bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of Inter‐α Inhibitor Proteins in Permanent and Transient Focal Ischemia
Authors: Imai Takahiko , de Morais Andreia Lopes , Qin Tao , Sasaki Yuichi , Lim Yow‐Pin , Ayata Cenk
Published: February 2025

Background

Ischemic stroke is among the most prevalent diseases, with high death and morbidity. Numerous preclinical studies have reported efficacious interventions in rodent stroke models. However, reperfusion therapies remain the only clinically efficacious intervention to date. Rigor and reproducibility are now recognized as critical to bridge the preclinical–clinical disconnect. Inter‐α inhibitor proteins (IαIPs) are a family of structurally related glycoproteins with 2 major forms (inter‐α inhibitor and pre‐α inhibitor) in blood. Purified human plasma–derived IαIP has beneficial effects in sepsis and hypoxic–ischemic brain injury. More recently, IαIP improved focal ischemic stroke outcomes in mouse models. Here, we tested IαIP efficacy in both transient and permanent stroke mouse models, mimicking previously published study designs and protocols to seek reproducibility.

Methods and Results

Using healthy young male and female C57BL/6 mice, we induced transient or permanent endovascular filament middle cerebral artery occlusion (MCAO). Mice were divided into transient MCAO+vehicle, transient MCAO+IαIP (30 mg/kg), permanent MCAO+vehicle, and permanent MCAO+IαIP groups. IαIP or vehicle was administered intravenously at 6 and 18 hours after MCAO. End points were assessed at 2 days. Efficacy readouts included death, infarct volume and swelling, and 3 neurological tests. Contrary to the previous work, we did not find IαIP efficacious on any outcome readout in either transient MCAO or permanent MCAO.

Conclusions

Our data highlight the contribution of interlaboratory heterogeneity to study outcomes and suggest that interventions considered for clinical development should undergo rigorous testing in multiple single‐laboratory studies before entering a multicenter preclinical trial.
Novel CT Image‐Based Intracerebral Bleeding Risk Score for Patients With Acute Ischemic Stroke Undergoing Thrombolysis
Authors: Fang Shuangfang , Lei Hanhan , Ambler Gareth , Werring David J. , Huang Huapin , Lin Huiying , Wu Xiaomin , Zhang Qinli , Han Xiuyan , Gao Genshan , Chen Ronghua , Chen Jie , Li Hangfeng , Wei Jin , Chen Guangliang , Chen Jianhua , Liu Nan , Du Hou‐wei
Published: February 2025

Background

Symptomatic intracerebral hemorrhage (sICH) after intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke (AIS) remains a feared yet unpredictable complication. We aimed to develop and validate a new predictive model incorporating clinical variables and noncontrast head computed tomography imaging features to predict sICH in patients with AIS receiving intravenous recombinant tissue plasminogen activator.

Methods and Results

The predictive model was derived from 808 patients with AIS in the derivation cohort in Southeast China, based on multivariable logistic regression analysis. External validation was conducted in a validation cohort from Central China. Discrimination, calibration, and clinical usefulness of the predictive model were assessed. We observed 32 sICH events among 808 patients with AIS in the derivation cohort, and 21 sICH events out of 612 participants in the validation cohort. The variables in the predictive model included cerebral small vessel disease burden and early infarct signs on head computed tomography scan, atrial fibrillation, age, systolic blood pressure, and initial National Institutes of Health Stroke Scale score. The fitted model showed promising discrimination (optimism‐corrected C statistic of 0.80) and acceptable calibration (Hosmer and Lemeshow goodness of fit
P
=0.816) in the derivation cohort. External validation showed similar discrimination (C statistic 0.82 [95% CI, 0.72–0.91]) and calibration (Hosmer and Lemeshow goodness of fit
P
=0.866).

Conclusions

Our internally and externally validated prediction model for sICH in patients with AIS who received intravenous thrombolysis may facilitate individualized prediction for intracerebral bleeding risk after intravenous thrombolysis for acute ischemic stroke.
Melanocortin 1 Receptor Regulates Pathological and Physiological Cardiac Remodeling
Authors: Suominen Anni , Suni Aino , Ruohonen Saku , Szabó Zoltán , Pohjolainen Lotta , Cai Minying , Savontaus Eriika , Talman Virpi , Kerkelä Risto , Rinne Petteri
Published: February 2025

Background

The melanocortin 1 receptor (MC1R) is abundantly expressed in the skin and leukocytes, where it regulates skin pigmentation and inflammatory responses. Recently, MC1R was also found in the heart, but its functional role has remained unknown. We aimed to investigate whether MC1R is involved in the regulation of pathological or physiological cardiac remodeling.

Methods and Results

Recessive yellow mice, as a model of global MC1R deficiency, and cardiomyocyte‐specific MC1R knockout mice were subjected to transverse aortic constriction or voluntary wheel running to induce pathological or physiological cardiac hypertrophy, respectively. Mice were phenotyped for cardiac structure and function by echocardiography, histology, and quantitative PCR analysis. H9c2 cells and neonatal mouse ventricular cardiac myocytes were used as in vitro models to investigate the effects of pharmacological MC1R activation on hypertrophy‐related responses. We found that the expression of MC1R progressively declines in the failing mouse heart. MC1R recessive yellow mice showed blunted hypertrophic response to transverse aortic constriction–induced pressure overload and exercise training. This phenotype was recapitulated in MC1R knockout mice, demonstrating that MC1R deficiency specifically in cardiomyocytes is responsible for the antihypertrophic effect. However, MC1R knockout mice subjected to pressure overload showed left ventricular dilatation that was associated with reduced ejection fraction and changes in left ventricular diastolic function. At the molecular level, the mRNA expression of myosin heavy chain β was upregulated in the hearts of MC1R knockout mice. In contrast, selective activation of MC1R promoted hypertrophic responses in cultured cardiomyocytes.

