bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPRESS: The Human Superiority Effect in Advice-taking: A Multi-method Exploration, and Implications for Policy Makers and Governmental Organizations
Authors: Jin Manhui , Yang Zhiyong , Freling Traci L. , Janakiraman Narayanan
Published: February 2025

Many policy makers and governmental organizations have started using generative artificial intelligence (AI) to provide advice to individuals. However, prior research paints an unclear picture of individuals’ receptiveness to the outputs generated by AI, relative to those from human advisors. While some studies (e.g., Longoni, Bonezzi, & Morewedge, 2019) show that individuals prefer outputs generated by humans over AI, others (e.g., Logg, Minson, & Moore, 2019) present an opposite pattern. To reconcile these mixed findings, this research differentiates two perspectives where relative preferences have been widely examined: (1) a bystander perspective, where consumers evaluate the content generated by human versus AI agents, and (2) a decision-maker perspective, where consumers accept recommendations made by the agents. We find that although there is a general trend of preferring human advice over AI advice in individual decision-making—exhibiting a “human superiority effect”—there is no significant difference between human and AI content preferences during bystander evaluations. Additionally, psychological distance constitutes an important contextual moderator explaining the relative preference for human versus AI recommendations. Specifically, when decision-making circumstances are perceived to be psychologically distant (e.g., low personal relevance), the human superiority effect is attenuated. Theoretical contributions are discussed, along with practical implications for businesses and governmental organizations.
Hydraulic cartridge valve group reliability evaluation and fault diagnosis based on data and model integration
Authors: Xi Xiangshuo , Wang Qingfeng , Liu Guangxu , Li Bingcheng
Published: February 2025

The hydraulic cartridge valve group (HCVG) stands as an intricately integrated, high-capacity flow device extensively employed in hydraulic transmission systems. Nonetheless, challenges concerning the dependability and fault diagnosis of the HCVG pose significant ramifications for the overall performance and safety of hydraulic systems. In response to these challenges, this endeavor devises a comprehensive method package to evaluate the reliability and diagnose faults within the HCVG. This method package encompasses two phases: the design and usage of the HCVG. During the design phase, our methodology assesses the HCVG reliability through conditional probability, meticulously accounting for each component’s failure modes and associated effects. Correspondingly, during the usage phase, the methodology encompasses three pivotal steps: state observation, fault diagnosis, and fault location. (1) In the state observation step, we employ an integrated data and model approach that fuses measured data with mathematical models to ascertain the true system state. (2) In the fault diagnosis step, we utilize an adaptive threshold technique, dynamically establishing thresholds based on discrepancies between observed and actual states. (3) In the fault location step, we harness the Graph Convolution sensitivity method, quantifying each component’s impact on reliability through Graph Convolution and pinpointing the faulty component exhibiting the highest sensitivity. Finally, the above method package undergoes validation via simulation and experimentation using a typical HCVG scenario, conclusively demonstrating its capacity to effectively and accurately diagnose and pinpoint faults within the HCVG. This undertaking holds substantial significance for enhancing the reliability and fault diagnosis of the HCVG and other hydraulic systems.
Solidarity on trial: On reliance, reason and logic at the Court of Justice of the European Union
Authors: Butler Graham
Published: February 2025

Solidarity has consistently played a pivotal role in the arguments presented before the Court of Justice of the European Union (CJEU). As a principle, value or concept, the idea of ‘solidarity’ offers an enticing avenue for parties seeking favourable interpretations of EU law. The notion of solidarity permeates various fields and areas of EU law, reflecting its partial legalization through its presence in the EU Treaties. The critical question that emerges is how and to what extent the CJEU should employ and interpret solidarity in its judgments. This article delves into the CJEU's case law where solidarity has been scrutinized, ‘on trial’, revealing that the CJEU is now poised, with particular enthusiasm, to integrate solidarity into its reasoning, by explicit reliance upon it. By doing so, the CJEU aims to embed the logic of solidarity within specific areas of the EU legal framework. Consequently, this article explores how solidarity might influence different sectors of EU law and the potential ramifications for this development if the CJEU does not exercise sufficient caution.
Dynamic response of foam-filled negative Poisson’s ratio beams under low-velocity impact
Authors: Zhao Modi , Yuan Long , Yuan Hui , Zhang Jianxun
Published: February 2025

