bluuebunny/crossref_metadata_2025 huggingface dataset:
Moderate and Vigorous Physical Activity Intensity Cut‐Points for Hip‐, Wrist‐, Thigh‐, and Lower Back Worn Accelerometer in Very Old Adults
Authors: Skjødt Mathias , Brønd Jan Christian , Tully Mark A. , Tsai Li‐Tang , Koster Annemarie , Visser Marjolein , Caserotti Paolo
Published: January 2025

Physical activity (PA) reduces the risk of negative mental and physical health outcomes in older adults. Traditionally, PA intensity is classified using METs, with 1 MET equal to 3.5 mL O2·min−1·kg−1. However, this may underestimate moderate and vigorous intensity due to age‐related changes in resting metabolic rate (RMR) and VO2max. VO2reserve accounts for these changes. While receiver operating characteristics (ROC) analysis is commonly used to develop PA, intensity cut‐points, machine learning (ML) offers a potential alternative. This study aimed to develop ROC cut‐points and ML models to classify PA intensity in older adults. Sixty‐seven older adults performed activities of daily living (ADL) and two six‐minute walking tests (6‐MWT) while wearing six accelerometers on their hips, wrists, thigh, and lower back. Oxygen uptake was measured. ROC and ML models were developed for ENMO and Actigraph counts (AGVMC) using VO2reserve as the criterion in two‐third of the sample and validated in the remaining third. ROC‐developed cut‐points showed good‐excellent AUC (0.84–0.93) for the hips, lower back, and thigh, but wrist cut‐points failed to distinguish between moderate and vigorous intensity. The accuracy of ML models was high and consistent across all six anatomical sites (0.83–0.89). Validation of the ML models showed better results compared to ROC cut‐points, with the thigh showing the highest accuracy. This study provides ML models that optimize the classification of PA intensity in very old adults for six anatomical placements hips (left/right), wrist (dominant/non‐dominant), thigh and lower back increasing comparability between studies using different wear‐position.

Clinical Trial Registration: clinicaltrials.gov identifier: NCT04821713
Chinese Characteristics of ESG Under Market Competition and Globalisation
Authors: Wu Ruohan , Jiang Zheng , Shi Huimin
Published: January 2025

We empirically examine how market competitiveness, which is subject to the influences of globalisation, affects Chinese firms' ESG (environmental, social and governance) performance. We acquire detailed information on A‐share listed Chinese firms between 2011 and 2020 and use foreign tariff shocks as instrumental variables of market competitiveness to control for endogeneity. We find that a higher market concentration (i.e., a lower level of market competition) significantly improves firms' ESG ratings. This finding remains robust under various instrumental variables of globalisation influences, various measurements of market competitiveness, various measurements of ESG and various empirical methods. Our mechanism analysis further reveals that market concentration takes positive effects primarily on state‐owned firms' ESG, especially their corporate governance. We attribute this finding to the Chinese characteristics of economy, where government power‐ and state‐owned firms play crucial roles. By studying determinants of Chinese firms' ESG performance by their ownership structures, we fill an important literature gap and provide a better understanding of the Chinese economy.

JEL Classification: L22, F18, F43, Q56
Carnot rectifiability and Alberti representations
Authors: Antonelli G. , Le Donne E. , Merlo A.
Published: January 2025

A metric measure space is said to be Carnot‐rectifiable if it can be covered up to a null set by countably many bi‐Lipschitz images of compact sets of a fixed Carnot group. In this paper, we give several characterisations of such notion of rectifiability both in terms of Alberti representations of the measure and in terms of differentiability of Lipschitz maps with values in Carnot groups. In order to obtain this characterisation, we develop and study the analogue of the notion of Lipschitz differentiability space by Cheeger, using Carnot groups and Pansu derivatives as models. We call such metric measure spaces Pansu differentiability spaces.
Conformal invariance of double random currents I: Identification of the limit
Authors: Duminil‐Copin Hugo , Lis Marcin , Qian Wei
Published: January 2025

This is the first of two papers devoted to the proof of conformal invariance of the critical double random current model on the square lattice. More precisely, we show the convergence of loop ensembles obtained by taking the cluster boundaries in the sum of two independent currents with free and wired boundary conditions. The strategy is first to prove convergence of the associated height function to the continuum Gaussian free field, and then to characterise the scaling limit of the loop ensembles as certain local sets of this Gaussian free field. In this paper, we identify uniquely the possible subsequential limits of the loop ensembles. Combined with Duminil‐Copin et al., this completes the proof of conformal invariance.
Enhanced myocardial perfusion in late gestation fetal lambs with impaired left ventricular inflow
Authors: Hagen Matthew W. , Louey Samantha , Alaniz Sarah M. , McClellan Eric B. , Lindner Jonathan R. , Giraud George D. , Jonker Sonnet S.
Published: January 2025