Conclusions

Cardiomyocyte‐specific MC1R deficiency attenuates physiological and pathological cardiac hypertrophy in mice, while pharmacological activation of MC1R promotes cardiomyocyte hypertrophy.
Age‐Based Classification and Outcomes in Pediatric Heart Failure: Findings From a Retrospective Multicenter Cohort Study
Authors: Yuan Yuxing , Pan Bo , Wang Fangjie , Chen Zhi , Guo Ying , Shen Xing , Liang Xuecun , Liang Yanyan , Xing Yanlin , Zhang HuiLi , Zhang Yingqian , Xie Chunhong , Li Li , Huang Zhilin , Sun Huichao , Zheng Min , Liu Lingjuan , Lv Tiewei , Li Zipu , Liang Xiaohua , Tian Jie
Published: February 2025

Background

Although heart failure is a well‐known major global public health concern, the general understanding of the clinical status of pediatric heart failure (PHF) is inadequate. Therefore, this study aims to enhance the general understanding of clinical characteristics across different PHF age groups and provide references for improving PHF treatment strategies.

Methods

This multicenter retrospective cohort study involved patients from 20 Chinese provinces, primarily including hospitalized patients (aged ≤18 years) diagnosed with heart failure between January 2013 and December 2022. The study subjects were categorized into 4 groups: neonatal, infant and toddler, young children, and adolescent.

Results

Herein, 2903 hospitalized patients with PHF were included. Significant differences were observed across age groups in clinical characteristics, auxiliary examination results, comorbid diagnoses, and hospitalization outcomes. After adjusting for covariates, the odds of in‐hospital death were significantly lower in the infant and toddler (odds ratio [OR], 0.46 [95% CI, 0.25–0.85]), young children (OR, 0.39 [95% CI, 0.18–0.85]), and adolescent (OR, 0.34 [95% CI, 0.13–0.87]) groups compared with the neonatal group. Furthermore, the odds of cardiovascular adverse events were significantly higher in the young children (OR, 1.91 [95% CI, 1.62–2.88]) and adolescent (OR, 2.16 [95% CI, 1.15–4.06]) groups compared with the neonatal group. Additionally, regarding the odds of a bad Ross class, the adolescent group had 1.85 times higher odds (95% CI, 1.11–3.09) compared with the neonatal group, 2.36 times (95% CI, 1.67–3.35) higher odds compared with the infant and toddler group, and 1.45 times (95% CI, 1.05–2.02) higher odds compared with the young children group (
P
<0.05).

Conclusions

This study emphasizes the importance of age‐specific stratification in PHF management, revealing distinct clinical and prognostic differences across various developmental stages.

Registration

URL:
https://www.chictr.org.cn
. Unique identifier: ChiCTR2300078262.
Association Between Age at Diagnosis of Atrial Fibrillation and Subsequent Risk of Ischemic Stroke
Authors: Cheng Yun‐Jiu , Deng Hai , Wei Hui‐Qiang , Lin Wei‐Dong , Liang Zhuomin , Chen Yili , Dong Yugang , Fang Xian‐Hong , Liao Hong‐Tao , Wu Shu‐Lin , Liu Fang‐Zhou , Xue Yu‐Mei , Wu Zexuan
Published: February 2025

Background

Atrial fibrillation (AF) significantly increases the ischemic stroke risk. However, the relationship between age at diagnosis of AF and subsequent stroke risk remains poorly understood.

Methods and Results

We analyzed data from 5 prospective cohorts: ARIC (Atherosclerosis Risk in Communities) study, CHS (Cardiovascular Health Study), CARDIA (Coronary Artery Risk Development in Young Adults), MESA (Multi‐Ethnic Study of Atherosclerosis), and Framingham Heart Study (including Offspring cohort and the Third‐Generation cohorts). Cox regression models and competing risk survival analyses were used to assess incidence rates and hazard ratios (HRs) for ischemic stroke stratified by age groups. Among 47 239 participants (median follow‐up: 21.1 years), 6689 (14.2%) developed AF, and 536 (8.0%) subsequently experienced ischemic stroke. Younger age at AF diagnosis was significantly associated with a higher ischemic stroke risk. Fully adjusted HRs for ischemic stroke were 5.35 (95% CI, 3.56–8.03), 2.99 (95% CI, 2.32–3.86), 2.13 (95% CI, 1.75–2.58), and 1.93 (95% CI, 1.59–2.34) for AF diagnosed at ages 55, 65, 75, and 85, respectively. Compared with participants without AF at age 55, HRs for ischemic stroke were 7.30 (95% CI, 3.27–16.31) for AF diagnosed >10 years earlier, 4.98 (95% CI, 2.99–8.29) for 6 to 10 years earlier, and 4.60 (95% CI, 1.48–14.34) for ≤5 years earlier (
P
‐trend <0.001). The presence of AF yielded a 13.9 years earlier occurrence of ischemic stroke among those with AF diagnosis at 55 years compared with 1.5 years earlier at age 85.

