bluuebunny/crossref_metadata_2025 huggingface dataset:
An integrative model to enhance students’ satisfaction in the use of e-learning systems in a developing country context
Authors: Attuquayefio Samuel Nii Boi , Aboagye-Darko David , Okronipa Amanda Quist
Published: February 2025

Purpose

Through the lens of the information systems success model, self-determination theory, and TAM2, this study proposes and tests an integrative model to investigate students’ satisfaction with the use of e-learning systems in higher education institutions in a developing country context.

Design/methodology/approach

This study adopted a quantitative approach. Based on data collected from a sample of 185 students, the study used partial least squares-structural equation modeling to investigate and test the model’s hypothesized relationships.

Findings

This study revealed that gamification significantly influences behavioral intention and learning engagement. Also, our study suggests that behavioral intention significantly influences learning engagement and students’ actual use of e-learning systems. In addition, our study revealed that learning engagement significantly influences students’ satisfaction.

Originality/value

This study contributes theoretically and practically by proposing an integrative model to investigate the antecedents to students’ satisfaction in the context of developing countries. In addition, this study extends the research stream of gamification and perceived security within the e-learning context in developing countries.
Investigating the effect of perforation geometry on the residual stress and mechanical behavior of 3D-printed honeycomb structure
Authors: Nazari Farshad , Abedi Afshin
Published: February 2025

Purpose

In this research, experimental and numerical methods were used to study the effect of pore geometry on residual stress and mechanical behavior of 3D-printed parts. In this regard, samples with circular, rhombic and hexagonal pore geometries were printed using fused deposition modeling (FDM), and their residual stress was measured through the mechanical strain release method. The finite-element method (FEM) was utilized to study the strength and natural frequency of the samples.

Design/methodology/approach

As a modern method of part manufacturing and repair, 3D printing has been highly regarded in industrial arenas for its ability to offer high precision without the need for different dies. Porosity has been studied as a solution for reducing weight in structures, and its effect on the mechanical behavior of a structure depends on the loading conditions and applications.

Findings

The results of the investigation showed that the rhombic pore geometry had the highest residual stress, while the sample with circular pores exhibited the lowest residual stress. Stress distribution and modal analyses indicated that the sample with rhombic pore geometry had the lowest displacement coupled with the highest strength and natural frequency. However, considering the total of external load-induced stress and residual stresses, the sample with hexagonal pore geometry outperformed the other samples and showed the longest fatigue life.

Originality/value

According to the literature review, residual stress is one of the key factors influencing the performance of 3D-printed parts. However, the effects of pore geometry on residual stress and structural strength in 3D-printed components remain underexplored. Therefore, this study investigates the impact of hexagonal, rhombic and circular pore geometries on residual stress and structural strength through both experimental and numerical analyses.
Corruption, economic globalisation, and resistance: Insights from the Philippine rice industry
Authors: Walton Grant W. , Espiritu‐Amador Shanice , Deinla Imelda
Published: February 2025

Scholars have shown that narratives of corruption can both intensify economic globalisation and fuel resistance to it. However, little research has been done on how policy debates are framed by people with competing perspectives on corruption. This article draws on interviews with key stakeholders to highlight how narratives of corruption have framed debates about policy reform in the Philippine rice industry. Respondents whose views reflect an economic perspective that promotes market mechanisms to address corruption justified a law designed to deregulate the rice market. Their actions were a panacea to the growing power of cartels illegally and often corruptly importing rice into the country. Respondents whose views reflect a critical perspective argued that this law would only bolster cartel power and that other policy solutions such as land reform and self‐sufficiency would reduce corruption and other injustices. Our analysis reveals how those debates informed deregulation of the Philippine rice sector and resulted in a Rice Tariffication Law in 2019. In the process, we reveal how competing perspectives on corruption and associated narratives are ideologically deployed to shape policy reforms that expand economic globalisation and benefit some groups, such as consumers, at the expense of others, particularly small‐scale farmers.
Translating digital health services for nutrition care management of chronic conditions in outpatient settings: A multi‐stakeholder e‐Delphi study
Authors: Barnett Amandine , Hickman Ingrid J. , Campbell Katrina L. , Kelly Jaimon T.
Published: February 2025

Aim

To identify and achieve expert consensus on the most important and feasible strategies to implement digital health services for nutrition care management of chronic conditions in outpatient settings.

Methods

Determinants and strategies for implementing digital health services for nutrition care management were identified in line with the literature and the Consolidated Framework for Implementation Research. These were presented to team leaders and senior clinicians, as well as dietetic and allied health directors in a two‐round e‐Delphi process. Consensus was reached when strategies were rated very important/feasible by at least 75% of respondents, calculated by the median, interquartile range and frequency. Following the two survey rounds, a final prioritisation survey was distributed to participants, where participants were asked to prioritise their top strategy for each determinant, which was analysed by frequency calculations.

Results

Twenty participants participated in round one of the survey and 18 completed the final prioritisation round. Following the two rounds, 3 strategies did not meet consensus for importance and 7 strategies did not meet consensus for feasibility out of 25 strategies presented. Nine strategies were prioritised following the survey rounds. Key concepts of the strategies that met consensus and were prioritised related to (i) adhering to quality of care with effective evaluation processes; (ii) providing options for digital health upskilling and support; and (iii) individualising patient care.