The dynamic behavior of foam-filled negative Poisson’s ratio beam (FNPRB) under low-speed impact is studied analytically and numerically in this work. The analytical solution for the dynamic behavior of foam-filled negative Poisson’s ratio beam is derived on the basis of the yield criterion. The numerical calculations are conducted. Theoretical results are consistent with finite element results. The influences of foam strength, negative Poisson’s structure width and foam thickness on the crashworthiness of foam-filled negative Poisson’s ratio beams are discussed. In the discussions on effects of parameters, it is considered the effect of the total weight of the sandwich beam due to the parameter change, a dimensionless quantity to study the influence of parameters on sandwich beams is defined. It is shown that foam strength and foam thickness play significant roles in influencing the low-speed impact of the foam-filled beam with negative Poisson’s ratio.
“A love-addled brain is an incurable malady”: Online debates on contemporary romantic relationships within a Chinese postfeminist context
Authors: Zou Wenxue , Yang Xiaoya , Liu Zikun
Published: February 2025

In the summer of 2023, the TV series “Fireworks of My Heart” sparked extensive online debates over its protagonists’ cross-class love story in China. This study aims to examine the distinctive gender ideology and views on romantic relationships expressed by young middle-class women on social media. By conducting a critical discourse analysis on 1079 Weibo posts under eight relevant hashtags, we identified three significant themes: the bold rejection of the love-addled mindset, privatized self and monetized love, and critiques of structural oppression against women. We argue that contemporary netizen's views on relationships bear a strong postfeminist influence, entwined with consumerism, neoliberalism, and romantic idealism. Despite the emerging trend of feminist awakening, the challenges faced by online discursive activism within China's unique internet environment led to a localized and somewhat extreme evolution that seems to detach from societal foundations.
A two-level multivariate response model for data with latent structures
Authors: Zhang Yingjuan , Einbeck Jochen , Drikvandi Reza
Published: February 2025

A novel approach is proposed for analysing multilevel multivariate response data. The approach is based on identifying a one-dimensional latent variable spanning the space of responses, which then induces correlation between upper-level units. The latent variable, which can be thought of as a random effect, is estimated along with the other model parameters using an EM algorithm, which can be seen in the tradition of the 'nonparametric maximum likelihood' estimator for two-level linear (univariate response) models. Simulations and real data examples from different fields are provided to illustrate the proposed methods in the context of regression and clustering applications.
Modern contraceptive discontinuation and associated factors among adolescent girls and young women in Tanzania: An analysis of a nationally representative data
Authors: Solomon Victoria J , Kibona Shadrack E , Mukyanuzi Elevatus N , Mbotwa Christopher H
Published: February 2025

Background:

Contraceptive use is vital in reducing the risk of unintended pregnancies and early motherhood. Despite the well-established benefits, the uptake of modern contraceptive methods among adolescent girls and young women (AGYW) is sub-optimal in sub-Saharan Africa. Furthermore, the discontinuation rate of modern contraceptive use poses a significant challenge to its effectiveness.

Objective:

We aimed to determine a 12-month modern contraceptive discontinuation rate, reasons for discontinuation, and associated factors among AGYW in Tanzania.

Design:

Retrospective nested within the cross-sectional utilizing quantitative approach.

Methods:

We retrospectively analysed calendar data on contraceptive use collected in the 2022 Tanzania Demographic and Health Survey (2022 TDHS). The 2022 TDHS data collection was implemented between February and July 2022. The study population comprised AGYW aged 15–24 years. The unit of analysis was the contraceptive episode of use, defined as the period between the start of use and the termination of the method. Our analysis was mainly based on the discontinuation due to dissatisfaction with the method. We used a life-table method to estimate the contraceptive discontinuation rates. A frailty model was employed to assess the factors associated with the discontinuation rate.

Results:

A total of 668 AGYW with a mean (±standard deviation) age of 21.5 ± 2.1 years were included in the analysis. The overall prevalence of 12-month discontinuation rate due to dissatisfaction with the method was 32.3%. Higher discontinuation rates were observed among injectable and pills. The main reasons for discontinuation were side effects (13.7%) and change in menstrual cycle (8%). Factors associated with higher discontinuation rates included higher age (adjusted hazard ratio (aHR) 1.64, 95% confidence interval (CI) 1.06–2.51 for the 20–24 age group), residing in households headed by a female (aHR 1.40, 95% CI 1.05–1.85), and residing in the western zone (aHR 1.87, 95% CI 1.21–2.90).