Conclusions

Younger age at AF diagnosis was associated with a higher risk of subsequent ischemic stroke.
Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction
Authors: Zhou Hui , Zhang Yiyi , Zhou Matt M. , Choi Soon Kyu , Reynolds Kristi , Harrison Teresa N. , Bellows Brandon K. , Moran Andrew E. , Colantonio Lisandro D. , Allen Norrina B. , Safford Monika M. , An Jaejin
Published: February 2025

Background

We compared the atherosclerotic cardiovascular disease (ASCVD) risk prediction performance of the American Heart Association's Predicting Risk of Cardiovascular Disease Events (PREVENT) Base and PREVENT Full equations (includes urine albumin/creatinine ratio, glycated hemoglobin, and social deprivation index) with the pooled cohort equations (PCEs).

Methods

We included adults, aged 40 to 75 years, with no history of ASCVD, diabetes, or statin use in 2009 from Kaiser Permanente Southern California and followed up through 2019. ASCVD was defined as myocardial infarction, fatal coronary heart disease, and fatal and nonfatal ischemic stroke. We compared model discrimination (Harrell C), mean calibration (estimated as the ratio of predicted/observed event rates), and calibration curve among the overall population and stratified by sex and race and ethnicity.

Results

Of the 559 241 adults (mean age, 54 years; 11% Asian, 11% non‐Hispanic Black, and 32% Hispanic), 10 695 developed an ASCVD event (median follow‐up, 10 years). Harrell C was 0.741 (95% CI, 0.736–0.745) for PREVENT Base, 0.743 (95% CI, 0.738–0.748) for PREVENT Full, and 0.741 (95% CI, 0.736–0.746) for the PCEs. Compared with the PCEs, both PREVENT equations improved Harrell C in men but not women, and in non‐Hispanic Black adults but not in other races and ethnicities. Both PREVENT equations were well calibrated (mean calibration, 0.85–1.36; calibration slope, 0.69–1.27), whereas the PCEs overestimated 10‐year ASCVD risk (mean calibration, 1.80–2.18; calibration slope, 0.32–0.45).

Conclusions

Compared with the PCEs, PREVENT Base and Full equations better predict absolute 10‐year ASCVD risk across sex and racial and ethnic groups in a contemporary US adult population.
The medico-legal pertinence of musculoskeletal nociplastic pain
Authors: Fitzcharles Mary-Ann , Assis Rodrigo D
Published: February 2025

Pain conditions can be challenging; nociplastic pain, defined as pain that cannot be sufficiently explained by structural/anatomical changes, is newly categorised as the third pain mechanism. Nociplastic pain complaints are subjective, often accompanied by symptoms of fatigue, sleep and mood disturbance and cognitive difficulties with no diagnostic biomarker or reliable measurement of severity. Medico-legal challenges include attribution of causation after an alleged triggering event, assessment of severity, and reported functional impairment. This review considers nociplastic pain in regard to the musculoskeletal system with focus on causation and temporality of the pain condition and impairment. We hope that this overview will provide a better understanding of these challenging pain conditions.
Activated carbon fibers derived from waste textiles for the removal of lead ions from water
Authors: Ge Yuanyu , Chen Tianye , Huang Yongsong , Li Zhiying , Zhang Chao , Li Ziyin
Published: February 2025

Activated carbon fibers (ACFs) demonstrate exceptional performance across a range of applications, including environmental remediation and energy storage. However, significant challenges, such as high production costs and low yield, hinder their widespread adoption. In light of the substantial global generation and inefficient recycling of textile waste, this study aimed to enhance resource valorization and promote environmental sustainability through the conversion of waste textiles into activated carbon fibers (W-ACFs). The research successfully synthesized W-ACFs, which exhibit physical and chemical properties comparable to those of commercial activated carbon fibers (C-ACFs). When applied to the adsorption removal of lead ions in water, W-ACFs showed similar lead ion adsorption efficiency to C-ACFs at low concentrations. Although the adsorption capacity of W-ACFs reached approximately 70% (adsorption capacity of nearly 62 mg g−1) of that of C-ACFs at high initial concentrations, it nonetheless exhibited significant application potential. The production efficiency and adsorption performance of W-ACFs were further enhanced by optimizing key preparation parameters, including pre-oxidation temperature, carbonization activation temperature, and the dosage of chemical activating agents. This research not only provides an effective adsorbent material for water treatment but also introduces a novel approach to waste recycling and environmental remediation, thereby achieving the dual objectives of economic efficiency and environmental protection.
Mental Health Problems Among Migrant Labourers in India
Authors: Yadav Sangeeta , Priya Kumar Ravi , Sinha Arvind K.
Published: February 2025