Robust preclinical models of asymmetric ventricular loading in late gestation reflecting conditions such as hypoplastic left heart syndrome are lacking. We characterized the morphometry and microvascular function of the hypoplastic left ventricle (LV) and remaining right ventricle (RV) in a sham‐controlled late gestation fetal lamb model of impaired left ventricular inflow (ILVI). Singleton fetuses were instrumented at ∼120 days gestational age (dGA; term is ∼147 days) with vascular catheters, an aortic flow probe and a deflated left atrial balloon. Balloons in ILVI fetuses were inflated over the 8 day study until aortic output was eliminated; Sham balloons remained deflated. At the study end‐point (∼134 dGA), cardiac function was assessed by echocardiography, microvascular perfusion of each free wall was measured by myocardial contrast echocardiography (MCE) and terminal morphometric data were collected. During the chronic study, flow through the ascending aorta of ILVI fetuses fell from 389 to −48 mL min−1 with minimal changes to other haemodynamics or blood chemistry. End‐point echocardiography and morphometry similarly showed significant and meaningful reductions in ILVI LV chamber volume and wall mass without statistically significant changes in RV size relative to Shams. MCE revealed modestly increased LV perfusion and profoundly increased RV perfusion in ILVI fetuses. Our model displays effective LV hypoplasia with preserved overall fetal health, and our finding of increased RV myocardial perfusion may indicate active vascular remodelling in response to the experimental lesion.

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Key points

Hypoplastic left heart syndrome can be caused by insufficient inflow of blood to the fetal left ventricle.

We found that eliminating fetal left ventricular input for 8 days reduced left ventricular size and volume, with minimal effects on the right ventricle or overall fetal health.

Blood and oxygen delivery increased significantly in the right ventricle and slightly in the hypoplastic left ventricle. Our results suggest functional and anatomical adaptation of the fetal coronary microvasculature to univentricular right heart conditions.
Incongruent virtual reality cycling exercise demonstrates a role of perceived effort in cardiovascular control
Authors: Bruce Richard M. , Rafferty Gerrard F. , Finnegan Sarah L. , Sergeant Martin , Pattinson Kyle T.S. , Runswick Oliver R.
Published: January 2025

In this study we have used a highly immersive virtual reality (VR) cycling environment where incongruence between virtual hill gradient (created by visual gradient and bike tilt angle) and actual workload (pedalling resistance) can experimentally manipulate perception of exercise effort. This therefore may provide a method to examine the role of effort perception in cardiorespiratory control during exercise. Twelve healthy untrained participants (7 men, age 26 ± 5 years) were studied during five visits. On visit 1 participants underwent cardiopulmonary exercise testing, and during subsequent visits (2–4) participants performed repeated hill climbs at different gradients (of 3%, 6% and 9% in counterbalanced order) with the actual workload ‘congruent’ with virtual hill gradient. On visit 5 participants completed three incongruent trials with virtual hill gradients of 3%, 6% and 9% but a fixed workload equal to that for the 6% climb (iVR3%, iVR6% and iVR9% trials). Despite no difference in power output, there was a significantly elevated rating of perceived exertion (RPE) and mean arterial blood pressure in iVR9% compared to iVR3% and iVR6%, although this effect decayed over time. There was no effect on any respiratory variable, and no significant reduction in RPE or cardiovascular responses was observed during the iVR3% trial. These data suggest that perception of effort and cardiovascular responses to exercise can be manipulated experimentally via virtual hill gradient (using visual and/or vestibular cues) in a VR environment. This work supports those previously showing the existence of a control mechanism which integrates perception of effort and the cardiovascular response to exercise in humans.

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Key points

We aimed to assess whether using a highly immersive virtual reality (VR) cycling environment to create incongruence between perceived effort (virtual hill gradient) and actual effort (pedal resistance) can manipulate cardiorespiratory responses to exercise.

At an equivalent power output cycling up a steeper virtual hill produced greater ratings of perceived exertion (RPEs) and blood pressure responses compared to a virtual hill congruent to power output.

This work suggests the existence of a control mechanism which integrates perception of exercise effort and the cardiovascular response to exercise, which can be experimentally manipulated by VR.
Predictions of Cell-to-Cell Propagation and Vent Gas Production in the Thermal Runaway of Lithium-Ion Battery Stacks
Authors: Qatramez Ala' E. , Kurzawski Andrew , Hewson John , Meehan Michael , Foti Daniel , Headley Alexander J.
Published: January 2025

This work presents the thermal runaway propagation model LIM1TR (Lithium-ion Modeling with 1-D Thermal Runaway) as an efficient tool to predict different cell-to-cell thermal runaway propagation scenarios. We explored the vent gas volume production and reaction duration highlighting the relationship between these parameters and thermal runaway propagation due to convection by the vented gases. Two metrics based on gas production rate and heating rate are utilized as good indicators of the start and end of thermal runaway. LIM1TR results are compared with and validated by experiments from the literature for single-cell and multicell array experiments of 5 Ah and 10 Ah cells. By accounting for intraparticle diffusion of reacting species in the electrodes, we were able to capture the general dynamics of thermal runaway propagation and estimate acceptable reaction durations compared with the experimental values. Simulation results further demonstrated that varying heating modes lead to distinct reaction durations, consistent with experimental observations. Vent gas volume predictions indicate the need to consider both full and partial oxidation of the electrolyte. The outcomes of this work are building blocks for further investigations of module-to-module propagation by vented gases through convective heat transfer.
Multiple testing for signal-agnostic searches for new physics with machine learning
Authors: Grosso Gaia , Letizia Marco
Published: January 2025

