bluuebunny/crossref_metadata_2025 huggingface dataset:
Current biomarkers in inclusion body myositis
Authors: Daniel Eden , Smith Ian C. , Sampaio Marcos L. , Melkus Gerd , Hamilton Leslie E. , Bourque Pierre R. , Warman-Chardon Jodi
Published: January 2025

Inclusion body myositis (IBM) is an idiopathic muscle disorder primarily affecting adults above the age of 50. IBM is characterized by weakness in the knee extensor and deep finger flexor muscles due to muscle atrophy and fibroadipose replacement. Dynamometry and manual muscle testing are commonly used to assess patient muscle strength, while magnetic resonance imaging and electromyography studies identify the patterns of muscle atrophy and motor unit potentials. Although the underlying pathophysiological mechanisms of IBM are still unknown, common histopathological markers include rimmed vacuoles and inclusions. The immune system is also largely implicated in pathogenesis, as skeletal muscle in IBM overexpresses major histocompatibility complex I (MHC-I), and cluster of differentiation (CD) 8+ T-cells, and features endomysial inflammation. Antibodies to the cytosolic 5′-nucleotidase 1A (cN1A) protein have been associated with IBM but have low sensitivity and specificity. As many classic features of IBM present only in advanced stages of disease, there are substantial challenges to the diagnosis and monitoring of IBM progression in its early stages. Identifying early diagnostic biomarkers and new biomarker signatures associated with IBM disease progression is necessary for clinical trial readiness.
Delayed-Onset White-Dot Syndrome in the Setting of Traumatic Choroidal Rupture
Authors: Husain Alina , Winebrake James P. , Goldberg Naomi R. , Mahrous M. Abdallah , Kovacs Kyle D.
Published: January 2025

Purpose:

To describe a patient with a traumatic choroidal rupture and a submacular hemorrhage, the course of which was complicated by delayed-onset posterior uveitis resembling a white-dot syndrome.

Methods:

A single case was evaluated.

Results:

A 34-year-old man presented after being struck in the left eye with a tennis ball. The visual acuity (VA) was 20/30 with otherwise normal ophthalmic vitals. An examination showed traumatic iritis and choroidal rupture with a submacular hemorrhage without subfoveal involvement. Despite treatment of anterior segment inflammation and a worsening hemorrhage with topical agents and intravitreal aflibercept, the VA decreased to 20/600. A repeat examination with optical coherence tomography showed new optic disc edema, placoid outer retinal lesions adjacent to the choroidal rupture, and corresponding ellipsoid zone atrophy. A broad workup was unremarkable, and the patient completed a long taper of high-dose oral prednisone without recurrence.

Conclusions:

Traumatic exposure of the immunologically privileged subretinal space to high-flow choroidal circulation likely triggered a pathway involving self-autoantigenicity and a uveitic response.
Planning a ‘sustainable city’ with hinterlands: The case of Yokohama City, Japan and its soft space planning to reach net-zero
Authors: Sato Haruno
Published: January 2025

This research paper draws on the re-scaling of urban studies, city–hinterland metabolic links and the emergence of soft space planning to analyse the case of Yokohama city and its collaboration initiative crossing municipal borders to ‘import’ clean electricity. Through the analysis, the paper interrogates how the urban sustainability idea, with the recognition of the roles played by spaces beyond city boundaries, is unfolding, with a particular focus on the negotiations taking place between a city and hinterlands. The objective also extends to revealing how the initiative reinterprets city–hinterland relationships. This research identified that the initiative was shaped based on the city's understanding of the issue, which allowed the city to have a dominant influence in the following negotiations to arrange the initiative's details. Through the investigation of those negotiations, evidence showed the presence of power asymmetries and the hinterlands’ vulnerability to ‘being used’ by a city and raised questions on the initiative's quality to deliver desirable outcomes. The paper discusses them as this initiative's weaknesses, which are also areas for future studies to investigate how the city–hinterland soft space approach could enhance urban sustainability.
Ethnomathematics-based technology in Indonesia: A systematic review
Authors: Sunzuma Gladys , Umbara Uba
Published: January 2025

Over the past decade, the integration of ethnomathematics based technology has grown in mathematics education. This systematic review explores digital cultural-based media integration into mathematics education in Indonesia. A systematic review was conducted following PRISMA guidelines to gather research that meets the inclusion criteria. Articles from 2013 to 2023 were searched using Google Scholar. Screening yielded 23 relevant articles. Thematic analysis was used to categorize research patterns and data from the 23 articles. The analysis reveals a surge in articles from 2016 to 2023, peaking in 2022, underscoring a heightened interest in enhancing mathematics education with digital cultural media. However, a gap from 2013 to 2015 suggests a need for more research during that period. Geometry emerges as the dominant topic, with limited representation of numbers, indicating potential for expansion. High school and primary school students were the primary participants, highlighting the significance of integrating digital cultural media at both levels. Various instructional design models, such as ADDIE, Borg and Gall, and Four-D (4D) were employed. At the same time, evaluation methods ranged from questionnaires to performance tests, providing insights into digital resource efficacy and usability. Overall, the review underscores the potential of integrating digital cultural media in Indonesian mathematics education. By utilizing innovative pedagogical approaches and technology, educators can create engaging, culturally relevant learning experiences, fostering a deeper understanding and appreciation of mathematics among students.
Feasibility of using Continuous Positive Airway Pressureviathe ‘LeVe CPAP System’ among Children with Acute Hypoxaemic Respiratory Failure at Mengo Hospital Kampala Uganda: A Mixed Methods study
Authors: Namulema Edith , Davis Birch William , Nakiriba Mayega Rhoda , Namugga Barbara , Musasizi Racheal , Tumwesigye Ambrose , Littlejohns Anna , Please Helen , Sharma Vishal , Cunningham Alice , Waters Ian , Brettle David , Parmar Jiten D , Miller Roy , Beacon Tim , Murdoch Stuart , Culmer Peter , Kapur Nikil , Winton Mark , Lawton Tom
Published: January 2025

