bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Relationship Between Empathy, Theory of Mind (ToM), and Parenting Styles Among Children With Disruptive Behaviour
Authors: Saranya M T Lakshmi , Jayakumar C. , Natarajan Gitanjali , Edward Monsy , George Shaju , Ashish Elsa
Published: February 2025

Disruptive behaviour has been recognized as one of the most common and persistent forms of childhood maladjustment, and predictive of a range of negative adolescent and adult outcomes including continuing aggression, failure in school and work settings, substance abuse, and late-onset psychopathology. As a child grows many factors influence the child’s development like genetic factors, parenting styles, attachment patterns, environmental factors etc. These factors help in the development of empathy, theory of mind (ToM), emotional and behaviour regulation. We need to understand the relation between these factors among children with disruptive behaviours, inorder to develop targeted interventions and support strategies tailored to the unique needs of this population. A sample of 70 children and their mothers completed validated psychometric scales. Pearson correlation & regression analysis were conducted to determine the relation between variables. Results indicated that a significant negative correlation was observed between the permissive parenting style of the father and ToM among children with disruptive behaviour. Empathy was considered a significant inverse predictor of disruptive behaviour among children with disruptive behaviour. Another finding suggests that there is no significant difference in disruptive behaviour between boys and girls and no evident association between parenting styles and disruptive behaviours in children. While this could imply that inherent factors (nature) may have a more notable influence on disruptive behaviour in this sample, it is important to consider that this does not rule out the potential impact of environmental factors (nurture). The results should be viewed as part of a complex interplay between nature and nurture, and further investigation, particularly through longitudinal studies, is needed to clarify their respective contributions. This study builds upon existing research in providing a better understanding of contributors to disruptive behaviour among children, which may assist in the development of interventions to promote positive socio-emotional development and enhance the overall well-being of children.
Women in Second Temple fiction
Authors: Culpepper R. Alan
Published: February 2025

During the tumultuous time of enormous threat, conflict, and change in the Second Temple period, a new literary genre emerged: works of fiction in which women take on new roles and serve as Jewish heroines. In addition to highlighting fantastic feats of women characters, these works provide insight into the everyday lives of women in the Second Temple period. These works also convey the rhetorical themes of protecting Jewish identity and purity. The heroines of the Second Temple period are remarkable in that they refuse to submit to “the tyrant” by eating forbidden foods, abandoning circumcision, the ancient sign of the covenant, or worshiping false gods. The portrayal of Mary in the Gospel of Luke draws upon these earlier traditions to present her as a heroine who has also found favor in God’s sight.
Exploring Barriers, Facilitators, and Needs Related to Mental Health Promotion for Police Officers: A Qualitative Approach
Authors: Ryu Gi Wook , Lee Ji Yeon
Published: February 2025

Police officers are vulnerable to psychological distress and trauma since they are constantly exposed to significant physical and mental violence. Poor mental health can lead to increased healthcare costs for individuals, organizations, and nations and negatively impacts public safety. Mental health interventions tailored to the nature of police work are needed; however, a research gap exists regarding understanding the mental health of police officers. This study aimed to explore the barriers, facilitators, and needs for mental health promotion among police officers. This study adopted a qualitative approach in South Korea. Twelve police officers working in a metropolitan city were recruited using purposive sampling methods. One-on-one interviews were conducted with open-ended questions regarding barriers, facilitators, and needs for improving mental health. Content analysis was used to derive relevant themes. The participants included 3 women and 9 men, with an average age of 37.8 years and working experience of 12.6 years. Three themes and 9 subcategories emerged. The theme related to barriers was “difficulty accessing resources”; the theme related to facilitators was “supportive environment for mental health prevention and management”; and the theme related to needs was “education and policies to promote mental health.” Considering the occupational and organizational characteristics of the police profession, individual and organizational interventions and policies are needed to adequately manage the mental health of police officers.
Creditor Rights, Conflict of Interest Among Creditors, and Borrowers’ Accounting Conservatism: Evidence From Anti-Recharacterization Laws
Authors: Cao Huijuan , Cheng C. S. Agnes , Li Xiaohui Fiona , Zhang Janus Jian
Published: February 2025

Using the staggered adoption of anti-recharacterization laws (ARLs) as an exogenous shock to creditor rights, we study the effects of creditor rights on borrowers’ accounting conservatism. By forbidding securitized assets from being recharacterized as collateral for secured debt, ARLs protect securitization creditors at the expense of non-securitization creditors. Given the conflict of interest between these creditors, we argue that non-securitization creditors may demand more conservative accounting in response to their decreasing rights. Consistent with this argument, we find an increase in borrowers’ accounting conservatism after ARL adoption. To further support our demand-side argument, we present evidence that the effect of ARLs on accounting conservatism is stronger for borrowers with a higher likelihood of securitizing assets, those with unsecured creditors, and those with loan contracts that include more financial covenants. We also find a stronger effect for borrowers that are more likely to default, as captured by their credit risk, and for borrowers that are more difficult to monitor, as indicated by their poor information environment. Overall, our study establishes a link between creditor rights and borrowers’ accounting conservatism. We also add to the literature by offering novel evidence that creditors’ demand for accounting conservatism shapes borrowers’ financial reporting practices.
Democratic legitimacy and its vulnerabilities: The case of South Africa
Authors: Levy Brian
Published: February 2025