Conclusion:

This study revealed a high prevalence rate of modern contraceptive discontinuation among AGYW in Tanzania. The management of side effects needs to be incorporated into programs aimed at promoting the sustained use of modern contraceptive methods.
Nest design and breeding success in intraspecific investigations of non-cavity nesting avian species
Authors: Lambrechts Marcel M. , Deeming D. Charles
Published: February 2025

Although more than 60 hypotheses predict associations between characteristics of nest architecture and at least one measure of breeding success, reproductive consequences of nest architecture remain quantitatively understudied. In addition, most detailed studies of animal constructions in natural conditions were conducted on species built inside human-made nest-boxes that facilitate monitoring. Here, we present the first review of methodologies and research findings in studies that examined the reproductive consequences of nest characteristics in wildlife species that build nests outside cavities, mainly focusing on nest-size components, animal-derived nest material, anthropogenic nest material, or fresh greenery (i.e., fresh vegetative materials placed in the nest). We found 84 published field studies that were conducted on 51 non-cavity nesting bird species from 10 different avian orders, mainly members of the Passeriformes (69%). We discuss why most investigations reported weak relationships between aspects of nest design and breeding success. We propose suggestions for future research on bird nests, and also highlight the importance of poorly studied research problems.
A perspective of persons with Parkinson's disease on the contribution of alpha-synuclein seed amplification assay biomarker to the diagnosis of Parkinson's disease
Authors: Bowen Susanne , Blacker David , Prettyman Richard
Published: February 2025

Alpha-synuclein is a normal protein, but misfolded forms in the cerebrospinal fluid can be detected using the alpha-synuclein seed amplification assay (αSyn-SAA), a potential biomarker for Parkinson's disease (PD). Some experts consider this assay a ‘game changer’ for redefining and reclassifying PD. In this article, we, three individuals with PD, share our perspective on the suitability of αSyn-SAA as the basis for a new classification and staging system for PD. We also discuss other biomarkers and their relevance to those with PD, drawing on our research and the scientific background of two authors. We aim to clarify complex media reports and study findings for the PD community. We argue that while αSyn-SAA can identify the presence of pathology, it cannot explain the underlying cause for such pathology or predict the progression of PD. Given the varied biological pathways leading to PD, using αSyn-SAA as a unified biological definition for a new classification system is premature. Further research is needed before it can serve as the foundation for defining and staging Parkinson's disease. Although αSyn-SAA has its place, like the DAT scan, it should be seen as a tool for confirming diagnoses rather than defining them.
Impact of dexmedetomidine during hypothermia on initiation of enteral feeding in newborns with hypoxic-ischemic encephalopathy
Authors: Marsh Kimberly R , Peeples Eric S
Published: February 2025

Background

After early studies suggested safety and potential for benefit of dexmedetomidine use in neonatal hypoxic-ischemic encephalopathy (HIE), our neonatal intensive care unit (NICU) decided to transition from morphine to dexmedetomidine as our standard sedative during therapeutic hypothermia (TH). The primary aim was to monitor the possible side effects of transitioning from morphine to dexmedetomidine with a primary goal of reducing the days to initiation of enteral feeds to less than 3 days, with the hypothesis that the gastrointestinal motility effects of morphine may have been hindering feeding progress during TH. The secondary aim was to determine rates of hemodynamically significant bradycardia.

Methods

This was a prospective quality improvement study using a retrospective comparison group to determine the comfort, hemodynamic, and early feeding effects of a clinical change in sedation management from morphine to dexmedetomidine. We included infants born at ≥35 weeks of gestation receiving hypothermia for hypoxic-ischemic encephalopathy (HIE) from 2017 to 2023.

Results

Data were collected from 107 infants: 48 morphine, 35 dexmedetomidine, and 24 neither. Heart rate was lower in the morphine and dexmedetomidine groups compared to no sedation. Blood pressures, pain scores, and blanket temperatures were not different between groups. Infants receiving dexmedetomidine initiated enteral feeds earlier than either of the other groups and reached full enteral feeds earlier than the no treatment group but not the morphine group.