In this work, we address the question of how to enhance signal-agnostic searches by leveraging multiple testing strategies. Specifically, we consider hypothesis tests relying on machine learning, where model selection can introduce a bias towards specific families of new physics signals. Focusing on the New Physics Learning Machine, a methodology to perform a signal-agnostic likelihood-ratio test, we explore a number of approaches to multiple testing, such as combining p-values and aggregating test statistics. Our findings show that it is beneficial to combine different tests, characterised by distinct choices of hyperparameters, and that performances comparable to the best available test are generally achieved, while also providing a more uniform response to various types of anomalies. This study proposes a methodology that is valid beyond machine learning approaches and could in principle be applied to a larger class model-agnostic analyses based on hypothesis testing.
Learning Attribute Attention and Retrospect Location for Instance Object Navigation
Authors: Zheng Yanwei , Li Yaling , Li Changrui , Zhang Taiqi , Zou Yifei , Yu Dongxiao
Published: January 2025

Visual object navigation, a classical problem in embodied intelligence tasks, requires agents to find a specified target using only the first-person view of visual information. A number of methods that search only for an object in the same category are known as category navigation. This is different from the real world where objects are labelled as “whose”. Then, the navigation task of distinguishing objects by using attributes is closer to practicality, which is called instance-level object navigation. However, the current instance-level object navigation approaches have some limitations. Firstly, different attribute information are jumbled together and the fine-grained feature relationships are ignored, resulting weakened discriminative ability. Secondly, the explored trajectories have insufficient correlation with the navigation target, resulting in degraded memory ability. In this paper, we present a novel cascade architecture from a fresh perspective to solve those limitations. Our approach has two main techniques: Object-Attribute Attention Graph (OAAG) and Objective Retrospect and Location Module (ORLM). OAAG consists of Object-aware Graph (OAG) which is created to encode the dynamically relations between all instances, and Attribute-Attention Graph (AAG) which assigns different attention weight to different attributes. ORLM makes it possible for the agent to review the region it explores and enhance the relevant memorization of the target. We connect them as the final model output and input it to the deep reinforcement learning A3C framework. We evaluate these two technologies on the AI2-THOR simulator. Experimental studies have shown that our approach outperforms other related works and achieves the state-of-the-art results on three specific tasks (Instance-Localization, Instance-Navigation and Category-Localization). The project is available at https://github.com/visee-sdu/Instance-Navigation.
Experimental Investigation of Strengthening Silt With the MICP Technique Combined With Cement
Authors: Zhang Jiayuan , Lin Wenbin , Zhuo Zulei , Tang Xiaoqiong , Wu Shanying , Luo Lijin
Published: January 2025

In this research, the microbial‐induced carbonate precipitation (MICP) technique combined with cement was proposed to improve the physical and mechanical properties of silt. A series of comparative experiments of the MICP technique combined with cement treatments on silt (MICP‐reinforced soil‐cement) were conducted. The unconfined compressive strength (UCS), internal friction angle, cohesive force, and ultrasonic velocity of the silt treated with the MICP technique combined with cement were higher than those treated with cement. The X‐ray diffraction (XRD) and scanning electron microscope (SEM) tests showed that the cement hydration products cemented the silt into agglomerates and formed a skeleton, and the calcite produced by the MICP process covered the surface of the agglomerates and filled the silt pores and cemented the particles, which played a role in increasing the strength of the specimens. In addition, the products and reactants of MICP accelerated the hydration reaction of the cement and played a role in the curing system consistent with carbonate‐based and alkaline earth metal–based early‐strengthening agents. The results of this study will provide basic theoretical and experimental data for the research and application of microbe‐based treatment approaches for silt.
Refractory and Relapsing Laryngeal Edema Possibly Associated With Chronic Tonsillitis and Mycoplasma Infection, Requiring Reintubation and Tracheostomy
Authors: Tsukamoto Yutaka , Sugimoto Takashi , Umeda Masataka , Furuse Yuki , Yoshida Haruo , Nagae Yuka , Ohsato Yasuo , Ueki Yukitaka , Takahiro Maeda , Ariyoshi Koya
Published: January 2025

Relapsing epiglottitis has rarely been reported, and its etiology is not well established. A 44‐year‐old previously healthy Japanese man presented with a quickly progressing choking sensation. He had been experiencing refractory and relapsing laryngeal edema and probably acute epiglottitis (three episodes within 2 weeks), with rash and elevated pancreatic amylase. The patient required immediate intubation. After the initial extubation, he required reintubation and a subsequent tracheostomy. Antibiotics, glucocorticoid, and antihistamines were administered, and he finally recovered with the tracheostomy’s closure. Potential causes of this patient’s relapsing epiglottitis are as follows: persistent right swollen tonsil; a positive result on a Mycoplasma pneumoniae antigen test and a particle agglutination (PA) test, implicating chronic tonsillitis; and/or Mycoplasma infection. This is the first case report of refractory and relapsing epiglottitis requiring reintubation possibly concurrent with chronic tonsillitis and Mycoplasma infection.
Radioprotective Effects of Vitamin C, Cimetidine, and Famotidine on Lipid Peroxidase and Hepatic Glutathione Levels in Mouse Liver
Authors: Gholami Mana , Ahmadi Ali Asghar , Yusofvand Reza , Khanchoupan Milad , Hajimazdarany Shima , Najibi Reza
Published: January 2025