One of the severely marginalised internal migrant populations in India has been the migrant labourers who not only face the challenges of acculturation but also experience acute powerlessness. They work within the unorganised sectors and are often denied employment opportunities and social security. The socioculturally induced distress makes them more prone to develop mental health-related problems and creates greater health disparities. To design an appropriate community-level intervention, it is crucial to accurately capture the symptoms experienced by a particular community. Hence, the current work explores the impact of migration on the mental health of migrant labourers in India. The data were collected with the help of an epidemiological survey on 234 unskilled migrant labourers and analysed using stepwise multiple regression analysis. Findings indicate that 47.9 per cent migrant labourers experienced mental health related issues, among whom female participants reported more symptoms of mental health related problems. Further, acculturative stress, experience of discrimination, and living constraints emerged as risk factors in the study. The findings indicate an alarming situation where the mental health of the migrant community flags the need to design appropriate community-based interventions to reduce health-related inequalities.
‘It shuttered down our hearts’: the mental health of caregivers of children with cerebral palsy in rural Limpopo, South Africa
Authors: Rachamose Ngokwana , Harvey Clare
Published: February 2025

Cerebral palsy is the most prevalent motor disability in childhood, with an estimated prevalence as high as 10 per 1,000 live births in South Africa. Cerebral palsy impacts the mental health of the maternal caregiver, who often assumes the responsibility of the primary caregiver. The current study aimed to explore the mental health of primary caregivers of children living with Cerebral palsy in rural communities of the Limpopo Province, South Africa. The study was conducted in three rural districts of Limpopo (Capricorn, Sekhukhune, and Waterberg). An exploratory qualitative research design was employed. Purposive convenience and snowball sampling were used to recruit 10 maternal primary caregivers of children living with cerebral palsy between the ages of 3 and 18 years. A semi-structured interview was used to collect data. Data were analysed using thematic analysis. The findings of the study include that maternal primary caregivers of children with cerebral palsy experience emotional and social difficulties that impact their mental health. The emotional difficulties include emotional distress, maternal shame and guilt, feelings of lost motherhood aspirations, and feelings of acceptance. The social difficulties include withdrawal and isolation, concern over the family’s social well-being, and impact on maintaining a ‘normal’ life. The study’s implications may extend to mental health providers, policymakers within the Departments of Health and Social Development, and other stakeholders invested in the overall health and well-being of children with disabilities and their caregivers.
Effect of Home Care on Physical Function in Post-Intensive Care Unit Patients: A Meta-Analysis
Authors: Pengpala Kornkanya , Buchholz Susan W. , Ling Jiying , Kao Tsui-Sui , Deka Pallav , Reeves Mathew J. , Mowbray Fabrice I.
Published: February 2025

Background:

A decline in physical function is commonly observed after patients transition to their homes following hospital admission; this is especially true for patients requiring mechanical ventilation in an intensive care unit (ICU).

Objective:

This meta-analysis examines characteristics and effects of home-based or outpatient+home-based interventions used to improve physical function post-discharge in patients who received mechanical ventilation in an ICU.

Methods:

PRISMA guidelines were utilized. The literature search was conducted with the assistance of a medical librarian. Study inclusion criteria were post-ICU adult patients receiving mechanical ventilation who then had home-based or outpatient+home-based care to improve physical function after discharge. Effect size (Hedges’ g) was calculated with random effects models.

Results:

Our search yielded 11 studies that met the inclusion criteria. The majority were randomized controlled trials, with 1 quasi-experimental study. All studies included physical therapists, and 2 included nurses. The 11 studies reported results for 39 physical function measurements. The overall pooled intervention effect across the 4 studies that utilized the 6-minute walk test was 0.32 (95% confidence intervals [CI]: 0.05 to 0.58), for the 3 studies that utilized the Timed Up and Go test it was 1.38 (95% CI: −0.09 to 2.84), and for the 8 studies that used the SF-36 Physical Function subscale, it was 0.31 (95% CI: 0.09 to 0.52).

Conclusions:

This review’s findings show that patients may improve their physical function after participating in specific intervention programs that are home-based alone or outpatient+home-based care. However, the effect sizes are small, so it may be useful to explore how to maximize the gains in physical function.
Validation of the Patient-Reported Outcomes Measurement Information System Pain Intensity and Brief Pain Inventory During Pregnancy
Authors: Vignato Julie , Perkhounkova Yelena , Marilim Hannah , Lee Jihye , Hein Maria , Santillan Donna , Santillan Mark
Published: February 2025

Objectives:

We sought to (1) validate the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity Short Form 3a measure and Brief Pain Inventory (BPI) for assessing pain during pregnancy and (2) evaluate pain in a sample of pregnant individuals.

Methods:

Pregnant individuals (N = 196) were prospectively surveyed: n = 171 up to 22 weeks gestational age, n = 123 during their third trimester of pregnancy, and n = 98 both times. Additional measures included SPRINT Post-Traumatic Stress Disorder Tool, Neurological Quality of Life, Edinburgh Postnatal Depression Scale and anxiety subscale, and Adverse Childhood Experiences Questionnaire. Validity evidence examined included content validity, reliability, convergent and discriminant validity, and relevant criterion relationships.

Results:

Content validity analysis suggests that the PROMIS pain measure was easy to use and interpret while the BPI provided more detail. However, BPI questions regarding medication usage and relief were unclear to some pregnant individuals. In addition, the relationships among pain ratings were stronger than relationships between pain ratings and measures intended to assess other constructs suggesting convergent and discriminant validity. Relationships with relevant criterions were presented for both the PROMIS and BPI by comparing ratings of pain intensity and severity for pregnant individuals with and without areas of pain reported on BPI.