This article uses the example of South Africa to explore how inequality, institutions, identity, and polarization interact. The first 15 years of the country’s constitutional democracy was characterized by a virtuous spiral fueled by hope that a thriving, inclusive society was in reach, an embrace of win-win cooperation, and a surge of civic confidence in the legitimacy of the public domain. The next 15 years witnessed rising discontent in response to continuing massive inequality and economic hardship – plus sustained efforts by populist political entrepreneurs to use economic discontent to fuel identity-based polarization and weaken institutions. In both periods, contrary to the either/or discourse of much scholarship, change was fueled by the ways in which economic expectations and identity politics interacted with one another. Renewal of the political center needs both reforms that address economic imbalances and engagement at the level of ideas.
Deformation mechanisms of high strength and plasticity Fe-24Mn-3.5Cr-0.4C austenitic steel at 4.2 K
Authors: Jiang Mingyue , Xie Liancheng , Yuan Yuan , Liu Kun , Geng Zhen , Liu Huiming , Wang Zekun , Huang Chuanjun , Miao Zhicong , Huang Rongjin
Published: February 2025

In this work, austenitic high-Mn steel that exhibits both high strength and plasticity at extremely low temperatures was designed and investigated, which demonstrates a yield strength of 1022 MPa, a tensile strength of 1532 MPa, and an elongation of 25% at 4.2 K, and enables potential operating in low-temperature structural materials. Compared to at room temperature, both the yield strength and the tensile strength of the high-Mn steel at low temperature increased, while the elongation at break decreased. A comparative study of its microstructural evolution was carried out using X-ray diffraction, transmission electron microscopy, and electron backscatter diffraction. The microstructure analysis revealed that the dislocations and nano-twinning control the strain-hardening behavior of the twinning-induced plasticity behavior of the Fe-24Mn-3.5Cr-0.4C steel.
Aquatic exercise interventions in the treatment of musculoskeletal upper extremity disorders: A scoping review
Authors: Murray Lynn , Kennedy Michelle , Malone Michael , Mair Lyn , Alexander Lyndsay
Published: February 2025

Objective

To identify literature on aquatic exercise therapy used to manage upper extremity musculoskeletal disorders and identify key concepts, intervention components, and gaps in the evidence base.

Data sources

The comprehensive search included MEDLINE (Ovid), CINAHL (EBSCOHost), Embase (Ovid), CENTRAL (Cochrane Central Register of Controlled Trials) databases and grey literature sources.

Review methods

JBI Scoping review methodology guided this review through protocol development, searching, screening, data extraction and analysis. Study Selection included: Participants – Adults with upper extremity musculoskeletal disorders; Concept – Aquatic based exercise therapy; Context – any setting in any very highly developed nation.

Results

The search identified 5045 sources with 68 studies included in the final synthesis. Findings outlined shoulder problems were the most reported upper extremity condition treated ( n = 78) especially following rotator cuff repair ( n = 17), followed by the hand and wrist ( n = 9), and elbow ( n = 6). Range of movement ( n = 36) and resistance exercises ( n = 17) were the most common interventions reported for aquatic therapy, however compliance with reporting guidance across included studies was poor. Sixteen health domains were identified with range of movement ( n = 21) and pain ( n = 20) the most common, and 62 outcome measures were reported related to the identified domains. Qualitative aspects of aquatic interventions were evaluated in two papers.

Conclusion

There is a need for more primary experimental and qualitative studies related to the upper extremity and aquatic therapy. Improved reporting quality of aquatic therapy exercise intervention is required as is the need to establish specific core outcome sets and domains in this area.
Combined Schools as a (Non) Protective Factor During the COVID-19 Pandemic: Exploring Middle School Transitions Under Typical versus Atypical School Conditions
Authors: Diliberti Melissa K. , Schweig Jonathan D. , Mariano Louis T. , Kuhfeld Megan , McEachin Andrew
Published: February 2025

Combined schools spanning the elementary and middle grades (like K–8 schools) can protect students from harms associated with structural transitions by offering a stable school environment at a time when youth are undergoing many physical, psychological, and social changes. Using math and reading MAP Growth assessment scores from 20,000 students in parallel prepandemic and pandemic event studies, we investigate the extent to which the protective benefits historically offered by combined schools prepandemic held during the COVID-19 pandemic—a period of prolong disruption to normal schooling conditions. We find sixth and seventh graders enrolled in combined schools before the pandemic had scores 0.12 to 0.16 standard deviation (SD) units higher than their peers in standalone middle schools. That advantage diminished during the pandemic; middle grade youth in combined schools in 2020–2021 and 2021–2022 had math and reading scores that were only 0.04 to 0.08 SDs higher than their transitional counterparts. During the pandemic, school configuration mattered more for students’ reading, but not their math, achievement if they were attending school in-person than if they were attending school remotely. Our findings raise questions about the mechanisms through which combined schools offer academic benefits under both typical and atypical schooling conditions.
Skills and AI literacy of engineering students
Authors: Bui Thuy Thanh , Do Son Hong , Dinh Ly Dieu
Published: February 2025