Conclusions

This study supports a growing body of literature suggesting dexmedetomidine is a well-tolerated alternative to opioids during hypothermia for HIE.
The Impact of Personal and Change Event Characteristics on Employee Wellbeing via Uncertainty and Insecurity
Authors: Nguyen Phong T. , Rafferty Alannah E. , Xerri Matthew J.
Published: February 2025

Over the past three decades, scholars have found that organizational change often results in high levels of psychological uncertainty about change as well as enhancing job insecurity. Research also has identified these variables as predictors of employee wellbeing during change. Despite this, researchers have not developed an integrative model of the antecedents and consequences of the different types of change-related uncertainty and insecurity that may emerge during change. In this conceptual paper, we draw on the conservation of resources theory to develop such an integrative model. We identify change event characteristics (i.e., change content, change processes, and the internal change context) as antecedents of different types of change-related uncertainty, which influence different types of insecurity, and ultimately influence multiple dimensions of employee wellbeing. We identify employees’ personal characteristics (i.e., demographic and individual dispositions) as moderators of relationships between change event characteristics and different types of change-related uncertainty and employee insecurity, which in turn influence wellbeing. We discuss the implications of this model for research and practice when managing change.
A nomogram for predicting mortality risk in geriatric patients with hip fractures complicated by pneumonia: A multicenter study
Authors: Zhang Kaiming , Li Xiangwei , Xiao Yujia , Zhou Cheng , Liu Yu , Zhen Fan , Zhang Hao , Nie Mao
Published: February 2025

Objectives:

Pneumonia is a common perioperative complication in geriatric patients with hip fractures. This study aimed to analyze demographic characteristics, mortality rates, postoperative outcomes, and perioperative comorbidities, identify risk factors for mortality, and develop a nomogram for predicting the prognosis of these patients.

Methods:

Data on patients hospitalized for arthroplasty for hip fractures from 2020 to 2023 at three hospitals were retrospectively analyzed. Patients were divided into the P group (patients with hip fractures complicated with pneumonia) and the C group (patients with hip fractures without pneumonia) and demographic characteristics, mortality, postoperative outcomes, and perioperative comorbidities of the patients were analyzed. Multiple logistic regression was then used to identify independent risk factors for inpatient mortality in the P group and a nomogram was constructed to predict inpatient mortality. The predictive performance of the nomogram was assessed using receiver operating characteristic curves, decision curve analysis, and calibration curves.

Results:

A total of 311 patients participated in the study. Patients in the P group had longer hospitalization ( p = 0.001), higher inpatient mortality ( p < 0.001), higher mortality (30 days) ( p < 0.001), and a poorer recovery of hip function ( p < 0.001). Multiple logistic regression showed that age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were independent risk factors for inpatient mortality in the P group; these factors were incorporated in the nomogram. The C-index of the nomogram was 0.868 (95% CI: 0.802–0.933), and the C-index of internal bootstrapping validation was 0.851 (95% CI: 0.793–0.908), indicating the effectiveness of the nomogram in predicting patient prognosis.

Conclusions:

Coinfection with pneumonia adversely affected both recovery of hip function and survival in geriatric patients with hip fractures. Age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were found to be independent risk factors for mortality in this patient population.
Longitudinal Associations Between Academic and Social Adjustment Among Chinese College Freshmen: The Mediating Role of Depressive Symptoms
Authors: Ti Yonghe , Yi Cong , Wei Jun , Shi Guangyuan
Published: February 2025

This study investigated the longitudinal associations between academic and social adjustment and the mediating role of depressive symptoms among Chinese college freshmen using a three-wave longitudinal design. A total of 1183 freshmen (467 males; Mean age = 18.61 years at Wave 1) from eight Chinese universities participated in this study. Using cross-lagged panel analysis, the results showed that academic adjustment predicted increases in social adjustment over time, but not vice versa. Academic adjustment, but not social adjustment, predicted decreases in depressive symptoms over time. Depressive symptoms predicted worsened academic and social adjustment over time. Longitudinal mediation analysis showed that depressive symptoms mediated the effect of academic adjustment on social adjustment over time among Chinese college freshmen. These findings highlight the contributions of academic adjustment to social adjustment for Chinese freshmen and emphasize the need for Chinese colleges to promote freshmen’s academic adjustment at the beginning of college life.
Impact of cigarette smoking and gender on EGFR mutation status in Iraqi lung cancer patients
Authors: Kareem Taghreed Abdulrahman , Mohammed Reyadh Salim , Nasir Ban Abbas
Published: February 2025

Background and aim

Lung cancer, particularly NSCLC, is the foremost reason behind deaths associated with cancer globally and the second most prevalent malignancy among males in Iraq. Mutations in the EGFR gene are significant druggable targets in NSCLC, linked to sensitivity to tyrosine kinase inhibitors. This study aims to analyse the incidence and kinds of EGFR mutations in Iraqi NSCLC patients and their correlation with gender and smoking status, despite global data indicating that EGFR mutations are more prevalent in females and non-smokers.

