bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of cleft palate type and manufacturing method on feeding plate adaptation: A volumetric micro‐computed tomography analysis
Authors: Akıncı Osman , Oğuz Ece İrem , Bozkurt Poyzan , Kadıoğlu Merve Berika , Ocak Mert , Orhan Kaan , Kişnişçi Reha Şükrü
Published: January 2025

Purpose

Feeding plates for cleft palate patients have been used by clinicians for many years to temporarily close the oro‐nasal communication until definitive treatment with surgical techniques. The current in vitro study aimed to evaluate the adaptation of the feeding plates manufactured by two different techniques for three cleft types.

Materials and Methods

Feeding plates were manufactured with conventional compression molding (CM) and 3‐dimensional (3D) additive manufacturing on main models representing bilateral cleft, unilateral right, and unilateral left cleft types (n = 10). The 3D volumetric space between the feeding plate and the corresponding main model was measured by micro‐CT to evaluate the adaptation. The adaptation of the plates was assessed based on three different measurement regions: anterior, left, and right. Repeated measure analysis of variance (ANOVA), three factorial ANOVA, and post hoc Bonferroni tests were used as statistical analysis (α = 0.05).

Results

CM groups showed higher volumetric space measurements between the base and master model than 3D groups regardless of measurement region and cleft type, which refers to misfit (p ˂ 0.05). Cleft type differed in the adaptation of 3D groups yet not in CM groups (p ˂ 0.05). The volumetric space evaluation for the right measurement region resulted in higher values regardless of manufacturing method and cleft type (p ˂ 0.05).

Conclusion

Considering that 3D‐printed feeding plates showed better adaptation compared to conventionally manufactured plates for all cleft types, 3D printing can be suggested as the manufacturing method of choice for feeding plates.
The asymmetry engine: how plants harness asymmetries to shape their bodies
Authors: Jonsson Kristoffer , Routier‐Kierzkowska Anne‐Lise , Bhalerao Rishikesh P.
Published: January 2025

Plant development depends on growth asymmetry to establish body plans and adapt to environmental stimuli. We explore how plants initiate, propagate, and regulate organ‐wide growth asymmetries. External cues, such as light and gravity, and internal signals, including stochastic cellular growth variability, drive these asymmetries. The plant hormone auxin orchestrates growth asymmetry through its distribution and transport. Mechanochemical feedback loops, exemplified by apical hook formation, further amplify growth asymmetries, illustrating the dynamic interplay between biochemical signals and physical forces. Growth asymmetry itself can serve as a continuous cue, influencing subsequent growth decisions. By examining specific cellular programs and their responses to asymmetric cues, we propose that the decision to either amplify or dampen these asymmetries is key to shaping plant organs.
Exploring child and youth understanding of loneliness through qualitative insights and evaluating loneliness measures considering those lived experiences
Authors: Qualter Pamela , Verity Lily , Walibhai Wahida , Fuhrmann Delia , Riddleston Laura , Alam Iqra , Conway Jasmine , Lau Jennifer Y. F.
Published: January 2025

The overall goal of this paper is to enhance the understanding and measurement of loneliness by identifying key experiential characteristics of loneliness in children and adolescents, and determine whether there is a need for refined assessment tools that accurately capture that experience. In Study 1, we synthesized the qualitative research on the child and youth experience of loneliness and found shared characteristics of loneliness, with some differences related to developmental changes (e.g., understanding of contexts influencing the experience of loneliness). In Study 2, we reviewed the items from loneliness questionnaires for children and youth and found they do not fully capture the affective dimension of loneliness, that is, the breadth of emotions associated with loneliness. That gap could lead to an incomplete understanding of the phenomenon, potentially undermining the validity of research findings and the effectiveness of interventions designed to alleviate loneliness because they underplay the distress of the experience for children and young people. Addressing this shortcoming should include the development and/or refinement of measurements of loneliness for children and youth, enhancing the accuracy and relevance of loneliness assessments.
The feasibility of using photovoice as a loneliness intervention with older Myanmar migrants
Authors: Akhter‐Khan Samia C. , Wongfu Chanyanut , Aein Nang Myat Pont , Lu Ben , Prina Matthew , Suwannaporn Sirinan , Mayston Rosie , Wai Khin Myo
Published: January 2025

Loneliness has detrimental physical and mental health outcomes. To date, there are few studies on loneliness interventions in lower‐resource settings. Based on participatory action research methods that are theoretically informed by the social relationship expectations framework, we developed a loneliness intervention called amanane using the photovoice method with older Myanmar migrants in northern Thailand. The aim of our study was to test the feasibility and preliminary effectiveness of photovoice as an intervention for lonely older adults. Over 6 weeks, we coproduced 5 weekly workshops, individual interviews, and a photo exhibition with an older Myanmar migrant cofacilitator and nine participants (57–82 years old). The workshops focused on older people's care provisions. The qualitative evaluation entailed group discussions, interviews, and videos. Results indicated a perfect completion rate and high acceptability. Participants reported a reduction in loneliness due to opening up to each other through photography, feeling united despite cultural differences, and feeling valued by visitors attending the photo exhibition. Overall, photovoice may be a promising intervention for lonely older adults and has the potential to be tested in larger trials across diverse settings.
Lesion Formation in Cardiac Pulsed‐Field Ablation: Acute to Chronic Cellular Level Changes
Authors: Garrott Kara , Bifulco Savannah , Ramirez David , Koop Brendan
Published: January 2025

