bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of artificial intelligence and virtual reality interventions in art therapy among older people with mild cognitive impairment
Authors: Cao Ying , Yin Hanfang , Hua Xinxin , Bi Shibo , Zhou Di
Published: February 2025

Objectives

Integrating artificial intelligence and virtual reality into an art health program, this study aimed to compare the effects of artificial intelligence (AI) intervention in art therapy, virtual reality (VR) intervention in art therapy and traditional art therapy on cognitive function and mental health in older people with mild cognitive impairment.

Methods

In a randomised controlled trial, this study recruited 60 older people with mild cognitive impairment, evenly assigned to the AI group, the VR group and the control group. The participants completed surveys, before and after art therapy interventions, which assessed changes in cognitive function, depressive symptoms and program attitudes.

Results

Following the intervention, the AI group and the VR group exhibited higher scores in cognitive function and mental health compared to the control group. The AI group demonstrated significant improvements in mental health, particularly in areas of boredom (p < .001, η2 = .093), activity reduction (p = .001, η2 = .082), life value (p = .003, η2 = .092), and happiness (p = .001, η2 = .093). While the VR group showed significant enhancements in cognitive abilities, particularly in attention (p = .006, η2 = .130), expression (p = .002, η2 = .139), orientation (p = .01) and memory (p = .02).

Conclusions

In art health programs, leveraging the painting and language technologies of AI, along with the painting and simulation technologies of VR, can effectively enhance cognitive function and mental health in older people with mild cognitive impairment.
Paediatric Hypotrichosis: A Clinical and Algorithmic Approach to Diagnosis
Authors: So Neda , Yip Leona , Orchard David
Published: February 2025

Paediatric hypotrichosis is the clinical feature of paucity of hair arising congenitally or in early life with the presentation being that of the child whose hair is growing insufficiently. It is a hallmark finding of a diverse group of genodermatoses and sporadic disorders, presenting as either an isolated symptom or in association with syndromic features. Hypotrichoses are rare, with numerous possible differentials requiring a thorough clinical assessment, additional investigations for hair shaft abnormalities and occasionally genetic counselling to reach a diagnosis. We propose a clinical algorithm for the investigation and diagnosis of paediatric hypotrichosis, designed to aid the clinician by utilising key clinical findings in conjunction with the forced hair pull test and trichoscopy to differentiate groups of hair shaft and hair loss disorders. We also discuss in further detail the pathogenesis, phenotypical features and microscopy findings of various types of hypotrichosis.
Decennial Ward‐Level Influence of Demographic, Farming, and Economic Predictors on All‐Cause Mortality
Authors: Trearty Kelly , Bunting Brendan , Mallett John
Published: February 2025

Objective

This study has arisen in response to a lack of studies examining how farming affects mortality patterns across areas of Northern Ireland (NI) over a 10‐year period. This paper aims to investigate whether agriculturally intensive electoral Wards have higher mortality rates compared to non‐agriculturally based Wards, controlling for relevant factors.

Methods

The population census and farm census information was downloaded from the Northern Ireland Neighbourhood Service (NINIS) website to construct two original mortality‐based datasets. Linear regression was used for the analysis.

Design

Decennial Ward‐Level Influence of Demographic, Farming, and Economic Predictors on All‐Cause Mortality.

Setting

Five hundred and eighty‐two Ward areas of Northern Ireland.

Main Outcome Measure

Mortality risk within Ward areas.

Results

Findings showed larger amounts of natural log of the population, 65 to 100+ year‐olds, limiting long‐term illnesses, Farming Intensity Scores, residents living alone and full‐time workers within Wards were predictive of mortality risk within those Wards.

Conclusions

This study is the first of its kind in NI to provide evidence for Farming Intensity Scores explaining the variation of mortality rates between areas, in addition to many of the usual predictors.
Telehealth after lockdown: evaluating a regional urological telehealth service before and after the pandemic
Authors: Neerhut Thomas , McLeod Kathryn , Willder Stuart , Harrison Benjamin , Mills Alexander , Grills Richard
Published: February 2025

Background

The COVID‐19 pandemic facilitated the rapid uptake of telehealth Australia wide. To date, no studies have analysed patient perceptions of a regional urological telehealth service before and after the pandemic. With over 10 years of experience delivering telehealth to Southwest Victoria, we aim to highlight the benefits, limitations and progress of a regional urological telehealth service.

Methods

Regional patients living within Western Victoria who participated in our 2017 survey and continued their urological telehealth consultations throughout 2021–2023 were invited to participate in our 2023 survey. Questions were both short answer and multiple choice. Seventy‐eight patients met inclusion criteria, and 42 responses were returned. Data analysis utilized a mixed methods approach.

Results

Overall patient perceptions were favourable in 2017 and improved throughout the Pandemic. The greatest improvements were seen within the performance areas: overall satisfaction, technological aspects, comprehension and financial benefits. Following the pandemic, the distance patients were prepared to travel for face‐to‐face reviews decreased and preferences for telehealth compared to face‐to‐face consultations increased by almost 20%. However thematic analysis revealed loss of personalized care, technological faults, fixed beliefs and unsuitable appointments as limitations of this model of care.

