bluuebunny/crossref_metadata_2025 huggingface dataset:
Programas de patinação artística com o Clima de Motivação para a Maestria: impacto no desenvolvimento motor de crianças
Authors: Valentini Nadia Cristina , Lazzaroni Paloma Mattos , Leonhardt Karen Schreiner , Cunha Giovani dos Santos
Published: February 2025

The present study aimed to verify the effect of two figure skating programs with the Mastery Motivational Climate (MMC) on girls' balance and fundamental motor skills. Twenty-four girls (7 to 10 years old) participated in study 1, and in study 2, 40 girls (5 to 10 years old), volunteers for the intervention groups. The skating group (SG) participated in 20 classes, emphasizing MMC concurrently with the regular Physical Education classes. The control group (CG) participated only in Physical Education classes. The results indicated significant and positive changes for the children of the SG concerning static and dynamic balance, locomotor skills, and ball skills. Stability in scores and motor declines were observed in children from the CG. No significant differences were found regarding the intervention impact at different ages. The CMM skating program was efficient in promoting motor gains and developing a diversified motor base.
Predicting Late Adverse Events in Uncomplicated Stanford Type B Aortic Dissection: Results From the ROADMAP Validation Study
Authors: Fleischmann Dominik , Mastrodicasa Domenico , Willemink Martin J. , Turner Valery L. , Hinostroza Virginia , Burris Nicholas S. , Yang Bo , Hanneman Kate , Ouzounian Maral , Ocazionez Trujillo Daniel , Afifi Rana O. , Estrera Anthony L. , Lacomis Joan M. , Sultan Ibrahim , Gleason Thomas G. , Pacini Davide , Folesani Gianluca , Lovato Luigi , Stillman Arthur E. , De Cecco Carlo N. , Chen Edward P. , Hinzpeter Ricarda , Alkadhi Hatem , Hedgire Sandeep , Sundt Thoralf M. , van Kuijk Sander M.J. , Schurink Geert Willem H. , Chin Anne S. , Codari Marina , Sailer Anna M. , Mistelbauer Gabriel , Madani Mohammad H. , Bäumler Kathrin , Shen Jody , Lai Kendrick M. , Fischbein Michael P. , Miller D. Craig
Published: February 2025

BACKGROUND:

Risk stratification is highly desirable in patients with uncomplicated Stanford type B aortic dissection but inadequately supported by evidence. We sought to validate externally a published prediction model for late adverse events (LAEs), consisting of 1 clinical (connective tissue disease) and 4 imaging variables: maximum aortic diameter, false lumen circumferential angle, false lumen outflow, and number of identifiable intercostal arteries.

METHODS:

We assembled a retrospective multicenter cohort (ROADMAP [Registry of Aortic Diseases to Model Adverse Events and Progression]) of 401 patients with uncomplicated Stanford type B aortic dissection presenting to 1 of 8 aortic centers between 2001 and 2013, followed until 2020. LAEs were defined as fatal or nonfatal aortic rupture, new refractory hypertension or pain, organ or limb ischemia, aortic aneurysm formation (≥6 cm), or rapid growth (≥1 cm per year). We applied the original model parameters to the validation cohort and examined the effect on risk categorization using LAE end points.

RESULTS:

One hundred and seventy-six patients (44%) with incomplete imaging or clinical data were excluded. Of 225 patients in the final cohort, 90 (40%) developed LAEs, predominantly driven by aneurysm formation. Baseline maximum aortic diameter was significantly larger in patients with (42.6 [95% CI, 39.1–45.8] mm) compared with patients without LAEs (39.9 [95% CI, 36.3–44.2] mm;
P
=0.001). A multivariable Cox regression model indicated that only maximum diameter was associated with LAEs (hazard ratio, 1.07 [95% CI, 1.03–1.11] per mm;
P
<0.001), while the other parameters were not (
P
>0.05). Applying the original prediction model to the validation cohort resulted in a poor 5-year sensitivity (38%) and specificity (69%).

CONCLUSIONS:

A clinical and imaging-based prediction model performed poorly in the ROADMAP cohort. Maximum aortic diameter remains the strongest predictor of LAEs in uncomplicated Stanford type B aortic dissection.
Intravascular Imaging Predictors Associated With Cardiovascular Events After Complex PCIs
Authors: Lee Joo Myung , Lee Sang Yoon , Kwon Woochan , Lee Seung-Jae , Lee Jong-Young , Lee Seung Hun , Shin Doosup , Lee Sang Yeub , Kim Sang Min , Yun Kyeong Ho , Cho Jae Young , Kim Chan Joon , Ahn Hyo-Suk , Nam Chang-Wook , Yoon Hyuck-Jun , Park Yong Hwan , Lee Wang Soo , Choi Ki Hong , Park Taek Kyu , Yang Jeong Hoon , Choi Seung-Hyuk , Gwon Hyeon-Cheol , Song Young Bin , Hahn Joo-Yong ,   The RENOVATE-COMPLEX-PCI Investigators
Published: February 2025

BACKGROUND:

Intravascular imaging-guided percutaneous coronary intervention (PCI) has been shown to improve clinical outcomes in patients with complex coronary artery lesions compared with angiography-guided PCI. However, the prognostic impact of suboptimal findings on intravascular imaging such as stent underexpansion, malapposition, or dissection is unclear in the era of contemporary drug-eluting stents.