As pulsed‐field ablation (PFA) emerges as a promising therapy for atrial arrhythmias, an understanding of the cellular injury to cardiac tissue is critical to evaluating and interpreting results for each PFA system. This review aims to detail the mechanism of cell death for PFA, compare the cell death mechanism to thermal ablation modalities, clarify common histology markers, detail the progression of PFA lesions from the acute, to subacute, to chronic maturation states, and discuss clinical indicators of PFA lesions.
Measuring scientific classroom discourse: The DiISC Version 2.0's validity and use in observing secondary science lessons
Authors: Lewis Elizabeth , Lucas Lyrica , Helding Brandon , Tankersley Amy , Hasseler Elizabeth , Rivero Ana , Baker Dale
Published: January 2025

To continue to support long‐term, ongoing science curriculum and instruction reform efforts in the United States, there is a significant need to be able to reliably measure teachers’ discourse‐rich, inquiry‐based instruction. In this external validation study, we present the Discourse in Inquiry Science Classrooms Version 2.0 (DiISC 2.0) as a valuable observational instrument for researchers to investigate multiple aspects of science teachers' lessons. The DiISC 2.0 is grounded in a researchbased conceptual framework of a scientific classroom discourse community, focused on fundamental socioconstructivist characteristics of lessons, including scientific inquiry, oral and written discourse, and academic language development. We collected and analyzed new data from 807 science lessons to develop and expand the instrument's original validity argument beyond the associated professional development program for broader use. We determined the DiISC's factor structure and examined its correlation with the Electronic Quality of Inquiry Protocol. Finally, some items that did not represent DiISC constructs were removed. Thus, the DiISC 2.0 instrument can be used to measure students’ opportunities to learn science and provide feedback to teachers on their progress toward building an inclusive scientific classroom discourse community for all students, in particular, historically marginalized groups and multilingual learners.
Assessing teacher candidate knowledge of the mathematical practices
Authors: Matney Gabriel , Roberts Audrey Conway , Bostic Jonathan , Roberts Thomas
Published: January 2025

The Standards for Mathematical Practice (SMPs; CCSSI, 2010) describe mathematical behaviors and habits that students should express during mathematics instruction. Teacher candidates should have knowledge about the SMPs and their implications for mathematical instruction. This study aims to share the validity evidence for interpretations of outcomes from the SMP‐Knowledge Assessment (KA) as a measure of teacher cadidates' knowledge related to the SMPs. Knowledge of the SMPs involves both mathematics content and a knowledge of students' behaviors as they engage with mathematics. The SMPs are an important part of teacher candidates growth in their knowledge for teaching. As such, teacher educators and researchers need robust ways of monitoring and measuring teacher candidates learning of growth in their knowledge of the SMPs. The SMP‐KA is an instrument to measure K‐12 teacher candidates' complex knowledge of the SMPs. The gathering of validity evidence with teacher candidates for the SMP‐KA followed validation standards (AERA, APA, & NCME, 2014). The results provide sufficient validity evidence to support the use of the SMP‐KA to assess teacher candidates' knowledge of the SMPs. We encourage other instrument developers to report validity evidence with the teacher candidate population.
STEM teachers' perceptions, familiarity, and support needs for integrating generative artificial intelligence in K‐12 education
Authors: Cheah Yin Hong , Kim Juhee
Published: January 2025

We applied a mixed‐method survey approach to explore STEM teachers' perceptions, familiarity, and the support needed for integrating generative artificial intelligence (GenAI) in K‐12 education. The study collected 48 responses from Idaho, USA, predominantly from White, female teachers servicing in rural schools. We analyzed data using both descriptive and inferential statistics, along with thematic and content analysis. The findings revealed diverse perceptions among STEM teachers regarding the impact of GenAI on education, with an almost equal split between those who viewed GenAI positively and those who viewed it negatively. Similarly, teachers' familiarity with GenAI integration varied widely, with over half lacking user experience. A significant positive correlation was found between teachers' perceptions of GenAI and their familiarity with its integration. Despite these varied views, there was a strong consensus among teachers on the importance of equipping students with AI‐related knowledge and skills. While professional development was identified as the most crucial support for GenAI integration, STEM teachers pointed to their own resistance and a lack of awareness among school leadership as major challenges to implementing GenAI‐focused professional development. The study discussed the implications for developing support systems that can better facilitate STEM teachers' GenAI integration.
Early‐Life Famine Experience and Households’ Diversity of Financial Asset Portfolio: Evidence From China
Authors: Xu Shulin , Yang Zhen
Published: January 2025

Objective

Based on imprinting theory, this study investigates the impact of famine experience on household portfolio diversification, focusing on the three core elements of imprint formation: sensitive period, environmental imprint, and lasting impact.