Conclusion

Patients' perspectives of a regional urological telehealth service were overwhelmingly positive highlighting the vital place of urological telehealth in the delivery of equitable urological healthcare to a regional population. Overall, post COVID‐19 there were improved patient perceptions of a telehealth service and its role in providing regional patients with the provision of timely, supportive and high‐quality urological care.
Needs assessment of surgical skills of interns: a qualitative study in metropolitan Melbourne, Australia
Authors: Wei Matthew Y. , Tang Howard H. Y. , Nestel Debra , Rumler Greg , Hall Kat , Martin Kate , Muralidharan Vijayaragavan , Hii Michael , Reid Fiona , Kumta Shektar , Mori Krinal , Yeung Justin M. C.
Published: February 2025

Introduction

Upon graduation, newly qualified doctors are expected to manage complex and unwell patients, and adapt their prior learning to navigate an often‐nuanced healthcare workplace environment. Surgical rotations can bring a unique set of learning curves and challenges to this already demanding transitional period. The aim of this study was to identify the training needs of medical students and early‐career doctors in surgical skills, incorporating viewpoints from all stakeholder groups to provide a holistic insight into the provision of surgical education currently, and how it can be optimized to improve work preparedness.

Methods

Final‐year medical students, interns and clinical educators from five clinical schools affiliated with the University of Melbourne were recruited for semi‐structured interviews. Following transcription, multi‐phased thematic analysis was performed to identify key themes.

Results

Thirty‐seven participants were interviewed (18 students, 8 interns and 11 clinical educators). Outside of commonly utilized procedural skills, different emphases were placed on non‐technical skills by students and interns, compared to clinical educators. Increased hands‐on learning and structured teaching were thought to be key to increasing confidence and work preparedness.

Conclusion

This qualitative study interviewed key stakeholders to identify important skills in order to help newly qualified interns to thrive in a surgical rotation. These skills in particular included more supervised hands‐on practical teaching. Future studies involving graduates from other medical schools may provide a better understanding of surgical education in the wider Australian context.
Modified penetrating deep sclerectomy versus conventional trabeculectomy for the treatment of glaucoma: A 12‐month randomized prospective study
Authors: Xu Zhike , Wang Lixiang , Wei Xin
Published: February 2025

Purpose

To compare the surgical outcomes and adverse events of modified penetrating deep sclerectomy with conventional trabeculectomy.

Methods

A prospective randomized clinical study that successively recruited patients with moderate and advanced primary open‐angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in West China Hospital. The modified penetrating deep sclerectomy creates a small triangular intrascleral lake, which aims to reduce the risk of flap adhesion in conventional trabeculectomy and sudden hypotony associated with the dissection of a larger rectangular deep scleral flap. The primary effectiveness endpoint was the IOP by non‐contact tonometer with or without medication use at each follow‐up visit. The primary safety endpoint was the incidence of all complications during the study.

Results

A total of 19 patients (21 eyes) were randomized to modified deep sclerectomy and 21 patients (21 eyes) to conventional trabeculectomy. Age, sex ratio, pre‐operative intraocular pressure (IOP) and the number of IOP‐lowering medications used were comparable between the two groups. At the end of the follow‐up period (12 months), IOPs were (15.52 ± 3.28) mmHg and (19.66 ± 4.01) mmHg in the modified deep sclerectomy and conventional trabeculectomy groups, respectively (p = 0.006). Deterioration of the visual field appeared in four eyes (19.0%) and seven eyes (33.3%) in the two groups (p = 0.33). At 12 months, the average areas of the aqueous outflow pathway were (0.67 ± 0.30) and (0.43 ± 0.26) mm2, demonstrating a significant difference (p = 0.016). Using 18 and 15 mmHg as the IOP criteria for surgical success, the modified penetrating deep sclerectomy group showed a higher overall success rate than the conventional trabeculectomy group at 12 months (18 mmHg: 80.95% vs 52.38%, Log Rank p = 0.033; 15 mmHg: 52.38% vs 4.75%, Log Rank p = 0.001). Complication rates were similar between the two groups (23.8% vs 33.3%, p = 0.55), and no sight‐threatening complications were reported.

Conclusions

Modified deep sclerectomy shows superior efficacy in IOP control and maintenance of the outflow pathway opening, with comparable rates of adverse events, resulting in a higher overall success rate.
Medical treatment of sand enteropathy with psyllium, magnesium sulphate and paraffin oil in 54 Western Australian equids
Authors: Entwisle IG , McConnell EJ
Published: February 2025

Background

Sand enteropathy describes the clinical signs attributed to accumulation of sand in the gastrointestinal tract. Psyllium combined with magnesium sulphate has been recommended for clearing intestinal sand, but this has only been evaluated in one population. The combination of these two agents with paraffin oil has not been investigated.

Objectives

To investigate the effectiveness of paraffin oil, psyllium and magnesium sulphate combined in clearing intestinal sand in horses diagnosed with sand enteropathy.

Study Design

Retrospective case series.