Radiation therapy is one of the most effective treatments for approximately 60% of patients with cancer. During radiation exposure, the overproduction of reactive oxygen species (ROS) disrupts the lipid layer of the membrane, leading to subsequent peroxide radical formation. Cimetidine (Cim) and famotidine (Fam) are histamine H2 receptor antagonists (H2 blocker), also known as peptic ulcer drugs, that exert radioprotective effects. Vitamin C (Vit.C) is an effective free radical and ROS scavenger with significant radioprotective effects. In this experimental study, male mice (6–8 weeks and 28 ± 3 g) were used in five groups. To evaluate ionizing radiation, gamma rays were used at two doses of 2 and 4 Gy and different doses of Cim, Fam, and Vit.C administered as the protectives. Finally, the livers of the mice were isolated and homogenized. The levels of lipid peroxidase and reduced and oxidized glutathione were measured using standard methods. With increasing radiation dose, lipid peroxidase activity, GSSG level, and glutathione content increased. The findings showed that in the drug‐only group, Vit.C had better protection than the other two drugs, and the combination of the three drugs had excellent radiation protection. Radiation protection of normal cells in radiotherapy is a valuable necessity. A number of drugs can protect cells against ionizing radiation through different mechanisms. The results suggest that Fam, Cim, and Vit.C can be radioprotective individually or in combination.
Comparative Evaluation of Canal Transport and Centralization Between ProTaper Next and XP‐endo Shaper Systems Using CBCT Analysis: An In Vitro Study
Authors: Karkehabadi Hamed , Shokri Abbas , Banitalebi Negar , Abbasi Roshanak
Published: January 2025

Aim: This study compared the apical transportation and centering ratio of ProTaper Next (PTN) and XP‐endo Shaper (XPS) nickel titanium (NiTi) rotary files in curved root canals using cone beam computed tomography (CBCT).

Methodology: The current in vitro study involved the mesiobuccal canals of mesial roots in 44 extracted mandibular first molars that exhibited apical curvature ranging from 10° to 30°. Two experimental groups were randomly formed from the teeth (n = 22) and subjected to instrumentation with PTN and XPS. CBCT scans were performed before and after instrumentation on the teeth, and the apical transport and centering ratio were calculated at 3, 4, and 5 mm from the apex. Group comparisons were conducted using an independent t‐test with a significance level set at alpha = 0.05.

Results: Comparisons within groups did not reveal any statistically significant differences in the magnitude of canal transportation in the buccolingual (BL) and mesiodistal (MD) directions at any level from the apex, neither in the XPS group nor in the PTN group (p > 0.05). Canal transportation in both BL and MD directions was significantly greater in PTN than in XPS (p < 0.05). The centering ratio in the MD and BL directions was the same at 3, 4, and 5 mm from the apex in the PTN (p > 0.05) and also in the XPS (p > 0.05) groups. The centering ratio was significantly higher in XPS than in PTN (p < 0.05) except at 5 mm from the apex in the MD direction and 4 and 5 mm from the apex in the BL direction (p > 0.05).

Conclusions: Both buccolingually and mesiodistally, PTN led to greater apical transport than XPS and also showed a lower centering ratio.
Novel Von Hippel-Lindau Germline Variants in Iranian Patients with Retinal Capillary Hemangioblastoma
Authors: Azimi Fatemeh , Bagherzadeh Kowsar , Khakpoor Golnaz , Talebi Saeed , Sedaghat Ahad , Mirshahi Reza , Kasraei Hengameh , Afshar Kiaee Reza , Naseripour Masood
Published: January 2025

Introduction: The aim of this study was to determine the potential genetic cause of retinal capillary hemangioblastoma (RCH) with symptoms of Von Hippel-Lindau (VHL) disease. Case Presentations: Three Iranian families (5 RCH patients) with novel variants are included in this study. The VHL variant analysis was performed by the Sanger sequencing technique. Molecular dynamics (MDs) simulations were conducted to analyze conformational changes resulting from variants in VHL protein structure and were compared with that of the native structure. Novel variant sites, including c.511A>C, c.511A>T, and c.514C>T in exon 3 of the VHL gene were identified. According to the American College of Medical Genetics (ACMG) classifications, c.514C>T (p.P172S) and c.511A>C (p.K171Q) are classified as variants of uncertain significance (VUS), and c.511A>T (p.K171*) is classified as a likely pathogenic variant. MD simulations demonstrated overall fluctuations of the proteins structure and a significantly lower degree of flexibility in the α-domain for the variant-encoded VHL protein structure compared to that of the native form. Conclusion: The structural information and computational analysis of the identified variants are predicted to induce conformational changes that limit the flexibility of protein VHL interaction interface with Elongin B/C, Elongin C/B, and Cullin-2, which are necessary for hypoxia-inducible factor 1-α binding. The genetic variants identified in Iranian patients with RCH may aid in the molecular confirmation of other patients diagnosed with VHL and their at-risk family members. These pioneering results that include detailed structural and functional analysis of a variant’s effect on the VHL protein may serve as a model for future studies.
Serum Irisin Levels Are Positively Correlated with Physical Activity Capacity in Hemodialysis Patients
Authors: Fan Zhengjia , Wu Feng , Wang Peixin , Wu Leiyun , Zhang Jialing , Li Wen , Pang Qi , Zhang Aihua
Published: January 2025