Continuous positive airway pressure (CPAP) is a well-established treatment modality for children in moderate and severe respiratory failure in well-resourced settings. However, the availability of CPAP is generally poor in many resource-limited settings, in large part because existing CPAP devices are not designed for cost and resource efficiency, which precludes their use. The LeVe CPAP System has been co-developed by an international multidisciplinary team specifically for use in low resource settings. In this paper we report the first study evaluating the efficacy of using the LeVe CPAP System as an intervention for children with Acute Hypoxaemic Respiratory Failure at Mengo Hospital in Kampala, Uganda.

A total of 42 paediatric patients were recruited onto the study, all of whom were failing to maintain oxygen saturation above 88% at room conditions. Key clinical measures including oxygen saturation, heart rate, respiratory rate, and dyspnoea were recorded every hour for the length of admission on the paediatric ward. At completion, 39 patients had recovered and were successfully discharged while 3/42 (7%) died in the early phases of treatment. Surviving patients showed improvements in all clinical measures, particularly in the first 12 h of treatment, and no adverse effects were reported after continued use. Additionally, we interviewed five parents whose children were undergoing treatment to gain a qualitative assessment of perceptions to the LeVe CPAP system.

Outcomes of the study demonstrate the capability of the LeVe CPAP system to treat paediatric patients in respiratory failure and support the system's wider adoption in low resource settings.
Factors contributing to anxiety in adolescents surviving thalassemia major in Indonesia
Authors: Mediani Henny Suzana , Fuadah Novitasari Tsamrotul
Published: January 2025

Background

Thalassemia major is a significant public health concern, passed from parents to children, which can be mitigated through screening programs. Inconsistencies in blood transfusions and iron chelation therapy result in physical changes that can cause psychological problems, with anxiety being the most prominent. This study aimed to examine the factors influencing anxiety levels among adolescent thalassemia major survivors.

Methods

The research utilized a quantitative approach with a correlational analytic design and cross-sectional method. It included a population of 122 adolescent survivors, all of whom were included using a total sampling technique. Data analysis involved univariate analysis by frequency distribution, bivariate analysis using the chi-square test, and multivariate analysis with logistic regression.

Results

The findings of the study showed that adolescent thalassemia survivors experienced varying levels of anxiety: mild anxiety in 70.5%, moderate anxiety in 9.8%, and severe anxiety in 19.7%. Significant associations were observed between anxiety levels and factors such as body image (p < 0.001), self-esteem, and coping strategies, while social support did not show a significant relationship. Body image was identified as the most impactful factor, with poor body image raising the risk of severe anxiety by 11.6 times.

Conclusions

Anxiety is common among adolescent thalassemia survivors, with body image, self-esteem, and coping skills being key factors. Poor body image notably increases the risk of severe anxiety, emphasizing the need for psychological support focused on body image, self-esteem, and coping strategies to improve mental health in this group.
Strategies and resources used by public health units to encourage COVID-19 vaccination among priority groups: a behavioural science-informed review of three urban centres in Canada
Authors: Langmuir Tori , Wilson Mackenzie , McCleary Nicola , Patey Andrea M. , Mekki Karim , Ghazal Hanan , Estey Noad Elizabeth , Buchan Judy , Dubey Vinita , Galley Jana , Gibson Emily , Fontaine Guillaume , Smith Maureen , Alghamyan Amjad , Thompson Kimberly , Crawshaw Jacob , Grimshaw Jeremy M. , Arnason Trevor , Brehaut Jamie , Michie Susan , Brouwers Melissa , Presseau Justin
Published: January 2025

Background

Ensuring widespread COVID-19 vaccine uptake is a public health priority in Canada and globally, particularly within communities that exhibit lower uptake rates and are at a higher risk of infection. Public health units (PHUs) have leveraged many resources to promote the uptake of recommended COVID-19 vaccine doses. Understanding barriers and facilitators to vaccine uptake, and which strategies/resources have been used to address them to date, may help identify areas where further support could be provided. We sought to identify the strategies/resources used by PHUs to promote the uptake of the first and third doses of the COVID-19 vaccine among priority groups in their jurisdictions. We examined the alignment of these existing strategies/resources with behavioral science principles, to inform potential complementary strategies/resources.