Methods

Medical records of horses presenting for sand enteropathy that underwent treatment with psyllium, paraffin oil and magnesium sulphate were reviewed. Area of sand was calculated from abdominal radiographs. Treatment was deemed a success if more than 75% of the sand area was cleared.

Results

There were 52 horses and 2 donkeys included in the study. Daily treatment with psyllium at 1 g/kg, 6–8 mL/kg of paraffin oil, and magnesium sulphate at 1 g/kg by nasogastric intubation, was successful in clearing intestinal sand accumulation in 81% of equids over a median of 4 days (interquartile range 3–5 days). Success rate was lower in Miniatures Ponies (44%). Complications were common (30%) but were generally mild or self‐limiting.

Main Limitations

Retrospective nature of study design. Limited to cases that consented to sand clearance treatment.

Conclusions

The combination of psyllium, magnesium sulphate and paraffin oil was effective at clearing intestinal sand in most cases. Miniature Ponies had a poorer response to treatment compared with other breeds and may be at increased risk of treatment failure.
Flexible Climate Adaptation Can Substantially Reduce Conservation Costs and Mitigate Risk
Authors: Cho Frankie H. T. , Williams Brooke A. , Archibald Carla L. , Brazill‐Boast James , Drielsma Michael J. , Lunney Daniel , Rhodes Jonathan R.
Published: February 2025

Climate change will have profound and unexpected impacts on biodiversity in the future. These impacts could potentially be mitigated through adaptive and responsive conservation planning, but it remains unclear how adaptation opportunities can be harnessed through careful planning of present‐day activities. Here, we show that the use of flexible conservation strategies that exploit opportunities for climate adaptation can mitigate climate risks without increasing total conservation costs. We estimate the value of allowing flexible delays of conservation investments for protecting habitats of the iconic and threatened koala (Phascolarctos cinereus) in eastern Australia. Conservation strategies that have no option to strategically delay investments face significant trade‐offs between minimizing conservation costs and reducing risks in conservation outcomes. These trade‐offs are substantially mitigated by flexible strategies that strategically delay investments into the future when the effects of climate change are likely to be better understood. Strategic delays are shown to mitigate climate risks in inflexible conservation strategies without even increasing conservation costs. These results show that conservation planning that strategically allocates present‐day conservation resources while also allowing the flexibility to shift these resources in the future is much more likely to achieve cost‐effective conservation outcomes in the face of uncertain climate change impacts.
What in the world is global health? A conceptual analysis
Authors: Giubilini Alberto
Published: February 2025

This article suggests that the concept of global health – and to an extent the field that it designates ‐ is problematic in various ways. Within public health, the concept of the ‘public’ has been widely investigated. However, “global health” has been introduced in academic, policy, and public discussion with comparably lower level of conceptual, philosophical scrutiny. Thus, while public health ethics addresses the ethical and political issues that the different meanings of ‘public’ allow to identify, global health ethics tends to leave ethical and political issues raised by the concept of ‘global health’ implicit and insufficiently analysed. I will briefly present the debate around the ‘public’ in public health, describing some of the ethical and political questions that might arise, depending on what ‘public’ is taken to mean. I will then use this discussion as a conceptual map for an analogous analysis of the concept of ‘global’ in global health. I will discuss what dimensions ‘global’ adds to the concept of ‘public’. In the second part of the article, I will briefly introduce the philosophical debate on the concept of health, before suggesting that its cultural sensitivity makes it ill‐suited to be qualified as ‘global’. All in all, this article wants to bring to light the ethical implications that the terminology of ‘global health’ introduces in academic research and public policy that goes under that heading, as a first step towards better defining the ethical contours of this discipline.
Brain 18F‐fluorodeoxyglucose positron emission tomography: An efficient tool at the initial diagnosis of nonlesional late onset epilepsy
Authors: Puisieux Salomé , Heyer Sébastien , Forthoffer Natacha , Doyen Matthieu , Tyvaert Louise , Verger Antoine
Published: February 2025

Objective

This study evaluates the diagnostic performance and prognostic value of brain 18F‐fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET) at the initial diagnosis of patients with nonlesional late onset epilepsy (NLLOE).

Methods

In this cohort study at the University Hospital of Nancy, France, newly diagnosed NLLOE patients, >50 years old, were consecutively included from June 2017 to January 2021 and systematically underwent brain 18F‐FDG PET. They were categorized into four presumed etiological NLLOE subtypes: neurodegenerative subtype (NDS; patients with a diagnosis of neurodegenerative disease), microvascular subtype (MVS; patients with ≥3 cardiovascular risk factors and ≥2 vascular lesions on magnetic resonance imaging), inflammatory subtype (IFS; patients meeting international criteria for encephalitis), and unlabeled subtype (ULS). A systematic patient follow‐up (at least 2 years) allowed assessment of cognitive outcomes under antiseizure medication by comparing for each patient the proportion of preserved/altered scores between initial and second neuropsychological assessment. Brain 18F‐FDG PET was analyzed using a combined visual and semiquantitative approach at the individual level.