This study investigates the self-assessed digital skills and AI literacy of 412 engineering students in Hanoi City using surveys and interviews. The aim is to assess students’ confidence in their digital skills and AI literacy within the university environment. Survey results, analyzed through descriptive statistics and regression, reveal that students self-assess as confident in information and communication skills but less so in content creation skills. Although they have a good understanding of AI, their ability to apply AI in practice is limited. Correlation and regression analysis indicate a significant relationship between digital skills and AI literacy, with content creation skills and digital empathy skills having the most influence on AI literacy. Data from in-depth interviews with 12 students provide detailed insights into individual perspectives and experiences, further clarifying the current state of digital skills and AI literacy among students. The study emphasizes the importance of developing digital skills and AI literacy in the modern educational environment.
Short-term effect of mirabegron on female sexual function in women with overactive bladder
Authors: Karabacak Nihat , Koparal Murat Yavuz , Erten Kadir Şerefhan , Çetin Serhat , Onaran Metin , Şen İlker
Published: February 2025

Background:

Overactive bladder (OAB) is a common syndrome that can negatively affect patients’ daily activities, sleep patterns, mental health, sexual function, and general health. In addition to reducing the frequency of attacks, treatment of OAB can be expected to improve the psychological and sexual health of patients.

Aims:

To evaluate the effects of mirabegron used in the treatment of overactive bladder (OAB) on female sexual function (FSF).

Methods:

This retrospective study includes 48 sexually active women who were diagnosed with overactive bladder and treated with a daily oral dose of 50 mg mirabegron between November 2021 and March 2022. The evaluation of FSF was conducted using female sexual function index (FSFI) along with urinary parameters before the start of the treatment and at the 6th week of the treatment.

Results:

In the study, out of 48 participants, 40 (83.3%) were identified with the dry type and 8 (16.7%) with the wet type OAB. The median age when diagnosed was 43.5 years. Although the decrease in the Overactive Bladder Questionnaire (OAB-V8) score did not reach statistical significance in the entire patient group after treatment ( p = 0.058), a statistically significant decrease in the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) score was detected in the wet type OAB group ( p < 0.001). During the assessment of sexual function, there was a statistically significant increase in the FSFI score, from 21.4 to 23.05, by the 6th week of treatment ( p = 0.017). Specifically, the scores for desire, lubrication, and satisfaction showed a statistically significant post-treatment improvement ( p < 0.001, p = 0.049, and p = 0.035, respectively).

Conclusion:

The study indicates that a 6-week regimen of a daily 50 mg mirabegron dose enhanced sexual function in women. This beneficial impact of mirabegron on sexual health should be taken into account when selecting a treatment for OAB.
Learning together: A quality improvement project on tandem training for dyad leadership partners in healthcare
Authors: Trask Michele , Webb Michelle , Dickson Graham , De Gagne Jennie C.
Published: February 2025

Formal training for those in managerial roles in healthcare is often fragmented, with clinical leaders and operational leaders receiving separate training or none at all. This project aimed to gain insights into how to better prepare leaders in dyad leadership roles through education provided to them in partnership. Understanding and strengthening dyad leader relationships can help shape positive experiences for leaders and their teams. To this end, a novel, free self-directed program, based on the Leads Self domain of the LEADS framework, was delivered. Participants reported a high satisfaction rate with the program. Self-assessed leadership scores indicated significant improvements in leadership capabilities. This project’s findings have the potential to inform future leadership development programs and contribute to improving co-leadership practices in real-world settings.
pH-triggered small molecule nanodrugs self-assembled from tryptamine-cinnamaldehyde and fisetin for targeted sepsis-associated encephalopathy therapy
Authors: Deng Ximing , Zhou Jinyao , Fang Wei , Sun Rao , Yan Guoqing , Sun Yun
Published: February 2025

Sepsis-associated encephalopathy (SAE) is an acute diffuse brain dysfunction, but its clinical treatment just focuses on antibiotics and supportive therapy, which fail to directly limit the development of SAE. Herein, this work highlights the development of pH-triggered small molecule nanodrugs self-assembled from tryptamine (Try)-cinnamaldehyde (CA) and fisetin for targeted SAE therapy. The imine linkage in Try-CA and acid-dependent protonation of Try and fisetin endow the nanodrugs with pH-triggered dynamic changes of particle sizes, surficial charges, and drug release. Moreover, the combined use of Try-CA and fisetin also endows the nanodrugs with superior antioxidative, anti-inflammatory and antibacterial capabilities compared to their individual use. These characteristics of the nanodrugs facilitate long-term circulation stability, effective penetration through BBB, selective accumulation in the brain, and target to central and peripheral focal areas, thereby achieving comprehensive treatment or relief of SAE. Thus, these attractive experimental results illuminate the enormous potential of such pH-triggered small molecule nanodrugs for targeted SAE therapy, advancing their use in clinics.
An efficient sparse code shrinkage technique for ECG denoising using empirical mode decomposition
Authors: Tiwari Vibha , Jain Divya , Sharma Deepak , Hassan Mohamed M , Althobaiti Fayez , Varkale Akshay , Al-Khasawneh Mahmoud Ahmad , Tirandasu Ravi Kumar
Published: February 2025