Materials and methods

A retrospective analysis was conducted on 214 FFPET samples. Information regarding the patients’ gender and smoking history was documented. DNA was extracted use the NucleoSpin tissue kit, and EGFR mutations were identified employing the Cobas z 480 analyser. The prevalence and types of mutations were associated with gender and smoking status; a p-value below 0.05 was regarded as statistically significant.

Results

Among 214 NSCLC cases, 51 (23.8%) exhibited EGFR mutations, with 58.8% being male and 41.2% female. The exon 19 deletion, Exdel19, represented the highest prevalence in both males and females, constituting 70% and 71.4%, respectively. The smoking status exhibited a significant correlation with Exdel19 mutation status ( p = 0.048), indicating a considerably greater mutation rate among nonsmokers.

Conclusion

The results of this study demonstrated the influence of smoking on the occurrence of EGFR mutations, particularly Exdel19, in Iraqi lung cancer patients. Systematic evaluation of EGFR mutations, in conjunction with smoking reduction initiatives, will enhance results with targeted therapy and diminish the burden of lung cancer both locally and globally.
Developing Presurgical Conversion Formulas to Predict Miniaci Angle for Personalized Realignment Targets in Opening-Wedge High Tibial Osteotomies
Authors: Chen Hongyu , Chen Liang , Zhang Yuan , Wu Qiang , Yan Mengning , Jiang Xu , Wang Liao
Published: February 2025

Background:

The correlation between the Miniaci angle and presurgical hip-knee-ankle (HKA) angle, weightbearing line (WBL) percentage, and changes in the HKA angle (ΔHKA angle) and WBL percentage (ΔWBL percentage) is significant in opening-wedge high tibial osteotomy (OWHTO). The conversion formulas that interrelate the Miniaci angle with pre-HKA angle (formula 1), pre-WBL percentage (formula 2), ΔHKA angle (formula 3), and ΔWBL percentage (formula 4) have been derived through the linear regression analysis. However, the accuracy of conversion formulas has not been validated.

Purpose:

To validate the precision of conversion formulas targeting various surgical objectives for OWHTO planning in the varus knee patient population.

Study design:

Cross-sectional study; Level of evidence, 3.

Methods:

A retrospective study of 155 lower limbs of 112 patients with medial unicompartmental knee osteoarthritis was conducted. A computer simulation of OWHTO was performed to calculate the Miniaci angle by delivering the WBL to the Fujisawa point (group 1), at 65% WBL percentage (group 2), and 4.5° of valgus (group 3). Spearman correlation and Bland-Altman analyses were conducted between the computer simulation and formula calculation.

Results:

Upon evaluating the widely accepted Fujisawa point as a postoperative target, all formula results demonstrated a strong correlation with computer simulation outcomes ( r = 0.962-0.999). Compared with the simulated Miniaci angle, the mean bias of the calculated angles derived from formulas 1 to 4 was 0.098° (formula 1), –0.268° (formula 2), 0.065° (formula 3), and −0.246° (formula 4). Notably, the formula based on the ΔHKA angle exhibited an ideal correlation with the simulated Miniaci angle ( r = 0.998-0.999). In the 3 groups with varying postoperative targets, the mean bias of this formula in predicting the Miniaci angle was 0.065° (group 1), 0.070° (group 2), and 0.080° (group 3).