METHODS:

From RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) which compared imaging-guided PCI with angiography-guided PCI in patients with complex lesions, post-PCI intravascular imaging findings, including minimum stent area (MSA), relative stent underexpansion (MSA≤80% of the average reference lumen area), malapposition, or dissection, were assessed in nonleft main target lesions. The primary end point was target lesion failure (TLF), a composite of cardiac death, target lesion–related myocardial infarction, target lesion revascularization, or definite stent thrombosis.

RESULTS:

A total of 897 nonleft main lesions from 714 patients undergoing imaging-guided PCI were included. During a median follow-up duration of 2.1 years, the optimal cutoff value of MSA to predict the occurrence of TLF was 5.5 mm
2
, and MSA<5.5 mm
2
was associated with a significantly higher risk of TLF than MSA≥5.5 mm
2
(2.2% versus 4.8%; adjusted hazard ratio, 3.09 [95% CI, 1.01–9.50];
P
=0.048). Compared with the reference group (MSA≥5.5 mm
2
and no suboptimal findings), the subgroup of patients with MSA≥5.5 mm
2
and post-PCI intravascular imaging findings of relative stent underexpansion, major malapposition, or major dissection was associated with a numerically increased risk of TLF (0.0% versus 3.2%;
P
=0.057). Compared with the same reference group, the subgroup of patients with MSA<5.5 mm
2
and suboptimal post-PCI intravascular imaging findings was associated with a significantly increased risk of TLF (0.0% versus 4.7%;
P
=0.017).

CONCLUSIONS:

After intravascular imaging–guided PCI with contemporary drug-eluting stents for nonleft main complex lesions, inadequate absolute stent expansion was independently associated with a higher risk of TLF. Suboptimal post-PCI intravascular imaging findings of relative stent underexpansion, major malapposition, and major dissection seem to contribute to the risk of TLF.

REGISTRATION:

https://www.clinicaltrials.gov
; Unique identifier: NCT03381872.
Introduction to “Back to the Site: Documentary as I Understand It”
Authors: Robinson Luke
Published: February 2025

Wu Wenguang's article ‘Back to the Site: Documentary as I Understand It’ is one of the first attempts to theorize the Chinese concept of xianchang, or working on site. A location-based practice common to filmmakers and experimental artists, xianchang evolved in 1990s China both as a reaction against Socialist Realist aesthetics, and as an attempt to recuperate their socially engaged potential. This introduction explores Wu's understanding of the distinct spatial, temporal, and everyday qualities of xianchang, while locating the emergence of on-site practices in relation to the period's rapid socio-economic changes, particularly the challenges and opportunities presented by large-scale urbanization.
Negotiating Identity through Music in Zimbabwe: Interrogating Some Selected Nambya Music
Authors: Mpinami Lindani Audrey , Sipeyiye Macloud
Published: February 2025

The Nambya music speaks to the socio-cultural identity of the Nambya people yet it has been jettisoned in music discourse in Zimbabwe. The article critically engages with selected song texts of the previously marginalised ethnic minority to glean the musicians’ use of their indigenous language voices to negotiate issues of identity. The article is qualitative and interpretive, grounded in the constructionist strand of Afrocentricity. Data were collected through in-depth interviews and a review of relevant literature. The findings established that the musicians deploy their voices in communicating beliefs and values of the Nambya people amid many challenges affecting postcolonial societies.
Under Control
Authors: Schwirck Samantha
Published: February 2025

The 'Ferrari of lighting systems’ makes the most of donor dollars at St. Jude Children's Research Hospital
Furniture-integrated lighting—equipment reviewed
Authors: Nuckolls James
Published: February 2025

A lighting designer looks at T/A lighting at NEOCON and offers a subjective evaluation of manufacturers' approaches
Use of Hookah and Age of Asthma Onset Among US Adults
Authors: Pérez Adriana , Valencia Sarah , Jani Pushan P. , Harrell Melissa B.
Published: February 2025

Objective

To explore the association of hookah use on the age of asthma onset among adults who were asthma/COPD free and who did not use cigarettes, cigars, electronic cigarettes or smokeless tobacco prior to asthma onset.

Methods

Secondary data analyses were conducted of the waves 1-6 (2013-2021) of the US nationally representative Population Assessment of Tobacco and Health Study among adults (>18 years). The four hookahs use exposures evaluated were (1) past 30-day (P30D) hookah use at the first wave of participation, (2) total number of waves before asthma onset in which adults reported P30D hookah use, (3) total number of years since first hookah use, and (4) average length of hookah sessions. Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. Associations of the exposures on the age of asthma onset were estimated using weighted interval-censoring-Cox-regression.

Results

The total sample size for analysis was 5,768, representing 66.6 million adults. There was a lack of statistical power to detect differences in the age of asthma onset by (1) P30D hookah use (Adjusted Hazard Ratio (AHR) 3.77, 95CI%: .90-15.71). There was an association between (2) total number of waves of P30D hookah use (AHR 1.72, 95% CI 1.28-2.30), (3) total number of years since first hookah use (AHR 2.94, 95% CI 1.36-6.36), and (4) average length of hookah sessions (AHR 4.52, 95% CI 1.61-12.67) with the age of asthma onset. Females and Hispanics with over one year since first hookah use had higher risk of earlier age of asthma onset.