Introduction: Regular physical activity is beneficial for health but is often reduced in patients receiving maintenance hemodialysis treatment. Irisin is a muscle-secreted hormone that reportedly improves metabolism and slows down the progression of some chronic diseases. In this study, we aimed to investigate the relationship between physical activity capacity and serum irisin levels in hemodialysis patients. Methods: Our study included 252 patients undergoing hemodialysis at Xuanwu Hospital Capital Medical University. Enzyme-linked immunosorbent assay was used to measure blood irisin levels. Body composition was analyzed by bioelectrical impedance analysis. The International Physical Activity Questionnaire (IPAQ) was used to score physical activity ability. Results: Bivariate correlation analysis showed a positive correlation between IPAQ scores and ln irisin (the natural logarithm of irisin; r = 0.326, p < 0.001). Independent determinants of IPAQ scores were ln irisin, age, fasting glucose, and carbon dioxide combining power. Conclusion: Our findings provide the first clinical evidence that serum irisin levels are positively correlated with physical activity capacity in hemodialysis patients.
Exploring Health Literacy among Adults with Hidradenitis Suppurativa
Authors: Koerts Nicole D.K. , Horváth Barbara
Published: January 2025

Background: Health literacy plays an important role in the management of chronic and debilitating skin diseases like hidradenitis suppurativa (HS). Adequate health literacy empowers patients to understand their disease, manage it effectively, and make informed decisions about their health. Exploring the interplay between health literacy and HS is essential to improve healthcare outcomes in this population.

Objectives: This study aims to assess the prevalence of limited health literacy among HS patients and its associated factors which has never been studied before.

Methods: In this epidemiological cross-sectional study data were collected through a population-wide survey-based study within the Lifelines Cohort Study in the Netherlands. Health literacy of participants with HS were compared to non-HS controls. Health literacy was measured using six validated questions covering functional, communicative, and critical health literacy. Associations between the characteristics of the HS group and limited health literacy were examined.

Results: Out of 56,084 adult respondents, 1,156 participants with HS were identified. The prevalence of limited functional health literacy was 24.5% in the non-HS group and 26.4% in the HS group. Our findings indicate that limited health literacy among HS patients is associated with higher BMI (26.9 vs 25.8) [OR 0.969, 95% CI 0.941-0.998], lower education level (34.5% vs 19.9%) [OR 0.495, 95% CI 0.350-0.701], lower socioeconomic status (-0.68 vs -0.58) [OR 1.194, 95% CI 1.029-1.386]), and more severe disease stage according to the Hurley stage (33.0% vs. 25.8%) [OR 1.400, 95% CI 1.005-1.952].

Conclusions: Our study highlights the importance of addressing health literacy in HS patients, given the high prevalence of limited health literacy among this group and associations with higher BMI and more severe disease stage. Limited health literacy may contribute to poorer health outcomes, suboptimal healthcare utilization, elevated healthcare costs, and health disparities. Targeted interventions to improve health literacy could enhance care quality and outcomes for HS patients.
Digital Plurilateralism in International Economic Law
Authors: Dimitropoulos Georgios
Published: January 2025

The rise of the digital economy has prompted states to turn to domestic law – including data localization, source code disclosure requirements, digital asset restrictions, and digital services taxes – to address its challenges. Simultaneously, states are increasingly leveraging plurilateral frameworks, such as the Indo-Pacific Economic Framework for Prosperity (IPEF), and plurilateral agreements, such as the Joint Statement Initiative (JSI) on e-commerce in the World Trade Organization (WTO), to address the economic and geoeconomic challenges posed by the digital economy. The article examines the role of plurilateralism and plurilateral agreements in regulating the digital economy. It explores plurilateralism as a regulatory strategy for digital technologies in international trade, both within and outside the WTO. It also compares digital plurilateralism with other modalities of international governance, including multilateral and regional approaches. The article concludes by underscoring the merits of plurilateralism as a form of ‘unilateral multilateralism’ and explores its potential to shape future international ordering in the digital economy.
A Retrospective Study of Laparoscopic Distal Gastrectomy Guided by Carbon Nanoparticle Suspension Injection Lymphography for Gastric Cancer
Authors: Gu Jiayi , Liu Tao , Ni Bo , Huang Yile , Shen Yanying , Zhang Yeqian , Guan Yujing , Bai Long , Zhang Haoyu , Aimaiti Muerzhate , Wang Shuchang , Yue Ben , Xia Xiang , Zhang Zizhen , Cao Hui
Published: January 2025

Background

The use of lymph node (LN) tracers can help obtain a complete dissection of the LNs and increase the detection rate of metastatic LNs. Carbon nanoparticle suspension injection (CNSI) has become increasingly used in radical gastrectomy procedures. This study is designed to evaluate the quality of LN dissection in gastric cancer patients with laparoscopic distal gastrectomy under the guidance of CNSI lymphography.

