bluuebunny/crossref_metadata_2025 huggingface dataset:
“Just a little overweight”
Authors: Alghazo Sharif , Ahmed Mervat M. , Rabab'ah Ghaleb , El-Dakhs Dina Abdel Salam
Published: February 2025

This study investigates the impacts of age and gender on the use of euphemistic strategies in Alexandrian Arabic, a dialect that is spoken in the coastal city of Alexandria to the north-west of Egypt. To achieve this objective, a role-play that includes 6 situations categorised to account for the age and gender variables groups was developed and administered to 160 Alexandrian Arabic speakers, who were divided into four primary groups, each consisting of 40 speakers based on age (old vs young) and gender (male vs female). The responses were analysed using a mixed-methods approach, with quantitative and qualitative measures. The analysis is based on a taxonomy we collected from many previous frameworks, such as Allan and Burridge (1991) and Warren (1992). The results revealed age to be a crucial factor in selecting euphemistic strategies: the older group most frequently employed the implication strategy, and the synonym strategy was more common among the younger group. The results further revealed that gender has a lesser effect on the choice of euphemistic strategies by the participants: borrowing is more common among the female participants, and other methods are utilised almost equally by the two genders. This denotes that although specific euphemism strategies, like synonymy and deletion, can be age-specific, others, such as understatement and taboo, cut across age groups, which can perhaps be seen as manifestations of norms culturally embedded. Gender differences are also only slightly significant except in borrowing, in which females use this strategy more than males, perhaps due to their sociocultural or sociolinguistic functions that shaped women’s language.
A relevance-theoretic approach to weak explicatures as a means to understanding poetic effects
Authors: Arga Bora , Doğan Gürkan
Published: February 2025

What makes the indeterminacy in poetic language so alluring, or at times, frustrating for some readers? How do we take pleasure in not being able to reach an ultimate meaning while reading poetry, in other words, from the impossibility of fully clarifying the message conveyed by the poet? In order to answer these questions and account for cognitive processes behind achieving poetic effects, most pragmaticians employing the lens of Relevance Theory mainly rely on the notion of ‘weak implicature’ (Sperber & Wilson, 1986/1995). However, taking the view held by Sperber and Wilson (2005) that explicatures can too be ‘stronger or weaker’ further, this paper argues that poetic effects on the basis of indeterminacy can similarly be triggered by weak explicatures. Poems by Turkish poet Özdemir Asaf (2020a, 2020b, 2020c) will be employed to provide relevant underpinnings—in terms of reference assignment and enrichment—for our claim.
Explicit performatives in Old Saxon and Old High German
Authors: Concu Valentina
Published: February 2025

This study explores the distribution and frequency of explicit performatives within the Old Saxon and Old High German corpora. Focusing on instances with verbs with meanings such as ‘request,’ ‘command,’ ‘advise,’ and ‘entreat,’ the analysis reveals a partial similarity between the two corpora, particularly in their portrayal of asymmetrical social relationships in religious texts. The findings indicate that higher-ranked addressers, such as God and Jesus, predominantly use verbs of ‘commanding’ and ‘instructing,’ while lower-ranked addressers, mainly believers, employ verbs for ‘requesting’ and ‘begging.’ A comparison with explicit performatives in Old English show a similar use of explicit performatives in these diachronic varieties, likely reflecting common practices in the use of this type of directives. Additionally, the absence of verbs for ‘advising’ or ‘suggesting’ used in explicit performatives aligns with findings in Old English, pointing to a preference for verbs that clearly delineate power dynamics within the texts. This study contributes to our understanding of historical pragmatic variation and the linguistic practices represented in early Germanic texts, offering insights into the portrayal of social hierarchies and power relationships in fictive religious writings.
The Challenge of “Chineseness”: Taiwan’s Identity and Education Policy for Hua-ch’iao and Malaysian Chinese from the 1990s to 2000s
Authors: Hung Tak Wai , Kwan Yuk Sing , Ching Ka Hung
Published: February 2025

This manuscript delves into the complexities of imagined hua-ch’iao identity and its interplay with the Taiwanese education policies for overseas Chinese in Malaysia from the 1990s to the 2000s. By examining the shift in Taiwan’s stance toward Chinese in diaspora, the study underscores the devolution of hua-ch’iao education within the broader context of Taiwan’s quest for a distinct national identity from China. We explore the historical underpinnings and the ideological shifts that informed the policies under the Kuomintang (kmt) and the Democratic Progressive Party (dpp), highlighting the contentious debate over “Chineseness” and its implications for overseas Chinese communities. By tracing the changes in educational policy, the study reflects on the broader questions of identity, nationalism, and the politics of belonging in the era of globalization. It raises critical inquiries about Taiwan’s engagement with overseas Chinese communities and the conceptual challenges of defining “Chineseness” since the twenty-first century.
Chinese Family Businesses, Dialect Groups, and Succession Planning: sme s’ Perseverance Practices in Malaysia
Authors: Lee John Kean Yew , Wong Sau Man
Published: February 2025