Methods

We reviewed the online and in-person strategies/resources used by three PHUs in Ontario, Canada to promote COVID-19 vaccine uptake among priority groups (Black and Eastern European populations, and/or neighbourhoods with low vaccine uptake or socioeconomic status). Strategies/resources were identified from PHU websites, social media, and PHU liaison. We used the Behaviour Change Techniques (BCT) Taxonomy – which describes 93 different ways of supporting behaviour change – to categorise the types of strategies/resources used, and the Theoretical Domains Framework – which synthesises 14 factors that can be barriers or facilitators to decisions and actions – to categorise the barriers and facilitators addressed by strategies/resources.

Results

PHUs operationalised 21 out of 93 BCTs, ranging from 15 to 20 BCTs per PHU. The most frequently operationalised BCTs were found in strategies/resources that provided information about COVID-19 infection and vaccines, increased access to COVID-19 vaccination, and integrated social supports such as community ambassadors and engagement sessions with healthcare professionals. Identified BCTs aligned most frequently with addressing barriers and facilitators related to Knowledge, Environmental context and resources, and Beliefs about consequences domains.

Conclusion

PHUs have used several BCTs to address different barriers and facilitators to COVID-19 vaccine uptake for priority groups. Opportunities should be pursued to broaden the scope of BCTs used (e.g., operationalizing the pros and cons BCT) and barriers/facilitators addressed in strategies/resources for ongoing and future COVID-19 vaccine uptake efforts among general and prioritised populations.
Exploring the hidden synergy between system thinking and patient safety competencies among critical care nurses: a cross-sectional study
Authors: Atalla Amal Diab Ghanem , Bahr Rwan Ragab Rabea , El-Sayed Ahmed Abdelwahab Ibrahim
Published: January 2025

Background

Patient safety remains a global priority, with nurses playing a crucial role in minimizing errors and improving patient outcomes. System thinking, which involves understanding how various components of a healthcare system interact, is increasingly recognized as essential for enhancing patient safety competencies.

Aim

This study investigates the impact of systems thinking on patient safety competencies among nurses in critical care units, exploring the relationship between systems thinking and various subdomains of patient safety competencies.

Methods

A cross-sectional study was conducted at all critical care units of Alexandria Main University Hospital, Egypt. Data were collected from a convenience sample of 289 nurses using the system thinking scale and the patient safety competency self-evaluation questionnaire. Correlation and regression analyses were performed to examine the relationship between systems thinking and patient safety competencies, controlling for demographic factors such as age, qualifications, and years of experience.

Results

Nurses demonstrated moderate to high levels of systems thinking (mean = 82.36 ± 12.14) and patient safety competencies (mean = 162.74 ± 23.56). Strong positive correlations were found between systems thinking and patient safety competencies (r = 0.605, p < 0.05), particularly in areas such as error reporting, communication, and infection prevention. Regression analysis revealed that systems thinking significantly predicted patient safety competencies, increasing the explained variance from 58.8 to 67.7%.

Conclusion

The findings highlight the critical role of systems thinking in enhancing nurses’ patient safety competencies. Nurses with higher systems thinking skills are better equipped to prevent errors and improve communication, ultimately enhancing patient care quality.

Implications

Nursing schools should integrate system thinking into nursing curricula to prepare future nurses for complex healthcare environments. Healthcare organizations should incorporate system thinking into professional development programs to enhance the competencies of practicing nurses. Nurse managers can foster a culture of safety by promoting interdisciplinary collaboration and reflective practice. Broader adoption of system thinking can improve patient outcomes, especially in resource-constrained environments.

Clinical trial number

Not applicable.
Evidence to practice – lessons learnt in developing an implementation strategy for an online digital health intervention (Eczema Care Online)
Authors: Howells Laura , Thomas Kim S. , Santer Miriam , Muller Ingrid , Greenwell Kate , Roberts Amanda , Williams Hywel C. , Harvey Jane , Lax Stephanie J. , Rogers Natasha K. , Sach Tracey H. , Lawton Sandra , Steele Mary , Sivyer Katy , Hooper Julie , Ahmed Amina , Wilczynska Sylvia , Langan Sinead , Leighton Paul
Published: January 2025

Background

Eczema Care Online (www.EczemaCareOnline.org.uk/) is an online self-management toolkit which includes tailored content for young people (13–25 years) and for parents of children that have eczema (0–12 years). Testing in two randomised controlled trials has shown that it is easy to use, cost effective and offers a sustained improvement in eczema symptoms.

Implementing Eczema Care Online outside of a funded research study and ensuring that it reaches those that will most benefit from is now a key challenge. This paper describes the lessons learnt from developing and delivering an implementation strategy.

Methods

Data from systematic reviews, stakeholder consultation meetings, interviews with trial participants, intervention usage data during the trial, and existing eczema information websites informed our implementation plan. Using Normalisation Process Theory, an implementation plan combined these findings with practical, context-specific actions to encourage wider adoption of the intervention.

Results

Data was successfully mapped to the four constructs of Normalisation Process Theory, and factors and processes that encourage implementation identified. These include: promoting how Eczema Care Online is different to other sources of information; aligning to and embedding in existing eczema resources (from charities and healthcare providers); simplifying aspects to aid ease of use; and, highlighting evidence that shows that Eczema Care Online works.

Key lessons in developing an implementation strategy include 1) start implementation work early 2) maintain flexibility to explore multiple routes to implementation 3) use secondary data sources 4) balance theory with practicalities 5) consider longer-term maintenance beyond the life of the research project.