Conclusion:

Results indicate that PROMIS and BPI provided valid information on pain intensity or severity for our perinatal sample. Depending on the research question, the PROMIS pain or BPI may be more appropriate to an individual study. Either measure could also be included in an electronic health record for accurate pain assessment in clinical settings.
Workplace Spirituality in the Tourism and Hospitality Sector: A Systematic Literature Review
Authors: Sreeja Thupili , Mukherjee Ujjal
Published: February 2025

Workplace spirituality has gained increasing recognition for its potential to enhance both employee and customer experiences. However, in the tourism and hospitality sector, which centres on employee–customer interactions, this subject remains notably underexplored, underscoring the need for further research to fully understand its impact in this setting. This gap likely stems from a limited understanding of workplace spirituality in this context. Most studies on workplace spirituality in tourism and hospitality emphasize its impact on business outcomes but provide little insight into its conceptualization, theoretical framework and measurement tools. Inconsistencies in operationalizing concepts and variations in dimensions further contribute to the confusion. A comprehensive review is crucial to bridging these gaps and advancing the field. The current study systematically reviews workplace spirituality studies by examining their definitions, theoretical backgrounds, instruments and role in tourism and hospitality. This study used the PRISMA technique to screen articles published between 2000 and 2023 in SCOPUS-listed journals. The authors found several operational definitions of the workplace spirituality used in tourism and hospitality studies. Importantly, the use of various instruments to operationalize concepts makes it challenging to compare findings across studies and leads to inconsistencies in the literature. Given the nature of work in the tourism and hospitality sector, we propose the inclusion of a workplace spirituality dimension. This dimension aims to assist practitioners and academics in measuring employees’ experiences with guests in tourism and hospitality settings. In addition, this study extensively discusses research gaps.
Curcumin inhibits growth and triggers apoptosis in human castration-resistant prostate cancer cells via IGF-1/PI3K/Akt pathway
Authors: Chen Chao , Wang Qiwu , Liu Jiwen
Published: February 2025

Objective

This study aimed to investigate the possible mechanism by which curcumin inhibits human prostate cancer (PCa) and castration-resistant prostate cancer (CRPC).

Methods

CRPC cells were treated with curcumin and their viability was assessed by MTT assay and apoptosis was detected by annexinV/propidium iodide double-staining and terminal deoxynucleotidyl transferase dUTP nick-end labeling assays. Expression levels of insulin-like growth factor 1 receptor (IGF-1R) were determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blotting. Phosphoinositide 3-kinase (PI3K), Akt, and forkhead box protein O1 (FOXO1) expression and phosphorylation were assessed by western blotting.

Results

The highly expressed PCa-related molecule IGF-1R was down-regulated in CRPC cells after curcumin treatment, as determined by RT-qPCR and western blotting. In addition, curcumin inhibited the tumor-related PI3K/Akt signaling pathway in CRPC cells. Moreover curcumin down-regulated the IGF-1/PI3K/Akt signaling pathway in tumors derived from CRPC cells.

Conclusions

These results demonstrated that curcumin inhibits growth and triggers apoptosis of human CRPC cells via the IGF-1/PI3K/Akt pathway, thus providing potential new therapeutic strategies for PCa and CRPC.
Coexistence of giant cell arteritis and subacute thyroiditis: A case report and literature review
Authors: Xu Cheng , Han Yongmei
Published: February 2025

Giant cell arteritis and subacute thyroiditis are often regarded as clinically distinct diseases with differing pathogenesis. We report a rare case of coexisting giant cell arteritis and subacute thyroiditis that were both successfully managed using glucocorticoid therapy. Ultrasound plays a vital role in the diagnosis and treatment of these diseases. A review of the literature revealed that cases of giant cell arteritis complicated by subacute thyroiditis are very rare, and their pathogenesis and association are still unclear. We summarized the clinical features of giant cell arteritis complicated with subacute thyroiditis and found that none of the patients had symptoms associated with polymyalgia rheumatica. Subacute thyroiditis could be misdiagnosed as giant cell arteritis, and ultrasound is a useful tool for distinguishing the two diseases. Glucocorticoids are effective in the active period in patients with giant cell arteritis complicated with subacute thyroiditis. This case report would encourage clinicians to pay more attention to this phenomenon.
Revision Anterior Cruciate Ligament Reconstruction: Surgeon-Reported Causes of Failure From the Norwegian Knee Ligament Register
Authors: Vindfeld Søren , Persson Andreas , Lindanger Line , Fenstad Anne Marie , Visnes Håvard , Inderhaug Eivind
Published: February 2025

Background:

Failed anterior cruciate ligament reconstruction (ACLR) leads to reduced quality of life and sometimes the need for repeat surgery. The reason for failure can be multifactorial and difficult to determine. Reports on failure leading to revision are few with limited generalizability. Also, no studies have investigated the reasons for early (<2 years) versus late (≥2 years) revision.