Chinese family businesses (cfb s) have been perceived as a cornerstone of Malaysia’s economic and social fabric. The history of cfb s can be referred back to the early fifteenth century, when the Hokkien arrived in Nanyang as the earliest Chinese immigrants to work in trade ports. Since that time, cfb s have undergone an evolution in their structure, from a traditional Chinese form to more professionalized form. To better understand how immigration patterns and traditional skills influence the industries dominated by different dialect groups, the present work adopts a business-history approach to understand small and medium enterprises owned by Chinese families in different dialect groups, namely Besfomec (Hakka), lh Plus (Henghua), and Fung Keong (Cantonese). This study highlights the historical building of business reputations to describe how these Malaysian cfb s in the dialect groups have adapted to Malaysia’s “New Economic Policy.” This study sheds light on the companies’ integration of unique challenges, and the strategies taken by the different dialect groups to achieve market prominence and sustain their businesses over generations. By promoting Nanyang-branded products in Malaysia, this paper aims to demonstrate the importance of Chinese-owned small and medium enterprises’ perseverance practices, the role of the state in fostering public-private partnerships, and inter-ethnic business strengthening during generational change.
Interactive cooking lessons improve attitudes towards food and weight statuses among preschool children
Authors: LeMay-Russell Sarah , Rowell Tiffany , Fernando Nimali , DiEugenio Heidi , Potock Melanie , Chilson Andie , Goldstein Eliza , Jennings Krystal , Zucker Nancy
Published: February 2025

Objective:

Data demonstrate that children in the USA eat below the recommended amount of fruits and vegetables, which has been linked with increased risk of obesity and low weight. Previous school-based interventions promoting healthy eating and enjoyment of food have yielded outcomes such as improved weight and children’s willingness to try novel foods. Therefore, we explored whether interactive cooking lessons could be an effective means of food exposure to fruit and vegetables, and improve weight statuses among young children.

Design:

This study utilised a community-based intervention.

Setting:

Head Start classrooms in a southern state of the USA.

Methods:

Monthly lessons led by classroom teachers introduced students to novel foods and explained nutritional benefits and guiding children through snack preparation and mindful appreciation of the new food. Teachers completed the Food Fussiness and Food Enjoyment subscales of the Child Eating Behaviour Questionnaire and recorded body mass index (BMI) percentiles, which were collected by trained Family Engagement Specialists, for each student at the beginning and end of the school year.

Results:

Among 614 Head Start students, children demonstrated a significant decrease in food fussiness ( p < .001) and increase in food enjoyment ( p < .001). There were significant changes ( p < .001) in BMI percentile. Children with high weight lost 16.9 percentile points over the year compared to those with healthy weight. Conversely, children with low weight gained 24.7 percentile points.

Conclusion:

Developmentally appropriate interactive cooking lessons that expose young children to fruit and vegetables in a social setting may be an effective strategy for improving attitudes towards food and weight statuses. Additional data are required to fully understand the mechanisms that cause beneficial weight changes in preschool age children.
Finite element analysis of interfacial shear behavior for CFRP flexural-externally strengthened reinforced concrete beams using a modified CZM model
Authors: Hamidi Kawthar , Bouziadi Farid , Boulekbache Bensaid , Hamrat Mostefa , Tahenni Touhami , Haddi Abdelkader , Hawileh Rami A. , Amziane Sofiane
Published: February 2025

The paper aims to develop a nonlinear finite element (NLFE) model to predict the response of carbon-fiber reinforced polymer (CFRP) flexural-externally strengthened reinforced concrete (RC) beams subjected to a four-point flexural test. The ANSYS© code based on the finite element method (FEM) is utilized to model a control RC beam as well as CFRP flexural-externally strengthened RC beams, using data from experimental tests found in the literature. A 3D NLFEA with perfect bonding is conducted alongside with seven cohesive zone material (CZMs) models employed to simulate the behavior of CFRP flexural-externally strengthened RC beams. Among the seven-bond stress-slip models and the perfect bonding model evaluated, it is found that Lu et al.’s bilinear CZM model demonstrates the closest match to the experimental results, predicting an ultimate load with a minimal deviation of 0.50%, making it the most accurate among the CZM models. This comparison highlights the effectiveness of Lu et al.’s bilinear CZM model in simulating the response of CFRP flexural-externally strengthened RC beams. Following this, a parametric study is conducted to analyze the effects of concrete compressive strength, tensile steel reinforcement diameter, length and thickness of the CFRP materials, and elastic modulus of epoxy resin on the behavior of CFRP flexural-externally strengthened RC beams. Also, Lu et al.’s bilinear CZM model is modified. The level of fitness between the modified Lu et al.’s bilinear CZM model and the experimental results is assessed with statistical metrics, including the coefficient of determination, mean, standard deviation, coefficient of variation, and root mean square error, which are equal to 0.996, 0.95, 0.19, 20%, and 1.64, respectively.
Research on low-velocity impact damage and influencing factors of composite laminates
Authors: Xue Lian , Li Weiping , Liu Jialei , Xue Caijun
Published: February 2025