Conclusion

Prevention and cessation programs for adults who use hookah are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate hookah users to stop.
Arabic heritage language education in Sweden: Opportunities and challenges
Authors: Bohnacker Ute , Wehbe Pascale , Daravigka Konstantina , Haddad Rima
Published: February 2025

In international comparisons, the Swedish heritage-language education (HLE) system is often described as being at the forefront of HLE in Europe. Following recent right-wing shifts in national politics, HLE has now come under threat. This article investigates the current state of HLE in Sweden, focussing on Arabic, through a survey of the literature, statistics on HLE provision and attendance and two empirical studies. Arabic is by far the most taught heritage-language in Swedish schools; research on Arabic HLE is surprisingly scarce though. Study 1, based on questionnaires and interviews, investigates the attitudes and experiences of parents of 100 Arabic-speaking preschool and primary-school children, cross-sectionally and longitudinally (age 4−10 years). Interview-based Study 2 sheds light on the practices and experiences of 17 HLE teachers. Both parents and teachers express appreciation of state-funded HLE, but critique similar aspects of its implementation (e.g. scheduling, class duration). Arabic HLE attendance is high. Teachers report that children make progress despite time constraints and heterogeneous groups. They emphasise how they align their lessons with other school subjects and act as cultural mediators. Unlike some parents, teachers view exposure to different varieties of Arabic in the HLE classroom as beneficial for developing children’s linguistic repertoires and promoting pluralism.
Scoping Review of Bidirectional Intimate Partner Violence Using Dyadic Data
Authors: Stover Carla Smith , Krauss Alison , Yeterian Julie , DeMoss Lauren , Funaro Melissa , Webermann Aliya , Presseau Candice , Portnoy Galina A.
Published: February 2025

Intimate partner violence (IPV) is often considered a unidirectional phenomenon even though historical debate has highlighted the prevalence of bidirectional IPV, where both partners in a couple use and experience IPV. Dyadic data, in which both partners report on IPV, is important because agreement in partner reports of IPV is low. This scoping review aimed to identify rates of bidirectional IPV and examined how different methods of reporting bidirectional IPV impacted rates in studies using dyadic data. Systematic database searches were conducted, and studies were reviewed for the following inclusion criteria: (a) adults over the age of 18; (b) reported rates of bidirectional IPV or provided data that would allow for calculation of bidirectional IPV in the sample; (c) used dyadic data; (d) was published in a peer-reviewed journal; and (e) a United States sample. Rates of bidirectional IPV varied significantly across the 34 studies with rates ranging from 10.0% to 96.6% (median = 35.0%). There was significant variability across studies in instrumentation, definition of bidirectional IPV, and type of sample, making cross-study comparison difficult. Most studies reported the presence of bidirectional IPV if either partner reported IPV use (i.e., perpetration) or experience (i.e., victimization), and if partners disagreed, the higher or positive score was used. Bidirectional IPV rates derived from this method ranged from 10% to 80% which may be an overrepresentation of bidirectional IPV. Further research is needed to inform the ideal method for defining bidirectional IPV, especially when partners do not agree in their reports of IPV.
An Emotional Affair
Authors: Walker Alicia M.
Published: February 2025

Speaking directly with dozens of married heterosexual men involved in extramarital affairs fleshes out a dirty little secret: it’s not always the sex they seek but the validation. By digging deeper, we learn how threatened masculinity gives rise to tacit expectations of wives’ relational labor.
EXPRESS: Upregulation of LRRC8A in the anterior cingulate cortex mediates chronic visceral pain in adult male mice with neonatal maternal deprivation
Authors: Lu Jin-Nan , Dou Jing-Heng , Yi Zi-Long , Lian Lian , Ben Xing-Lei , Zhang Fu-Chao , Xu Guang-Yin
Published: February 2025

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder primarily characterized by chronic visceral pain. Studies have reported that the anterior cingulate cortex (ACC) is involved in chronic visceral pain, however, the molecular mechanisms underlying this involvement remain largely unclear. In this study, we aimed to investigate the molecular mechanisms of the ACC in chronic visceral pain induced by neonatal maternal deprivation (NMD) in male mice. We showed that the expression of leucine-rich repeat-containing protein family member 8A (LRRC8A) at both mRNA and protein levels was significantly upregulated in the ACC of NMD male mice, with LRRC8A primarily co-localized in neurons. DCPIB, an inhibitor of LRRC8A, greatly alleviated chronic visceral pain. Moreover, the ATP concentration was significantly upregulated in the ACC of NMD male mice. However, LRRC8A was not involved in somatic pain induced by complete Freund’s adjuvant (CFA) injection into the hind paw. In conclusion, our findings demonstrate that LRRC8A plays a critical role in regulating chronic visceral pain in NMD mice. These findings are expected to provide new ideas for the treatment of chronic visceral pain in IBS patients.
A case of intercurrent shigellosis and rectal gonorrhea in an acutely unwell febrile returned traveler
Authors: Fuller Charlotte , Bagga Ruchika , Bado Ezra , Ahmad Syed Zain , Boggild Andrea K.
Published: February 2025