Method

Using data from the 2013–2019 China Household Finance Survey, we examine how early‐life famine experience affects household investment choices by applying ordinary least squares (OLS) and ordered probit models.

Results

We find that household heads who experienced famine during childhood tend to hold more stocks and other risky financial assets, leading to more diverse investment portfolios. Further, the impact of famine experience is greater in urban areas and for households with low levels of education and financial literacy. Mechanism analyses reveal that famine experience leads to risk aversion, which increases the diversity of household investments. However, the effect of famine experience weakens over time as the gap between experience and survey period grows.

Conclusion

The study offers new insights into how early‐life famine experience shapes household investment behaviors. The findings deepen our understanding of how psychological factors, rooted in early adversities, influence financial portfolio choices, contributing to both upper echelons theory and behavioral finance research.
Understanding hepcidin for iron management in pregnancy
Authors: Rosson Sarah , Pavord Sue
Published: January 2025

Iron deficiency anaemia (IDA) poses a significant health challenge during pregnancy, affecting up to 30% of pregnant women in the UK. It has been linked to poor health outcomes for the mother, foetus, and the infant. Despite its prevalence and impact, current diagnostic and therapeutic approaches are limited. Ensuring an adequate iron status in pregnancy requires prompt investigation and treatment whilst avoiding excessive iron supplementation and its associated side effects. Hepcidin, a key regulator of iron trafficking in the body, has emerged as a promising candidate for tailoring iron supplementation to individual needs and responsiveness. However, current research on hepcidin‐based approaches yields mixed findings, necessitating a comprehensive review to elucidate its potential utility in guiding iron therapy for pregnant women with IDA. This literature review seeks to synthesise existing evidence to explore the role of hepcidin in personalised iron supplementation for pregnant women with IDA and to identify avenues for future research to pave the way for improved management of IDA in pregnancy.
Critical Appraisal of Integrated Computational Fluid Dynamics/Surface Roughness Models for Additive Manufactured Swirl Burners
Authors: Al-Ajmi Rashed , Al-Shaghdari Mohammed , Goktepe Burak , Psomoglou Ianos , Bowen Phil
Published: January 2025

Additive manufacturing (AM) technology can create complex parts that are otherwise impractical to manufacture by traditional methods. However, the process often results in rough and irregular surfaces that can affect performance. In this study, computational fluid dynamics (CFD) is considered as a tool to optimize component design for use in applications such as a gas turbine. However, modeling the interactions between turbulent flows and AM-generated wall roughness affect the predictive capability of numerical models due to difficulty in thoroughly characterizing rough wall texture. To progress toward addressing this issue, this study aims to appraise two common wall roughness approaches within the Reynolds-averaged Navier–Stokes (RANS) framework: the modified “law-of-the-wall” and roughness-resolving approaches. The modified law-of-the-wall is based on the correlation that converts the measured surface roughness parameters to the equivalent sand-grain roughness height. The second approach involves the resolution of the roughness elements within the computational grid. The simulations were compared against the velocity data published for the burner with AM swirl nozzle inserts of different surface finishes. At this stage of development, the realizable k–ɛ turbulence model was selected for all the CFD simulations. The results show that the roughness-resolving approach was better suited than the modified law-of-the-wall correlation, demonstrating good agreement with the experimental velocity data, predicting the velocity shift to the center. The model also revealed the shortened recirculation zone with increasing surface roughness, which is important in predicting flame stability and emissions performance to be studied subsequently.
Density-Refine: Patent Image Retrieval by Density-Based Region Extraction and Feature Fusion
Authors: Lin Yu-Hsun , Hung Min-Chian , Lee Chen-Fan
Published: January 2025

Design-by-analogy (DbA) is an important methodology in mechanical design that generates innovative solutions in the target domain with inspiration from a source domain. The patent database is one of the valuable source domains for the DbA method. Meanwhile, patents are crucial in engineering, especially for engineering design and acquiring an exclusive business advantage. Therefore, efficient patent exploration is essential in patent application and design inspiration. Patent image complements text-based descriptions with visual information. The visual information is practical for patent devices with complex structures. We found that spatial density is vital in extracting the relevant subregions. Therefore, we leveraged this property by incorporating density-based clustering to enrich the training dataset. We also proposed a feature fusion mechanism to utilize the newly extracted subregion information. As a result, we named our method Density-Refine since we improved the performance of patent image retrieval by employing the density property. Our method outperformed the state-of-the-art approaches in the benchmark dataset for patent image retrieval. We also investigate the performance of applying the density property to other similar mediums, such as sketch image retrieval. We expect this work to be a stepping stone to inspire more influential studies in image retrieval and design inspiration.
Exploration of the dynamics of otic capsule and intracochlear pressure: Numerical insights with experimental validation
Authors: Dobrev Ivo , Lim Jongwoo , Kim Namkeun , Niermann Johannes , Röösli Christof , Pfiffner Flurin
Published: January 2025