Results

Eighty‐seven patients were included (NDS, n = 18; MVS, n = 22; IFS, n = 7; ULS, n = 40). A normal 18F‐FDG PET was observed in 46% of patients, with the final diagnosis of 88% of these patients excluding a neurodegenerative or inflammatory disorder. 18F‐FDG PET had a negative predictive value of 94% for a cognitive decline at follow‐up, similar for the overall population (n = 71) and the ULS population (n = 32). Moreover, a PET hypometabolic pattern suggestive of a neurodegenerative disorder was indicative of cognitive decline at follow‐up in 74% of cases.

Significance

18F‐FDG PET as part of the initial diagnosis of NLLOE patients may have a significant impact on both NLLOE diagnosis and cognitive prognosis. For almost half of NLLOE patients, a normal 18F‐FDG PET could help to exclude neurodegenerative and inflammatory epilepsy etiologies as well as future cognitive decline.
Career and education planning among young black women: Implications for FCS educators
Authors: Hough Twyla D. , Rogers Christy , Miller Cynthia L. , Alexander Karen L.
Published: February 2025

This qualitative study investigated how young Black women experience career and education planning (CEP). Eight women from West Texas completed a career exploration and decision‐making learning experiences scale and participated in semi‐structured interviews. Findings from the data provided a contextualized understanding of CEP, indicating that career exploration and decision‐making learning experiences, work‐based learning, and social agents positively influence CEP. These findings provide an awareness of CEP experiences that can inform how family and consumer sciences educators and practitioners support CEP in a way that helps individuals from marginalized communities circumvent career‐related disadvantages encountered during the transition from adolescence into adulthood.
Study on Borehole Pressure Relief Failure Behavior and Crack Evolution Characteristics of Rock Mass With Multiple Prefabricated Joints
Authors: Chen Yang , Li Pengfei , Xu Chongbang , Huang Jun
Published: February 2025

In engineering construction, the presence of internal fissures in rock masses and the accumulation of internal energy are the main factors affecting rock failure. To study the effects of fissures and borehole pressure relief on rock masses separately, this paper has prepared various drilling samples with different fissures in the laboratory. On the basis of maintaining the original number of fissures, new fissures and holes are added to explore their effects on the rock mass. Combined with discrete element numerical simulation, the microscopic characteristics of multi‐fissure samples and borehole samples are analyzed. The research results indicate that as the fissure dip angle increases, failure occurs gradually along the existing fissures, while the crack development in the borehole samples is mainly concentrated around the holes, and the boreholes have a greater impact than fissures. The study of the change rule and damage characteristics of the fissures before and after drilling of multi‐fissure specimens can provide a reference for controlling the deformation of the rock mass in engineering applications.
Board busyness and financial leverage: The impact of corporate tax avoidance
Authors: Trinh Vu Quang , Li Teng , Ha Oanh , Liu Jia
Published: February 2025

This study investigates the impact of “busy” independent directors on corporate financial leverage. Using a sample of 3321 Chinese listed firms from 2004 to 2019, we find that firms with busier boards tend to have higher leverage, with corporate tax avoidance acting as a mediating mechanism. Supporting the reputational incentive hypothesis, busy boards discourage aggressive tax avoidance strategies that would otherwise allow managers to accumulate excess cash reserves. Consequently, these firms become more reliant on external debt financing to meet potential investment needs. Our findings highlight the role of “busy” independent directors in mitigating agency conflicts and shaping financial strategies.
Prevalence of primary stabbing headache: A meta‐analysis
Authors: Osiowski Aleksander , Osiowski Maksymilian , Taterra Dominik
Published: February 2025

Objectives/Background

This study was undertaken to assess the prevalence of primary stabbing headache (PSH) among adult patients seeking medical attention for headache in a clinic‐based setting. PSH is a primary headache disorder and is one of the representatives of indomethacin‐responsive cephalalgias. The epidemiology of PSH in adult patients assessed for headache in a tertiary care setting remains not well established.

Methods

PubMed, Embase, MEDLINE, and ScienceDirect databases were thoroughly searched for observational studies published between January 1, 1988, and August 9, 2024, that reported the relative frequency of PSH among adult patients evaluated for headache in a clinic‐based setting. The Meta‐Analysis of Observational Studies in Epidemiology guidelines were strictly followed by the study's design. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Studies Reporting Prevalence Data. The study's protocol was preregistered on PROSPERO (ID: CRD42024573776).

Results

Of the initial 1153 records, 15 articles (n = 35,904 individuals) met all of the eligibility criteria. Most of the studies revealed a low risk of bias. The prevalence of PSH among adult patients evaluated for headache in a tertiary care setting was 1.6% (95% confidence interval [CI] = 0.7–3.4, 95% prediction interval [PI] = 0.00–0.29), with substantial heterogeneity (I2 = 98.42) noted across the studies. PSH was diagnosed more often in females than in males (1.6%, 95% CI = 0.8–3.2, 95% PI = 0.00–0.18 vs. 0.5%, 95% CI = 0.2–1.1, 95% PI = 0.00–0.06). The mean age at onset of PSH was 41.6 years (SD = 13.7), and the mean delay time of diagnosis was 64.6 months (SD = 73.9).