Both acute traveler’s diarrhea and sexually transmitted infections are common causes of fever in the returned traveler, with the male sex corresponding to two-fold increased odds of a sexually transmitted infection (STI) diagnosis related to travel. Shigella flexneri is the most common cause of shigellosis in low- and middle-income countries, while within the men who have sex with men (MSM) population, outbreaks of S. flexneri 3a, S. flexneri 2a, and S. sonnei have been reported. We herein present a case of a febrile returned MSM traveler with a predominantly gastrointestinal presentation and proctocolitis whose microbiological work-up confirmed coinfection with S. flexneri and rectal gonorrhea. Based on his travel history and epidemiologic risk factors, it is unclear if food- and waterborne shigellosis versus transmission via sexual contact was the major route of acquisition. This case highlights the broad differential for proctocolitis and the importance of consideration of intercurrent infections.
Oral healthcare for older adults in Swedish municipal healthcare—a qualitative study of healthcare professionals’ experiences
Authors: Snogren Maria , Ek Kristina , Lindmark Ulrika , Browall Maria , Eriksson Irene
Published: February 2025

Introduction

Oral health is multi-faceted and influences a person’s daily life, and numerous potential barriers and factors can challenge and pose barriers to good oral health. Shortages of healthcare professionals or incorrect care practices can be barriers to performing good oral healthcare. A knowledge gap has been identified in qualitative research on description of healthcare professionals’ experiences of oral healthcare among older adults in municipal healthcare.

Aim

To describe healthcare professionals’ experiences of oral healthcare among older adults in Swedish municipal healthcare.

Design and methods

The study employed a qualitative design guided by a secondary qualitative analysis method comprising inductive qualitative content analysis. Data were collected through semi-structured individual interviews with healthcare professionals.

Results

Good relationships and mutual trust create the conditions for delivering good oral healthcare. Knowledge provides confidence and trust in performing oral healthcare, experiences and strategies influence the individual adaptation of oral healthcare, and priorities and collaboration influence oral healthcare provision.

Conclusion and implications

The performance of oral healthcare is complex and cannot be achieved without establishing a relationship with the older adult who needs care. Oral healthcare includes prerequisites such as routines, sufficient time, work-time planning, and collaboration between healthcare professionals. Registered nurses positively experience opportunities to collaborate with other healthcare professionals regarding oral healthcare and are seen as leaders in the Fundamentals of Care and are sharing good examples of oral healthcare in palliative care.
Adverse childhood and school experiences: a retrospective cross-sectional study examining their associations with health-related behaviours and mental health
Authors: Hughes Karen , Bellis Mark A , Ford Kat , A Sharp Catherine , Hopkins Joanne , Hill Rebecca , Cresswell Katie
Published: February 2025

Background

Adverse childhood experiences (ACEs) increase individuals’ risks of poor health across the life course. For children that suffer household-based ACEs, experiences in other settings such as schools have the potential to exacerbate or mitigate risks of poor health. However, few studies have examined such effects. This study aimed to examine relationships between household-based ACEs, school experiences and adult health outcomes.

Methods

A national cross-sectional household survey (N = 1,868 aged 18+) was undertaken in Wales using random quota sampling (November 2022 to March 2023). Measures included nine household-based ACEs; two measures of childhood school experience (having been bullied, sense of school belonging); and adult health outcomes (smoking, binge drinking, low mental wellbeing, mental illness, violence). Associations between ACEs, school experience and health outcomes were examined using chi squared tests and binary logistic regression.

Results

The proportion reporting both having been bullied and lower school belonging increased with ACE count (0 ACEs 6%, 4 + ACEs 51%). Higher ACE count was independently associated with increased risk of all adult health outcomes except binge drinking, while poorer school experience (having been bullied, lower school belonging) was associated with increased risk of low mental wellbeing, mental illness and violence victimisation. For example, adjusted odds of current mental illness rose to 3.98 in those reporting 4 + ACEs (vs. 0 ACEs) and 3.37 in those reporting both having been bullied and lower school belonging (vs. not bullied, higher school belonging). In individuals with 4 + ACEs, adjusted prevalence of current mental illness reduced from 44% in those reporting both having been bullied and lower school belonging to 19% in those reporting not having been bullied and higher school belonging.

Conclusions

For children who grow up in adverse home environments, exposure to further adversity at school may amplify risks of poorer health and life outcomes. However, schools are opportune settings for children who lack safety and support at home to recover from stress, develop resilience and access support. Trauma-informed approaches in schools that recognise the impacts of adversity and support children to overcome it have the potential to improve educational and health outcomes. Further research is needed to identify effective approaches.
Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study
Authors: Yu-ting Yang , Li-xiang Chen , Miao Yao , Yong-wei Yang , Ting Lin
Published: February 2025

Background

Screen time encompasses activities conducted on digital devices, including traditional devices such as televisions and computers, as well as modern devices like smartphones, tablets, and other digital screens. Excessive screen time among children has been linked to a heightened likelihood of engaging in high-risk problem behaviours. This study aimed to quantify the prevalence of excessive screen time and delve into its correlation with problem behaviours among school-aged children in Fujian, thereby gaining insight into the prevalence and trends within this region.