Method

This was a retrospective cohort study including patients with a pathological biopsy diagnosis of resectable gastric cancer who underwent laparoscopic distal gastrectomy. Data was focused on patients at [Renji Hospital of Shanghai Jiaotong University] from July 2023 to January 2024. Patients were divided into the CNSI group and control group after 1:1 propensity score matching analysis. The median number of LNs harvested was compared between groups. Perioperative status and any complications that arose within 30 days were also analyzed.

Result

After 1:1 propensity matching analysis, there were 49 patients each in the CNSI group and control group. The median number of harvested LNs was larger in the CNSI group than the control group ( P = 0.01). A significant difference between 2 groups was observed in surgery time ( P = 0.008). The morbidity of any short-term postoperative complications within 30 days after surgery revealed a similar outcome ( P > 0.05).

Discussion

CNSI-guided laparoscopic distal gastrectomy is less time-consuming and harvests more LNs. For laparoscopic distal gastrectomy, CNSI-guided lymphography can be an excellent adjuvant.
Cost-Benefit Analysis of Various Management Algorithms for Suspected Choledocholithiasis
Authors: Kelley Jesse K. , Mormol Jeremy , Reiber Mary , Sena Avery , Joy Abutin Camille , Sypniewski Jake , Reed Charles , Zambito Giuseppe M. , Banks-Venegoni Amy L.
Published: January 2025

The goal of our study is to evaluate the safest, efficient, and most cost-effective way to manage suspected choledocholithiasis. This retrospective study evaluated adult patients with suspected choledocholithiasis based on labs and imaging at a single institution between 2017 and 2022 and characterized them into 1 of 3 groups based on their management pathway: (1) ERCP-first, (2) MRCP-first, or (3) surgery-first with possible intraoperative cholangiogram pending laboratory trend. Our primary outcome was hospital length of stay. 34 patients (25%) had MRCP-first, 60 patients (45%) had ERCP-first, and 39 patients (30%) received surgery first. There was no statistically significant difference in the length of stay with respect to the management pathway utilized ( P > .05); however, those admitted to a surgical service were discharged on average one day before those admitted to the medicine service ( P = .01).
Novel Use of Drug-eluting Stent in Otologic Surgery to Prevent Restenosis
Authors: Karasik Daniel , Killeen Daniel E. , Anne Samantha , Mowry Sarah E.
Published: January 2025

Objectives:

The primary objective of this case series is to assess the effectiveness of the off-label use of the PROPEL drug-eluting stent, traditionally FDA-approved for sinus surgery, in preventing restenosis following canalplasty in patients with chronic otologic conditions or congenital anomalies. The stent provides both mechanical support to maintain canal patency and localized steroid delivery to reduce inflammation and scarring.

Methods:

Four patients with various otologic conditions underwent canalplasty, followed by the placement of drug-eluting stents into the external auditory canal. The stents were inserted to address postoperative stenosis. Clinical outcomes, including ear canal patency, hearing improvement, and the rate of restenosis, were evaluated through regular follow-ups.

Results:

All patients showed improved ear canal patency, with minimal restenosis observed during follow-up. Hearing improvement was reported in 3 out of 4 patients. The pediatric case exhibited mild medial canal stenosis despite stent placement, but overall improvement was noted. No adverse effects were associated with the stent usage.

Conclusions:

The off-label use of a drug-eluting stent in canalplasty appears to reduce restenosis rates and maintain canal patency in adults effectively. Further research is warranted to standardize protocols and expand its indications for otologic surgery, particularly in pediatric cases where outcomes may vary.
Folic and folinic acid load tests for dynamic assessments of compliance and metabolism in folate deficiency and hyperhomocysteinaemia patients unresponsive to high-dose folate replacement
Authors: Kalaria Tejas , Sobczyńska-Malefora Agata , Rebbapragada Himabindu , Hussein Rawya , Harrington Dominic J , Gama Rousseau , Basu Supratik
Published: January 2025

We describe the utility of ‘folic and folinic acid load tests’ in the investigation of a 26-year-old woman with persistently low serum folate and moderate hyperhomocysteinaemia unresponsive to folic acid supplements. Serum folate, plasma 5-methyltetrahydrofolate (5-MTHF), red cell 5-MTHF and plasma total homocysteine at baseline, 2-h, 4-h and 2- or 4-days (if applicable) post administration of a large dose of oral folic acid, or oral or parenteral folinic acid were measured. The tests confirmed non-compliance but also suggested an unsuspected possible defect in the folate pathway based on differential response to folic versus folinic acid supplements. The folic and folinic acid load tests identify non-compliance and can help identify possible defects related to the absorption, transportation, or metabolism of folate.
Patterns of (Mis)Behavior: An Assessment of Predictors of Institutional Misconduct Among Elderly Incarcerated Individuals
Authors: Wronski Beatriz Amalfi , Narvey Chelsey S.
Published: January 2025

