg sleeves to measure the surface electromyography(sEMG) signal collection performance. The signal-to-noise ratios(SNR) of textile-type electrode manufactured by SD - AP and DT - AP were 4.54 and 14.96, respectively, confirming the possibility of collecting EMG signals. Thus, this study is expected to be applicable to a wider range of fields than smartwear.
Examining differences in exposure to digital marketing of unhealthy foods reported by Canadian children and adolescents in two policy environments
Authors: Vergeer Laura , Soto Carolina , Bagnato Mariangela , Pauzé Elise , Amson Ashley , Ramsay Tim , Olstad Dana Lee , Welch Vivian , Potvin Kent Monique
Published: February 2025

Background

There has been relatively little research on youth’s exposure to food marketing on digital media, which is important as new digital platforms emerge and youth spend more time online. Evidence evaluating different policy approaches to restricting digital food marketing to children is also limited. This study examined differences in self-reported exposure to digital food marketing between children and adolescents in different policy environments: Ontario (where food marketing is self-regulated) and Quebec (where advertising is government regulated).

Methods

An observational cross-sectional online survey was conducted in April 2023 among children (aged 10–12 years) and adolescents (13–17 years) from Ontario and Quebec, recruited by Leger Marketing. Participants self-reported their frequency of exposure to food marketing via various digital platforms and marketing techniques. Logistic regression and proportional odds models examined differences in exposure by province and age group, adjusting for sociodemographic characteristics and digital device usage.

Results

The odds of reporting more frequent exposure to marketing of sugary drinks (OR: 0.48; 95% CI: 0.33, 0.69), sugary cereals (OR: 0.59; 95% CI: 0.41, 0.86), salty/savoury snacks (OR: 0.67; 95% CI: 0.47, 0.96), fast food (OR: 0.65; 95% CI: 0.45, 0.92), and desserts/sweet treats (OR: 0.54; 95% CI: 0.37, 0.78) were lower among Quebec children than Ontario children. Quebec children were less likely than Ontario children (OR: 0.56; 95% CI: 0.38, 0.84), but more likely than Quebec adolescents (OR: 1.58; 95% CI: 1.04, 2.42), to report exposure to unhealthy food marketing on one or more gaming/TV/music streaming platform/website(s). Compared with Ontario children, Quebec children were less likely to report exposure to marketing featuring characters or child/teenage actors (OR: 0.51; 95% CI: 0.34, 0.76), child-appealing subjects, themes and language (OR: 0.59; 95% CI: 0.40, 0.89), and visual design, audio and special effects (OR: 0.64; 95% CI: 0.41, 0.99), and to report exposure to a greater number of marketing techniques (OR: 0.60; 95% CI: 0.43, 0.84).

Conclusions

Exposure to unhealthy food marketing on digital media is high for youth from Ontario and Quebec, particularly for Ontario children. These findings reinforce the need for federal regulations to protect Canadian youth from unhealthy food marketing on digital media.
A Personalized Muscle–Tendon Assessment and Exercise Prescription Concept Reduces Muscle–Tendon Imbalances in Female Adolescent Athletes
Authors: Domroes Theresa , Weidlich Kolja , Bohm Sebastian , Mersmann Falk , Arampatzis Adamantios
Published: February 2025

Background

Imbalances between muscle strength and tendon stiffness influence the mechanical demand on the tendon (i.e., tendon strain) and may increase tendon injury risk. The purpose of this study was to identify muscle–tendon imbalances and to promote a more balanced musculotendinous adaptation through a personalized assessment and exercise prescription concept in female adolescent handball athletes (13–16 years).

Methods

At four measurement time points during a competitive season, we used dynamometry and ultrasonography to assess knee extensor muscle strength, patellar tendon stiffness and strain. Tendon micromorphology was assessed with a peak spatial frequency (PSF) analysis of proximal tendon ultrasound images. Muscle–tendon imbalances were identified based on tendon strain during maximum voluntary contractions. A control group (n = 15) followed their usual training. In the intervention group, athletes with a deficit in tendon stiffness (strain ≥ 9%; n = 6) or no muscle–tendon imbalances (strain between 4.5% and 9%; n = 15) performed exercises (3x/week for 32 weeks) with a personalized load to reach ~ 6.2% tendon strain to predominantly promote tendon or both muscle and tendon adaptation. Individuals with a muscle strength deficit (strain ≤ 4.5%; n = 1) trained with submaximal loads to failure to promote muscle strength.