Methods

From October to November 2022, we used cluster sampling and invited 891 school-age children from Fujian as participants. Parents recorded children’s screen time for a week, taking the average value of seven days, and the unit is minutes. The Child Behaviour Checklist was used to assess their problem behaviours. Correlation analysis, Propensity Score Matching, Single-factor analysis, and Multi-factor analysis were used to explore the influencing factors and correlation.

Results

Screen exposure time of school-age children was 34.29 (17.14, 55.71) min/day. Then, 17.06% were exposed to excessive video. The total CBCL score of school-age children was 10.00 (3.00, 22.00), and 10.00% had problem behaviours. After matching the propensity score, the total score of problem behaviours in the daily over-exposure group was higher than that in the non-over-exposure group (Z = 5.466, p < 0.001). Generalized linear model analysis showed that after controlling confounding variables, daily video exposure time or daily excessive screening could affect problem behaviours (p < 0.05).

Conclusions

The incidence of problem behaviours among school-age children is low in Fujina. The daily screen time, weekday screen time, and weekend screen time were positively associated with problem behaviours. We suggested family members shift to more serious and cautious attitudes toward children’s screen exposure and adopt appropriate digital-related parenting practices, such as accompanying children when they inevitably need to watch electronic devices, to better understand and manage their screen time.
Age at type 1 diabetes onset does not influence attained brain volume
Authors: Claesson Tor-björn , Mutter Stefan , Putaala Jukka , Salli Eero , Gordin Daniel , Groop Per-Henrik , Martola Juha , Thorn Lena M.
Published: February 2025

Introduction

Type 1 diabetes is suspected to hamper brain growth, implying that people with earlier diabetes onset would, on average, achieve lower maximal brain volume. We set out to test this hypothesis.

Methods

Examining brain MRI scans of middle-aged people with type 1 diabetes, we related age at diabetes onset to intracranial volume in 180 participants, as well as to cerebral gray and white matter volumes in a subset of 113 (63%) participants, using fractional polynomial regression models. Of the participants, 118 (67%) had been diagnosed with diabetes before 18 years of age.

Results

Of our participants, 54% were women, the median age 40.0 (IQR 33.2–45.0) years and the range of age at diabetes onset was 1.2–39.0 years. We found no association between age at diabetes onset and intracranial volume (p = 0.85), cerebral white (p = 0.10), or gray matter volumes (p = 0.12). Further, correlations between age at diabetes onset and the measured brain volumes were poor in analyses stratified for sex (all correlation coefficients ρ ≤ 0.16).

Conclusions

We found no association between age at diabetes onset and attained intracranial volume or gray or white matter volumes, indicating that type 1 diabetes may not have a clinically significant influence on brain growth.
Healthcare organizations in crisis context: decision-making models and roles of CEOs
Authors: Romiti Anna , Del Vecchio Mario , Cavicchi Caterina , Vagnoni Emidia
Published: February 2025

Background

In times of crisis, decision-making can become a highly complex process that is shaped differently than in ordinary contexts. The literature presents different decision-making models that have not yet been thoroughly tested in practice. This paper aims to enhance our understanding of the distinctive characteristics of healthcare organizations’ decision-making models in crisis contexts, building upon and expanding the framework proposed by Arendt et al. (2005).

Methods

Based on a qualitative research design, data were collected through semi-structured interviews with 49 CEOs of Italian healthcare organizations, including both local health authorities and independent hospitals.

Results

CEOs’ decision-making processes demonstrated several commonalities: a shift from strategic issues to operational issues; a narrowed CEO focus on only a few areas of operations, and a significant concentration of the DMP in time and space. These shared elements provide insights into the nature of the centralization process adopted by CEOs in such situations. Additionally, we identified various decision-making models to manage the same crisis, with each model presenting a different level of involvement of other actors in the decision-making process, reflecting the CEO’s unique vision and background.

Conclusions

This research makes a significant contribution to the growing literature on crisis management in three key ways. First, it emphasizes the importance of analyzing the decision-making process through the combined lens of different dimensions and phases. Second, it enhances the Arendt et al. (2015) model to include multiple critical dimensions of the decision-making process beyond the initial focus on decentralization, and demonstrates how, in a crisis context, the actors involved by the CEOs diverge from the original framework. Third, it offers new insights into the variables affecting the roles of the CEOs and other key actors in crisis-related decision-making, transcending the boundaries of role theory. In terms of managerial implications, reflecting on and interpreting the core of the organization’s decision-making processes, can support top management teams in navigating change, providing them a more robust and rational base for guiding the transition to a post-crisis “new normal”.
A rapid state-of the-art review of client-reported outcomes measures used to assess dogs’ clinical signs and quality of life during chemotherapy
Authors: Harris Jenny , Fournier Quentin , Sutton Katie , Armes Jo , Ream Emma , Bacon Nick
Published: February 2025

Background

Quality of life is an essential component of decision-making in veterinary oncology. Poor management of adverse events during chemotherapy can impair dogs’ quality of life and be life-threatening. Consequently, client-reported outcome measures (CROMs) are being proposed to help assess both clinical signs and quality of life. The purpose of this rapid review was to: (1) identify existing CROMs that have been used to assess dogs’ clinical signs and quality of life during chemotherapy; and (2) evaluate their methodological development to inform adaptation or development of a CROM for use in routine clinical practice, including remote monitoring. Databases (Scopus, Web of Science, PUBMED/MEDLINE) were searched for CROMs (questionnaires) completed by a non-expert family member about their companion dog. CROM content (domains measured) and scale quality were appraised.