The incarcerated elderly population has been steadily increasing in the past few decades. Placed in a prison system not designed to attend to their needs, the elderly face a myriad of challenges and struggle to adjust to the rules and expectations of the correctional system. Our study builds on previous works to assess the heterogeneity within this population and assessing the predictors of institutional misconduct among two theoretically distinct group of incarcerated elderly: those imprisoned young(er) and those imprisoned for a crime they committed while elderly. Results highlight the importance of age-specific programing to attend to the needs of a diverse incarcerated population.
Item Classification by Difficulty Using Functional Principal Component Clustering and Neural Networks
Authors: Zoucha James , Himelfarb Igor , Tang Nai-En
Published: January 2025

Maintaining consistent item difficulty across test forms is crucial for accurately and fairly classifying examinees into pass or fail categories. This article presents a practical procedure for classifying items based on difficulty levels using functional data analysis (FDA). Methodologically, we clustered item characteristic curves (ICCs) into difficulty groups by analyzing their functional principal components (FPCs) and then employed a neural network to predict difficulty for ICCs. Given the degree of similarity between many ICCs, categorizing items by difficulty can be challenging. The strength of this method lies in its ability to provide an empirical and consistent process for item classification, as opposed to relying solely on visual inspection. The findings reveal that most discrepancies between visual classification and FDA results differed by only one adjacent difficulty level. Approximately 67% of these discrepancies involved items in the medium to hard range being categorized into higher difficulty levels by FDA, while the remaining third involved very easy to easy items being classified into lower levels. The neural network, trained on these data, achieved an accuracy of 79.6%, with misclassifications also differing by only one adjacent difficulty level compared to FDA clustering. The method demonstrates an efficient and practical procedure for classifying test items, especially beneficial in testing programs where smaller volumes of examinees tested at various times throughout the year.
Prosodic Modifications to Challenging Communicative Environments in Preschoolers
Authors: Yi Hoyoung , DiCristofaro Delaney , Song Woonyoung
Published: January 2025

Adapting one’s speaking style is particularly crucial as children start interacting with diverse conversational partners in various communication contexts. The study investigated the capacity of preschool children aged 3–5 years ( n = 28) to modify their speaking styles in response to background noise, referred to as noise-adapted speech, and when talking to an interlocutor who pretended to have hearing loss, referred to as clear speech. We examined how two modified speaking styles differed across the age range. Prosody features of conversational, noise-adapted, and clear speech were analyzed, including F0 mean (Hz), F0 range (Hz), energy in 1–3 kHz range (dB), speaking rate (syllables per second), and the number of pauses. Preschoolers adjusted their prosody features in response to auditory feedback interruptions (i.e., noise-adapted speech), while developmental changes were observed across the age range for clear speech. To examine the functional effect of the modified hyper-speech produced by the preschoolers, speech intelligibility was also examined in adult listeners ( n = 30). The study found that speech intelligibility was higher in noise-adapted speech than in conversational speech across the preschool age range. A noticeable increase in speech intelligibility for clear speech was observed with the increasing age of preschool talkers, aligning with the age-related enhancements in acoustic prosody for clear speech. The findings indicate that children progressively develop their ability to modify speech in challenging environments, initiating and refining adaptations to better accommodate their listeners.
Death Penalty in Modern Japan (1868–1945): Evolving Execution Practices and Their Societal Impact
Authors: Lin Cheng-Yu
Published: January 2025

This article investigates the evolution of capital executions in modern Japan, focusing primarily on two major aspects: the reform of execution methods to reduce physical suffering, and the implementation of measures to preserve the confidentiality of executions. These aspects created a notable distance between public awareness and the realities of death penalty, particularly regarding actual executions. Consequently, calls for abolition gradually shifted from concerns about the suffering of death-row inmates to societal issues and abstract theoretical considerations. Although reform efforts were generally viewed as progressive, they did not lead to a significant reduction in the state’s reliance on the death penalty. On the contrary, the public’s detachment from the death penalty contributed to the persistence of the practice.
Risk of Suicide Among Patients With Major Physical Disorders Considering Comorbidities of Mental Disorders: An Instrumental Variable Analysis
Authors: Lu Ning , Wen Tzu-Jung , Huang Kuo-Cherh
Published: January 2025

Suicide is an important health concern. Excepting cancer, the association between physical disorders and suicidal risk is comparatively less explored. Instrumental variable analysis has been suggested as a powerful technique to deal with possible bias caused by unmeasured confounders in observational research. This population-based study set out to assess the suicidal risk of patients with major physical disorders by employing the instrumental variable analysis. Data were retrieved from the National Health Insurance Research Database and the Death Certification Registry in Taiwan (years 2010–2018). The Cox proportional hazards model with an instrumental variable estimator was performed, adjusting for comorbidities of mental disorders and other covariates. Analytical results showed that compared to their counterparts, patients with major physical disorders had an elevated risk of death by suicide within one year and three years after diagnosis of physical illness. Only did epilepsy not demonstrate a statistically significant impact on the risk of suicide.
Limited Impact of Introducing Proportional Representation on Women’s Representation: Insights from a Quasi-Experiment in Local Elections
Authors: Gulczyński Michał , Köppl–Turyna Monika , Kantorowicz Jarosław
Published: January 2025