To explore the damage behavior of composite laminate panels under low-velocity impact loading, an investigation of the impact performance of composite material plates under low-velocity impact loading was conducted through drop hammer impact tests. A unified theoretical framework regarding intra-layer damage and interlayer delamination in composite laminates was proposed. An enhanced strain-based Hashin criterion was implemented through the Abaqus/Explicit User Material Subroutine (VUMAT) to model intra-layer damage, while a modified traction-separation law, accounting for strain rate effects, along with the B-K criterion, were employed to simulate interlayer damage. A detailed low-velocity impact model was developed, and the simulation results exhibited strong agreement with experimental data. A novel approach incorporating strain rate effects is proposed. The damage characteristics of low-velocity impact were systematically analyzed, and the effects of impact energy, impactor radius, and impact angle on the low-velocity impact damage characteristics of laminate panels were examined. The results revealed that the predominant damage modes in composite laminate panels under low-velocity impact were matrix cracking and delamination. Impact energy and impact angle significantly influenced low-velocity impact, with the damage degree increasing as impact energy increases and decreasing as impact angle increases. In contrast, the effect of impactor radius was negligible. The proposed high-precision modeling approach could effectively predict the evolution of low-velocity impact behavior.
Disinterested and Disillusioned? Information and Political Engagement Practices of Young People From Disadvantaged Backgrounds
Authors: Wunderlich Leonie
Published: February 2025

Inequalities in news use and political participation exist among young people from (dis-)advantaged backgrounds which challenge the idea of informed citizens that can participate in democratic processes. Relating to self-actualizing (AC) and dutiful (DC) citizen identity paradigms and performative citizenship, this study investigates information and engagement practices of low-educated young people. The results from ten focus groups N = 46 with young Germans (14- to 22-year-olds) conducted in 2023 show four analytical networks that are mostly related to AC qualities. Contact and potential engagement with political information result from incidental news exposure on social media platforms. Participants’ engagement practices are characterized by exchange on political topics in interpersonal contexts as well as little participation experience and limited self-efficacy. Participants’ critical perception of media coverage comprises a limited representation of relevant topics and perspectives as well as a discouraging presentation of news. Group differences and explanations for participants’ limited engagement are analyzed.
Is There a Difference Between the Real Self and the Virtual Self of Internet Game Players? The Effect of Avatar Identity
Authors: Liang Leilei , Yuan Tongshuang , Liu Kai , Zheng Chengbin , Fei Junsong , Mei Songli
Published: February 2025

TThe purpose of this study was to validate a proposed theoretical model of adolescent internet gaming disorders from a reality-virtual perspective. A questionnaire survey was conducted using random stratified cluster sampling on 3,058 middle school students with internet gaming experience, drawn from four middle schools in a province in northern China. The research tools included measures of ego identity, avatar identification, ego depletion, and the internet gaming disorder (IGD) scale. The study’s results revealed that avatar identity mediated the relationship between ego identity and IGD, with a mediation effect of 25%. Additionally, ego depletion was found to moderate the relationship between ego identity and avatar identity/avatar identity and IGD. These findings highlight the importance of considering the virtual self (avatar) in future diagnoses or interventions for IGD.
Gender-based violence against female patients in hospitals
Authors: Bhattacharya Surajit , Bhattacharya Kaushik , Bhattacharya Neeta , Bhattacharya Neela
Published: February 2025

Gender-based violence (GBV) against female patients in Indian hospitals is an under-recognized but critical issue that undermines the principles of equitable healthcare. This phenomenon encompasses physical, verbal, emotional, and structural abuse, often exacerbated by deeply entrenched societal norms, gender discrimination, and systemic inefficiencies in healthcare delivery. Female patients in India frequently encounter GBV in its various forms, namely neglect, inappropriate physical contact, discriminatory attitudes, and breaches of confidentiality. Women from marginalized communities (lower socio-economic or minority groups) are particularly vulnerable. Contributing factors include insufficient privacy protocols, overburdened healthcare facilities, inadequate staff training on gender sensitivity, and power dynamics, all of which particularly disadvantage female patients. The consequences of GBV are profound, leading to psychological trauma, diminished trust in healthcare systems, or delayed or avoided medical care. Despite its prevalence, GBV in Indian hospital settings remains under-reported owing to fear of stigma, societal pressure, and lack of accessible reporting mechanisms.
Planned approach of virtual training in organizations
Authors: Srivastava Sunaina , Kunte Monica
Published: February 2025

Background

Virtual learning has been widely employed to promote employee learning as technology and globalization have advanced. Critically examining workers’ views on virtual learning is important since their opinions of its design and delivery affect their acceptance of it.

Objective

The research aims to explore the influence of service quality, information quality (virtual learning training components), and self-efficacy factors on employees’ perceived value and flow at work, towards their learning satisfaction, using perceived organizational support as a moderator in this relationship and employing the SOR architecture as a theoretical foundation.

Methods

A total of 352 research samples were collected from the IT sector employing convenience sampling and analyzed using a structural equation model.