Results

Ten CROMs were identified and three were variations of the same tool. Content of the CROMs varied considerably (range 3–17 domains) with gastrointestinal being the most frequently measured clinical sign cluster (9/10 studies), followed by mobility/ambulatory activity (7/10) and global quality of life (6/10). No CROMs adhered to quality standards for the development of questionnaires and most failed to include qualitative design methods and basic psychometric assessment to ensure reliability and validity (such as internal consistency, test-retest reliability or factor analysis).

Conclusion

The validity and reliability of existing chemotherapy CROMs for dogs remains under-tested. Although CROMs combined with remote digital monitoring have the potential to enhance patient care, as has been demonstrated with physician-based oncology, there is a need to apply quality standards to ensure optimal validation. Interdisciplinary collaborations would likely improve CROM quality and clinical utility thereby allowing veterinary healthcare professionals to better support their patients.
Enhancing the uptake of intermittent preventive treatment for malaria in pregnancy: a scoping review of interventions and gender-informed approaches
Authors: Kretchy Irene A. , Atobrah Deborah , Adumbire David A. , Ankamah Samuel , Adanu Theodosia , Badasu Delali M. , Kwansa Benjamin K.
Published: February 2025

Background

Malaria infection in pregnancy is a critical determinant of maternal and neonatal health outcomes in endemic regions. Intermittent preventive treatment of malaria in pregnancy (IPTp) using sulfadoxine-pyrimethamine has been recommended by the World Health Organization (WHO), but its uptake remains low because of factors such as gender norms and expectations. However, interventions to optimize IPTp uptake, especially in malaria-endemic regions, have resulted in a decline in malaria during pregnancy, maternal and neonatal mortality, low birth weight, and placental parasitaemia. This scoping review aimed to synthesize evidence on IPTp uptake, particularly emphasizing gender-related strategies.

Methods

The modified version of Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) were adopted for this review. Documents were retrieved from the following electronic databases and search engines: scopus, Web of Science, CINAHL Complete (EBSCO), PubMed, WHO, Global Index Medicus, and Google Scholar. The titles and abstracts of the publications were independently screened via Rayyan review management software, and the data were organized using the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and gender analysis matrix.

Results

A total of 32 studies met the inclusion criteria. The most reported criterion was the effectiveness of the interventions, which demonstrated an increase in IPTp uptake after the intervention. The gender analysis framework revealed that involving both men and women in decision-making processes, empowering women, and promoting shared roles could improve the success of IPTp interventions.

Conclusions

Interventions to increase IPTp uptake should be targeted at empowering women through education, increasing financial independence, and making decisions about their health.
Sway frequencies may predict postural instability in Parkinson’s disease: a novel convolutional neural network approach
Authors: Engel David , Greulich R. Stefan , Parola Alberto , Vinehout Kaleb , Student Justus , Waldthaler Josefine , Timmermann Lars , Bremmer Frank
Published: February 2025

Background

Postural instability greatly reduces quality of life in people with Parkinson’s disease (PD). Early and objective detection of postural impairments is crucial to facilitate interventions. Our aim was to use a convolutional neural network (CNN) to differentiate people with early to mid-stage PD from healthy age-matched individuals based on spectrogram images obtained from their body sway. We hypothesized the time–frequency content of body sway to be predictive of PD, even when impairments are not yet clinically apparent.

Methods

18 people with idiopathic PD and 15 healthy controls (HC) participated in the study. We tracked participants’ center of pressure (COP) using a Wii Balance Board and their full-body motion using a Microsoft Kinect, out of which we calculated the trajectory of their center of mass (COM). We used 30 s-snippets of motion data from which we acquired wavelet-based time–frequency spectrograms that were fed into a custom-built CNN as labeled images. We used binary classification to have the network differentiate between individuals with PD and controls (n = 15, respectively).

Results

Classification performance was best when the medio-lateral motion of the COM was considered. Here, our network reached a predictive accuracy, sensitivity, specificity, precision and F1-score of 100%, respectively, with a receiver operating characteristic area under the curve of 1.0. Moreover, an explainable AI approach revealed high frequencies in the postural sway data to be most distinct between both groups.