Conclusion

Implementation planning is a key stage of the research process that is often not adequately resourced. Implementation planning ensures effective interventions developed and evaluated in research studies are utilised in everyday practice.
Experimental hypothermia by cold air: a randomized, double-blind, placebo-controlled crossover trial
Authors: Helland Ane M. , Mydske Sigurd , Assmus Jörg , Brattebø Guttorm , Wiggen Øystein , Kvidaland Haakon K. , Thomassen Øyvind
Published: January 2025

Background

Accidental hypothermia is associated with high morbidity and mortality. Research on treatment strategies for accidental hypothermia is complicated by the low incidence and heterogeneous patient population. We have developed a new method for clinical trials of experimental hypothermia, to enable further studies of active rewarming. If cold ambient air is effective as a cooling method, this would mimic the most frequent clinical setting of hypothermic patients and provide a feasible cooling method for field studies. We aimed to induce mild hypothermia in healthy volunteers by exposure to cold ambient air, and tested the hypothesis that drug-induced suppression of endogenous thermoregulation would be required.

Methods

In a randomized, double-blind, crossover design, 15 healthy volunteers wearing wet clothes were put in a windy climate chamber set to 5 °C. Each participant completed the experimental procedure twice, once receiving active drugs (meperidine and buspirone) and once receiving placebo. The experiments were separated by a one-week wash-out period. Primary outcome was core temperature at termination, defined as 3 h of exposure or 35 °C. The between-groups difference was assessed using analysis of covariance (ANCOVA) with left censoring (Tobit model) and individual random intercept. Secondary outcomes were trajectory of core temperature and reduction of shivering.

Results

At termination, the active drug vs placebo group differed in temperature by 1.4 °C. With adjustment for the removal of participants reaching 35 °C, the estimated mean difference was 1.7 °C (1.4–2.0, p < 0.001). Shivering was effectively reduced, but not completely inhibited by the drug regimen, and core temperature declined at a rate of − 0.82 °C per hour.

Conclusion

The novel protocol utilizing cold air as a cooling method and drug-induced suppression of endogenous thermoregulation, is effective and enables future research projects. We have provided suggestions for minor alterations.

Trial registration:

EudraCT ID 2023–506020-81–00.
Midgut immune profiling and functional characterization of Aedes aegypti ABC transporter gene(s) using systemic and local bacterial challenges
Authors: Kumar Vikas , Garg Shilpi , Sisodia Diksha , Gupta Lalita , Kumar Sanjeev , Saxena Vishal
Published: January 2025

Background

The mosquito midgut is crucial for digestion and immune interactions. It produces several immune factors that protect the organ from invading pathogens and can limit their propagation. Studies on mosquito midgut transcriptome following pathogen exposure have revealed the presence of non-canonical immune genes, such as ABC transporters, whose function in insect immunity remains unexplored. Therefore, this study focuses on identifying and characterising the immune role of ABC transporters in the midgut of Aedes aegypti, a primary arboviral vector.

Methods

To identify the midgut-expressed ABC transporters, the mosquitoes were challenged with a mixture of gram-negative (Escherichia coli) and gram-positive (Micrococcus luteus) bacteria, and the expression of all ABC transporters was analysed with PCR using gene-specific primers. Furthermore, the transcriptional alterations of midgut ABC transporters were explored at different time points upon a thoracic nano-injection (systemic challenge) or infectious blood meal (local challenge) of the bacterial mixture through quantitative real-time PCR (qPCR), and one gene was selected for RNAi-mediated gene silencing and its role assessment in midgut immune responses.

Results

The expression of all 48 microbial-induced midgut-expressing Ae. aegypti ABC transporter genes upon systemic or local bacterial challenges was analyzed. Based on the transcriptomic data and potential immune expression similar to the well-known immune gene defensin, AaeABCG3 was selected for RNAi-mediated gene silencing and characterization. The AaeABCG3 gene silencing exhibited a significant reduction of midgut bacterial load through the induction of nitric oxide synthase (NOS) in sugar-fed and systemic bacterial-challenged mosquitoes. In contrast, midgut bacterial load was significantly regulated by induction of defensin A and cecropin G in the late hours of local bacterial challenges in AaeABCG3-silenced mosquitoes.

Conclusions

The silencing of AaeABCG3 modulated the mosquito midgut immune response and disturbed the midgut microbiota homeostasis. The systemic immune responses of AaeABCG3-silenced mosquitoes were influenced by the JAK-STAT pathway with no induction of Toll and IMD immune pathways. Interestingly, Toll and IMD immune pathways actively participated in the late hours of local bacterial challenges, suggesting that the route of infection influences these immune responses; however, the molecular mechanism behind these phenomena still needs to be explored. Overall, this work provides significant insight into the importance of ABC transporters in mosquito immunity.

Graphical Abstract
Destabilization of mutualistic interactions shapes the early heat stress response of the coral holobiont
Authors: Marangon Emma , Rädecker Nils , Li Joan Y. Q. , Terzin Marko , Buerger Patrick , Webster Nicole S. , Bourne David G. , Laffy Patrick W.
Published: January 2025

Background

The stability of the symbiotic relationship between coral and their dinoflagellate algae (Symbiodiniaceae) is disrupted by ocean warming. Although the coral thermal response depends on the complex interactions between host, Symbiodiniaceae and prokaryotes, the mechanisms underlying the initial destabilization of these symbioses are poorly understood.