Accurate denoising of Electrocardiogram (ECG) signals is essential for reliable cardiac diagnostics, but traditional methods often struggle with high-frequency noise and artifacts, leading to potential misinterpretations. It is often impeded by interference such as power line interference (PLI) and Gaussian noise. To address this challenge, we suggest a novel ECG denoising technique that combines empirical mode decomposition (EMD) with wavelet domain sparse code shrinking. Our approach first decomposes the noisy ECG signal into Intrinsic Mode Functions (IMFs) using EMD. These IMFs are then transformed into the wavelet domain, where a sparse code shrinking function is applied to effectively reduce both Gaussian noise and PLI while preserving the integrity of the original signal. The effectiveness of the technique is assessed on the MIT-BIH database, where it shows marked improvements in Signal-to-Noise Ratio (SNR), Mean Squared Error (MSE), and Percentage Root Mean Square Difference (PRD). The suggested approach demonstrates improved SNR and reduced MSE when compared to prior approaches, which suggests that the ECG signals are clearer and more precise. This method presents a rather effective approach to enhancing ECG analysis as it is important for diagnosis and interpretation. At 10 dB SNR, the suggested technique achieves an MSE of 0.005, which is much less than the 0.076 and 0.0025 MSEs obtained by EMD wavelet adaptive thresholding and soft thresholding correspondingly. This indicates that the proposed approach effectively eliminates noise while preserving significant signal characteristics, leading to an improved and less erroneous signal reconstruction. Furthermore, the proposed method outperformed conventional techniques and demonstrated improved noise reduction and signal clarity, achieving an SNR of 19.24 and a PRD of 20.38 at 10 dB SNR.
Hybrid event-based anti-bump finite-time H∞ control for cyber-physical switched systems under denial-of-service attacks
Authors: Ren Hangli , Jiang Zhenxuan , Wang Yifan , Jia Wanying
Published: February 2025

This paper aims to investigate the hybrid event-based anti-bump finite-time H∞ control method for cyber-physical switched systems under Denial of Service (DoS) attacks. By gaining insights into the characteristics of DoS attacks, a novel hybrid event-triggered scheme (HETS) is proposed. This scheme effectively reduces network transmission load and accurately captures the network service denial behavior caused by attack interference. In the context of complex network environments with multiple switching characteristics, this study addresses the challenges posed by HETS, transmission delays, and DoS attacks on the input signals of controllers. To tackle these challenges, we utilize an asynchronous switching strategy, along with bumpless transfer constraints and a zero-order hold mechanism. The objective is to design sustainable input asynchronous control signals while ensuring that the control scheme exhibits bumpless transfer (BT) characteristics and achieves H∞ performance. By employing the asynchronous switching strategy and the admissible edge-dependent average dwell time method (AED-ADT), a dual-mode Lyapunov function is devised to establish finite-time stability criteria and provide a design approach for constructing anti-bump H∞ controllers. Finally, two examples illustrate the applicability and effectiveness of the method.
Advocacy – defending science or destroying it? Interviews with 47 climate scientists about their fundamental concerns
Authors: Messling Lydia , Lu Yuyao , van Eck Christel W.
Published: February 2025

The discourse on scientists’ involvement in climate advocacy has intensified, with a growing number participating in civil disobedience. This trend has sparked criticism within the academic community. We conducted 47 interviews with climate scientists about the fundamental concerns that underpin their arguments. Scientists worry that advocacy may compromise scientific impartiality and invite allegations of biased science and abuse of authority. Despite this, some scientists view informing and warning the public as their duty and as an act of defending science’s credibility. Concerns about independence and the role of scientists in society exist at both ends of the debate, underscoring the challenging landscape scientists currently navigate. While this article does not comment on the acceptability of advocacy, we propose that scientists engage in discussions about their duties and delineate the types of values deemed acceptable for incorporation in science communication about climate change.
Towards a Robust and Inclusive Entrepreneurial Ecosystem: Insights from the Himalayas
Authors: Dey Anamika , Sharma Sapna , Patel Chetan , Patel Ramesh , Nadeem  , Abhijit  , Gupta Anil K.
Published: February 2025

The inclusive entrepreneurial ecosystem needs several new strategies to leverage community knowledge and grassroots innovations, particularly by women. In low population density regions such as mountains, the transaction costs of engagement and delivery of services are high and one needs more imaginative approaches for inclusive development. This article is divided into three parts. Part one deals with scouting strategies for identifying entrepreneurial talent, particularly leveraging individual women members of self-help groups and converting traditional knowledge into innovation-based enterprises. In part two, the challenges to the innovation-based bioenterprises-based ecosystem are discussed. While traditional enterprises help in generating jobs, it is desirable to focus on novelty. The methods of prior art search are discussed, and four case studies are shared. It is highlighted that giving names of the innovators/knowledge providers on the label of the products acts as not only an incentive for the knowledge providers but also generates trust among the consumers. Finally, in part three, recommendations are made to make the ecosystem more robust and move from microfinance to microventure finance. The recommendations in this article may help other enterprises also. It is worthwhile to focus on the circular economy, in situ value addition, publicly funded validation and value addition and flexible financing and market support systems.
Child Mortuary Practices Among the Bhumij Tribe of Odisha, Eastern India: An Ethnographic Study
Authors: Chakraborty Tanni , Basa Kishor K.
Published: February 2025