Results

The results indicate that service quality, information quality, and self-efficacy positively influenced the employee’s perceived value, flow at work, and learning satisfaction. Employee perceived value and flow at work positively mediated the association between service quality, information quality, self-efficacy, and employee learning satisfaction. Additionally, perceived organizational support had a significant moderating role.

Conclusion

This research enhances the existing knowledge in the field of information technology and innovative technology adoption by investigating the fast-growing trend of virtual training in the IT industry.
‘An aerial slum’: Race, air pollution and the affective atmospheres of urban modernity
Authors: Chapman Kiera
Published: February 2025

In this paper, I investigate the changing connections between atmospheric pollution, spectral colour, ideas of a spatially ‘modern’ built environment, and racism. In the nineteenth century, the blackening effects of air pollution were seen as creating disordered spectral colour in the city, in a manner that was sometimes associated with ideas of the physical regression and degeneration of the urban population. By the middle of the twentieth century, however, this colour disorder was more often depicted as the sign of an ‘out of joint’ temporality in which the ‘bad old’ Victorian era was haunting the present. This enabled urban reformers to advocate for planning as a force that could exorcise these spectres and instead create a clean, white and unpolluted urban environment, with a colour palette that was restrained rather than vivid. However, in the post-war context of mass immigration, this created a series of associations in which ideas of urban decay were all too easily associated with racialised blackness, with new immigrants figuring simultaneously as a blackening and blighting influence on urban neighbourhoods, and as too vivid in their sartorial colour choices to ‘belong’ within British culture.
Marana on the Map
Authors: Tarricone Paul
Published: February 2025

With layers of light hidden in plain view, a new government building represents a coming out party for Marana, AZ
What's inside the Blue Box?
Authors: Barr Vilma
Published: February 2025

New lighting systems for Tiffany & Co.'s restored main and fifth floors make its landmark New York flagship sparkle and glow
The Perfect Match
Authors: Lowe Roslyn
Published: February 2025

Former colleagues Richard Spry and Trish Connor have reunited to take high-end design global, by way of Seattle
Putting the past in Pasadena
Authors: Falzano Rebecca
Published: February 2025

Starting out as a seismic retrofit, the landmark Pasadena City Hall became a civic centerpiece after an exterior lighting makeover
The Phoenix Soars
Authors: Tarricone Paul
Published: February 2025

Illuminated ceiling latticework&–reminiscent of a phoenix with wings spread proudly&– rises to the occasion at a Tokyo banquet hall
A Collector's Item
Authors: Hall Elizabeth
Published: February 2025

Once a novel curiosity on display, electric light reveals art and architecture at the Morgan Library & Museum
A Case for Credentials
Authors: Mesh Steven
Published: February 2025

With utilities eager to reward energy-saving measures, the author argues for new credentials above and beyond the LC. The result could put dollars in your pocket
Reflections of Absence
Authors: Hall Elizabeth
Published: February 2025

The 9/11 Memorial design pays tribute to the victims by acknowledging their loss
Enhancing efficiency of an old hydropower plant turbine through a mutual runner design and component optimization
Authors: Seydim Sıla , Yildirim Gözde , Ulucak Oguzhan , Buyuksolak Fevzi , Ejder Beril , Kantar Ece Nil , Guzey Kaan , Tasaltin Yusuf , Ayli Ece , Aradag Selin , Celebioglu Kutay
Published: February 2025

This paper presents a systematic approach to the rehabilitation process of Sarıyar HEPP, a hydroelectric power plant that has been operational for more than 50 years. Units 1 and 2 (U1-U2) were originally designed with a head of 93 m and a turbine power of 48.5 MW, while Units 3 and 4 (U3-U4) were designed with a lower head of 76.5 m but the same turbine power of 48.5 MW. A methodology combining reverse engineering and CFD analysis is developed to identify and evaluate the critical parameters that have an impact on the existing turbine performance. A hybrid design is proposed to replace the existing two different types of turbines, which reduces manufacturing costs and design time. The performance of the new hybrid design is evaluated in detail with CFD analysis. For both existing and hybrid design, steady and unsteady analyses are performed. For all of the situations hill charts are obtained and the comparison of the old and new hybrid design is discussed in detail. The results show that the new design has improved the efficiency of the turbine and the power plant, resulting in a 14.2% efficiency increase in U1-U2 and a 21% system efficiency improvement in U3-U4. This study provides a guide to designers and practitioners for the rehabilitation of hydroelectric power plants.
Bond Market Transparency and Innovation Along the Supply Chain
Authors: Chen Jun , Liu Jianfeng , Ma Xiaofang , Wang Wenming
Published: February 2025