Results

In a 2-month manipulative experiment, we exposed the coral Porites lutea to gradually increasing temperatures corresponding to 0–8 degree heating weeks (DHW) and assessed the response of the coral holobiont using coral and Symbiodiniaceae transcriptomics, microbial 16S rRNA gene sequencing and physiological measurements. From early stages of heat stress (< 1 DHW), the increase in metabolic turnover shifted the holobiont to a net heterotrophic state in which algal-derived nutrients were insufficient to meet host energy demands, resulting in reduced holobiont performance at 1 DHW. We postulate the altered nutrient cycling also affected the coral-associated microbial community, with the relative abundance of Endozoicomonas bacteria declining under increasing heat stress. Integration of holobiont stress responses correlated this decline to an increase in expression of a host ADP-ribosylation factor, suggesting that Symbiodiniaceae and Endozoicomonas may underlie similar endosymbiotic regulatory processes.

Conclusions

The thermotolerance of coral holobionts therefore is influenced by the nutritional status of its members and their interactions, and this identified metabolic interdependency highlights the importance of applying an integrative approach to guide coral reef conservation efforts.
Telehealth group intervention for adolescents and young adults with cancer: a feasibility pilot study protocol
Authors: Chan Sherilynn F. , Patten Joanna , Lau Nancy
Published: January 2025

Background

Providing opportunities for social interaction and access to psychosocial interventions are 2 of the 15 Standards for Psychosocial Care for Children with Cancer and Their Families. Peer relationships are especially important among adolescents and young adults (AYAs), and cancer disrupts this aspect of social development. Many AYAs with cancer report a desire to engage in peer support groups; however, this remains a critical unmet need. Telehealth is a cost-effective and increasingly common modality for delivering health care that reduces access barriers and may be an especially good fit for AYAs with cancer. Little work has evaluated the feasibility and acceptability of peer support groups for AYAs with cancer. The purpose of this study is to evaluate the feasibility and acceptability of a telehealth peer support group intervention for AYAs with cancer.

Methods

Telehealth group interventions are offered twice yearly as standard of care at Seattle Children’s Hospital to AYAs on or off treatment for cancer or a brain tumor. Group members are assigned to a High School Group (grades 9–12) or an AYA Group (spring of grade 12 or older). Aim 1 is to determine the feasibility and acceptability of the intervention for all patients who participate in groups in their clinical care. Feasibility will be assessed based on a priori metrics (enrollment, attendance, attrition) for all group members. Group and telehealth acceptability will be assessed by a 16-item internally developed measure that was adapted from the Client Satisfaction Questionnaire. Aim 2 is to conduct patient stakeholder semi-structured interviews post-intervention with 20 AYAs to gather feedback and inform intervention refinement. Participants who opt-in for study procedures will also complete exploratory measures of social connectedness/isolation, depression, and benefit finding, pre- and post-intervention (Aim 3).

Discussion

Findings from this pilot study will inform intervention refinement, intervention implementation, and sample sizes for future powered trials. This study will provide preliminary empirical evidence to support the development of effective group interventions for AYAs with cancer that increase opportunities for social interaction and access to peer support, with the potential to contribute to improved psychosocial care of AYAs with cancer.
Medical negligence claims against Indian neurosurgeons and neurologists—A records review of National Consumer Dispute Redressal Commission (NCDRC) judgments
Authors: Sethi Aakash Ashishkumar , Laha Gayatri Suvro , Shringarpure Kalpita Samrat
Published: January 2025

Background

As a specialty that frequently treats acute pathology and refractory pain, neurosurgery is at risk for medical negligence suits. In India, patients alleging medical negligence can seek compensation by approaching the “National Consumer Dispute Redressal Commission [NCDRC].” We aim to analyze NCDRC judgments against neurologists/surgeons based on the type of doctor (neurologist or neurosurgeon) implicated; neurological illnesses and interventions performed that frequently gave rise to negligence claims and the steps that the doctors can take to protect themselves.

Methodology

This is a retrospective records review. The judgments were accessed from https://www.scconline.com/.

Judgment’s body having the words “Medical,” “Negligence,” “neurosurgeon,” “neurosurgery,” etc., were included. Mann Whitney and chi-square test were used as tests of significance.

Results

Thirty-five judgments met the inclusion criteria. The majority of the cases were against neurosurgeons (23, 65%). The doctor’s specialty (neurosurgeon vs neurologist) (p = 0.28) had no bearing on the outcome of the case (doctor winning or losing). Significantly higher compensation was not awarded based on doctor’s specialty (U value = 20.5, p = 0.2). Spondylolisthesis (4, 11.4%) was the most common condition for which a patient was operated on by the neurosurgeon.

Conclusion

We found that the neurosurgeon was more commonly implicated in negligence cases as compared to neurologists. Meningioma and spondylolisthesis were the common Neurological illnesses that gave rise to negligence claims in India.