Conclusion

Team leaders and senior clinicians as well as dietetic and allied health directors have indicated that there are many important digital health strategies yet not all are feasible to implement within current resourcing and systems.
A Novel Multidisciplinary Approach for Reptile Movement and Behavior Analysis
Authors: Zotos Savvas , Stamatiou Marilena , Marketaki Sofia‐Zacharenia , Konstantinou Michael , Aristidou Andreas , Irschick Duncan J. , Bot Jeremy A. , Shepard Emily L. C. , Holton Mark D. , Vogiatzakis Ioannis N.
Published: February 2025

The study of animals’ activity and behavior in the wild is an extremely challenging task. Although tri‐axial accelerometers are invaluable for behavioral analyses, their use is more frequent in large charismatic endotherms with limited application in ectotherms. The scarce utilization of this methodology on small‐size reptiles is focused on animals’ activity and energetics, showing few records of rapid displays and behavior signals. Here, we present a novel multidisciplinary approach capable of advancing research on reptiles’ behavior. Our proposed approach uses advanced technologies for the digitization, reconstruction and visualization of reptiles and their behavior. We (i) record movement through tri‐axial accelerometers, video cameras, and motion capture systems; (ii) ground‐truth data through the video records; (iii) develop realistically accurate 3D avatars of the recorded movement for visualization purposes, and (iv) archive data on a Behavior Pattern Database. As case studies, we used two small Mediterranean reptiles, the lizard Laudakia cypriaca and the snake Dolichophis jugularis. Through our approach, we successfully recorded, ground‐truthed, and labeled for the first time, several detailed movements and behaviors of the two case study species. We developed an accurate digital overview of those movements using motion capture and 3D animal reconstruction. Finally, we structured a database for archiving all behavioral data and demonstrated how those archives can be used for advancing behavioral research, providing ecological insights into this animal group. Our approach can enhance research on reptiles’ behavior by contributing to the analysis of complex or isolated behaviors, poorly studied, such as signals and social interactions, providing valuable insights and assisting behavioral analysis.
Patient experience with quality‐of‐life questionnaires for obstructive salivary gland disorders: a cross‐sectional study
Authors: Boogaard Saskia , Basheeth Naveed
Published: February 2025

Background

Disease severity and treatment efficacy in salivary gland disorders can be gauged through quality‐of‐life (QoL) questionnaires. However, limited research has explored patient experience with these questionnaires. This cross‐sectional study assessed the usability of, and patient experience with, six validated QoL questionnaires.

Methods

This cross‐sectional study assessed the usability of and patient experience with the QoL‐15D, Oral Health Impact Profile‐14, Manukau Salivary Symptom Score, Chronic Obstructive Sialadenitis Symptoms, Multidisciplinary Salivary Gland Society, and Glasgow Benefit Index questionnaires. We measured the time to complete each questionnaire, patient‐perceived questionnaire coverage of symptoms and disease impact using a 5‐point Likert scale, patient experience with the questionnaires through open feedback, and which questionnaire patients most preferred. There were 30 participants in this study.

Results

All questionnaires tested could be completed in under 5 min each. The most preferred questionnaire was the Manukau Salivary Symptom Score (43%). Participants raised the following concerns regarding the questionnaires: unclear timeframes (90%), questions not being relevant (67%), initial questions not addressing their primary symptoms (40%), confusing or unclear question wording (37%), inconsistent response scale between questions (27%), and antibiotic use during flare‐ups assuming access to primary medical care (7%).

Conclusion

No previous study has measured and analysed patient experience with the currently validated QoL questionnaires used in salivary gland disorders. This study's findings can be used to inform both questionnaire selection as well as the development of future QoL questionnaires for salivary gland disorders in order to achieve a better overall patient experience and reduce unintentional bias.
Up Against the Wall: Disorganising and Silencing Political Blackness in Portugal
Authors: Alves Ana Rita
Published: February 2025

This article examines antiblackness in Portugal as a manifestation of its global dimensions, focusing on the interplay between race, space, law, and the political. Resulting from empirical and archival research as well as socio‐legal accompaniment of individuals and families in cases involving police brutality over the last decade in the Lisbon Metropolitan Area (Portugal), the article investigates the role played by the criminal justice system in endorsing institutional racism and silencing/sanctioning (extra)legal state violence. First, it focuses on public housing and security policies as political devices in criminalising and managing political blackness, through displacement, place annihilation, and law enforcement. Further, the article analyses three paradigmatic court cases involving police brutality to explore how the criminal justice system has been the ultimate institution sanctioning white innocence by managing accountability for black victimisation, leaving Black people "little space to breathe" (https://www.youtube.com/watch?v=TiltKebm2Jg).
Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD) Impacts Long‐Term Outcomes After Curative‐Intent Surgery for Hepatocellular Carcinoma
Authors: Uluk Deniz , Pein Justus , Herda Sophia , Schliephake Frederik , Schneider Carolin V. , Bitar Jude , Dreher Katharina , Eurich Dennis , Zhang Ingrid W. , Schaffrath Lukas , Auer Timo A. , Collettini Federico , Engelmann Cornelius , Tacke Frank , Pratschke Johann , Lurje Isabella , Lurje Georg
Published: February 2025

Background

Curative surgery for hepatocellular carcinoma (HCC) includes liver resection (LR) and orthotopic liver transplantation (OLT). Due to the obesity epidemic, metabolic dysfunction‐associated steatotic liver disease (MASLD) is a frequent HCC aetiology that often coincides with increased alcohol consumption, termed MetALD, or even alcohol‐associated liver disease (ALD).