The otic capsule and surrounding temporal bone exhibit complex 3D motion influenced by frequency and location of the bone conduction stimulus. The resultant correlation with the intracochlear pressure is not sufficiently understood, thus is the focus of this study, both experimentally and numerically. Experiments were conducted on six temporal bones from three cadaver heads, with BC hearing aid stimulation applied at the mastoid and classical BAHA locations across 0.1–20 kHz. Three-dimensional motions were measured on various skull regions, including the promontory and stapes. Intracochlear pressure was measured using a custom acoustic receiver. The experiment was digitally recreated by a custom finite element model (FEM), based on the LiUHead, with the addition of an auditory periphery. The Young's modulus of the cortical bone domain within the FEM was varied between 4, 8, and 20 GPa. The predicted differential intracochlear pressures aligned with experimental data for most frequencies, and showed that skull deformation, particularly in the otic capsule, depends on skull material properties. Both experimental and FEM results indicated that the otic capsule behaves as a rigid accelerometer, imposing inertial loads on cochlear fluids, even above 7 kHz. Future work should explore the solid-fluid interactions between the otic capsule and cochlear contents.
Bone Stress Injury Epidemiology and Risk Factors in Female Off-Road Runners: A Systematic Review
Authors: Stennett Richard , Scheer Volker , Kaulback Kelly
Published: January 2025

Background: Off-road running is a growing sport with little research investigating injury profiles of female participants. Bone stress injuries (BSIs) are a particularly detrimental injury with little known about their incidence and risk factors in female off-road runners. Objective: Collate and review the available evidence reporting epidemiological data and risk factors associated with BSI in female off-road runners. Design: Systematic literature review, without meta-analyses. Data Sources: MEDLINE OVID, PubMed, SPORTDiscus, and MEDLINE EBSCO. Searches were finalized in July 2024. Eligibility Criteria: Studies that reported injury surveillance statistics and/or risk factors associated with BSIs in female off-road runners. Results: Seventeen eligible studies were included, of which all reported surveillance statistics and 2 reported risk factors associated with BSI among 897 female runners. Owing to the scarcity of data, cross-country runners were included in the population of off-road runners. Most BSIs were high severity and in the lower leg, with an overall incidence ranging from 0 to 34.39 BSIs per 100,000 athlete-exposures and prevalence ranging from 0% to 40.9%. Study characteristics were reported alongside risk of bias, quality, and level of evidence assessment outcomes from varying tools. Eight significant intrinsic risk factors were associated with BSIs in female off-road runners: increasing age, disrupted menstruation, previous BSI, increased female triad risk, and lower calcium, vitamin D, and calorie intake. Discussion: Limited by the number of studies available reporting data on the specific target population, which highlights the need for performing high-quality prospective studies in the future, this review summarizes the current epidemiological data and risk factors associated with BSIs in female off-road runners.
Antigen receptor ITAMs provide tonic signaling by acting as guanine nucleotide exchange factors to directly activate R-RAS2
Authors: Hortal Alejandro M. , Calleja Enrique , Oeste Clara L. , Arellano Irene , Lacuna Marta , Blanco Soledad , Martín-Blanco Nadia , Montanuy Inmaculada , Alcamí Antonio , Bustelo Xosé R. , Alarcón Balbino
Published: January 2025

The small GTPase R-RAS2 regulates homeostatic proliferation and survival of T and B lymphocytes and, when present in high amounts, drives the development of B cell chronic lymphocytic leukemia. In normal and leukemic lymphocytes, R-RAS2 constitutively binds to antigen receptors through their immunoreceptor tyrosine-based activation motifs (ITAMs) and promotes tonic activation of the phosphatidylinositol 3-kinase (PI3K) signaling pathway. Here, we examined the molecular mechanisms underlying this direct interaction and its consequences for R-RAS2 activity. R-RAS2 exhibited direct, high-affinity interactions with ITAM peptides derived from B and T cell receptors through a proline-rich sequence in the hypervariable domain of R-RAS2. In resting T and B cells, the presence of antigen receptors at the plasma membrane was sufficient to promote the activation of R-RAS2 and PI3K, and mutations that abolished the interaction of R-RAS2 with ITAMs reduced R-RAS2 signaling. Binding to ITAMs increased GDP-GTP exchange on R-RAS2 through a mechanism distinct from that by which conventional cytosolic guanosine nucleotide exchange factors (GEFs) activate RAS proteins. These results define antigen receptors as noncanonical GEFs involved in the basal activation state of R-RAS2 in lymphocytes. Such a mechanism may underlie the leukemic transformation of B cells that occurs when wild-type R-RAS2 is present in high amounts.
Impact of a virtual cardiology programme for postdischarge patients with cardiovascular disease: a matched cohort analysis
Authors: Zinzuwadia Aniket , Goldberg Jana , Hanson Mark A , Mandrayar Lindsey , Pratt Stacey , Jain Nayan , Littleton Sarah , Levine Hillari , Prescott Keisha , Truong Hannah , Wessler Jeffrey D
Published: January 2025

Introduction

Telemedicine programmes have shown promise in reducing hospital readmissions, but varied RPM strategies and study populations have contributed to mixed results. Here, we evaluate a standardised virtual care programme in discharged patients with cardiovascular disease (CVD).