Neurosurgeons can protect themselves by prompt postsurgical radiological tests when postoperative complications are suspected (Vijay Dutt v. Nagpal) and avoid expediting non-urgent surgeries solely at the request of the patient (Raj Hospital Vs Mahesh Varma).
A novel ViT-BILSTM model for physical activity intensity classification in adults using gravity-based acceleration
Authors: Wang Lin , Luo Zizhang , Zhang Tianle
Published: January 2025

Aim

The aim of this study is to apply a novel hybrid framework incorporating a Vision Transformer (ViT) and bidirectional long short-term memory (Bi-LSTM) model for classifying physical activity intensity (PAI) in adults using gravity-based acceleration. Additionally, it further investigates how PAI and temporal window (TW) impacts the model’ s accuracy.

Method

This research used the Capture-24 dataset, consisting of raw accelerometer data from 151 participants aged 18 to 91. Gravity-based acceleration was utilised to generate images encoding various PAIs. These images were subsequently analysed using the ViT-BiLSTM model, with results presented in confusion matrices and compared with baseline models. The model’s robustness was evaluated through temporal stability testing and examination of accuracy and loss curves.

Result

The ViT-BiLSTM model excelled in PAI classification task, achieving an overall accuracy of 98.5% ± 1.48% across five TWs-98.7% for 1s, 98.1% for 5s, 98.2% for 10s, 99% for 15s, and 98.65% for 30s of TW. The model consistently exhibited superior accuracy in predicting sedentary (98.9% ± 1%) compared to light physical activity (98.2% ± 2%) and moderate-to-vigorous physical activity (98.2% ± 3%). ANOVA showed no significant accuracy variation across PAIs (F = 2.18, p = 0.13) and TW (F = 0.52, p = 0.72). Accuracy and loss curves show the model consistently improves its performance across epochs, demonstrating its excellent robustness.

Conclusion

This study demonstrates the ViT-BiLSTM model’s efficacy in classifying PAI using gravity-based acceleration, with performance remaining consistent across diverse TWs and intensities. However, PAI and TW could result in slight variations in the model’s performance. Future research should concern and investigate the impact of gravity-based acceleration on PAI thresholds, which may influence model’s robustness and reliability.
Sorbitol induces flavonoid accumulation as a secondary signal via the nanoencapsulated SPc/lncRNA809-MmNAC17 module against Alternaria alternata in Malus micromalus
Authors: Du Tingting , Meng Dong , Cao Hongyan , Lian Yi , Wu Rui , Liu Tengyue , Wang Tianyi , Qin Cai , Song Zhihua , Dong Biying , Fu Yujie , Yang Qing
Published: January 2025

Sorbitol is an important primary metabolite that serves as both a carbon source and signal to pathogens. The leaf diseases caused by Alternata alternata are particularly serious in crabapple (Malus micromalus). Here, we found that sorbitol can enhance the resistance of crabapple to A. alternata R1 by increasing the content of flavonoid catechin. Nanomaterials as an emerging technology tool can efficiently deliver lncRNA to target cells. Here, we found nanoencapsulated lncRNA809 (SPc/lncRNA809) exhibits significant resistance to R1strain. To elucidate the effect of SPc/lncRNA809 on flavonoids catechin synthesis, we observed the expression of lncRNA809 was consistent with that of MmNAC17 which regulates the synthesis of catechin and both could jointly respond to sorbitol. MmNAC17 induced the accumulation of catechin in vivo by directly activating the expression of catechin synthase genes MmF3H and MmLAR. Correspondingly, overexpression of lncRNA809 significantly upregulated the expression of MmNAC17 and enhanced the disease resistance. This study reveals for the first time that sorbitol positively regulates the expression of MmNAC17 through lncRNA809, promoting the accumulation of catechin via the expression of MmF3H and MmLAR, ultimately improving the defense response of M. micromalus. This research provides a crucial foundation for the establishment and application of sorbitol-based signaling regulatory networks.
Optimization and experimental validation of a high-efficiency oil–water cyclone separator for well testing conditions
Authors: Li Zhimin
Published: January 2025

The performance of surface oil–water cyclone separators impacts the measurement accuracy of crude oil produced from exploration and appraisal wells, thereby influencing the formulation of exploration and development plans. To obtain the optimal structural configuration for cyclone oil–water separators, this study optimizes the design of a high-efficiency oil–water cyclone separator suitable for special conditions in well testing. A numerical simulation was performed using the discrete phase model to analyze the three-dimensional turbulent swirl field of the oil–water phases within the separator. Separation efficiency and pressure drop were used as evaluation criteria. The Plackett–Burman experimental method was employed to evaluate six factors affecting separation performance, with oil outlet diameter and cyclone chamber cone angle identified as significant factors. Mathematical models for separation efficiency and pressure drop were developed based on these factors. The central composite design method was then applied to investigate the interactive effects of oil outlet diameter and cyclone chamber cone angle on separation efficiency and pressure drop. The optimal parameter combination was determined: oil outlet diameter of 4.241 mm and cyclone chamber cone angle of 9.622°. The predicted separation efficiency was 93.870%, and the predicted pressure drop was 48.287 kPa. Field tests of the optimized cyclone separator verified the rationality of these optimized parameters, achieving a separation efficiency of 92.9%. This research offers a foundation for optimizing the design of oil–water cyclone separators.
Quantitation of Plasma Proteins to Predict Taxane-Induced Peripheral Neuropathy
Authors: Nguyen-Hoang Nam , Liu Yaping , Henry N. Lynn , Pai Manjunath P. , Zhu Hao-Jie , Hertz Daniel L.
Published: January 2025

PURPOSE

Taxane-induced peripheral neuropathy (TIPN) is a dose-limiting toxicity of paclitaxel in patients with cancer. TIPN prediction is challenging although patients with higher systemic paclitaxel exposure have higher TIPN risk. This study aimed to identify protein predictors of TIPN and paclitaxel pharmacokinetics (PK).