Methods

Patients undergoing LR or OLT for HCC at Charité—Universitätsmedizin Berlin (2010–2020) were included in this retrospective cohort study investigating disease aetiology, time to recurrence (TTR), overall survival (OS) and CT‐based body composition.

Results

Out of 579 patients with HCC, 417 underwent LR and 162 OLT. Tumour aetiologies were viral n = 191 (33.0%), MASLD n = 158 (27.3%), MetALD n = 51 (8.8%), ALD n = 68 (11.7%) and other/cryptogenic n = 111 (19.2%). Patients with MASLD and MetALD had more intramuscular (p < 0.001, p = 0.015) and visceral fat (both p < 0.001) than patients with non‐metabolic dysfunction aetiologies. Patients with MASLD‐HCC had comparable TTR (median 26 months, [95% CI: 23–31] vs. 30 months [95% CI: 4–57], p = 0.425) but shorter OS than patients with other HCC aetiologies (63 months [95% CI: 42–84] vs. 80 months [95% CI: 60–100], hazard ratio: 1.53 [95% CI: 1.050–2.229], p = 0.026) after LR. Multivariate analysis confirmed MASLD aetiology, portal vein thrombosis and MELD score ≥ 10 as independent prognostic factors for OS in LR (adjusted p = 0.021,p < 0.001,p = 0.003), even after excluding in‐hospital mortality (adjusted p = 0.016,p = 0.002,p = 0.002). Causes of death were similar in MASLD and non‐MASLD aetiology.

Conclusions

Patients with HCC undergoing LR and meeting the new MASLD criteria have significantly shorter OS. This study provides empirical prognostic evidence for the novel MASLD/MetALD classification in a large European cohort of patients undergoing curative‐intent HCC therapy.
Training Future Managers About Sustainability With Retrospective Analysis: The Role of Reflexivity
Authors: Djedidi Amina
Published: February 2025

While public discourse emphasizes the social role of businesses, a gap remains between the theory and practice observed in corporate strategies and the Sustainable Development Goals (SDGs) set out in the UN 2030 Agenda. Many studies have pointed to the lack of research on uncommon teaching methodologies to develop reflexivity and critical thinking in future managers as a meta knowledge being more inclusive of SDGs in the future. This gap causes educators and researchers in the marketing management field to continuously question the adequacy of current teaching methodologies. This paper uses new lenses to address this gap. Using reflexivity model in case studies and relating it to bounded agency, this paper aims to explore how adopting reflexivity in higher education programs in the fields of business and marketing prepares future managers to embrace SDGs. The results underline the importance of the educator as a facilitator, as well as the student's engagement in: semi‐structured reflexivity, decontextualization, recontextualization, deconstruction as a path to a mindset involving SDGs and awareness of contexts, paradigms, and meta analytic dimensions. Practical implications around pedagogy depict practices to be adopted in order to facilitate, develop, and diffuse SDG‐related reflexivity and critical thinking with a long‐term strategic ambition to make sustainability development an “ordinary” business paradigm.
Judging Firms' Unethical Behaviors: Does Cultural Similarity Matter?
Authors: Meriane Youcef , Dib‐Slamani Hind , Jabeur Sami Ben
Published: February 2025

Do people mete out harsher punishments for identical unethical behaviors committed by foreign compared to domestic firms? Liability of foreignness (LOF) reasoning suggests that this is the case. Using a quasi‐experimental survey in France, we go a step further by investigating the influence of cultural similarity on ethical judgment. We examine whether people mete out less harsh judgment on a foreign company from a culturally similar country compared to a foreign company from a culturally dissimilar country. Our findings show that cultural similarity does not have a significant impact. Moreover, in the French context, the findings show that punishment for unethical behavior meted out to domestic and foreign firms relates more to cultural characteristics and does not apply in the same way for all dimensions of corporate social responsibility. Thus, we discuss various strategies and managerial implications.
Parental reflective functioning and internalizing symptoms predict altruistic prosocial behaviour in children
Authors: McGlade Daniel , Rutherford Helena , McCrory Eamon , Steinbeis Nikolaus
Published: February 2025