Death is the most certain yet enigmatic incident in human society. Eschatological beliefs and rituals are deeply plowed areas in the field of social science, especially in anthropology. However, most of the studies have focused on the rituals associated with the mortuary practices of adults. While anthropological research on children and childhood in India has explored various aspects of children and childhood, the mortuary practice of the little ones remains relatively unexplored. This article attempts to shed light on child mortuary practices among the Bhumij tribe of the Mayurbhanj district in the vicinity of the Similipal Biosphere Reserve in northern Odisha. In this article, the authors have explored the significance of child mortuary studies in understanding adults’ perception toward children, the emotional entanglement of parents reflected through burials, eschatological beliefs, and the reconstruction of personhood and gender roles through the survey of the burial ground of the Bhumij tribe of Mayurbhanj, Odisha.
In Vitro Biological Evaluation and In Vivo Anti-inflammatory Effect of Chicozapote (Manilkara zapota (L.) P. Royen) Leaf Extracts in Mice with Internal Atrial Edema
Authors: Martínez Araceli Torres- , Fernández Juan José Acevedo- , Pérez Nelly del Carmen Jiménez- , Alejo Fanny Adabel González- , Alamilla Pedro García- , Botello Maximiano Antonio Estrada- , León Jesús Alfredo Araujo- , Lanestosa Areli Carrera-
Published: February 2025

Background

In Mexico, the fruit of the Manilkara zapota (L.) P. Royen (Chicozapote) tree is widely consumed; however, numerous studies have identified bioactive compounds within its leaves.

Purpose

To evaluate the bioactive properties of M. zapota leaf extracts, focusing on their anti-oxidant, anti-diabetic, and anti-hypertensive potentials, and assessing their efficacy in mitigating inflammation.

Materials and Methods

This study evaluated the anti-oxidant properties of aqueous (AE), ethanolic (EE), and hydroalcoholic (HE) extracts, utilizing 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays. Anti-diabetic activity was assessed by inhibiting the enzymes α-amylase and α-glucosidase, while anti-hypertensive efficacy was measured via angiotensin-converting enzyme (ACE) inhibition. The anti-inflammatory potential was also examined in vivo using a murine model of 12- O-tetradecanoylphorbol-13-acetate-induced ear edema.

Results

The DPPH assay revealed that all extracts exhibited equivalent anti-oxidant capacities at the same concentration, with no significant statistical difference ( p < 0.05). Conversely, the ABTS assay demonstrated that AE possessed superior activity (4.6−28.5%) across varying concentrations. EE exhibited the most potent inhibition of α-amylase, α-glucosidase, and ACE, with 81.8%, 58.9%, and 87.8%, respectively. In anti-inflammatory assays, EE at a 5 mg dosage significantly outperformed other extracts.

Conclusion

These findings suggest that M. zapota leaf extracts, mainly through EE, could offer a viable natural alternative for reducing inflammation and potentially managing diabetes and hypertension.
Determinants of Antibiotic Prescription in Outpatient Hospice: A Regional Observational Study
Authors: Crowley Patrick D. , Whalen Francis X. , Siegel Leslie R. , Challener Douglas W.
Published: February 2025

Background

Patients enrolling in hospice care are asked their preferences for antibiotic treatment. There is little information regarding which patients are more likely to receive antibiotics. To better inform discussions, we sought to characterize the use of antibiotics in the outpatient hospice setting.

Methods

We performed a retrospective review of patients enrolled in outpatient hospice within the Mayo Clinic Health System from 1/1/2017 through 1/1/2023. We calculated what percent of patients received antibiotics based on Hospice Qualifying Condition (HQC), age at enrollment, sex, survival time, and Charlson Comorbidity Index and calculated adjusted odds ratios (aOR). We documented which antibiotics were prescribed based on HQC.

Results

Of 6452 patients identified, 1259 (19.5%) received antibiotic prescriptions. Cephalosporins were the most common class of antibiotics prescribed (22.8% of antibiotics prescribed), followed by fluoroquinolones (20.3%) and penicillin derivatives (14.9%). Patients with Pulmonary HQCs were most likely to receive antibiotics (28.6% aOR 1.85 [1.51-2.25]), those with neurologic HQCs were least likely (14.9% aOR 0.66 [0.53-0.83]). There was no difference of age for those receiving antibiotics (80.7 yr) vs those not receiving (80.3 yr [ P = 0.25]), or for sex (male vs female aOR 1.10 [0.96-1.26). 4.6% of those surviving <7d received antibiotics (aOR .22 [0.17-0.29]), compared to 47.7% of those surviving >6mo (aOR 4.46 [3.50-5.69]).