METHODS

This is a retrospective analysis of a prospective study of females with early-stage breast cancer receiving weekly paclitaxel. TIPN was assessed using the sensory subscale of the European Organisation for Research and Treatment of Cancer QLQ-Chemotherapy-Induced Peripheral Neuropathy (CIPN)20 (CIPN8). A blood sample was collected within 10 minutes before the end of the first paclitaxel infusion to measure plasma proteins using liquid chromatography-mass spectrometry and to estimate maximum systemic paclitaxel concentration (
C
max
). A second sample was collected approximately 24 hours after the first infusion to estimate paclitaxel time above threshold (
T

c
>0.05

). Linear mixed-effect and regression models were used to identify proteins predictive of TIPN and paclitaxel PK parameters, respectively, using a Bonferroni-adjusted α = .0006.

RESULTS

Data from 36 participants were included in the analysis testing associations of 83 proteins with TIPN or PK. Higher levels of complement C3 were associated with more severe TIPN trajectories (
P
= .0002). No proteins were associated with either
C
max
or
T

c
>0.05

(all
P
> .0006).

CONCLUSION

Complement C3 concentration at the end of initial paclitaxel infusion may be useful for identifying patients with breast cancer and potentially other tumor types who could benefit from TIPN prevention strategies to improve long-term treatment outcomes.
Preoperative Psychological Factors, Postoperative Pain Scores, and Development of Posttraumatic Stress Disorder Symptoms After Pediatric Anterior Cruciate Ligament Reconstruction
Authors: Sadacharam Kesavan , Uhl Kristen , Kelleher Stephen , Ungar Galit Kastner , Staffa Steven , Cravero Joseph , Bradley James , Milewski Matthew D. , Lau Brian , Muhly Wallis T. ,   on behalf of SPAIN-ACL Investigators
Published: January 2025

BACKGROUND:

Acute orthopedic injuries and subsequent surgical repair can be challenging for children and adolescents and result in posttraumatic stress reactions that can be problematic after the acute perioperative period. In a cohort of patients undergoing anterior cruciate ligament reconstruction (ACLR), we investigated the incidence and explored risk factors associated with the development of posttraumatic stress disorder (PTSD) symptoms after surgery.

METHODS:

We analyzed data from a multicenter, prospective, observational registry of pediatric patients undergoing ACLR. Patient data included demographic, psychological assessments, postoperative pain measures, and a posttraumatic stress disorder assessment (Child PTSD Symptom Scale [CPSS]) collected after the operation. An analysis of patients who provided survey data at 6 months was used to determine the incidence of posttraumatic stress reactions and to explore associated risk factors.

RESULTS:

A total of 519 patients were enrolled in a prospective observational study of outcomes after ACLR. A cohort of 226 patients (44%) provided completed data collection and CPSS follow-up surveys at 6 months. We found that 17 of the patients (7.5%) met the criteria for PTSD at 6 months which represents 3.3% of our total study population (17/519). A univariate analysis suggested that a negative (P = .017), excitable (P = .039), or inhibitory (P = .043) temperament compared to a positive temperament, high preoperative scores for anxiety (P = .001) or depression (P = .019) and high pain scores on postoperative day (POD)1 (P = .02) increased the odds of PTSD at 6 months. A multivariable model revealed that patients self-reporting symptoms consistent with clinical anxiety/depression preoperatively and patients with a max pain score ≥7 on POD1 were 29 times (P = .018) and 9.8 times (P = .018) more likely to develop PTSD at 6 months.

CONCLUSIONS:

A portion of patients undergoing ACLR are at risk for the development of symptoms consistent with PTSD. Risk factors include preoperative anxiety or depression and high postoperative pain scores. Interventions designed to address preoperative risk factors and optimization of postoperative pain may represent opportunities to improve outcomes in this patient population.
The Childbearing of Immigrants Who Arrived as Children: Understanding the Role of Age at Arrival for Women and Men
Authors: Wilson Ben
Published: January 2025

It is well-known that childbearing is associated with age at migration, but most research has focused on foreign-born women who migrated as adults. Much less is known about male immigrants or immigrants who arrived as children, despite the importance of studying these groups to understand theories of adaptation and socialization. This study addresses these gaps with a case study of Sweden, using longitudinal whole-population data to analyze the role of age at arrival in determining childbearing. The results suggest that age at arrival affects fertility across the childbearing life course, although there is little evidence of critical ages at arrival. These results hold for women and men, particularly for immigrants from higher fertility origins, with more ambiguous results for immigrants from lower fertility origins. The main findings also persist after examining sources of selection and reverse causality using sex-specific family fixed-effects models and separate analyses for specific countries of birth. Therefore, the study provides evidence of an underlying process of childhood socialization, followed by adaptation, that is common for women and men who migrate. Theoretical implications are discussed, including the need for further work on the determinants and mechanisms of adaptation.
IA generativa versus profesores: reflexiones desde una revisión de la literatura
Authors: Chiappe Andres , Sanmiguel Carolina , Sáez Delgado Fabiola Mabel
Published: January 2025