Mental health has a profound impact on how we interact with the world. How it shapes prosocial behaviour during middle childhood, a period crucial for establishing healthy relationships, remains poorly understood. Moreover, whilst child mental health and prosocial behaviour are influenced by caregiving experience more broadly, less is known about how they are shaped by parental reflective functioning (PRF), that is parents' capacity to represent their child's underlying mental states. A longitudinal design, with assessments at baseline and 1 year follow‐up, was used with 233 children (111 boys; 6–13 years old; 54.9% White, 17.2% Asian, 2.58% Black, 14.2% Multiple ethnic groups, 2.58% Other, 8.58% data unavailable). Using path modelling, we examined interrelations between baseline PRF, baseline child internalizing symptoms, and follow‐up child altruistic prosocial behaviour. At baseline, PRF was associated with child internalizing symptoms, whilst PRF and internalizing symptoms positively predicted altruistic behaviour 1 year later. These findings suggest that mental health and caregiving experience are key influences on altruistic behaviour in childhood.
Revisiting Quebec's Quiet Revolution: A synthetic control analysis
Authors: Geloso Vincent , Reilly Chandler S.
Published: February 2025

The year 1960 is often presented as a break year in the economic history of Quebec and Canada. It is used to mark the beginning of the “Quiet Revolution” during which Canada's French‐speaking province of Quebec underwent rapid socio‐economic change in the form of rapid economic convergence with the rest of Canada and the emergence of a more expansive state (more so than in the rest of Canada). Using synthetic control methods, we analyze whether 1960 is associated with a departure from previous developments. With regards to GDP per capita, GDP per worker, household‐size adjusted income, real wages and enrolment rates in primary and secondary schools, we find that 1960 was not an important date. For all macroeconomic indicators and enrolment rates, the counterfactual scenarios do not significantly differ from the actual data. For life expectancy at birth and completed schooling outcomes by schooling cohorts, we find that 1960 did mark a significant departure—albeit a modest one. We also find signs that size of government changed markedly after 1960. Shifting to other methods such as panel approach or time series strategy do not alter these results.
Neural Oscillations in the Somatosensory and Motor Cortex Distinguish Dexmedetomidine‐Induced Anesthesia and Sleep in Rats
Authors: Ge Dengyun , Han Chuanliang , Liu Chang , Meng Zhiqiang
Published: February 2025

Background

Anesthesia is featured by behavioral and physiological characteristics such as decreased sensory and motor function, loss of consciousness, etc. Some anesthetics such as dexmedetomidine (DEX), induce electroencephalogram signatures close to non‐rapid eye movement sleep. Studies have shown that sleep is primarily driven by the activation of subcortical sleep‐promoting neural pathways.

Aims

However, the neuronal level electrophysiology features of anesthesia and how they differ from sleep is still not fully understood.

Materials and Methods

In the present study, we recorded neuronal activity simultaneously from somatosensory cortex (S1) and motor cortex (M1) during awake, sleep, and DEX‐induced anesthesia in rats.

Results

The results show that DEX increased local field potential (LFP) power across a relatively wide band (1–25 Hz) in both S1 and M1. The coherence between S1 LFP and M1 LFP increased significantly in the delta and alpha bands. Power spectrum analysis during DEX‐induced anesthesia revealed relatively high power in the delta and alpha bands, but low power in the theta and beta bands. Overall, the firing rate of individual neurons decreased after DEX. Correlation analysis of firing rate and LFP power indicate that more neurons were correlated, either positively or negatively, with LFPs during DEX‐induced anesthesia compared to sleep.

Discussion

Although these results showed enhancement of cortical LFP power in both DEX‐induced anesthesia and sleep, different patterns of spike‐field correlation suggest that the two states may be regulated by different cortical mechanisms.

Conclusion

Distinguishing anesthesia from sleep with neural oscillations could lead to more personalized, safer, and more effective approaches to managing consciousness in medical settings, with the potential for broad applications in neuroscience and clinical practice.
Rewilding and Indigenous Community‐Led Land Care
Authors: Derham Tristan T. , Mathews Freya , Johnson Christopher. N.
Published: February 2025

In the 1990s, pioneers of rewilding described a bold vision of wilderness connected at the continental scale, with thriving populations of large, wild animals. Much of the resulting discourse has emphasized uninhabited places or has promoted a “hands‐off” approach to environmental management. This clashes with many Indigenous (e.g., First Nations) perspectives and has made rewilding largely irrelevant to Indigenous communities, especially in colonized countries. Yet rewilding can support Indigenous community aspirations for sovereignty, health, and justice. Moreover, Indigenous communities and their traditional ecological knowledge are vital to conservation. We suggest two principles by which rewilding can align with, and support, Indigenous communities: shifting focus from wilderness to the creative agency of wild beings, and framing restoration as a collaborative endeavor between humans and wildlife. As an approach to conservation policy and practice, rewilding should seek opportunities to place Indigenous communities in leadership positions, in terms of both practical restoration and the conceptual reshaping of rewilding itself. We relate two case studies of Indigenous community‐led conservation which exemplify the potential of such an approach: the Buffalo Treaty in North America, and the Lungtalanana Cultural Restoration Project in southern Australia.
The Linear Association of Chest Radiograph Opacification With Both Respiratory Physiology and Systemic Inflammation in Hospital In‐Patients With Covid‐19 Infection
Authors: Crooks Colin J. , Shaw Dominick , Card Timothy R. , Au‐Yong Iain , Higashi Yutaro , Giannotti Elisabetta , Fogarty Andrew W.
Published: February 2025

Background

Chest radiographs are generally used for diagnostic purposes. They also have potential to quantify disease severity. This analysis tested the hypothesis that there was an association between chest radiograph opacification and measures of respiratory physiological status and systemic inflammation in patients with Covid‐19 infection.