Conclusion

Heeding our small and heterogeneous sample, our findings suggest a CNN classifier based on cost-effective and conveniently obtainable posturographic data to be a promising approach to detect postural impairments in early to mid-stage PD and to gain novel insight into the subtle characteristics of impairments at this stage of the disease.
Stereotactic body radiotherapy with carbon ions as local ablative treatment in patients with primary liver cancer
Authors: Hoffmeister-Wittmann Paula , Hoegen-Saßmannshausen Philipp , Wicklein Livia , Weykamp Fabian , Seidensaal Katharina , Springfeld Christoph , Dill Michael T. , Longerich Thomas , Schirmacher Peter , Mehrabi Arianeb , Mathy René Michael , Köhler Bruno C. , Debus Jürgen , Herfarth Klaus , Liermann Jakob
Published: February 2025

Background and aims

Liver cancer is the third leading cause of cancer related death due to treatment resistance and late onset of symptoms (Rumgay in J Hepatol 77: 1598–1606, 2022). The role of external beam radiotherapy (EBRT) in treatment of unresectable liver cancer needs to be defined. The use of particle therapy such as carbon ion radiation therapy (CIRT) with high linear energy transfer (LET) could increase efficacy of EBRT while limiting the toxic effects of radiation on non-cancerous liver tissue. Promising effects of CIRT have been described in several studies during the past decades, mostly in Japan. To date, no standardized treatment protocol has been established and European data on CIRT for liver cancer is lacking. This retrospective analysis aims to investigate efficacy and safety of hypofractionated CIRT compared to photon-based stereotactic body radiation (SBRT) in primary liver cancer.

Method

Thirty-six (n = 36) and twenty (n = 20) patients with primary malignant liver tumors were treated with hypofractionated CIRT (4 fractions) and photon-based SBRT, respectively, between 2011 and 2022 and were retrospectively evaluated for survival, local control, and toxicity.

Results

Two-year local control rate after CIRT was 92.3%. Compared to photon- based SBRT, CIRT scores with a significantly longer median distant progression free survival (3.1 versus 0.9 years). In a matched pair comparison of the two treatment regimens, the CIRT cohort demonstrated both longer 2-year overall survival (100% versus 59.6%) and longer 2-year distant PFS (75.7% versus 22.9%). No significant impairment of liver function was observed in either cohort.

Conclusion

In this retrospective analysis, patients who received CIRT presented excellent local tumor control and had better oncologic outcomes than patients who received photon-based SBRT. SBRT with carbon ions is a promising local ablative treatment option that needs further investigation in large prospective trials.
Health outcomes and drug utilisation in children with Noonan syndrome: a European cohort study
Authors: Santoro Michele , Barisic Ingeborg , Coi Alessio , Tan Joachim , Garne Ester , Loane Maria , Odak Ljubica , Abate Maria Valentina , Ballardini Elisa , Cavero-Carbonell Clara , Gatt Miriam , Gissler Mika , Klungsøyr Kari , Lelong Nathalie , Tucker David , Wellesley Diana , Morris Joan K.
Published: February 2025

Background

Noonan Syndrome (NS) is a rare multisystemic disorder with heterogeneous phenotypic manifestations. The aim of this study was to analyse rates of survival, hospitalisation, surgeries and prescriptions in children born with NS in the first 10 years of life.

Methods

This is a multi-centre population-based cohort study. Data on 175 liveborn children diagnosed with NS from 11 EUROCAT congenital anomaly registries were linked to healthcare databases. Each registry applied a common data model to standardise data and run common syntax scripts to produce aggregated results which were pooled using random effects meta-analyses.

Results

Mortality rates were high in the first year of life with 5.4% (95%CI 1.5%-10.1%) of children dying before the age of 1 year with a further 2% dying up to age 5. In the first year, 87.9% (95%CI 75.3%-94.3%) of children were hospitalized and the median Length Of hospital Stay (LOS) was 15.3 days (95%CI 9.3–21.2). After the first year, the proportion of children hospitalized remained higher than 70%, but the LOS decreased to 1.3 days per year. In the first 5 years, 65.2% of children underwent a median of two surgical procedures. The median age at first surgery was 29 weeks. The proportion of children with an antibiotic prescription increased from 53.6% at age 1 to 62.4% yearly until 4 years of age.

Conclusions

Children with NS have high mortality and morbidity not only in the first year of life but also up to five years of age. This study evaluated the health burden of NS and provided information for clinicians, health-care providers and families.
Sympatric non-biting flies serve as potential vectors of zoonotic protozoan parasites on pig farms in China
Authors: Liu Yufeng , Dhakal Pitambar , Hou Wenyan , Shan Fa , Wang Nanhao , Yang Bin , Qin Huikai , Li Xiaoying , Wang Rongjun , Zhang Longxian , Zhang Sumei , Li Junqiang
Published: February 2025

Background

Cryptosporidium spp., Enterocytozoon bieneusi, and Blastocystis sp. are common enteric parasites in humans and pigs. Ascertaining whether non-biting flies (NBFs) serve as potential vectors of these parasites on pig farms is a crucial aspect of disease control.

Methods

Non-biting flies were collected and identified by morphology analysis together with sequence analysis of the mitochondrial cytochrome c oxidase I (CO1) gene as confirmation. In a cross-sectional study, the small-subunit ribosomal RNA (SSU rRNA) gene of Cryptosporidium spp., the internal transcribed spacer region (ITS) region of E. bieneusi and the SSU rRNA gene of Blastocystis sp. were investigated in fresh pig fecal samples and sympatric NBFs.