La creciente integración educativa de la inteligencia artificial está reconfigurando la educación superior, especialmente a través del uso de chatbots y modelos de lenguaje generativo. Este artículo realiza una revisión de la literatura, aplicando las directrices PRISMA a 155 artículos revisados por pares, para examinar las ventajas, limitaciones y aplicaciones pedagógicas de la IA en comparación con la enseñanza humana. Se identificaron tres principales escenarios de impacto en las prácticas educativas: a) Pérdida de ciertos aspectos tradicionales de la enseñanza, como la transmisión exclusiva de información y tareas de reporte, b) Transformación de roles, incluyendo el control sobre contenidos educativos y el contrato didáctico, c) Emergencia de nuevos elementos, como la personalización del aprendizaje y enfoques innovadores en la evaluación. A pesar de su potencial para automatizar procesos y ahorrar tiempo, los chatbots no replican cualidades humanas esenciales como la empatía y la adaptabilidad. Por ello, su integración óptima requiere análisis pedagógicos profundos que equilibren innovación y efectividad educativa. Este trabajo es valioso para investigadores, docentes y diseñadores educativos interesados en entender cómo aprovechar la IA sin comprometer la calidad de la enseñanza. Representa un paso crucial hacia estrategias de incorporación de IA basadas en principios pedagógicos sólidos.
Phubbing: edad y presencia en línea como condiciones necesarias [Phubbing
Authors: Matas-Terrón Antonio
Published: January 2025

El phubbing, el acto de ignorar a alguien en favor del teléfono móvil, se ha convertido en un problema social prevalente en la era digital actual. Este estudio tiene como objetivo identificar las condiciones necesarias para el comportamiento de phubbing, centrándose en los factores asociados establecidos por Schneider y Hitsfeld (2021). Utilizando datos de su encuesta, se analizó una muestra de 278 participantes, en su mayoría mujeres (74%), con una edad promedio de 26.78 años. La metodología empleada fue el Análisis de Condición Necesaria (NCA). Los resultados revelaron que una edad menor es un factor significativo en los niveles más altos de auto-phubbing. En concreto, el estudio encontró que en contextos de elevado auto-phubbing, la juventud era un determinante crítico. Además, estar Permanentemente Conectado en Línea surgió como un factor clave en el auto-phubbing, especialmente en niveles altos, lo que sugiere una dependencia creciente de estar constantemente conectado. El estudio concluye que otras variables, como el Miedo a Perderse Algo y las Normas de Uso del Teléfono Móvil, no parecen ser condiciones necesarias para el phubbing. Estos hallazgos subrayan la naturaleza multifacética del phubbing y destacan la importancia del NCA en la identificación de las condiciones esenciales que contribuyen a este comportamiento.
CONSTRUCCIÓN Y VALIDACIÓN DE RÚBRICAS PARA VALORAR LA IDONEIDAD DIDÁCTICA DE CLASES DE MATEMÁTICA
Authors: Figueroa María Virginia , Malet Omar
Published: January 2025

En este artículo se describe la construcción y validación de rúbricas destinadas a sistematizar información para valorar la idoneidad didáctica de un proceso de instrucción matemática en sus seis facetas. Para la construcción se tomaron como base los indicadores de idoneidad que propone Juan D. Godino, precursor del Enfoque Ontosemiótico de la Instrucción Matemática (EOS), a los que se les asociaron cuatro niveles de logro; a cada uno de los niveles se le hizo corresponder un puntaje, habilitando el tratamiento cuantitativo de los indicadores y de las distintas facetas de idoneidad. La confiabilidad de equivalencia de los instrumentos fue evaluada a través de la técnica test-retest y el cálculo del coeficiente kappa de Cohen; la validez de contenido de los niveles propuestos para cada uno de los indicadores fue evaluada mediante el criterio de jueces expertos y el cálculo de la V de Aiken.
Retention or Acquisition? Behavior-Based Quality Disclosure
Authors: Zhang Jianqiang , Li Krista J.
Published: January 2025

Firms frequently extend their brand by introducing products in new categories and offering free samples or demonstrations for customers to learn about the quality of the new products before purchasing. When introducing new products based on customers’ purchase behavior in the former category, firms face two customer segments: their own customers and the competitor’s customers. Firms can practice behavior-based pricing (BBP) by charging different prices in the two segments. Moreover, firms can practice behavior-based quality disclosure (BBD) by disclosing quality information to the two customer segments differently. In this paper, we examine how firms practice BBD in addition to BBP. We find that in contrast to the acquisition-focused BBP, firms perform retention-focused BBD by increasing quality disclosure to their own customers and decreasing it to the competitor’s customers. Unlike BBP, which decreases second-period profit and increases first-period profit, BBD increases second-period profit but decreases first-period profit when the disclosure cost is low. We also show that when firms endogenously choose BBD, the equilibrium is a prisoner’s dilemma when the disclosure cost is low and a win-win outcome when the disclosure cost is high.

This paper was accepted by Raphael Thomadsen, marketing.

Funding: This research was supported by the National Natural Science Foundation of China [Grant 72171103] and the Blanche “Peg” Philpott Professorship.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2022.01081 .