Methods

We conducted an open-label prospective randomised study on discharged patients with known CVD comparing those who received a 100-day postdischarge virtual cardiology programme with individuals receiving standard cardiology care. The care programme consisted of telemedicine, RPM and medication titration. The study included patients recently followed by a partnering cardiology practice. Intervention patients with low engagement and late postdischarge onboarding were excluded from analysis. Control patients were matched 1:1 to the intervention patients. Readmission data were collected using an admission notification system. Statistical significance at 90 days was established via Cox proportional hazard analysis.

Results

The matched cohort included 95 patients each in the intervention and control groups, aged 69 years, enrolled February 2021–May 2022. Intervention patients had on average 10.1 visits and 4.3 medication changes. Relative to controls, intervention patients had significantly lower rates of cardiac (8.4% vs 17.9%, p=0.04) and all-cause (15.8% vs 28.4%, p=0.02) readmissions over 90 days post discharge. They also experienced weight loss (4.5 pounds), reduced systolic blood pressure (−11.0 mm Hg) and improved dyspnoea during exercise and daily activities.

Conclusion

In this matched cohort analysis of recently hospitalised patients with CVD, a postdischarge virtual cardiology programme combined with traditional outpatient follow-up reduced readmissions when compared with traditional care alone.
1  No NEWS is good NEWS – a machine learning approach to improve physiological early warning scoring
Authors: Pang Allan
Published: January 2025

Background

Current Early Warning Scoring (EWS) systems in clinical practice are threshold rules-based systems using physiological data to highlight patients at risk of impending in-hospital death.

Examples include the National Early Warning Score (NEWS2) and the Electronic Cardiac Arrest Triage (eCART) score, the standards of care within the UK and the USA, respectively.

The current EWS modelling framework has two limitations. Firstly, they consider risk at a single time point and, therefore, cannot consider trajectories. Secondly, they negate relational information between covariates by decomposing physiological signals into a single value.

We propose using Long Short-Term Memory (LSTM) units, a Machine Learning (ML) technique that uses time-series modelling and neural networks to address these limitations and better utilise the available information.

Methods

We extracted the sequences of vital signs, NEWS2, and eCART values within a 72-hour observation window from MIMIC-IV, a dataset containing anonymised electronic healthcare records. We masked the last 24 hours for each sequence and trained multiple ML models to identify patients at risk of death. We compare the models’ discriminative ability using the metrics, recall, F1-score, AUROC and AUPRC and conducted 10-fold stratified cross-validation.

Results

The LSTM model has statistically significant performance advantages in F1-score (0.3391±0.0093), AUROC (0.7399±0.0119), and AUPRC (0.337±0.0212). The clinical benefit of such a model allows clinicians to correctly identify more at-risk patients without increasing the false alarm rate.

We hypothesise that this ML pipeline can be used to predict other clinical outcomes of interest, such as a requirement for escalation of care/additional organ support, which is the focus of future work.

Conclusions

Our results demonstrate that the ML time-series framework can utilise trajectory information to give further context and significantly improve the prediction of impending death. We propose any future EWS systems should incorporate physiological time-series.
2  The effects of multidisciplinary team (MDT) residential rehabilitation versus outpatient physiotherapy for the management of non-arthritic hip pain (NAHP) in UK military personnel: a randomized controlled trial (RCT)
Authors: Coppack Russell , Cassidy Robyn , Bilzon James , Houston Andrew , Papadopoulou Theodora , Bennett Alexander
Published: January 2025

Background

Despite the acceptance of residential MDT rehabilitation in the UK military, there is no evidence supporting its use in the management of non-arthritic hip pain (NAHP). This study compared the effects of a residential MDT care programme with physiotherapy led outpatient treatment on the clinical outcomes in UK military personnel with NAHP.

Methods

This was a single-blind, parallel group RCT. UK military personnel (N=87, 11 female), mean age 31 yrs (SD 7.1) were randomly allocated to receive: (1) a 7-day MDT residential rehabilitation course or, (2) conventional physiotherapy led outpatient care. The primary outcomes were pain (visual analogue scale, VAS 0-100mm) and physical function (Hip and Groin Outcome Score [HAGOS] activities in daily living [ADL] score). Secondary outcomes included hip muscle strength, hip range of motion, and walking ability (six-minute walk test [6MWT]). All outcome scores were taken at baseline (T1), after treatment (T2) and at 3-months (T3).