Methods

Data on chest radiograph opacification were compared with concurrent measures of oxygen requirements and saturation and serum C‐reactive protein.

Results

Data were available from 628 individuals. The median opacification on chest radiographs was 20% (interquartile range 5–45). This was associated both SFR (oxygen saturation/supplementary oxygen) with an r value of −0.38 (95% confidence intervals CI: −0.45 to −31, Pearson's correlation coefficient) and CRP (+0.33; 95% CI: +0.24 to +0.41, Pearson's correlation coefficient).

Conclusion

Chest radiograph opacification scores are associated with both respiratory physiology status and systemic inflammation levels in patients with Covid‐19 infection.
Bots and insights: Combining perspectives of analytics and software development in systems analysis and design projects
Authors: Sharma Madhav , McHaney Roger
Published: February 2025

Many management information systems (MIS) faculty have adopted a project‐oriented approach in their systems analysis and design courses. In these courses, students use a software development methodology to create a web or mobile application project, which can be based on a predefined case or developed for an external stakeholder. Because most information systems programs emphasize cybersecurity, analytics, and artificial intelligence (AI), traditional systems analysis and design courses for web applications may seem one‐dimensional in comparison. To address this limitation, we developed and implemented a project based on Merrill's Pebble‐in‐the‐Pond instructional design. In this project, students were required to build an application with two key components: a chatbot and a dashboard, both integrated with the same database. These components cater to multiple user groups, allowing us to combine perspectives from analytics and AI within a single project. Drawing from our experience and feedback from students, we have compiled a set of recommendations for successfully implementing such a project.
Myocardial Characterization on CT: Late Iodine Enhancement and Extracellular Volume
Authors: Bartoli Axel , Gnasso Chiara , Palmisano Anna , Bettinelli Andrea , Vignale Davide , Esposito Antonio
Published: February 2025

Myocardial tissue characterization is fundamental in diagnosing, treating, and managing various cardiac diseases. In recent years, cardiac computed tomography (CCT) emerged as a valuable alternative to cardiac magnetic resonance (CMR) for myocardial tissue characterization, with the possibility to detect myocardial scar and quantify the extracellular volume fraction in a single CT study with the advantage of combined coronary arteries evaluation, shorter scanning time, and less susceptibility to device artifacts compared to CMR. However, CCT is typically affected by a lower contrast‐to‐noise ratio and potentially increased radiation exposure. Therefore, a deep understanding of the available technology and the strategies for acquisition optimization is of fundamental importance to improve image quality and accuracy, while minimizing radiation exposure. This review summarizes principles of myocardial characterization on CCT, acquisition protocols according to the different technologies available including the dual‐energy CT and the innovative photon‐counting detector CT, and setting of clinical utility.
ARIES domains: functional signaling units of type I interferon responses
Authors: Landau Lauren M. , Kagan Jonathan C.
Published: February 2025

The innate immune system relies on a network of signaling proteins classified by shared domains, which serve as functional units that orchestrate inflammatory and host defensive activities. Within type I interferon (IFN) responses, the stimulator of interferon genes protein (STING), mitochondrial antiviral‐signaling protein (MAVS), Toll‐IL‐1 receptor‐resistance protein domain‐containing adapter‐inducing interferon‐β (TRIF), Toll‐like receptor adapter interacting with SLC15A4 on the lysosome (TASL), insulin receptor tyrosine kinase substrate protein of 53 kDa (IRSp53), and GEM interacting protein (GMIP) utilize a conserved pLxIS motif to recruit IRF family transcription factors. Notably, the pLxIS motif functions within a larger signaling unit, which is referred to here as an Activator of Interferon Expression via a pLxIS motif (ARIES) domain. ARIES domains consist of the pLxIS motif and adjacent kinase activation motifs that together drive IFN responses. This review explores how ARIES domains promote immune responses via shared and distinct signaling mechanisms, protein localization, and regulation of metabolic shifts, underscoring their evolutionary conservation and critical role in host defense.
Multicenter observational study to characterize fibroblast growth factor receptor 2 fusions or rearrangements in patients with advanced/metastatic cholangiocarcinoma
Authors: Satake Tomoyuki , Morizane Chigusa , Isayama Hiroyuki , Katanuma Akio , Endo Masato , Kobayashi Noritoshi , Kojima Yasushi , Kubo Shoji , Matsubara Saburo , Shiraishi Takeshi , Ohta Takashi , Uwagawa Tadashi , Kobayashi Shingo , Sahara Takatoshi , Funasaka Setsuo , Ikezawa Hiroki , Okusaka Takuji
Published: February 2025

Aim

We conducted this observational study to investigate patterns of fibroblast growth factor receptor 2 (FGFR2) fusions or rearrangements, and how they relate to other characteristics of patients with unresectable advanced cholangiocarcinoma.