Conclusion

Our results showed that PSH is a rare headache disorder among adults evaluated for headache in a clinic‐based setting. Moreover, PSH is typically diagnosed in the early fourth decade of life and predominantly in females.
Data set for reporting of peripheral neuroblastic tumours: recommendations from the international collaboration on cancer reporting (ICCR)
Authors: Jarzembowski Jason A , Webster Fleur , Beiske Klaus , Cohn Susan L , de Krijger Ronald R , Irwin Meredith S , Navarro Samuel , Okita Hajime , Shimada Hiroyuki , Stahlschmidt Jens , Vokuhl Christian , Wang Larry L , Cohen Marta , Reyes‐Mugica Miguel
Published: February 2025

Peripheral neuroblastic tumours are the most common extracranial solid neoplasms occurring in children. Proper classification is critical for directing therapy and predicting prognosis. Nonetheless, their relative rarity makes accurate pathological assessment challenging, even for experienced pathologists. Here we report on a new international data set for the pathology reporting of biopsy and resection specimens with peripheral neuroblastic tumours. The data set was produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter‐)national pathology and cancer organisations. According to the ICCR's process for data set development, an international expert panel consisting of paediatric pathologists and oncologists produced a set of core and non‐core data items for biopsy and resection specimens based on a critical review and discussion of current evidence. All professionals involved were neuroblastic tumour experts affiliated with tertiary referral centres. Commentary was provided for each data item to explain the rationale for selecting it as a core or non‐core element, its clinical relevance and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the documents were finalised and ratified, and the data sets, including a synoptic reporting guide, were published on the ICCR website. This first international data set for paediatric peripheral neuroblastic tumours is intended to promote high‐quality, standardised pathology reporting. Its widespread adoption will improve the consistency of reporting, facilitate multidisciplinary communication and enhance comparability of data, all of which will help to improve management of children with peripheral neuroblastic tumours.
A new era in myeloma: the advent of chimeric antigen receptor‐T (CAR‐T) cells and bispecific antibodies
Authors: Ho P. Joy , Li Eric W.
Published: February 2025

T‐cell re‐directional therapies, including chimeric antigen receptor (CAR)‐T cell and bispecific antibodies (BsA), have transformed the treatment landscape to benefit patients with multiple myeloma. A number of these novel therapies has been approved internationally, with CAR‐T therapy recently approved in Australia. In this clinical perspective, we describe the development of CAR‐T and BsA therapies, highlighting the clinical benefits and risks, together with the significant costs and infrastructure support required for the provision of these therapies to myeloma patients.
Use of sodium–glucose cotransporter‐2 inhibitors among Aboriginal people with type 2 diabetes in remote Northern Territory: 2012 to 2020
Authors: Hare Matthew J. L. , Chen Winnie , Berhane Thomas , Corpus Sumaria M. , Maple‐Brown Louise J.
Published: February 2025

Aboriginal people in remote Northern Territory communities experience the highest burden of type 2 diabetes (T2D) globally. Sodium–glucose cotransporter‐2 inhibitors (SGLT2i) improve cardiac and renal outcomes in selected populations. However, safety in this context is unknown. We investigated SGLT2i use and outcomes in remote Aboriginal people with T2D between 2012 and 2020.
Challenges and Opportunities Faced by Migrant Nurses in the Receiving Country: A Mixed‐Methods Study on Cultural Adaptation and Professional Integration
Authors: Atta Mohamed Hussein Ramadan , Baraka Azza Abd Elrazek , Hassan Eman Arafa
Published: February 2025

Aim

To provide a comprehensive understanding of the cultural adaptation and professional integration experiences of migrant nurses in the receiving country.

Design

A convergent parallel mixed methods design with concurrent sampling was employed.

Methods

Professional nurses who migrated from various Middle Eastern and North African countries, including Egypt, Syria, Palestine, Yemen, Jordan, Iraq and Saudi Arabia, were enrolled. The Quantitative data was collected through an online questionnaire involving open‐ended questions for the qualitative data. Data was collected from November 2023 to March 2024.

Findings

One hundred five nurses responded to the quantitative questionnaire, and 32 answered the open‐ended questions. The findings revealed that mean scores for cultural competence and professional self‐concept were 83.41 ± 12.90 and 76.28 ± 11.16, respectively. Migrant nurses experienced challenges such as language barriers (91.4%), social interaction (82.9%) and difficulties adapting to daily living activities (100%). The majority of them reported positive outcomes as better working conditions (91.4%), higher standard of living (89.5%) and professional development opportunities (94.3%). Nurses emphasised accepting cultural diversity, participating in cultural competency training, building relationships with local colleagues and utilising support mechanisms and mentorship for cultural adaptation.

Conclusion

This study highlighted the importance of support systems, cultural competency training and integration initiatives to facilitate successful adaptation and professional integration.

Implications for Profession

Orientation programs and cultural competency training should be developed to support migrant nurses. Initiatives should include language acquisition support, financial assistance for certification programs and promotion of diversity and inclusion in healthcare settings.

Impact

This study addressed the challenges migrant nurses face when transitioning to a new cultural and professional environment. It found that migrant nurses experience difficulties with language, social interaction and daily living activities. The research impacted healthcare institutions by guiding the development of orientation programs and cultural competency training, supporting policymakers in addressing systemic barriers and empowering migrant nurses with practical strategies for adaptation.