Utilizing the introduction of the Trade Reporting and Compliance Engine (TRACE) as an exogenous shock to enhance secondary bond market transparency, we investigate the informational feedback effect of the bond market on supplier innovation in vertical relationships. We find that the increased availability of trading details regarding major customers’ outstanding bonds significantly fosters their supplier firms’ innovative investment. This positive effect of bond market transparency enhancements on supplier innovation is weakened when major customers demonstrate a better information environment, have higher levels of institutional ownership, and share common institutional investors with suppliers, while strengthened when the bond market conveys positive information about major customers, and when major customers face tighter financial constraints, exhibit higher levels of risk-taking, and possess greater importance to suppliers. Our findings clearly identify the informational role of the bond market in corporate investment decisions and specifically highlight the importance of bond market information regarding customer firms to the innovation along the supply chain.
Using a Trauma-Informed Care Approach to Understand Family Caregivers’ Experiences of Accessing Formal Supports in Dementia Care
Authors: Meng Christine , Lachapelle Safira , Adekoya Adebusola , Kervin Lucy , Seetharaman Kishore , Basu Khan Koushambhi , Baumbusch Jennifer
Published: February 2025

Family caregivers provide essential care and support for individuals living with dementia, yet their contributions and needs are often unrecognized within formal health care systems. Over time, this marginalization can contribute to long-term trauma. Guided by a trauma-informed care (TIC) framework, we explored the experiences of 15 family caregivers in a longitudinal, qualitative study. Set in British Columbia, Canada, data were collected through semi-structured interviews and reflective diaries. Data were analyzed using inductive-deductive thematic analysis. Deductive analyses demonstrated that participants’ experiences aligned with existing TIC principles. Inductive analysis identified “Uncertainty” as a novel principle, reflecting the ongoing challenges caregivers face from diagnosis to the inadequacy of in-home supports. Our study highlights the importance of recognizing trauma induced by interactions with formal health care services and the value of using a TIC approach with family caregivers of people living with dementia.
Stakeholder Perspectives on Community Participation and Ownership in Community Mental Health Policy and Services: Mixed Methods Study in Ghana
Authors: Yaro Peter Badimak , Teg-NefaahTabong Philip , Asampong Emmanual
Published: February 2025

Addressing the mental healthcare needs of the population at the Primary Health Care (PHC) level has gained global consensus as a key strategy to realising the mental health targets of the United Nations (UN) Sustainable Development Goals (SDGs), especially SDG3. This research explored the question ‘What is the nature and level of community participation and ownership in the development and integration of mental healthcare service provision at the PHC, especially at Community Health Planning and Services Centre (CHPS) level(s) in Ghana?’. A cross-sectional study that adopted concurrent mixed quantitative and qualitative research methods was undertaken to explore and answer the question. The quantitative data of the study was collected through a survey questionnaire. Key informant interviews and focus group discussions were used to collect the qualitative data. Thematic analysis with the use of NVivo 12 was applied for the qualitative field data and Stata SE16 used for quantitative data. Data triangulation strategy was used to report both the qualitative and quantitative data sets. The study findings show that community participation and ownership was low, requiring more concerted efforts to engender that into mental health care policy and services development and implementation to realise the seamless integration of mental healthcare into general healthcare at the PHC level. Community participation and ownership will substantially enhance the (re-)organisation and resourcing of mental health services in Ghana to make them more responsive and inclusive.
Features and effectiveness of electronic audit and feedback for patient safety and quality of care in hospitals: A systematic review
Authors: Soresi James , Bertilone Christina , Banks Eileen , Marshall Theresa , Murray Kevin , Preen David B
Published: February 2025

Background: Increasing digitisation in healthcare is flowing through to quality improvement strategies, like audit and feedback. Objectives: To systematically review electronic audit and feedback (e-A&F) interventions in hospital settings, examining contemporary practices and quantitatively assessing the relationship between features and effectiveness. Methods: We performed a systematic review using a structured search strategy from 2011 to July 2022. Searches yielded a total of 5095 unique publications, with 152 included in a descriptive synthesis, reporting publication characteristics and practices, and 63 in the quantitative synthesis, to evaluate the effect size of intervention features. Results: The search returned publications across characteristics, including countries of origin, feedback topics, target health professionals, and study design types. We also identified an association with effectiveness for all but one of the features examined, with a Cohen’s d ranging from above +0.8 (a large positive effect), to −0.67 (a medium negative effect). Socio-technical features related to supportive organisations and the involvement of engaged health professionals were most associated with effective interventions. Conclusion: Key findings have confirmed that a common set of features of e-A&F systems can influence effectiveness. Results provide practitioners with insight into where resources should be focused during the implementation of e-A&F.
Semi-parametric model approach to causal mediation analysis for longitudinal data
Authors: Li Youjun , Albert Jeffrey M.
Published: February 2025

There has been a lack of causal mediation analysis implementation on complicated longitudinal data. Most existing work focuses on extensions of parametric models that have been well developed for causal mediation analysis. To better handle more complex data patterns, our approach takes advantage of the flexibility of penalized splines and performs the causal mediation analysis under the structural equation model framework. We also provide the formula for identifying the natural direct and indirect effects based on our semi-parametric models, whose inference is carried out by the delta method and Monte Carlo approximation. Our approach is first evaluated by conducting simulation studies, where the two methods for inference are compared. Finally, we apply the method to data from a longitudinal cohort study to examine the effect of a training programme for healthcare providers on improving their patients' type 2 diabetes condition.
Registered Dietitian Nutritionists as Leaders in Lifestyle and Culinary Medicine
Authors: Wilson Kelly , McCleery Abigail
Published: February 2025