Results

There were no significant between-group differences for VAS pain scores after treatment (T2) -3.05 (95%CI, -13.9 to 7.8, P=0.4), or at 3-months (T3), 4.5 (95% CI, -6.1 to 15.1, P=0.4). The mean reduction in pain from T1 to T3 for the residential group was 10.1 mm which reached the minimal clinically important difference (MCID) threshold of 10 mm. The mean (SD) HAGOS ADL scores improved from 68.7 (19.7) to 72.6 (23.0) in the residential group and 67.9 (21.9) to 74.4 (22.6) in the physiotherapy group. There were significant between-group differences for secondary outcomes after treatment (T2) in favour of outpatient physiotherapy that were not maintained at T3.

Conclusions

This is the first global RCT to compare residential rehabilitation with outpatient care in adults with NAHP. There were no significant between group differences at 3-months for any self-report or physical test scores. Outpatient physiotherapy showed superior muscle strength, HAGOS and 6MWT outcomes after treatment. Both residential and outpatient treatment resulted in improved function and pain outcomes and can be recommended in the UK military rehabilitation setting.
Seeking consensus on dilemmas related to euthanasia in dementia based on an advance directive: a Delphi study from a medical, ethical and legal perspective
Authors: de Boer Marike E , Coers Djura O , Sizoo Eefje M , ten Bokkel Huinink Danique M J , Leget Carlo J W , Hertogh Cees M P M
Published: January 2025

Euthanasia in dementia based on advance euthanasia directives (AEDs) is possible within the Dutch Euthanasia law. Yet, physicians struggle with the responsibility of interpreting the law’s open norms in cases of advanced dementia, which includes the fulfilment of the due care criteria. This Delphi study aims to analyse arguments and seek consensus from medical, ethical and legal perspectives on ethical dilemmas in such cases. Thirty participants, equally divided in expertise, took part in a three-round Delphi with a total of 11 statements on ethical dilemmas. Despite differences in opinions and argumentations between panellists, consensus was reached on seven statements regarding different topics. Consensus was reached that the (behavioural) expressions of a person with dementia should be considered throughout the progression of decision-making disabilities. In such cases, a wish to live should be prioritised over an AED. Although substitute decision-making is not an option in case of euthanasia requests, both people around the person with dementia as well as their AED can be supportive in the decision-making process. Advance directives with formulations such as ‘if I have to admitted to a nursing home, then I want euthanasia’ are found to be infeasible. At all times, it is important to pay attention to alternatives to euthanasia, which includes following existing guidelines on problem behaviour. Physicians may benefit from the arguments pertaining to dilemmas encountered and the fulfilment of the due care criteria to either justify their decisions in euthanasia cases based on an AED, or to support decisions to refrain from euthanasia.
Tranexamic acid as an adjunct to resuscitative endovascular balloon occlusion of the aorta does not worsen outcomes in a porcine model of hemorrhage
Authors: Neidert Leslie E , Morgan Clifford G , Lonowski Dominic , Castro Cecilia , Hemond Peter J , Lozano Valeria R , Tiller Michael M , Cardin Sylvain , Glaser Jacob J
Published: January 2025

Background

Non-compressible torso hemorrhage (NCTH) represents a leading cause of preventable mortality in trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) stabilizes NCTH but may predispose patients to thrombus generation. REBOA must therefore be prospectively evaluated for coagulation risks with concomitant usage of anti-fibrinolytic tranexamic acid (TXA). Using a porcine model of hemorrhage, it was hypothesized that TXA with REBOA would worsen coagulation outcomes and organ damage.

Materials and methods

Thirty-two male Yorkshire swine underwent 30% blood volume hemorrhage with randomization to vehicle control (VC; normal saline), VC+REBOA, TXA, or TXA+REBOA. At T0, animals received 10 mL/minute of group-specific infusion (GSI) followed at T10 by 500 mL of whole blood (WB), second GSI at 13 mL/hour, and Zone 1 REBOA inflation in REBOA groups. At T40, REBOA was deflated, with additional 500 mL WB, and continuation of GSI for 3 hours. Physiological, coagulation, and inflammatory parameters were measured throughout the protocol, with postmortem histopathology.

Results

After REBOA deflation at T40, lactate was significantly higher for the REBOA groups versus the non-REBOA groups, and pH, bicarbonate, and base excess were all significantly lower than the non-REBOA groups. There were no significant differences observed between groups in coagulation, inflammatory, metabolic, or histopathologic parameters.

Conclusions

Administration of TXA with REBOA did not cause more deleterious coagulation outcomes. All significant changes were expected results of REBOA ischemia, and not attributable to TXA treatment. This suggests NCTH can safely be treated with both hemorrhage control methods without exacerbating clotting outcomes.