Methods

Patients aged 20 years or older with intrahepatic cholangiocarcinoma (ICC) or perihilar cholangiocarcinoma (PHC) had tumor samples assessed for FGFR2 fusions or rearrangements by a break‐apart fluorescence in situ hybridization probe kit analyzed at a central laboratory; multivariate analyses using a logistic regression model were conducted to investigate the relationship between FGFR2 fusions or rearrangements and patients' baseline characteristics; two cut‐off values (p‐values of 0.15 and 0.05) were used.

Results

Of the 453 patients observed, 25 (5.5%) had FGFR2 fusions or rearrangements, corresponding with 7.4% (23/306) of patients with ICC and 1.4% (2/144) of patients with PHC. Of 426 evaluable patients, FGFR2 fusions or rearrangements were associated with hepatitis C antibodies (odds ratio [OR] 6.901; p < 0.05); patients who had PHC versus ICC (OR 0.273; p < 0.05) or were men (OR 0.431; p < 0.15) were less likely to have FGFR2 fusions or rearrangements. Of 252 evaluable patients with ICC, FGFR2 fusions or rearrangements were associated with hepatitis C antibodies (OR 9.500; p < 0.05); patients who were men (OR 0.419; p < 0.05) or were aged ≥65 years (OR 0.406; p < 0.15) were less likely to have FGFR2 fusions or rearrangements.

Conclusions

This large observational study helps to characterize factors associated with FGFR2 fusions or rearrangements. Further study is warranted to explore differences in prevalence among different geographic populations and patients with PHC.
Comparative performance of PD‐L1 scoring by pathologists and AI algorithms
Authors: Plass Markus , Olteanu Gheorghe‐Emilian , Dacic Sanja , Kern Izidor , Zacharias Martin , Popper Helmut , Fukuoka Junya , Ishijima Sosuke , Kargl Michaela , Murauer Christoph , Kalson Lipika , Brcic Luka
Published: February 2025

Aim

This study evaluates the comparative effectiveness of pathologists versus artificial intelligence (AI) algorithms in scoring PD‐L1 expression in non‐small cell lung carcinoma (NSCLC). Immune‐checkpoint inhibitors have revolutionized NSCLC treatment, with PD‐L1 expression, measured as the tumour proportion score (TPS), serving as a critical predictive biomarker for therapeutic response.

Methods and Results

In our analysis, 51 SP263‐stained NSCLC cases were scored by six pathologists using light microscopy and whole‐slide images (WSI), alongside evaluations by two commercially available software tools: uPath software (Roche) and the PD‐L1 Lung Cancer TME application (Visiopharm). The study examined intra‐ and interobserver agreement among pathologists at TPS cutoffs of 1% and 50%, revealing moderate interobserver agreement (Fleiss' kappa 0.558) for TPS <1% and almost perfect agreement (Fleiss' kappa 0.873) for TPS ≥50%. Intraobserver consistency was high, with Cohen's kappa ranging from 0.726 to 1.0. Comparisons between the AI algorithms and the median pathologist scores showed fair agreement for uPath (Fleiss' kappa 0.354) and substantial agreement for the Visiopharm application (Fleiss' kappa 0.672) at the 50% TPS cutoff.

Conclusion

These results indicate that while there is strong interobserver concordance among pathologists at higher TPS levels, the performance of AI algorithms is less consistent. The study underscores the need for further refinement of AI tools to match the reliability of expert human evaluation, particularly in critical clinical decision‐making contexts.
Barriers and Facilitators to Physical Activity in People With Young‐Onset, Aged 18–40 Years Type 2 Diabetes: A Qualitative Study
Authors: Zhao Xiaoyan , Duaso Maria , Ghazaleh Haya Abu , Guo Xiaodi , Forbes Angus
Published: February 2025

Aim

To explore the barriers and facilitators to physical activity engagement among people with young‐onset type 2 diabetes.

Design

A qualitative research design using individual semi‐structured interviews.

Methods

A purposive sampling technique was used to recruit individuals with young‐onset type 2 diabetes through social media, based on: age, gender, diabetes duration, diabetes complication and physical activity level. Interviews were audio recorded, transcribed verbatim and analysed using Framework analysis integrating the Capability, Opportunity, Motivation and Behaviour model.

Results

Twenty‐three individuals with type 2 diabetes (median age 29 years; 13 women; median diabetes duration 1 year) were interviewed. Nineteen subthemes were identified across all domains of the Capability, Opportunity, Motivation and Behaviour model. The most common domains and the related subthemes were psychological capability (physical activity knowledge, self‐monitoring); social opportunity (stigma, family commitments, guidance from professionals, interactive physical activity, emotional support); and reflective motivation (perceived physical impact of physical activity, perceived mental impact of physical activity, social role & responsibility, perceived self‐efficacy). Interactions were also observed between the different domains of the Capability, Opportunity, Motivation and Behaviour model.

Conclusion

This study revealed in‐depth and novel information on the barriers and facilitators to physical activity in people with young‐onset type 2 diabetes. Future interventions would require multimodal approaches to enhance physical activity motivation in this population by addressing these underpinning psychological and social barriers.

Implications for the Profession and Patient Care

This study highlighted the need for a multimodal strategy that addresses psychological capability, social opportunity and reflective motivation for increasing physical activity in people with young‐onset type 2 diabetes.