Registered Dietitian Nutritionists (RDNs) are uniquely positioned to lead in Lifestyle Medicine, Culinary Medicine and Food is Medicine, overlapping initiatives currently gaining momentum in health care. To become a credentialed practitioner, RDNs must demonstrate competency as outlined in The Scope and Standards of Practice defined by the Commission on Dietetic Registration (CDR), the credentialing agency for the Academy of Nutrition and Dietetics. Many CDR competencies align with the interventional and operational components necessary to deliver and direct effective Lifestyle Medicine (LM) and Culinary Medicine (CM) initiatives. Capitalizing on the skills and expertise of RDNs trained in LM and CM is an effective strategy to address the Quintuple Aim of better health care outcomes, lower cost, improved patient satisfaction, improved provider wellbeing and the advancement of health equity. Successful examples like Cooking with Plants, Trinity Health Ann Arbor’s virtual CM series, showcase the positive impact of RDN-led CM initiatives on culinary literacy and health behavior change. This article provides an overview of the Cooking with Plants program and practical guidance for initiating similar programs at other institutions. Guidance includes strategies for assessing community needs, identifying funding sources, engaging stakeholders, and developing and evaluating curriculum.
Anatomical variations of the intracranial arteries and their association with intracranial aneurysms: Insights from digital subtraction angiographies
Authors: Aburto-Murrieta Yolanda , Marquez-Romero Juan Manuel , Martínez-Arellano Pablo , Serrano-Arias Fabiola Eunice , Montenegro-Rosales Héctor Alfredo , López-Mena Diego
Published: February 2025

The purpose of this study was to identify the anatomical variants (AVs) in the intracranial arterial circulation of patients who underwent neuro-interventional procedures (NIPs) and to describe their relationship with intracranial aneurysms (IA). We performed a cross-sectional analysis of angiographic images from patients who underwent NIP at the Interventional Neuroradiology Department of the National Institute of Neurology and Neurosurgery in México between July 1, 2020, and January 1, 2022. After reviewing images from 150 NIPs, we found 144 AVs., yielding a prevalence of 81%. Of these, 49 AVs (34%) were located in the anterior circulation (AC) and 95 (66%) in the posterior circulation (PC); 23 NIPs (16%) showed AVs in both the AC and PC. The most frequent AVs were the fetal pattern of the posterior cerebral artery (19%) and hypoplasia of the A1 segment (12%). AVs were significantly more common in patients with neurovascular disorders than those without (80% vs 49%, p = .003) and in patients with IA compared to those without (68% vs 47%, p = .048). In the studied population, AVs were predominantly located in the PC and are significantly more frequent in patients with neurovascular disorders, particularly those with IA.
Association of reported sleep disturbances with objectively assessed mild cognitive impairment among adults in the United States
Authors: Shen Chan , Wang Hao , Djiotsop Arthur Nguimatsa , Wiener R. Constance , Pathak Mona , Mitra Sophie , Findley Patricia A , Sambamoorthi Usha
Published: February 2025

Background:

Sleep is a multifaceted phenomenon influenced by both duration and quality. Various sleep disturbances have been associated with mild cognitive impairment, but the role of specific disturbances in mild cognitive impairment pathophysiology remains unclear. This study investigated the associations between distinct sleep disturbances and mild cognitive impairment in adults aged 50 and older using nationally representative data.

Methods:

Longitudinal data from the Health and Retirement Study were analyzed to explore the association between mild cognitive impairment and three types of sleep disturbances: trouble falling asleep, trouble waking up, and waking up too early. Logistic regression models estimated unadjusted (Model 1) and adjusted associations accounting for sex, race/ethnicity, age, social determinants of health (Model 2), general health (Model 3), depression (Model 4), and pain and physical activity (Model 5).

Results:

The study cohort included 8877 participants aged ⩾50 years in 2018 (baseline) who were followed up in 2020. Overall, 15.4% reported trouble falling asleep, 23.2% reported trouble waking up, and 12.8% reported waking up too early and being unable to fall back asleep most of the time. Among older adults, approximately 13.1% reported experiencing mild cognitive impairment; The prevalence of mild cognitive impairment was even higher in those who experienced sleep disturbances. The unadjusted odds ratio (uOR) for experiencing trouble falling asleep most of the time was 1.69 (95% CI: 1.42–2.03), for trouble waking up most of the time was 1.31 (95% CI: 1.10–1.57), and for waking up early most of the time was 1.88 (95% CI: 1.51–2.35). However, these positive associations attenuated depending on the covariate adjustment.