Level of evidence

Not applicable—basic animal research.
Modeling and Prediction of Demand Response Based on Deep Quantum Neural Networks
Authors: Huang Youpeng , Cai Qianqian , Cai Yongzhi , Liu Chang , Huang Sheng
Published: January 2025

Demand Response (DR) plays a crucial role in modern power networks, addressing the challenges posed by increasing renewable energy integration, grid modernization, and sustainability goals. By modifying electricity consumption patterns in response to signals such as price fluctuations or grid conditions, DR helps balance supply and demand on the grid, reduce peak demand, alleviate grid congestion, and integrate renewable energy resources more effectively. However, effective DR strategies require accurate modeling and prediction of DR behavior. In this research, a novel modeling and prediction strategy for DR that integrates deep learning and quantum computing principles is proposed. The approach involves two main phases: preprocessing and prediction. During preprocessing, input data undergo normalization using an improved Z-score technique. Subsequently, the normalized data are processed by the Modified Deep Quantum Neural Network (MDQNN) model during the prediction phase. MDQNN, an enhanced version of Deep Quantum Neural Networks (DQNN), employs angle encoding to enhance prediction accuracy by effectively identifying patterns. The efficacy of this strategy is demonstrated through comprehensive analyzes, highlighting its potential to enhance DR prediction accuracy and contribute to the advancement of power network optimization and sustainability objectives.
Evolution and Impact of the Global Trade Network for Strategic Environmental Products
Authors: Xu Shuanglei , Liu Zhixi , Youn Ik Joong
Published: January 2025

Amid global economic integration and changes in international patterns, strategic emerging industries have become the core driving force for high-quality economic development and industrial structure upgrading. Studying the structural evolution of the global trade network of strategic environmental products and its influence mechanism can help reveal the changes in the industrial division of labour and guide the formulation of green trade policies. Based on this, this paper analyses the evolution of trade networks of products in the fields including energy-saving technologies, new materials, renewable energy, etc., using social network analysis and an exponential random graph model with 50 countries around the world as the research object from 2010 to 2022. It is found that the global trade network of strategic environmental products has been affected by the decoupling of the international situation, and trade links have been reduced, forming three major independent groups, with a stable core-edge structure, and the United States, Germany, and China playing an important pivotal role. Factors such as economic fundamentals, R&D expenditures, and trade openness have a positive impact on network formation, while external factors and internal structural features of the network also influence network evolution.
Controlled Language Increases Comprehension of Law for People
Authors: Guitton Clement , Tamò-Larrieux Aurelia , Mayer Simon , Zumbrunn Lukas
Published: January 2025

Law is written in a way that is not easily understandable by most people. This also hinders the translation into computer code, which would permit tools that increase access to the law. The use of controlled language in legal texts is a promising way to implement laws that are better comprehensible by people, and computer-executable at the same time. However, while the scholarship on controlled language has been concentrating on its automatic translation into (logic) programs, the effects on people have not been investigated. We conducted an experiment to test the understandability, usability, and perceived open-texture (e.g., ambiguity, vagueness) of legal texts that are formulated in natural language and in controlled language. Among our 73 participants—including members of parliament (MPs) and public servants—we found that the use of controlled language increases understandability across legal domains and increases the number of terms that are perceived as open-texture. We also found that public servants show higher comprehension of legal statutes but lower perception of open-texture than MPs, regardless of whether these are in controlled or natural language. We conclude that controlled language can therefore support a wider access to law, thereby bringing democratic societies closer to their underpinning ideals and principles.
MedProm: Bridging Dialogue Gaps in Healthcare with Knowledge-Enhanced Generative Models
Authors: Varshney Deeksha , Behera Niranshu , Katari Prajeet , Ekbal Asif
Published: January 2025

In medical dialogue systems, recent advancements underscore the critical role of incorporating relevant medical knowledge to enhance performance. However, existing knowledge bases often lack completeness, posing a challenge in sourcing pertinent information. We present MedProm, a novel generative model tailored for medical dialogue generation to address this gap. Motivated by the need for comprehensive and contextually relevant responses, MedProm leverages state-of-the-art language models such as BioGPT. Our model is designed to integrate extensive medical knowledge into conversations, facilitating effective communication between patients and healthcare providers. At the core of MedProm lies the MediConnect Graph, a meticulously constructed knowledge graph capturing intricate relationships among medical entities extracted from dialogue contexts. By employing a KnowFusion encoder with a pretraining objective and masked multi-head self-attention, MedProm effectively processes the MediConnect graph, enabling precise control over information flow to capture its underlying structure. Furthermore, MedProm incorporates a sophisticated Curriculum Knowledge Decoder, leveraging transformer-based decoding to generate response utterances conditioned on input representations from the KnowFusion Encoder. The training process is guided through curriculum learning, gradually increasing optimization difficulty based on a coherence-based criterion. Experimental results on two datasets demonstrate the efficacy of MedProm in generating accurate and contextually relevant responses compared to state-of-the-art models.
The Effects of Information and Incentive Interventions on the Adoption of Algorithms in Human Resources: An Experimental Study
Authors: Ochmann Jessica , Zilker Sandra , Michels Leonard , Tiefenbeck Verena , Matzner Martin , Laumer Sven
Published: January 2025