Reporting Method

This study adhered to the Good Reporting of A Mixed Methods Study (GRAMMS).

Patient or Public Contribution

No patient or public involvement.
Association Between Longitudinal Changes in Left Ventricular Structure and Function and 24‐Hour Urinary Free Cortisol in Essential Hypertension
Authors: Cao Gao‐Zhen , Huang Jia‐Yi , Lin Qing‐Shan , Wang Run , Chen Cong , Xiu Jian‐Cheng , Yiu Kai‐Hang
Published: February 2025

This study aimed to investigate the associations between 24‐hour urinary cortisol levels (24 h‐UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypertension who underwent baseline 24 h‐UFC measurement and echocardiographic evaluation of left ventricular mass (LVM), left ventricular ejection fraction (LVEF), and the E/e′ ratio. Over a mean follow‐up period of 28.54 ± 14.21 months, patients were grouped into tertiles based on baseline 24 h‐UFC levels. Higher baseline 24 h‐UFC levels were significantly associated with greater increases in LVM and E/e′, reflecting adverse LV remodeling and diastolic dysfunction. These associations persisted after adjusting for potential confounders, including age, gender, baseline blood pressure, and their changes during follow‐up. Moreover, patients in the highest 24 h‐UFC tertile showed an increased prevalence of LV hypertrophy, contrasting with a reduction observed in the lower tertiles. These findings underscore the independent role of elevated 24 h‐UFC levels in driving adverse cardiac structural and functional changes in essential hypertension.
YY2 mediates transcriptional repression of PHGDH and expedites oxidative stress in retinal pigment epithelial cells in diabetic retinopathy
Authors: Lei Xiang , Wang Xiu , Zhang Xinai
Published: February 2025

Aims/Introduction

Phosphoglycerate dehydrogenase (PHGDH), which controls serine synthesis, has been linked to retinal disease. However, there are no clues about its involvement in the diabetic retinopathy (DR) progression. Therefore, we aimed to investigate the relationship between PHGDH, serine synthesis, and DR and their underlying molecular mechanisms.

Method

Differentially expressed genes in DR were screened using bioinformatics tools. DR mice were induced, and retinal histopathology was observed in mice. Overexpression of PHGDH was induced in the DR mice to measure l‐serine, ROS, and MDA content in the retinas of DR mice. ARPE‐19 cells were transfected with overexpression of PHGDH and exposed to high glucose to induce a DR in vitro model, and cell viability and apoptosis assays, serine content, and oxidative stress factor measurement were conducted. The transcriptional regulation of PHGDH by YY2 was explored by ChIP and dual‐luciferase reporter assays. Finally, the combined role of YY2 and PHGDH in regulating serine synthesis, oxidative stress, and ferroptosis was investigated.

Results

PHGDH expression was reduced in DR mice, and overexpression of PHGDH alleviated DR progression by promoting serine synthesis and attenuating oxidative stress. YY2 bound to the promoter of PHGDH and mediated its transcriptional repression. YY2‐mediated transcriptional repression of PHGDH caused disturbances in serine synthesis, leading to oxidative stress‐triggered ferroptosis.

Conclusions

Our data prove that YY2 plays a vital role in modulating PHGDH expression, impairing serine synthesis, and expediting oxidative stress and ferroptosis.
FungiCAP Survey: Insights Into Physicians' Knowledge, Attitudes and Practices in Antifungal Prescriptions in Colombia
Authors: Gómez‐Chaves Carolina Isabel , Díaz‐Brochero Cándida , Nocua‐Báez Laura Cristina , Cortés Jorge Alberto
Published: February 2025

Introduction

The main objective of this study was to evaluate the knowledge, attitudes, and practices of physicians related to the prescription of antifungals in a Latin American country.

Materials and Methods

A close survey of Colombian physicians' knowledge, attitudes and practices was conducted through an online or paper questionnaire (Fungicap). We performed a descriptive analysis of the main sociodemographic variables, which were related to the respondents' medical practices and the survey results. Moreover, an exploratory analysis of the associations between the knowledge score and sociodemographic characteristics and between the knowledge score and factors concerning medical practice was performed.

Results

A total of 285 physicians participated, with a mean age of 34.6 years, and 57.1% were men. The most frequently participating hospital services were internal medicine (47.7%), intensive care (8%), and geriatrics (4.4%). The average knowledge score was 11.3 (SD 2.1, possible score 0–17). Eighty‐seven percent lacked knowledge about the pharmacokinetics, and 61% lacked knowledge about the pharmacodynamics of antifungals. A total of 63.5% had poor knowledge about the antifungal drug of choice according to the type of disease. A total of 78% thought that undergraduate education was insufficient to prescribe antifungals. There were statistically significant differences between the degree of knowledge and the type of institution in which the doctor worked.