Discussion

19.5% of patients will receive antibiotics during their hospice course, with more frequent prescriptions in those surviving longer periods and those enrolled for pulmonary conditions. It is important to clarify patient preferences regarding antimicrobial utilization at the time of hospice enrollment.
“Weigh Easy”: Use of an At-Home Weight Reporting System to Improve Weight Monitoring in Infants With a Cleft
Authors: Murari Karthi , Nguyen Steven , Sherman Ashley , Jiang Shao , Tracy Meghan , Bergman Hannah , Goldstein Jeffrey
Published: February 2025

Objective

To evaluate the effectiveness and parental satisfaction of an at-home weight reporting system for the maintenance of weight stability in infants with cleft lip and/or palate (CLP).

Design

A prospective cohort of infants with CLP was provided an at-home scale to track weekly weights compared to a retrospective cohort of infants with CLP that underwent standard weight checks at routine healthcare appointments.

Setting

Tertiary care pediatric hospital.

Patients/Participants

Infants from 0 to 3 months of age who presented to a large midwestern Cleft Clinic with a diagnosis of CLP without a secondary major birth difference.

Interventions

“Weigh Easy” at-home scale and reporting system.

Main Outcome Measure(s)

Weight loss or plateau.

Results

Infants enrolled in the prospective cohort (n = 25) were significantly less likely to have a destabilizing weight loss compared to the retrospective cohort (n = 131) (OR = 0.09, 95% CI = 0.01-0.60, P = .001 at 30 g/day; OR = 0.15, 95% CI = 0.04-0.60, P = .001 at 25 g/day; OR = 0.24, 95% CI = 0.09-0.61, P = .002 at 20 g/day). Over at least 90 days of data collection, the prospective group had a median of 12 weight changes compared to 4 in the retrospective cohort ( P < .001). The Parent Satisfaction Survey (n = 17) revealed 94.1% preferred to weigh their child at home with the Weigh Easy Scale compared to commuting to a publicly available scale and 88.2% would recommend the “Weigh Easy” scale to their friends and family.

Conclusions

Providing parents of infants with CLP with the “Weigh Easy” scale identifies feeding and nutritional needs more quickly than standard weight checks.
Psychometric Properties of the Flourish Index and the Secure Flourish Index in Healthcare Settings
Authors: Liu Xitao , Falco Christopher , Guldner Gregory , Siegel Jason T.
Published: February 2025

Research on the construct of flourishing spans many fields of study. This study extends previous work by VanderWeele by investigating the measurement of flourishing, focusing on the structure and convergent validity of the Flourish Index (FI) and the Secure Flourish Index (SFI) within a national, multi-site sample of resident physicians. Through exploratory and confirmatory factor analyses (EFAs and CFAs), we assessed whether the FI and the SFI aligned with the theoretical flourishing models that VanderWeele suggested. We examined the convergent validity of both indices by testing whether they exhibited expected correlations with six different scales. The results of factor analyses and scale validation showed that data collected by the FI and the SFI fit the structural model of flourishing proposed by VanderWeele. Although prior studies reliably indicate that CFA results align with VanderWeele’s model, this is a rare study where the EFA results also demonstrated a structure that aligns with his framework. Both scales exhibited strong convergent validity, producing data correlated with all six measures in the predicted directions. Although convergent validity has been previously shown, this study replicated and expanded evidence of the construct validity of data provided by the FI and the SFI.
The Role of Language Aspects in the Assessment of Cognitive and Developmental Functions in Children: An Analysis of the Intelligence and Development Scales–2
Authors: Odermatt Salome D. , Grieder Silvia , Schweizer Florine , Bünger Anette , Grob Alexander
Published: February 2025

The assessment of multilingual participants is challenging, as, for example, proficiency in the test language may interfere with test performance. We examined whether different language aspects (i.e., receptive and expressive language abilities, bi/multilingualism) contribute independently to the variance in scores on cognitive and developmental functions of the Intelligence and Development Scales–2 (IDS-2). The sample comprised 826 children aged 5 to 10 years living in German-speaking regions. Hierarchical regression analyses revealed that receptive language ability was significantly associated with almost all IDS-2 scores. Expressive language ability explained little additional variance, except for the intelligence composites, Verbal Reasoning (including subtests), and the basic skills subtests. Bi/multilingualism explained variance above language abilities only in subtests of Verbal Reasoning and verbal Long-Term Memory. Findings highlight the importance of considering language proficiency, particularly in tasks with high verbal demands, when assessing cognitive and developmental functions with the IDS-2 in participants at risk for linguistic disadvantages.
Automated Patient-specific Quality Assurance for Automated Segmentation of Organs at Risk in Nasopharyngeal Carcinoma Radiotherapy
Authors: Wang Yixuan , Hu Jiang , Chen Lixin , Zhang Dandan , Zhu Jinhan
Published: February 2025

Introduction

Precision radiotherapy relies on accurate segmentation of tumor targets and organs at risk (OARs). Clinicians manually review automatically delineated structures on a case-by-case basis, a time-consuming process dependent on reviewer experience and alertness. This study proposes a general process for automated threshold generation for structural evaluation indicators and patient-specific quality assurance (QA) for automated segmentation of nasopharyngeal carcinoma (NPC).