The economic potential of human resources (HR) algorithms requires organizations to ensure their adoption, but HR employees are often reluctant to use them. One driver of this reluctance may be employees' overconfidence in their own judgments and the sensitive nature of HR decisions, which directly affect human beings. Interventions that aim to increase technology adoption can help organizations overcome this issue. Drawing on the theoretical lens of information and incentive interventions, we conducted a survey-based incentive-compatible online experiment with 276 participants to determine the effects of interventions on the adoption of algorithms in an organizational HR context. We distinguish between adoption in the short and long runs. Our study, which contributes to research on the use of algorithms in HR and induced technology adoption, has practical implications for HR leaders who seek to increase HR employees' adoption of algorithms in completing HR-related tasks.
Increasing cellular NAD+ protects hepatocytes against palmitate-induced lipotoxicity by preventing PARP-1 inhibition and the mTORC1-p300 pathway activation
Authors: Guo Rui , Li Yanhui , Song Qing , Huang Rong , Ge Xiaodong , Nieto Natalia , Jiang Yuwei , Song Zhenyuan
Published: January 2025

This study explores the mechanisms of palmitate-induced hepatotoxicity, highlighting the role of PARP-1 downregulation in triggering the mTORC1-p300 pathway and resultant hepatocyte cell death. It further reveals that enhancing cellular NAD+ levels through either precursor supplementation or NNMT inhibitors prevents lipotoxicity by restoring PARP-1 activity. Finally, the study identifies that the TLR4-NF-κB activation mediates palmitate-induced PARP-1 suppression and offers potential therapeutic insights for metabolic liver diseases caused by lipotoxicity.
Effects of Cold Stress on Skin Color, Immuno‐Antioxidant Function, Muscle Compositions, and Intestinal Microbiota of Red Tilapia During Overwintering
Authors: Yang Hao-ran , Munyaradzia Herbert Brightmore , Zhu Wen-bin , Dong Zai-jie , Wang Lan-mei
Published: January 2025

Cold stress due to overwintering is considered a major issue limiting the development of the red tilapia (Oreochromis spp.) industry. This study was the first to systematically investigate the effects of cold stress on skin color, immuno‐antioxidant function, muscle compositions, and intestinal microbiota of red tilapia during overwintering. Fish (initial weight: 72.71 ± 1.32 g) were divided into the cold stress group (cold) and the control group. In the control group, the water temperature (WT) was maintained at 20°C, which is consistent to with the overwintering WT indoors or greenhouse in the local area. In the cold group, the WT was decreased from 20°C to 8°C by 2°C per day during the experiment. At the end of the experiment, we found that the L∗ value of fish ventral skin in the cold group was lower than that in the control group (p < 0.05). The superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), catalase (CAT), and total antioxidant capacity (T‐AOC) activities were higher, but complement 3 (C3) and complement 4 (C4) activities were lower in the liver of cold group fish than those in the control group (p < 0.05). For the gill tissue, the SOD, MDA, and GSH activities were higher, but the C3 activity was lower in the cold group than those in the control group (p < 0.05). The total amino acid (TAA) content in the muscle of fish in the cold group was higher than that in the control group (p < 0.05). 16 s rRNA analysis showed that the intestinal microbial abundance and alpha diversity of fish in the cold group decreased (p < 0.05). Component analysis revealed a significantly higher relative abundance of Cetobacterium spp. in the fish of the cold group. The findings of this study will provide a valuable understanding of fish cold stress during overwintering, which will contribute to facilitating the breeding of new cold‐resistant varieties of red tilapia in the future.
Global Scientific Trends on Anxiety Disorders in the Early Twenty‐First Century: A Data‐Driven Bibliometric Analysis
Authors: Wang Zhongqing , Wang Fang , Cui Zhiying , Meng Fanyu , Guo Haoxin , Tian Bailing , Li Nannan
Published: January 2025

Objective: Interest in the study of anxiety disorders is growing rapidly. However, there is still a lack of comprehensive bibliometrics research in measuring and analyzing global scientific publications. The aim of this article is to review the current research status and trends of anxiety disorders worldwide through bibliometrics and to provide reliable support for future in‐depth research.

Methods: In this bibliometric study, we utilized VOSviewer to evaluate the Web of Science Core Collection (WoSCC) publications and to build visualizing maps to analyze the research progress on this topic between January 1, 2000, and August 7, 2024.

Results: Up to August 7, 2024, the study included a total of 67,386 English original articles and review articles published in 4054 journals by 206,496 authors from 164 countries/regions. The United States was a leader in articles, researchers, and institutions in the field of anxiety disorders. Using cluster analysis, the keywords were divided into five major clusters: (1) etiology and pathogenesis, (2) clinical classification and interventions, (3) comorbidity, (4) anxiety caused by the COVID‐19 pandemic and specific groups, and (5) anxiety disorders in children and adolescents.

Conclusion: Molecular and neural circuit mechanisms, adolescent psychological problems, objective indicators of diagnosis and classification, and technology‐assisted therapy are still the focus of future research. The findings provide a comprehensive overview of anxiety disorder research, which may help physicians, researchers, and local authorities and community health staff to more fully understand trends and influence in the field and highlight under‐researched areas, which could be the basis for future research.