Results

The results revealed the occurrence of five species of NBFs (Musca domestica, 91.2%; Lucilia sericata, 5.8%; Chrysomya megacephala, 1.7%; Aldrichina grahami, 0.6%; Helicophagella melanura, 0.6%) in the collected pig fecal samples. The prevalence of Cryptosporidium spp., E. bieneusi and Blastocystis sp. on the body surface of NBFs was 0.6% (2/342), 4.4% (15/342) and 20.8% (71/342), respectively. Similarly, the prevalence of these parasites in the lysates of NBFs (= in vivo carriage) was 0% (0/342), 2.7% (9/342) and 10.5% (36/342), respectively. The prevalence of Cryptosporidium spp., E. bieneusi and Blastocystis sp. in pigs from which fly samples were collected was 2.3% (41/1794), 12.6% (226/1794) and 30.8% (553/1794), respectively. The zoonotic Cryposporidium suis/C. scrofarum, E. bieneusi ITS genotypes EbpA/EbpC and Blastocystis sp. subtypes ST1/ST3/ST5 were identified in both NBFs and pig feces. NBFs were found to carry E. bieneusi and Blastocystis sp. on their body surface as well as in the lysates.

Conclusions

These findings demonstrate the role of NBFs as potential vectors in the dissemination of these zoonotic parasites in pig farms, and also highlight the possibility of their transmission to humans.

Graphical Abstract
BBSome deficiency in Lotmaria passim reveals divergent functions in trypanosomatid parasites
Authors: Yuan Xuye , Kadowaki Tatsuhiko
Published: February 2025

Background

The BBSome is an octameric protein complex crucial for ciliary transport, though it also participates in multiple other cellular processes. These diverse functions may result from the co-option of its ancestral roles. Studying the BBSome in flagellated protists can provide insights into these ancestral functions and their subsequent adaptations.

Methods

We examined the functions of the BBSome (LpBBS1 and LpBBS2) in Lotmaria passim, a monoxenous trypanosomatid parasite infecting honey bees. The phenotypes resulting from depletion of LpBBS1 using the auxin-inducible degron system and disruption of LpBBS2 were characterized.

Results

Parasites deficient in LpBBS2 are smaller and less motile compared with wild-type. Although intraflagellar transport of a marker membrane protein is only mildly impaired, its association with lipid rafts is significantly disrupted in the mutants. This suggests that the BBSome is essential for maintaining lipid raft integrity in L. passim. Transcriptomic comparisons between wild-type and LpBBS2-deficient parasites reveal that the BBSome may also influence processes related to metabolism, membrane localization of specific proteins, DNA repair, microtubules, and mitochondria.

Conclusions

In contrast to Leishmania mexicana, the BBSome in L. passim is crucial for efficient infection of the honey bee gut, demonstrating that its cellular functions vary between related trypanosomatid species. The BBSome is likely an adaptor that links multiple proteins in a species-specific manner under various cellular contexts.

Graphical Abstract
Broad consent in the emergency department: a cross sectional study
Authors: Fischer-Rosinský Antje , Eienbröker Larissa , Möckel Martin , Hanses Frank , Hans Felix Patricius , Wolfrum Sebastian , Drepper Johannes , Heinrich Philipp , Slagman Anna
Published: February 2025

Background

The Medical Informatics Initiative (MII) introduced a broad consent form (MII-BC) encompassing clinical, insurance, and biomaterial data, along with re-contacting options. In the emergency department (ED), outpatient and inpatient patients of all illnesses and severity could be reached early in their treatment course. The BC-ED (Broad Consent in the Emergency Department) project uniquely investigated the implementation of MII-BC in EDs, exploring feasibility, selection bias and patients’ perceptions of voluntariness, information recall, motivation, and satisfaction.

Methods

The BC-ED project involving four university hospital EDs in Germany, is part of CODEX+ (Collaborative Data Exchange and Usage), an initiative within the Network University Medicine (NUM). To minimize selection bias, a systematic sampling approach (every 5th/30th patient) was applied, with patient recruitment and consent processes adapted to local conditions and therefore varying among sites. Data collection included patient questionnaires, surveys completed by study nurses, and routine clinical data. Analysis was conducted descriptively using SPSS.

Results

Of 1,138 patients approached, 553 (48.6%) were capable of giving consent. Of 353 patients who could not consent, primary reasons included language barriers (35.4%) and inability to grasp study details (21.5%). Of all eligible patients, 3.3% could not be contacted. Of 535 (47.0%) patients able to consent and contacted, 313 consented to the MII-BC. Resulting in a consent rate of 27.5% corresponding to the baseline population and 58.5% of those contacted. Motivations for consenting were general support for research (85.3%) and the desire to help future patients (78.2%). Patients generally reported a high level of understanding and satisfaction with the consent process, reporting comprehensive understanding of scientific data use (89.8%) and associated risks (82.2%). However, discrepancies were noted between consented options and patient recall.

Conclusions

This study is the first to investigate the implementation of the MII-BC in the challenging ED environment. With a consent rate of 27.5% total baseline population and 58.5% of those contacted, it demonstrates that patients were able and willing to participate in research. Reasons for non-consent were barriers like language and medical conditions. Strategies to address these barriers are crucial for inclusivity. Although patients generally understood the consent process, discrepancies in recall highlight the need for improved comprehension strategies.

Trial registration

German Clinical Trials Register on 25 October 2022 (DRKS0003054).