Purpose:

To describe patients undergoing revision surgery, the surgeon's reported cause of failure, and the risk of undergoing early versus late revision surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Primary ACLR cases without concomitant ligament injuries or surgery, registered in the Norwegian Knee Ligament Register from 2004 throughout 2023, were eligible. Descriptive analyses were conducted on intraoperative findings and procedures, time from injury to surgery, activity at the time of injury, revision surgery, surgeon-reported cause of revision, and reporting method. The Kaplan-Meier method was used to calculate revision rates. A multivariable Cox regression model, adjusted for confounders, was used to calculate the hazard ratio of early and late revision surgery.

Results:

A total of 30,035 primary ACLR cases were analyzed, of which 1599 resulted in revision surgery. The overall revision rate was 7.1% at 15 years. Female patients were younger at the time of both primary and revision surgery (23.8 and 22.5 years, respectively) compared with male patients (28.2 and 22.2 years, respectively). Age at the time of primary surgery was significantly lower for patients who underwent revision (20.4 years) compared with those who did not undergo revision (26.5 years). Male sex, lower age, hamstring tendon graft, and no cartilage injury at the time of primary reconstruction were all associated with a higher risk of early revision. Lower age, hamstring tendon graft, and no meniscal injury were associated with a higher risk of late revision. New trauma (38.1%) was found to be the most common cause of failure leading to revision.

Conclusion:

In the current study, representing one of the largest cohorts to date investigating failed primary ACLR leading to revision, the overall 15-year revision rate was estimated as 7.1%. Patients receiving hamstring tendon grafts were at a particular risk for early revision during the first 2 years after primary reconstruction. New trauma was the most common reported cause of failure leading to revision ACLR.
Implementing the pillars of value-based care: Leadership lessons from the CIUSSS Centre Ouest de l’Ile de Montreal
Authors: Gutberg Jennifer , Cook Erin , Rosenberg Lawrence
Published: February 2025

The Canadian healthcare landscape is characterized by its ambitious pursuit of innovation in response to challenges such as resource limitations and system restructuring. However, meaningful innovations cannot be sustained without leadership that empowers a patient-first integrated model of care. This article will explore the transformative changes of CIUSSS Centre Ouest de l'Île de Montréal directed to implanting the pillars of a value-based health system. We showcase our “Hospital-at-Home” program as an example to highlight the critical role of leadership in setting our vision of “Care Everywhere,” empowering our healthcare workforce, and in ensuring successful implementation and sustainment. Our manuscript aims to provide insights into the leadership strategies that have underpinned these achievements, focusing on how these innovations have anticipated emerging healthcare demands, and highlighting a sustainable model for health leaders and policy-makers who are addressing similar challenges.
Smart libraries: Unveiling research trends and knowledge dynamics through scientometrics
Authors: Yaseen Ufaira , Gul Sumeer
Published: February 2025

Smart libraries, integrating advanced digital technologies to enhance information retrieval and user experience, have seen a dynamic research growth from 1990 to 2023. This study investigates the global research landscape of smart libraries, analyzing 1801 articles from 92 journals using scientometric techniques with Bibliometrix and MS-Excel. Findings indicate a 12.2% annual publication growth rate, with significant contributions from the USA, UK, and China, and highlight the prevalence of collaborative research. Prominent figures such as Professor Edward A. Fox and institutions like the University of California System are identified as key contributors. Thematic analyses underscore the importance of concepts like “digital libraries,” “information retrieval,” and “user studies” in shaping the field. The study provides practical insights for researchers, policymakers, and practitioners, identifying leading journals and institutions, and offering strategic directions for technological adoption and interdisciplinary collaboration in smart library initiatives.
Understanding the Facets of Work-Related Fatigue Moderated by Cognitive, Behavioural and Contemplative Coping Strategies: A Conceptual Analysis
Authors: Sharma Sakshi , Kumar Sudesh
Published: February 2025

Background:

New-day technology evolutions and modern pedagogical approaches have significantly benefitted teaching environments and teachers. While digital tools have helped ease a lot of work, the challenges of proficiency, better performances, long workable hours and overload of duties have created a cognitive burden on teachers, making them feel mentally, emotionally and physically tired.

Objective:

The objective of this study is to find and fill research gaps in understanding the facets of work-related fatigue in teachers in Indian scenarios. Furthermore, a framework is proposed that investigates the dimensions and facets of fatigue associated with common work stressors, moderated by various categories of coping strategies.

Key Arguments:

The study highlights the prevalence of work-related fatigue in teachers, the impact of stressors, the effectiveness of coping strategies and the need for targeted interventions to enhance teacher well-being and educational outcomes.

Theoretical Framework:

The research is grounded in the job demands-resources theory and conservation of resources theory, which explain the relationship between work demands, available resources and resultant fatigue.