Methods

The patient-specific QA process for automated segmentation involves determining the confidence limit and error structure highlight stage. Three expert physicians segmented 17 OARs using computed tomography images of NPC and compared them using the Dice similarity coefficient, the maximum Hausdorff distance, and the mean distance to agreement. For each OAR, the 95% confidence interval was calculated as the confidence limit for each indicator. If two or more evaluation indicators (N2) or one or more evaluation indicators (N1) exceeded the confidence limits, the structure segmentation result was considered abnormal. The quantitative performances of these two methods were compared with those obtained by artificially introducing small/medium and serious errors.

Results

The sensitivity, specificity, balanced accuracy, and F-score values for N2 were 0.944 ± 0.052, 0.827 ± 0.149, 0.886 ± 0.076, and 0.936 ± 0.045, respectively, whereas those for N1 were 0.955 ± 0.045, 0.788 ± 0.189, 0.878 ± 0.096, and 0.948 ± 0.035, respectively. N2 and N1 had small/medium error detection rates of 97.67 ± 0.04% and 98.67 ± 0.04%, respectively, with a serious error detection rate of 100%.

Conclusion

The proposed automated patient-specific QA process effectively detected segmentation abnormalities, particularly serious errors. These are crucial for enhancing review efficiency and automated segmentation, and for improving physician confidence in automated segmentation.
Informal Support Networks of Parents Involved With the Child Welfare System: Needs and Mental Health Symptoms
Authors: McWey Lenore M. , Radey Melissa , Outler Carson , Posada Kristine
Published: February 2025

Studies show the protective power of informal support networks for parents, however, most research in this area is not specific to the child welfare context. With a sample of parents with children involved with the U.S. child welfare system due to substantiated child maltreatment ( N = 118), latent profile analyses revealed three distinct profiles of parents’ informal support networks including perceived support, received support, and network demands. The profiles were associated with differences in sociodemographic risks, ACEs, and symptoms of depression and stress. Parents with four or more ACEs were more likely to be classified in the very little support profile versus the profile of parents with some support. Parents who had high levels of informal network support and a manageable level of network demands had lower levels of depression and stress compared to parents with very little network support. Implications for research and practice are discussed.
Examining the ethical grey area: Do sustainable travelers prioritize hotel websites over booking platforms?
Authors: Singh Pratibha , Ahuja Parul , Sharma Ruchika
Published: February 2025

The present research applies experiment-based investigation to analyze the premature departure of customers from online intermediary booking platforms in light of the sustainability initiatives on hotel websites. Four experimental studies have been adopted to inspect the interrelationship between the customer's platform bypass intentions and the presence of sustainability initiatives on hotel's websites. The findings disclose the serial mediation between three variables, namely, sustainability initiatives, ontological security, and impregnability, along with validation of the conditional moderated mediation effect of high territoriality. It provides important implications for marketing managers and web designers to redesign the travel offerings on the intermediary platforms in a way that provides customers with a holistic appeal of sustainable travel.
Outcomes of contemporary stents with deep femoral artery coverage
Authors: Tokuda Takahiro , Yoshioka Naoki , Tanaka Akiko , Kojima Shunsuke , Yamaguchi Kohei , Yanagiuchi Takashi , Ogata Kenji , Takei Tatsuro , Nakama Tatsuya
Published: February 2025

Introduction:

We aimed to investigate deep femoral artery (DFA) status during endovascular treatment (EVT) and the patency of the femoropopliteal (FP) artery and DFA using current stent devices for ostial FP lesions.

Methods:

A multicenter, retrospective study analyzed data from 457 patients who underwent EVT with stent deployment for de novo ostial FP lesions between April 2018 and December 2021 at eight centers in Japan. Propensity score-matched analysis was performed to compare the clinical impacts of DFA coverage for ostial FP lesions with stent deployment. The prognostic value was analyzed based on DFA status during EVT, primary patency of the FP artery, clinically driven-target lesion revascularization (CD-TLR) of the FP artery, and incidence of DFA occlusion/major amputation/acute limb ischemia (ALI) at 3 years.

Results:

A total of 132 matched pairs of patients was analyzed using propensity score matching. The percentage of DFA occlusion and stenosis was significantly higher in the DFA coverage group. However, there were no significant differences in terms of primary patency of the FP artery, CD-TLR, DFA occlusion, major amputation, or ALI after 3 years.