Discussion

There is national and international uncertainty about the prescription of antifungals, including basic knowledge and the appropriate treatment of infections. The survey allowed us to identify some weaknesses in the knowledge of antifungal prescribing among Colombian physicians. Thus, there is a need to strengthen antifungal education for physicians.
Goal Hierarchies: Understanding Sub‐Goal and Primary Goal Interdependency
Authors: Sobrepere Xavier , Greve Henrich R.
Published: February 2025

There is increased research on how organizations respond to performance feedback on multiple goals. Most of it considers goals that have ambiguous ranking and thus differs from goal hierarchies with sub‐goals that are instrumental for accomplishing a primary goal. We develop theory on how goal hierarchies lead to primary goal and sub‐goal interactions influencing organizational decision‐making. We show that sub‐goals are important because they are temporally prior and instrumental for primary goals, making organizational responses to sub‐goals and primary goal interdependent in interesting ways. Empirically, we demonstrate a more sophisticated approach to multiple goals than earlier work suggests. This advances the behavioural theory of the firm, and supports and refines key assumptions for organizational design and organizational economics, encouraging further research on the role of goal structures and incentive schemes. Our theory and findings call for increased consideration of the March and Simon's (1958) hierarchical goals’ model in management research.
Resting‐State fMRI to Map Language Function for Surgical Planning in Patients With Brain Tumors: A Feasibility Study
Authors: Bozzano Annalisa , Barletta Laura , Caneva Stefano , Truffelli Monica , Bennicelli Elisa , Rebella Giacomo , Zona Gianluigi , Castellan Lucio
Published: February 2025

Background and Purpose

In neurosurgery, functional MRI is crucial for preoperative planning to obtain the cortical cortex map of language areas. This preliminary work involved analyzing the functional MRIs of 20 oncological patients. Our question is if resting‐state functional MRI (rs‐fMRI) can replace standard task‐based functional MRI (tb‐fMRI) in routine clinical applications. The aim of this challenge is to determine if rs‐fMRI is as effective as tb‐fMRI and to develop a systematic approach for the extraction of a cortical language map.

Methods

We started by analyzing our rs‐fMRI images and validated the correct mapping of language regions using an independent components analysis approach; then, we used the analysis of connectivity networks to compare the two techniques.

Results

The regions identified in rs‐fMRI align with established medical knowledge; a comparison of rs‐fMRI and tb‐fMRI reveals that the four language regions—Broca's and Wernicke's areas in both hemispheres—exhibit activation in both techniques; furthermore, we highlighted that rs‐fMRI reveals more comprehensive details about functional connectivity in contrast to tb‐fMRI.

Conclusions

rs‐MRI and tb‐MRI provide similar levels of efficacy in revealing the functional areas of the brain for preoperative mapping when a lesion lies in areas related to language; thus, both techniques can be utilized for this goal. Based on this, we developed an rs‐fMRI processing pipeline for clinical usage and applied it to a patient outside the study.
Missed Opportunities for Preventing or Diagnosing Acute Rheumatic Fever: A Retrospective Cohort Study of 20 Young Australians Diagnosed With Rheumatic Heart Disease on Screening Echocardiography
Authors: Rouhiainen Oliver , Gatti Jessica , Ramadani Seide , Stewart Jayden , Matthews Melanie , Fairhurst Helen , Remenyi Bo , Francis Joshua R. , Yan Jennifer
Published: February 2025

Background and Aim

A cross‐sectional echocardiographic screening study in a remote Aboriginal community in Australia identified hyperendemic levels of rheumatic heart disease (RHD). 20/613 screened were newly diagnosed with RHD, and 18/20 had no known history of acute rheumatic fever (ARF). Our aim was to explore the medical histories of those newly diagnosed with RHD for potential (1) missed opportunities for primary prevention of ARF through management of Group A Streptococcal (Strep A) infection, and (2) missed opportunities for diagnosis of ARF.

Methods

We assessed community clinic and tertiary hospital medical records of those children with new diagnoses of RHD (n = 20), and collected information regarding previous episodes of possible Strep A infection or its sequelae.

Results

All 20 participants had previous documented possible or confirmed Strep A infections, predominantly in the form of impetigo or infected scabies (range 1–17 episodes per participant). At least 15/20 participants had potential Strep A infections where treatment that was documented may not have adequately covered Strep A. 11/20 participants had scabies diagnosed without documented scabies treatment. 2/20 participants had previously diagnosed ARF, however these were diagnosed within the month prior to the community‐wide screening for RHD. 2/20 participants had undiagnosed, probable or possible ARF when classified retrospectively from review of their case documentation. 13/20 participants had non‐specific presentations with joint complaints that may have represented an ARF episode but with inadequate workup to fulfil diagnostic criteria on retrospective assessment.
Hepatocytes and Hepatic Stellate Cells Carry Different Levels of DNA Damage due to Their Sensitivity to Oxidative Stress in Chronic Hepatitis B
Authors: Zhang Yansong , Jin Danjing , Zhu Hongqiong , Lin Minyi , Peng Xiaomou
Published: February 2025

Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) occur in spite of current antiviral therapies in patients with chronic hepatitis (CHB). It is not yet known why HCC and LC are related to hepatocytes and hepatic stellate cells (HSCs), respectively, in the same inflammation circumstances. The expression of the phosphorylated form of histone H2AX (γ‐H2AX), a biomarker of DNA damage, was detected in hepatocytes and interstitial cells within the liver tissues of 69 patients with CHB using immunohistochemical assay and immunofluorescence colocalisation technique. Hydrogen peroxide (H2O2) was applied to establish an oxidative DNA damage model. Hepatocytes in CHB patients carried much higher levels of DNA damage than interstitial cells. The DNA damage‐carried interstitial cells were confirmed to be HSCs. They lost the damaged DNA during differentiation into myofibroblasts near the foci of inflammatory necrosis. Hepatocyte was much more sensitive to oxidative stress and DNA damage than HSCs, but both MIHA and LX‐2 repaired DNA damage efficiently in vitro. Hepatocytes carried much higher levels of DNA damage than HSCs due to their remarkable difference in sensitivity to inflammation‐induced oxidative DNA damage. The different sensitivity may render hepatocytes and HSCs to be respectively involved in HCC and LC in the same inflammation circumstances.
Inteligencia emocional y su relación con inteligencia, rendimiento académico, apoyo social percibido, satisfacción con la vida y realización de conductas de riesgo
Authors: Lorenzo Alegría Mayurena , González Sierra Miguel Angel , Borges del Rosal África
Published: February 2025

El objetivo de esta investigación es estudiar la relación entre la Inteligencia Emocional, medida con dos tipos de instrumento, y la inteligencia, el rendimiento académico, la satisfacción con la vida, el apoyo social percibido y las conductas de riesgo. En el estudio participó una muestra de 381 estudiantes de La Universidad de Guadalajara (México), quienes cumplimentaron dos test de Inteligencia Emocional MSCEIT y TMMS-24, el test de aptitudes mentales primarias (PMA), el de apoyo social percibido (MOS-SSS), una escala de satisfacción con la vida y un cuestionario ad hoc de conductas de riesgo. Los resultados señalan que la IE tiene relación con la satisfacción con la vida y con el apoyo social percibido y muestran ausencia de relación con las otras variables del estudio.
Sintering Mechanisms in Metal Extrusion-based Sintering-assisted Additive Manufacturing: State-of-the-Art and Perspectives
Authors: Liu Yulin , Jiang Dayue , Ning Fuda
Published: February 2025

Extrusion-based sintering-assisted additive manufacturing (ES-AM) has enabled the fabrication of intricate metal structures, spanning from simple geometries to complex lattice structures. The sintering process plays a vital role in metal densification that requires effective design and optimization of sintering processes for high-quality sintered parts. Notably, sintering behaviors in ES-AM differ from those in traditional methods, primarily due to the heterogeneous distribution of particles and pores induced by the anisotropic fabrication nature of AM. This literature review offers an overview of process and mechanisms of sintering that lay the foundation for the development of ES-AM. Theories governing solid-state sintering and liquid-phase sintering are summarized to advance a thorough comprehension of associated sintering mechanisms. Computational studies on sintering processes at different length scales are also discussed, including atomic-level molecular dynamics, micro-level simulations (Monte Carlo, phase field, and discrete element method), and macroscopic continuum models. The distinctive anisotropic sintering behaviors in the ES-AM process are further elucidated across multiple levels. Ultimately, future directions for ES-AM, encompassing materials, sintering process, and sintering mechanisms, are outlined to guide research endeavors in this field. This review summarizes multi-scale sintering behaviors in both traditional manufacturing and AM, contributing to a deeper understanding of sintering mechanisms and paving the way for innovations in the next generation of manufacturing, particularly in AM involving sintering mechanism.
The genus Halacarus (Acari: Halacaridae), description of two new species and two new records from Türkiye
Authors: Durucan Furkan
Published: February 2025

This paper reports on four species of the genus Halacarus Gosse, 1855, collected from Izmir and Antalya in the eastern Mediterranean Sea, Türkiye. Two species, Halacarus elifae sp. nov. and Halacarus ercani sp. nov., are newly described, while two others, H. bisulcus Viets, 1927, and H. subtilis Viets, 1940, are reported from the eastern Mediterranean Sea for the first time. Detailed descriptions and illustrations of these species are provided.
Visual Athlete Rebrands: Discussing the Factors That Influence Athletes to Alter Their Personal Brand Logo
Authors: Pedersen Zack P. , Blaszka Matthew , Walsh Patrick
Published: February 2025

Even though the widespread practice of athletes utilizing a visual symbol to represent and communicate their brand (i.e., a personal logo) is still in its infancy, a number of athletes who have previously established a personal logo have undergone a visual rebrand. The practice of rebranding is not seen as an enviable branding tactic in other realms (e.g., professional teams and business), given that its utilization is typically tied to a miscommunication of the brand or lacking consumer connection. Furthermore, the consequences of athlete branding may even be amplified in comparison to that of team or organizational brands, given the significantly shorter brand life cycle that athletes have to communicate their associations and logo. However, athletes are still using this brand management strategy, indicating a need to further examine rebranding in this context. This commentary discusses current examples of athlete rebrands, what these rebrands communicate, the influence that endorsers have in this phenomenon, and how future scholars can utilize communication theories to better understand this branding strategy.