Reporting Method

This study was reported using the Consolidated Criteria for Reporting Qualitative Research checklist.

Patient or Public Contribution

An advisory group including six individuals with young‐onset type 2 diabetes contributed to the design of the interview topic guide.
Advance Directives in Mental Health Service: A Qualitative Study on Stakeholders' Perspectives
Authors: Jóhannesdóttir Ína Rós , Fridjónsdóttir Helga Sif , Klinke Marianne Elisabeth
Published: February 2025

Background

Advance directives in mental health services aim to reduce coercion, enhance adherence, and prevent violence by giving patients a voice during relapses. However, their use is limited due to diverse stakeholder perspectives and insufficient familiarity.

Objectives

To explore stakeholders' perspectives on advance directives in Icelandic mental health services, focusing on potential benefits and implementation challenges.

Methods

Data were gathered via focus groups with purposively sampled mental health service users and providers. Using a multiple category design allowed for constant comparative and interpretive analysis of data collected from these two groups.

Results

The study involved 19 individuals divided into four focus groups, with service users comprising one group (n = 4) and service providers comprising three groups (n = 15). Participants had limited familiarity with advance directives and had not used them. While both service users and providers viewed advance directives favourably, significant differences emerged: users valued the opportunity for self‐expression and autonomy, whereas providers, though supportive of user empowerment, struggled with relinquishing control in the therapeutic relationship, thereby preserving power imbalances.

Conclusions

Implementing advance directives in mental healthcare requires in‐depth dialogue to align stakeholder expectations. A strategy should focus on education, stakeholder engagement, and co‐created interventions to reconcile diverse perspectives.
Conceptualisation of Mental Health Recovery by Health Professionals and Students in Southeast Asia: A Qualitative Systematic Review and Meta‐Aggregation
Authors: Chatwiriyaphong Rinlita , Fernandez Ritin , Bosworth Rebecca , Kinghorn Grant , Moxham Lorna
Published: February 2025

Introduction

While the recovery approach is gaining recognition in non‐Western countries, it remains underexplored in Southeast Asia. This study addressed this gap by examining how health professionals and students conceptualised recovery, providing insights for enhancing mental health practices.

Aim

To synthesise how health professionals and students in Southeast Asian countries understand mental health recovery.

Methods

A search across CINAHL, MEDLINE, PsycINFO, Scopus, and the Web of Science identified ten qualitative studies (2006–2024). Data extraction, quality appraisal, and synthesis were conducted following the JBI methodology.

Results

The findings highlighted a medically driven and determined return to normal functioning for individuals living with mental illness. This was classified into six categories: return to being a ‘normal person’, symptom‐free status, medication adherence, access to mental health services, living with residual symptoms, and holistic care with a psychosocial focus.

Discussion

Medical‐oriented practices have dominated mental health care, creating a power imbalance. Training, education, culture, socioeconomic status, and stigma have shaped the understanding of recovery.

Implications for Practice and Recommendations

Shared decision‐making and formal training prioritising lived experiences are vital to reducing power imbalances. A shift towards recovery‐oriented approaches is critically needed to enhance mental health practices in Southeast Asia.
Evolutionary history mediates adaptation through shaping genetic variance
Authors: Han Jia‐Xu , Bai Zhuang‐Dong , Wang Rui‐Wu
Published: February 2025

Organisms exhibit diverse responses when exposed to novel environments, and successful adaptation depends on aligning evolutionary histories with these new conditions. Reusing standing genetic variation is a critical mechanism for this adaptation process. Using an extended Fisher's geometric model, we conducted simulations of evolving populations to investigate how evolutionary histories influence adaptation to novel environments. Our results highlight that distinct evolutionary histories produce varying patterns of genetic variance within populations. When organisms return to previously experienced environments, they exhibit enhanced performance and rapid adaptation. This supports the validity of the strategy commonly employed in ecological restoration to revert habitats to their original state. Moreover, small deviations of the greatest genetic variance direction from the optimum are beneficial for both fitness and fitness increase. A small genetic variance size is advantageous for fitness but impedes fitness increase. A short distance to the optimum and a sharp genetic variance shape are beneficial for fitness but have no significant effects on fitness increase. Our findings underscore the crucial role of evolutionary histories in shaping genetic variance and evolutionary potential when adapting to a new optimum. These results contribute to an evolutionary understanding of the factors underlying the disparate responses of phenotypically similar species to environmental change.
A Test of the Long‐Term Efficiency of Genetic Rescue With Drosophila melanogaster
Authors: Pérez‐Pereira Noelia , Kleinman‐Ruiz Daniel , García‐Dorado Aurora , Quesada Humberto , Caballero Armando
Published: February 2025