Results

In the intervention group we found lower fluctuations of maximum tendon strain (p = 0.005) and a decrease in tendon strain over time (p = 0.010), which was more pronounced in individuals with initially high tendon strain. While there were no systematic changes in muscle strength or tendon stiffness at the group level (p > 0.05), the marked decrease in tendon strain in individuals with a deficit in tendon stiffness was caused by a predominant increase in tendon stiffness. Overall, the prevalence of muscle–tendon imbalances was reduced in the intervention group, while it temporarily increased in the control group. PSF did not differ between groups at baseline but decreased significantly in the intervention group (p = 0.013).

Conclusions

The findings suggest that the personalized concept is suitable to promote a more uniform adaptation of knee extensor muscle strength and patellar tendon stiffness and to reduce the prevalence of musculotendinous imbalances in female adolescent athletes, which may have important implications for tendon injury prevention.

Trial Registration

DRKS, DRKS00035110. Registered 20 September 2024–retrospectively registered, https://drks.de/search/de/trial/DRKS00035110.
Scrotal migration of the abdominal end of the ventriculoperitoneal shunt
Authors: Karatas Fatih , Yuksek Muhammed Erkam , Gul Busra , Kenan Mehmet , Erdi Mehmet Fatih
Published: February 2025

Background

The most common treatment of hydrocephalus is ventriculoperitoneal shunt (VPS) operation. Shunt dysfunction may develop in patients with ventriculoperitoneal shunt. The most common causes of shunt dysfunction, which are more common in pediatric patients, are infection, obstruction, visceral injury, pseudocyst formation, and excessive or inadequate drainage. Shunt migration is a rare complication of VPS operation, and the shunt catheter may migrate to the gastrointestinal tract, scrotum, bladder, and other organs. Revision surgery is a safe treatment option in most cases of shunt dysfunction or migration.

Case presentation

In this report, a 2-year and 10-day-old baby patient was observed to have bilateral hydrocele in the outpatient clinic follow-up after the VPS operation, and after radiological imaging, it was determined that the shunt peritoneal catheter was in the scrotum. The patient underwent shunt revision surgery.

Conclusion

Although malposition of the VPS peritoneal catheter is not always an emergency, reinsertion and surgical revision should be done promptly due to the risk of perforation due to malposition. Close follow-up of patients with VPS is important for early diagnosis and treatment of complications.
A comprehensive review on elucidating the host disease resistance mechanism from the perspective of the interaction between cotton and Verticillium dahliae
Authors: Zhang Yalin , Zhao Lihong , Li Dongpo , Li Ziming , Feng Hongjie , Feng Zili , Wei Feng , Zhou Jinglong , Ma Zhiying , Yang Jun , Zhu Heqin
Published: February 2025

Verticillium wilt, caused by the infamous pathogen Verticillium dahliae, presents a primary constraint on cotton cultivation worldwide. The complexity of disease resistance in cotton and the largely unexplored interaction dynamics between the cotton plant host and V. dahliae pathogen pose a crucial predicament for effectively managing cotton Verticillium wilt. Nevertheless, the most cost-effective approach to controlling this disease involves breeding and cultivating resistant cotton varieties, demanding a meticulous analysis of the mechanisms underlying cotton’s resistance to Verticillium wilt and the identification of pivotal genes. These aspects constitute focal points in disease-resistance breeding programs. In this review, we comprehensively discuss genetic inheritance associated with Verticillium wilt resistance in cotton, the advancements in molecular markers for disease resistance, the functional investigation of resistance genes in cotton, the analysis of pathogenicity genes in V. dahliae, as well as the intricate interplay between cotton and this fungus. Moreover, we delve into the future prospects of cutting-edge research on cotton Verticillium wilt, aiming to proffer valuable insights for the effective management of this devastating fungus.
Perioperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement: an observational study
Authors: Awad Gehad , Fetoh Fetoh Alaaeldin , Gwely Noureldin Noaman , Hamza Usama , Amer Sameh , Yehya Yomna Mohammed , Abdellateef Amr
Published: February 2025