Proportional representation electoral systems were long argued to increase the share of women, compared with majoritarian systems. However, recent studies provide strong evidence that, usually, less women are elected in open-list proportional representation than in closed-list proportional representation. In this study, we test whether open-list proportional representation is enough to increase the share of women in local legislative bodies. We examine a change from a first-past-the-post to an open-list proportional representation with gender quota in Polish municipality council elections. We exploit an arbitrary population threshold to use the difference-in-discontinuities and regression discontinuity designs and do not find sufficient evidence that this change affected women’s representation. We find little evidence for any effect on higher council fragmentation that could have harmed women’s chances, and, analysing simultaneously held regional elections, we find no effect of the reform on voter behaviour. We also show that women’s representation in Poland has been increasing over the past two decades, regardless of the electoral system changes. Thus, even substantial electoral reforms may have relatively little effect on women’s representation.
Integration in the Host Country, Mean Political Interest and Focus Shift towards Host Country Politics: Patterns of Transnational Political Interest among Germans from Turkey
Authors: Goerres Achim , Elis Jonas , Mayer Sabrina J , Spies Dennis C
Published: January 2025

Transnational political interest is the sustained attention to politics in at least two polities. Why do some immigrant-origin citizens show high levels of political interest in both their host countries and their familial countries of origin, some none, and others favour one over the other? With the 2017 Immigrant German Election Study, we describe the diverse patterns of transnational political interest among Germans from Turkey and their children, one of the largest immigrant-origin communities. We explicitly focus on the effects of three dimensions of integration and reveal that social integration has, by far, the strongest association with mean political interest. In addition, all dimensions of integration tilt the focus of political interest in favour of German politics, effects that are mediated by the individual identification with Germany and Turkey. Integration thus seems to activate immigrant-origin citizens into politics in general but tilts their transnational political interest towards host country politics.
Necessary Conditions in Social Media Addiction: Identifying Key Antecedents
Authors: Liao Chien-Po , Wu Chi-Cheng , Chen Chi-Chung
Published: January 2025

This study aims to address the fragmented understanding of the antecedents of social media addiction (SMA) by examining key factors and their roles as necessary and sufficient conditions. By integrating key variables from previous research, including the Dark Triad traits, self-regulation, social anxiety, and Fear of Missing Out (FoMO), the study investigates their relationships with SMA. Data were collected through 369 questionnaires and analyzed using regression analysis and Necessary Condition Analysis (NCA). The findings reveal that Machiavellianism, narcissism, and FoMO are significantly associated with SMA, while only Machiavellianism and FoMO are identified as necessary conditions. These results contribute to the theoretical understanding of SMA by identifying critical antecedents and offer practical insights for designing targeted interventions to mitigate its impact.
Using discrete-event simulation for planning and managing mass vaccination centers: a comprehensive examination
Authors: Jerbi Abdessalem
Published: January 2025

Different studies based on discrete-event simulation have been conducted to evaluate the operation of mass vaccination centers and assist healthcare planners in improving their performance. These studies explored different parameters and scenarios for the operation of mass vaccination centers and generated several results. This review aims to assess discrete-event simulation applications in mass vaccination center management. This critical analysis concentrated on every phase of the project method for discrete-event simulation. To ensure comprehensive coverage, scholarly works about the application of discrete-event simulation in mass vaccination centers were sourced from the World Health Organization’s COVID-19 research database and other databases, including Web of Science, Scopus, MDPI, Sage, PubMed, medRxiv, and the WHO COVID-19 research database. Only English-language studies detailing the application of discrete-event simulation in mass vaccination centers were taken into account. The vaccines, simulation software, strategies, or origins were all unrestricted. Hence, the search was expanded to include other vaccination campaigns besides COVID-19. Our investigation included vaccination campaigns against H1N1 and the influenza virus. Eleven studies were selected. The results show that most simulation studies of vaccination centers have several shortcomings that are visible at every phase of the discrete-event simulation project. Through an analysis of the current state of vaccination center simulation studies, our research identifies best practices for upcoming studies. Following these recommendations ought to raise the standard of upcoming studies at large vaccination centers.
Educating the United States on the ‘China threat’
Authors: Pennanen Henna-Riikka
Published: January 2025

This article studies representations of China as a threat in the United States with a particular focus on the years of the Trump presidency, and on actors networked in and around the administration. The research questions are: how is the ‘China threat’ image constructed through representations, and with what intentions? The article contributes to IR studies on state-based threats in general, and studies on the current US-China relations in particular. The empirical analysis shows that in representing China, the actors intentionally or unintentionally tapped onto multiple IR theories and in the process, they created a compelling blueprint for threat images. The intention of the actors was then to ‘educate’ the US with this ‘China threat’ image. This intent to educate had the objective of invoking threat perception, and thus receive public and political support for the strategies and policies the actors proposed to counter the threat. This observation leads to a proposition that threat representations have the potential to influence threat perceptions/misperceptions. Therefore, a cultural studies perspective of represented ‘China threat’ images – as adopted in this article – can complement political psychology studies of ‘China threat’ images held by individual and collective elites.