Conclusions:

Nearly one in seven adults had mild cognitive impairment. The relationship between sleep disturbances and mild cognitive impairment has been challenging to delineate. Our findings demonstrate a positive association between sleep disturbances and mild cognitive impairment, although these associations were sensitive to covariate adjustments. These findings suggest multifaceted pathways for reducing the risk of mild cognitive impairment.
Operation time as a prognostic indicator on postoperative complications following percutaneous nephrolithotomy
Authors: Pakdel Alireza , Mohammadi Abdolreza , Shamshirgaran Amirreza , Zemanati Yar Ehsan , Zareian Baghdadabad Leila , Alaeddini Farshid , Koohi Ortakand Roghayeh , Oliveira Reis Leonardo , Hosseini Seyed Reza , Aghamir Seyed Mohammad Kazem
Published: February 2025

Objective:

We aimed to find an optimal cut-off time for percutaneous nephrolithotomy to prevent complications.

Methods:

This study enrolled 165 patients aged 18–80 with renal stones ⩾2 cm or ⩾1 cm in lower pole, confirmed via noncontrast computed tomography. Baseline characteristics, stone features, operation time, and anesthesia time were recorded. Logistic regression models were fitted and the ability of the surgery time to predict complications, major complications, and systemic inflammatory response syndrome was evaluated using receiver-operating characteristic curves. Area under the receiver-operating characteristic curve analysis was used as a general indicator of quality.

Results:

Out of 165 enrolled patients, 157 were analyzed (8 excluded due to follow-up and surgery data issues). The cohort consisted of 115 males (73.2%) and 42 females (26.7%), with a mean (SD) age of 47.4 (12.65) years. Multivariate analysis indicated that longer operation times and lower body mass index correlated with higher complication rates. A cut-off of 65 min for operation time showed 96.8% specificity for predicting complications. Additionally, 47.8% of patients were systemic inflammatory response syndrome positive postprocedure, and operation times were not shown to be predictive of systemic inflammatory response syndrome.

Conclusion:

Operation time seemed to be a potential risk factor for postpercutaneous nephrolithotomy complications and lowering the operation time could prevent postoperative complications.
Cooperative Learning Instructional Approach and Student’s Biology Achievement: A Quasi-Experimental Evaluation of Jigsaw Cooperative Learning Model in Secondary Schools in Gedeo Zone, South Ethiopia
Authors: Kebede Yidnekachew Awraris , Zema Firew Kebede , Geletu Girma Moti , Zinabu Samuel Assefa
Published: February 2025

The jigsaw model is a dynamic cooperative learning approach where students become experts on different segments of the material and teach their peers, thereby enhancing engagement accountability, team work, and ultimately improving academic achievement. This study investigated the effectiveness of a cooperative learning strategy on secondary school students’ biology achievement using the jigsaw learning model. A quasi-experimental, nonequivalent control group pretest-posttest design was employed, involving two secondary schools. One school ( n = 40 students) was randomly assigned to the intervention group, while the other ( n = 41 students) served as the control group. Data were collected through achievement tests, with a pretest administered to both groups before the intervention. Analysis of the pretest data revealed that no significant difference in biology scores between the two groups (mean difference = 4, ES = .02, p > .05). After a 16-week intervention, the cooperative learning strategy using the jigsaw model resulted in a statistically significant improvement in the experimental group’s post-test performance (mean difference = 19.2, ES = .33, p < .05). However, the intervention showed no notable impact on gender-based post-test achievement scores among experimental group participants (mean difference = 2.2, ES = .008, p > .05). Therefore, the study affirmed that cooperative learning strategy, specifically employing the jigsaw model, is a valid and effective approach for secondary school biology.
Interventions to Modify Psychological Processes in Patients Undergoing Spine Surgery: A Systematic Review
Authors: Skarsgard Matthew , Almojuela Alysa , Gagliardi Martin , Swamy Ganesh , Nicholls Fred , Jacobs W Bradley , Thomas Kenneth C , Soroceanu Alex , Eckenswiller Denise , Soumbasis Elias , Tanguay Rob , Evaniew Nathan
Published: February 2025

Objectives

Among patients undergoing elective spine surgery, psychological processes such as kinesiophobia and pain catastrophizing are associated with postoperative disability and poor quality of life. These represent risk factors which could be modified to improve surgical outcomes. We reviewed perioperative interventions to modify psychological processes and their effects on psychological and surgery-related outcomes.

Methods

We searched MEDLINE, EMBASE, and Cochrane databases for studies examining any interventions for modifying psychological processes in adult patients undergoing spine surgery. Two reviewers screened studies for eligibility, extracted data in duplicate, and performed risk of bias assessments. Outcomes included pain, disability, quality of life, kinesiophobia, self-efficacy, and pain catastrophizing.

Results

368 titles and abstracts were retrieved, of which 27 studies underwent full-text screening. We included 12 studies which reported on 1263 patients. Eight were randomized controlled trials. Interventions included preoperative and postoperative cognitive behavioural therapy, cognitive-behavioural-based physical therapy, a web-based interactive platform, an information booklet, and music therapy. The psychological and surgery-related outcomes of interventions were variable, with some studies reporting significant benefits and others reporting no differences between groups. The greatest potential benefits were found in studies of post-operative cognitive-behavioural-based physical therapy. Risk of bias among studies was high due primarily to lack of blinding and limited standardization of interventions.