Main Conclusions:

The findings underscore the necessity for educational institutions and policymakers to implement targeted interventions that support teachers in managing fatigue, thereby improving educational quality and fostering a healthier work environment.
Strategic Entrepreneurship Behaviour and the Explorative and Exploitative Innovation of SMEs
Authors: Khan Golam Mostafa , Taghizadeh, Seyedeh Khadijeh , Riyami Said Al , Rahman Syed Abidur , AlAbri Salem
Published: February 2025

Balancing explorative and exploitative innovations poses a significant challenge for small- and medium-sized enterprises (SMEs) due to resource limitations. Strategic entrepreneurship behaviour offers a potential solution; yet an understanding of specific behaviours fostering these innovations remains limited. This study proposes that strategic entrepreneurship behaviour, synthesised from innovation attitude, perceived innovation control and subjective innovation norms, influences SMEs' explorative and exploitative innovation activities. These innovation activities, in turn, are expected to impact new product development and market performance. Data collected, with government permission from 244 SMEs and analysed using SmartPLS, revealed significant effects of innovation attitude and perceived innovation control on both types of innovations. However, subjective innovation norms show no influence. Findings exhibit that explorative and exploitative innovation activities have a favourable influence on new product performance, with the latter significantly affecting the market performance. This study uniquely integrates strategic entrepreneurship behaviours from the Theory of Planned Behaviour and innovation activities from the resource-based view, promoting performance enhancement and offering insights into strategic management and policy formulation.
Exploring Reciprocal and Non-reciprocal Policies of Market Access for SAARC Countries
Authors: Masood Amjad , Ahmed Junaid , Kareem Fatima Olanike
Published: February 2025

This study examines the effect of trade agreements on the bilateral export flows of South Asian Association for Regional Cooperation (SAARC) countries. For empirical estimation, we applied a structural gravity model using the Poisson pseudo-maximum likelihood estimator on annual data from 2000 to 2019. Our approach, following recent developments in gravity trade literature, incorporates domestic sales alongside international trade to fully account for multilateral resistance to trade. The findings show that free trade agreements (FTAs) play a significant role in facilitating trade among SAARC countries, particularly in exporting raw materials and intermediate goods. In contrast, extra-bloc trade largely depends on preferential market access through programmes such as the generalized system of preferences (GSPs) scheme of the European Union. However, preferential tariff schemes designed for the least developed countries have no discernible impact. Surprisingly, no trade facilitation role is evident in the exports of capital goods. Based on these findings, the study offers policy guidance on how the structure of a trade agreement impacts trade connectivity within and beyond the bloc as well as export composition. Well-designed agreements with comprehensive tariff line coverage can facilitate exports of high-value-added products. Moreover, to effectively leverage the trade benefits enabled by GSP arrangements, developing countries must enhance their institutional capacities to ensure compliance with the social, environmental and other prerequisites outlined by GSPs.
An International Reconstruction of Teachers’ and Teacher Educators’ Perspectives on the Challenges of Education for Sustainable Development in Teacher Education
Authors: Dittrich Ann-Kathrin
Published: February 2025

The study aims to discuss the challenges of teachers and teacher educators in the context of Education for Sustainable Development (ESD) and how teacher education can support the implementation of the concept. Teacher education is a central part of higher education which plays a crucial role in supporting the sustainable future. The work is based on qualitative research with the help of group interviews during international online webinars. The findings point out challenges and needs at the stakeholders and policy levels. Educational stakeholders as well the policymakers need more knowledge and a better awareness of sustainable learning for the transformation in teacher education and to rethink educational programmes.
Outlook and Policy Options for Philippine Employment Towards 2040
Authors: Tuaño Philip Arnold P. , Sescon Joselito T. , Castillo Rolly Czar Joseph T. , Lubangco Cymon Kayle , Ponce Brian Jason H. , Vicario Prezatia Moseska Maria H.
Published: February 2025

The Philippine labour market is characterized by a large and diverse workforce but faces significant issues, including adoption to continuing global technological changes in production. Addressing these challenges requires policies that target vital strategic industries for sustainable economic growth and job creation to fulfil its ambitions for the Filipino people in 2040. Using a computable general equilibrium model, we simulate the labour market in the 2024–2040 period, assuming growth targets with modest capital and technological factor productivity changes. The results show an increase in employment shares and presumably the share of value added overall in skilled and unskilled workers. The conduct of multi-sectoral employment planning summits from the national to regional levels as mandated by the recently passed employment law called the Trabaho Act would address issues related to productivity growth.
Considerations for Unaccompanied Immigrant Children in the Child Welfare Reform Debate
Authors: Lyon Zayna , Evans Kerri , Mack Linda-Jeanne M. , Pardue-Kim Morgan
Published: February 2025

This article is temporarily under embargo.
Defining the Characteristics and Outcomes Associated With the Primary Service Provider Teaming Approach: A Systematic Review
Authors: Park Kyunghwa Kay , Carta Judith J.
Published: February 2025

The Division for Early Childhood (DEC) recommends the Primary Service Provider (PSP) approach as the best teaming practice, but research on its core components and outcomes in early intervention remains limited. Using the DEC Recommended Practices Evidence Synthesis Group Guidelines, we conducted a systematic review to identify PSP core components and associated outcomes. An electronic database search and supplementary methods identified six correlational studies. The findings highlight six core components: forming a transdisciplinary team, designating a PSP, the use of an individual team member serving as the PSP and point of contact, delivering and coordinating services, adopting family-centered practices, and fostering team collaboration and support. Implementation of PSP practice was related to enhanced family outcomes, including family satisfaction and quality of life, particularly when family-centered practices were employed, but showed no relationship to child outcomes. Implications for future research and practice are discussed.
Do Citizens Know About Other States’ Policy Choices?
Authors: Harper Samuel F.
Published: February 2025