Conclusions:

Stent deployment in DFA coverage significantly led to the DFA stenotic events of EVT during the procedure, but patency of the FP artery and DFA, major amputation, and ALI up to 3 years did not differ according to stent deployment for ostial FP lesions.
A review of integrative dynamic lighting and associated well-being impact for people living with dementia
Authors: Turley K , Rafferty J , Bond R , Mulvenna M , Ryan A , Crawford L
Published: February 2025

Integrative lighting considers light for both visual and non-visual impact and can therefore benefit human health and well-being. More specifically, it can benefit circadian-related well-being, an umbrella term which within dementia cohorts considers factors such as sleep, rest-activity, mood, agitation and activities of daily living. As people living with dementia experience disruptions to their circadian rhythms and spend large amounts of time indoors, the understanding of how integrative interior lighting could influence their body clock could help support their well-being. A review of 18 studies found that papers are difficult to compare due to unsystematic study designs and reporting of study characteristics, light characteristics and participant characteristics. The findings at most imply that indoor integrative lighting could be beneficial to these aspects of well-being. This review finds suggestion that for this cohort there may be a relationship between colour variation and mood and agitation, alongside a relationship between intensity variation and sleep, and that the influence on rest-activity may be more unpredictable. These findings are inferred and due to heterogeneous study designs they are inconclusive. The outcome of this review therefore recommends future studies that follow systematic checklists for study designs which seek to test these inferred hypotheses within this cohort.
Impact properties of banana/coir/palm/hexagonal boron nitride particles reinforced epoxy composites
Authors: Gopalan Venkatachalam , Subramonia Anish , Elango Meiyarasi Rithikkumar , Pitchumani Shenbaga Velu , Sampath Aravindh , Annamalai K
Published: February 2025

Natural fiber-reinforced polymer composites have gained attention due to their biodegradability, lower density and cost-effectiveness. In this study, the impact strength of banana fibre, coir fibre, palm fibre powder, individually used with hexagonal Boron Nitride (h-BN) particles in the epoxy polymer composites, is studied. The Response Surface Methodology (RSM), based on a Box-Behnken design, helps to analyze the effects of h-BN content (wt. %), fiber content (wt. %) and type of fibers on impact strength. The Izod test is carried out to find the impact strength of each sample. ANOVA and regression equations are used to examine the result. It is noticed that the impact strength of the composite is improved with a rise in h-BN and fiber content (wt. %). It is also concluded that the optimum composition is 3.95 wt. % of h-BN and 5 wt. % of palm fiber content exhibits the highest impact strength of 0.32 kJ/m2. A confirmation test is also conducted to confirm the same. The findings demonstrate that the mechanical properties of the epoxy-palm fiber composite are affected by the properties of palm fiber. The morphological studies shows superior interfacial bonding between the matrix and fiber and also uniform distribution of the reinforcement particle helps in improving the mechanical properties of the materials.
Midterm Outcomes of Minimally Invasive Aortic Valve Replacement via Right Lateral Minithoracotomy
Authors: Furutachi Akira , Nakamura Yoshitsugu , Niitsuma Kusumi , Ushijima Masaki , Yasumoto Yuto , Yoshiyama Daiki , Kuroda Miho , Nakamae Kosuke , Hayashi Yujiro , Nakayama Taisuke , Tsuruta Ryo , Ito Yujiro
Published: February 2025

Objective:

Minimally invasive aortic valve replacement (MIAVR) procedures have been found to have good short-term results. However, no known reports regarding outcomes of MIAVR via a right lateral minithoracotomy (LT) approach over longer terms have been presented. The aim of the present study was to analyze the midterm outcomes of the use of MIAVR with the right LT approach over an 8-year period.

Methods:

Between September 2014 and February 2023, MIAVR was performed for 348 patients with severe aortic valve stenosis and regurgitation at our hospital. Operative mortality, all-cause mortality, and valve-related events were retrospectively examined.

Results:

The mean patient age was 72.3 ± 10.9 years, while 78 patients (22.4%) were more than 80 years old. Surgical, cardiopulmonary bypass, and cross-clamp times were 194.7 ± 43.2, 118.6 ± 28.7, and 89.4 ± 23.3 min, respectively. The 30-day mortality rate was 0.3%. The mean follow-up period was 35.6 ± 25.9 months. Overall survival shown by Kaplan-Meier analysis at 1, 3, and 5 years was 96.4%, 90.3%, and 83.2%, respectively, and freedom from valve-related events at those time points was noted in 100%, 99.5%, and 96.9% of the cases, respectively.

Conclusions:

MIAVR via a right LT approach was found to be associated with excellent short-term and midterm outcomes and is considered to have the potential to become an established surgical option.
The risk of recurrence of acute fatty liver of pregnancy – a review of the current literature
Authors: Morton Adam , Phillips Liza , Nisbet Janelle , He Jin-Wen
Published: February 2025

Acute fatty liver of pregnancy is associated with significant maternal and fetal morbidity and mortality. Defects in fatty acid metabolism appear to play a role in pathogenesis, and several pathogenic variants leading to enzyme deficiencies have been associated with the development of acute fatty liver of pregnancy. The risk of recurrence in subsequent pregnancies is unknown. A review of 10 small case series of women with acute fatty liver of pregnancy disclosed only one case of recurrence in 35 subsequent pregnancies. This contrasted with a survey where 5 of 24 women reported recurrent acute fatty liver in subsequent pregnancies. Retrospective and prospective studies examining subsequent pregnancy outcomes following a diagnosis of acute fatty liver of pregnancy would be useful to better define risk and aid in preconception counselling of women who have had a diagnosis of acute fatty liver of pregnancy and wish to consider further pregnancies.