Background

Minimally invasive mitral valve surgery has been introduced as a safe alternative to full sternotomy through smaller chest wall incisions to reduce the potential sternal complications in addition to the favorable aesthetic effect. This observational study has been designed to evaluate and compare operative and short-term postoperative outcomes of video-assisted versus right anterior thoracotomy mitral valve replacement. The study was conducted on 40 cases and divided into two groups: group 1, comprised of 20 patients who underwent video-assisted mitral valve replacement (VAMVR), and group 2, comprised of 20 patients who underwent right anterior mini-thoracotomy mitral valve replacement (ATMVR). Preoperative data, intraoperative procedures, and early postoperative results have been compared between both techniques.

Results

Intraoperative parameters showed no statistical difference between the two groups. Wound length in the VAMVR group was statistically smaller than the ATMVR group, 5.33 ± 0.96 cm versus 7.08 ± 1.24 cm, respectively (P < 0.001). The intraoperative assessment by TEE showed a well-suited, well-functioning prosthetic valve, and no paravalvular leak in the two groups. In both groups, there were statistically significant reductions in left ventricular end diastole, left atrial diameter, and pulmonary artery systolic pressure in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). There was a statistically significant decrease in left ventricular end-systole in the VAMVR group in the 3-month postoperative ECHO in comparison to the preoperative ECHO (P < 0.001). ICU visual analog scale (VAS) was significantly lower in the VAMVR group than in the ATMVR group (P = 0.049). There was a gradual reduction in VAS in both groups along the period of 3 months postoperatively without significant differences between the two groups in 2 weeks and 3 months postoperatively.

Conclusions

VAMVR and ATMVR could be considered safe, feasible approaches with favorable perioperative surgical and echocardiographic results. VAMVR showed statistically significant smaller wounds and less postoperative pain than ATMVR, which may offer potential advantages in terms of reduced postoperative discomfort and cosmetic appearance for the thoracoscopic technique. Further randomized studies with larger cohorts and longer follow-ups are recommended to evaluate the long-term benefits and safety of both techniques.
Professorships in child and adolescent psychiatry relative to a similarly sized medical specialty in the UK and Ireland: cross-sectional study
Authors: Kelleher Ian , Poziemska Aleksandra Z. , Kieseppä Valentina , Thapar Anita , Dubicka Bernadka , Lockhart Elaine , Ford Tamsin , Minnis Helen , Gallagher Louise , McNicholas Fiona , O'Hare Kirstie
Published: February 2025

Background

A youth mental health crisis is considered one of the great challenges of our time, and research and clinical services in child and adolescent psychiatry have become a priority for governments and funders. Academic leadership is needed to drive forward research. It is not clear how many senior academic leadership posts (professorships) there are in child and adolescent psychiatry, nor how this benchmarks against a similarly sized medical specialty.

Aims

This study aimed to determine the number of professorships in child and adolescent psychiatry in the UK and Ireland compared to a similarly sized specialty. A secondary aim was to identify the number of clinical trials registered for mental and behavioural disorders in children.

Method

We identified registered specialists in child and adolescent psychiatry and a similarly sized specialty who held full professorships in medical schools. We searched the International Standard Randomised Controlled Trial Number (ISRCTN) and ClinicalTrials.gov for trials.

Results

As of 23 March 2023, there were 1725 doctors on the General Medical Council's (GMC) specialist register in child and adolescent psychiatry. The closest specialty in terms of number of registered specialists was neurology (N = 1724). We identified 24 professors in child and adolescent psychiatry across the UK and Ireland, compared to 124 in neurology. For every intervention trial registered for mental and behavioural disorders in children, there were approximately ten trials registered for diseases of the nervous system.

Conclusions

Despite equivalent numbers of medical specialists in child and adolescent psychiatry and neurology, there is a striking disparity in the number of professorship appointments. While young peoples’ mental health has, ostensibly, become a priority for policy-makers and funders, this is not reflected in medical professorship appointments. The paucity of senior academic child and adolescent psychiatrists has real-world implications for training, research, innovation and service development in mental health services.