While citizens’ knowledge of their own state’s policies has been investigated, little attention has been paid to citizens’ knowledge of policy differences across the United States. Citizen knowledge of out-of-state policy adoptions may drive diffusion, but a direct test of this knowledge has yet to be conducted. Using a national survey of US adults, I investigate the relationship between individual, state, and policy characteristics and out-of-state knowledge of four policies: recreational marijuana legalization, assault weapon bans, physician-assisted suicide, and in-state tuition for undocumented immigrants. I find that Americans know about out-of-state policies. However, this knowledge varies with an individual’s education attainment and ideological strength, a policy’s observability and complexity, and a state’s liberalism and population.
Maintaining Safety and Promoting Student Dignity: Recommendations for Developing Crisis Response Plans for Students Who Exhibit Escalated Behaviors
Authors: Robinson Jason , Gershwin Tracy , Wiedemann Katherine , London Dina
Published: February 2025

This article is intended to provide educators with recommendations for maintaining safety and protecting student dignity when writing and implementing crisis response plans. These recommendations include reducing student agitation by recognizing and responding to early signs of escalated student behaviors, embedding choice-making opportunities, and using verbal de-escalation strategies in school settings. Each recommendation is described in practical detail using case study vignettes about students who engage in escalated behaviors.
Nonlinear PID-LQR controller based ACO for enhancing dynamics of active suspension systems
Authors: Benhiba Ayoub , lahlouh Ilyas , Bybi Abdelmajid , Drissi Hilal , Chater El Ayachi
Published: February 2025

This paper presents an innovative approach to analyzing and optimizing the performance of nonlinear hydraulic actuators for vehicle suspension systems. It focuses on dynamic behavior modeling and advanced control strategies designed to improve both driver comfort and vehicle performance. The study uses a comprehensive set of differential equations to model hydraulic operations, incorporating state-of-the-art control methodologies such as nonlinear PID (NL-PID) and advanced techniques such as genetic algorithms (GA), ant colony optimization (ACO), and particle swarm optimization (PSO). The novelty of this work lies in the development and application of the NL-PID-ACO control strategy, which shows superior performance in minimizing chassis displacement and sprung mass acceleration. Specifically, the NL-PID-ACO reduced displacement to 0.0126 m, representing a 35.38% improvement over the NL-PID-PSO, and achieved an optimal acceleration of 0.0632 m/s2, a reduction of 90.6% compared to passive systems. On average, the NL-PID-ACO achieved a displacement of 0.0016 m and an acceleration of 0.078 m/s2, corresponding to a 63.38% improvement over passive suspension systems. These findings underscore the unprecedented efficiency of the NL-PID-ACO control strategy, highlighting its potential as a transformative solution for optimizing the performance of nonlinear hydraulic actuators, ultimately contributing to enhanced driver comfort and vehicle dynamics.
In Silico Analysis and Characterization of the Immunogenicity of Toxoplasma gondii Rhoptry Protein 18
Authors: Foroutan Masoud , Karimipour-Saryazdi Amir , Ghaffari Ali Dalir , Majidiani Hamidreza , Arzani Birgani Arezo , Karimzadeh-Soureshjani Elaheh , Soltani Shahrzad , Elsheikha Hany M
Published: February 2025

Rhoptry protein 18 (ROP18) is a key virulence factor secreted into host cells during the invasion of Toxoplasma gondii ( T. gondii) and plays an important role in the pathogenesis of infection. Due to its potential as a vaccine candidate, this study aimed to characterize several properties of the T. gondii ROP18 (TgROP18) protein to support its inclusion in vaccine formulations. Using a range of bioinformatics tools, we investigated its T-cell and B-cell epitopes, physicochemical properties, subcellular localization, transmembrane domains, and tertiary and secondary structures. Our analysis revealed 48 post-translational modification sites in TgROP18. The secondary structure was composed of 4.87% beta-turns, 38.45% random coils, 42.42% alpha helices, and 14.26% extended strands. Several potential T- and B-cell epitopes were identified on ROP18. The Ramachandran plot of both crude and refined models showed that 85.8% and 95.3% of the amino acid residues, respectively, fell within favored regions, indicating energetically stable conformations. Allergenicity and antigenicity assessments indicated that TgROP18 is a nonallergenic, immunogenic protein. Predictions using the C-ImmSim server suggest that TgROP18 can stimulate humoral and cell-mediated immune responses, based on antibody titers and cytokine profiles following antigen administration. These findings provide baseline data for future investigations focused on the potential of TgROP18 in developing therapeutic strategies against toxoplasmosis.
Is intonation learnable in the classroom? Evidence from Turkish learners of English
Authors: Sonsaat-Hegelheimer Sinem , Levis John
Published: February 2025

For language learners, intonation is widely considered to be important in communicating meaning in context, but intonation is also considered by teachers to be difficult to teach, and some have even argued that it may be unteachable. This exploratory study examines whether explicit teaching of three final intonation contours (falling, rising, falling–rising) led to improved perception and production. Thirty-one Turkish learners of English as a foreign language (EFL) participated in a three-week training session on the perception and production of the three contours at the end of a course on English pronunciation. Results from a pre-test/post-test design showed that perception of all three intonation contours improved after instruction, whereas for the production only the falling–rising and rising contours showed improvement. Results also showed that providing contextual information did not affect production but was helpful in perception. This study suggests intonation can improve when it is explicitly taught to L2 learners, like other aspects of pronunciation.