Genetic rescue is considered a promising but underutilised conservation strategy to mitigate inbreeding depression and restore genetic diversity. Yet, empirical evidence supporting its long‐term efficacy is limited to studies investigating short‐term effects. Here, we conducted an experiment with Drosophila to test the long‐term efficiency of genetic rescue across generations. A wild population was captured to found a genetically diverse mass‐bred base population (BP) in the laboratory. Smaller populations of 50 individuals each (N50) were then founded from the BP and maintained for 31 generations. Three sets of lines of eight individuals each were founded from these N50 populations: non‐rescued (control), rescued with BP males, and rescued with N50 males. These lines were maintained for 33 generations. Pupae productivity analysis showed substantial purging in N50 populations and adaptation to laboratory conditions in the BP. Rescued‐BP lines showed a higher productivity and lower extinction rates compared to non‐rescued lines. Whole‐genome sequencing of individuals from a non‐rescued line and a rescued‐BP line revealed fewer deleterious alleles, lower genetic diversity, and higher inbreeding in the rescued line, suggesting efficient rescue. Our results enlighten the importance of introducing new genetic variation allowing for adaptation to increase survival even in small populations despite the simultaneous introduction of an inbreeding load, particularly when facing global changes affecting environmental conditions of both donor and recipient populations.
The Impact of Alpha‐Neurofeedback Training on Gastric Slow Wave Activity and Heart Rate Variability in Humans
Authors: Mathew Jerin , Galacgac Jacob , Smith Mark Llewellyn , Du Peng , Cakmak Yusuf Ozgur
Published: February 2025

Introduction

Neuromodulation of cortical brain regions associated with the gut‐brain axis may have the potential to modulate gastric function. Previous studies have shown phase‐amplitude coupling between the electroencephalogram (EEG) alpha band frequency of the insula (Ins) and gastric slow wave (GSW) activity. This study investigated the first evidence of alpha band EEG‐neurofeedback (EEG‐NF) training to explore its effects on GSW activity and heart rate variability (HRV).

Methods

A randomized crossover design was employed with 20 healthy participants attending two separate sessions [active‐training: uptraining left posterior Insula (LPIns) and active‐control: uptraining primary visual cortex (PVC Brodmann area 17)] following the baseline recording period. A 5‐min water loading test (5WLT) was conducted following the EEG‐NF sessions. Finally, a post EEG‐NF/5WL period was also recorded. Participants were blinded to the training program, and the sessions were randomized and conducted at least 48 h apart. Electrocardiogram (ECG), EEG, and electrogastrogram (EGG) data were recorded throughout theexperiment. In addition, the duration of successful NF training was also extracted. Correlation analysis was performed to assess the relationships between outcome variables.

Results

Pearson correlation coefficient analysis revealed a significant relationship between the duration of successful NF training and HRV metrics (RMSSD: r = 0.59; p = 0.005, SI: r = −0.59; p = 0.006) in the LPIns training group and EGG‐gastric rhythm index (r = −0.40; p = 0.028) in the PVC training group. Moreover, the duration of successful LPIns NF correlated with EEG activity of the infraslow band over the left anterior Ins (r = 0.45; p = 0.043), slow band over the right posterior Ins (r = −0.5; p = 0.022), and beta band over the left (r = 0.44; p = 0.04) and right anterior Ins (r = 0.45; p = 0.04). Significant correlations were also observed between LPIns NF duration and connectivity in the beta and gamma bands between cortical regions of interest.

Conclusion

The alpha band EEG‐NF training of LPIns demonstrated significant association with HRV, and EEG (activity and functional connectivity)measures and did not show a negative correlation with Gastric Alimetry Rhythm Index (GA‐RI) following the 5WLT as in the PVC training group. These findings underscore the importance of considering the duration of successful NF as an important variable when evaluating NF training efficacy in future studies.
Changes in the predictive effects of family function and depressive symptoms of suicide‐related behaviours in Chinese adolescents during COVID‐19
Authors: Hu Rui , Ma Sisi , Lin Yuan‐jie , Feng Yi‐wei , Li Xiang , Shi Wei , Zhao Li , Shek Daniel T. L.
Published: February 2025

Background

The COVID‐19 pandemic has led to a global mental health crisis, with increased rates of depression among adolescents, exacerbated by interventions such as social distancing and school closures. While widespread anti‐epidemic experiences may have strengthened social cohesion and improved adolescents' mental health, the long‐term impact of the pandemic on mental health remains a concern, particularly regarding suicide‐related behaviours.

Method

This study explored changes in suicide‐related behaviours among adolescents with depressive symptoms during the pandemic. A cohort of 4245 students aged 10–19 participated in a school‐based survey in 2020, followed by a follow‐up in 2021. Cross‐lagged panel analysis was used to examine associations between depressive symptoms, suicide‐related behaviours and family functioning over time.

Results

Depressive symptoms increased from 2020 to 2021, with a significant rise in mild symptoms (95% CI: 15.53%, 17.78%), whereas severe symptoms decreased (95% CI: 10.24%, 12.14%) (p < .05). Suicide‐related behaviours, except suicidal plans, showed a decreasing trend (p < .05). Significant correlations were found between family functioning, depressive symptoms and suicide‐related behaviours.

Conclusions

While some aspects of adolescent mental health, such as depressive symptoms, showed improvement during the pandemic, depressive symptoms remained a strong predictor of suicide‐related behaviours. The findings underscore the importance of addressing depressive symptoms as a key risk factor for suicide and highlight the role of family functioning in mitigating these risks. Continued attention to adolescent mental health, especially in the context of prolonged pandemic‐related stressors, is essential.