Conclusions

Several interventions to potentially modify psychological processes in patients undergoing spine surgery have been reported. Post-operative cognitive-behavioural-based physical therapy might be associated with improved outcomes, but confidence is limited by inconsistency, risk of bias, and limited long-term follow-up.
No Difference in Chondrocyte Viability Using Manual Versus Custom-Cutting Technique for Matrix-Induced Autologous Chondrocyte Implantation
Authors: Chang Wen-Teh , Atzmon Ran , Vel Monica S. , Lin Kenneth M. , Abrams Geoffrey D. , Sherman Seth L.
Published: February 2025

Background:

Matrix-induced autologous chondrocyte implantation (MACI) was developed for knee cartilage restoration involving seeding autologous chondrocytes onto a collagen membrane. Maintaining chondrocyte viability and achieving proper membrane size and contour are crucial for successful outcomes. Scissor cutting (Sc) has traditionally been used to shape the membrane, but recently, custom cutting (CC) have gained popularity for their enhanced preparation efficiency.

Purpose:

To determine the difference in chondrocyte viability using the Sc versus CC methods.

Study Design:

Controlled laboratory study.

Methods:

Using Sc and CC methods, 15 mm–diameter circular specimens were cut from 5 residual membranes. Membranes were stained, and confocal microscopy was used to visualize live/dead cells. Three zones were defined: the impact zone (the outermost zone at the cut edge), the central zone (the least manipulated zone), and the adjacent zone (the intermediate zone between the central and impact zones). For each circular specimen, the following measurements were recorded: the dimension of the impact zone, cell viability (percentage of live cells among total) for each zone, and the total number of cells within each zone (as cell density ×105/cm2).

Results:

The width of the impact zone (mean ± standard error) was 355 ± 31 μm and 342 ± 24 μm for CC and Sc, respectively, and the impact zone occupied approximately 10% of the specimen. With both cutting techniques, cell viability was significantly lower in the impact zone (mean ± standard error: CC, 36.42% ± 3.85%; Sc, 40.94% ± 2.85%) compared with the adjacent zone (CC, 77.69% ± 2.97%; Sc, 74.17% ± 2.8%). The cell density from all zones varied from 5.84 ± 0.26 to 6.49 ± 0.34 × 105/cm2, with no significant difference in cell viability in the impact zones between the cutting methods.

Conclusion:

Both cutting techniques led to a significant reduction in cell viability in the impact zone compared with other zones of the MACI specimen. There was no significant difference in chondrocyte viability or cell density for membranes cut by Sc or CC.

Clinical Relevance:

This evaluation of the newly introduced CC method on the chondrocyte viability of the MACI membrane will enable surgeons to make a more informed decision regarding cutting techniques.
Evaluation of Pickleball-Related Injuries at a Single Institution From 2017 to 2022
Authors: Herzberg Simone D. , Bowman Eric N. , Hill Kelly L.
Published: February 2025

Background:

Pickleball is currently the fastest-growing sport in the United States, and participation has increased 3-fold throughout the study period.

Purpose/Hypothesis:

This study aimed to evaluate the epidemiology of pickleball-related injuries, detailing the descriptive data, injury patterns, and health care utilization at a single center over 6 years. It was hypothesized that there would be a substantial increase in pickleball-related injuries during the study period, particularly with increasing age, along with increased orthopaedic visits for pickleball-related injuries.

Study Design:

Case series; Level of evidence, 4.

Methods:

We systematically queried the Electronic Health Record System at a single institution from January 1, 2017, to December 31, 2022, to identify patients with injuries associated with pickleball participation. Data were collected on descriptive data, injury characteristics, and health care utilization.

Results:

Pickleball injuries were confirmed in 487 patients, accounting for a total of 618 injuries. Patient age ranged from 12 to 82 years (mean, 62 years), and 53% of injuries occurred in male patients. The number of injuries increased 6.8-fold from 2017 to 2022. Overall, soft tissue strain or rupture (n = 296; 47.9%) was the most common injury category, followed by arthritis-related pain (n = 62; 10%) and fracture (n = 57; 9.2%). However, age-stratified analysis revealed a shift toward fractures and arthritis-related pain in patients >60 years. Women were 2 times more likely to sustain fractures. Injuries to the rotator cuff were most commonly seen (n = 67, 11%), followed by those to the back (n = 48; 7.8%) and calf (n = 35; 5.6%). Most patients (n = 426; 87%) were initially evaluated by a nonorthopaedic provider, with orthopaedic/sports medicine providers seeing 63% of patients.

Conclusion:

Our institution observed a 6.8-fold increase in pickleball-related injuries from 2017 to 2022, which far outpaces the reported increase in pickleball participation nationally. Women >60 years were found to be at the highest risk of injury and were more likely to sustain fractures. Most injuries were musculoskeletal related, with soft tissue injury occurring most commonly in patients <60 years and fractures more commonly seen in patients >60 years.