Conclusion:

Formulas based on the presurgical HKA angle and WBL percentage showed perfect accuracy for measuring the Miniaci angle targeting the Fujisawa point. The formula based on ΔHKA angle achieved the best accuracy and may be a valuable tool for measuring the Miniaci angle in broader surgical targets.
Outperformance of Combined Artificial Anterolateral Ligament and ACL Reconstruction Compared With Isolated Artificial ACL Reconstruction in Knees With Anterolateral Structure and ACL Deficiency: A Biomechanical Analysis
Authors: Cheng Rongshan , Dimitriou Dimitris , Yao Gai , Li Xianghui , Lv Xiaolong , Yang Yangyang , Ying Hua , Wang Ziming , Tsai Tsung-Yuan
Published: February 2025

Background:

Despite the promising clinical outcomes of artificial polyethylene terephthalate (PET) ligaments in isolated anterior cruciate ligament reconstruction (ACLR), their biomechanical performance after combined anterolateral ligament reconstruction (ALLR)/ACLR in anterolateral structure (ALS)/anterior cruciate ligament (ACL)–deficient knees has not been investigated.

Purpose/Hypothesis:

The purpose of this study was to compare biomechanical performance in cadaveric knees between combined artificial ALLR/ACLR and isolated artificial ACLR using PET ligaments. It was hypothesized that combined artificial ALLR/ACLR would restore native knee stability and outperform isolated artificial ACLR in ALS/ACL-deficient knees.

Study Design:

Controlled laboratory study.

Methods:

Eight fresh-frozen cadaveric knees were tested using a robotic manipulator. Each knee was tested in 4 states: (1) ALS/ACL intact, (2) ALS/ACL deficient, (3) ACLR, and (4) ALLR/ACLR. The anterior tibial translation (ATT) and tibial internal rotation (IR) in each knee condition were measured under 3 loads: (1) 89 N of anterior tibial loading, (2) 5 N·m of IR torque, and (3) simulated pivot shift (combined 5 N·m of IR torque and 7 N·m of valgus load).

Results:

During 89 N of anterior tibial loading, there were no significant differences in ATT between the isolated ACLR and ALLR/ACLR knees. During 5 N·m of IR torque, the mean tibial IR at 45° of flexion was significantly higher in the ACLR knees (32.49°± 7.96°) than in the ALLR/ACLR knees (21.78°± 3.03°) ( P < .05). During the simulated pivot shift, the mean ATT and tibial IR at 30° and 45° of flexion were significantly higher in the ACLR knees (ATT: 5.09 ± 2.74 mm at 30°, 5.43 ± 2.79 mm at 45°; IR: 30.08°± 7.31° at 30°, 32.55°± 6.48° at 45°) than in the ALLR/ACLR knees (ATT: 1.93 ± 2.71 mm at 30°, 1.17 ± 2.26 mm at 45°; IR: 22.12°± 4.05° at 30°, 22.18°± 3.37° at 45°) ( P < .05).

Conclusion:

Combined artificial ALLR/ACLR restored native knee stability across multiple flexion angles and outperformed isolated artificial ACLR in ALS/ACL-deficient knees, particularly with respect to ATT and tibial IR during the pivot-shift test.

Clinical Relevance:

The indications of the artificial PET ligament may be expanded to include combined ALLR/ACLR to restore knee stability better than isolated artificial ACLR in ALS/ACL-deficient knees.
Comparison of Arthrofibrosis After ACL Reconstruction According to Graft Choice: Quadriceps Tendon Versus Bone-Patellar Tendon-Bone Autograft
Authors: Johnson Bailey E. , Smith Chelsea L. , Smith Cory D. , Quilligan Edward J. , Deshpande Viraj A. , Gardner Vance O. , Parvaresh Kevin C. , Shepard Michael F. , Petrie Russell S. , Prietto Carlos A. , Grumet Robert C. , Gazzaniga David S.
Published: February 2025

Background:

Arthrofibrosis is a complication of anterior cruciate ligament reconstruction (ACLR), and it is possible that graft choice such as the quadriceps tendon (QT) autograft may be a risk factor. With the increasing popularity of the QT autograft, it is important to compare it with other graft choices.

Purpose/Hypothesis:

The purpose of this study was to identify whether graft choice, QT versus bone–patellar tendon–bone (BTB) autograft, is a risk factor for early return to the operating room for arthrofibrosis after ACLR. It was hypothesized that the rate of arthrofibrosis surgery would be higher for the QT autograft recipients.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A single-center retrospective chart review was conducted between January 2010 and November 2022. Skeletally mature patients who underwent primary ACLR with either QT or BTB autograft were considered for inclusion. Patients who received an alternate graft or those undergoing revision ACLR were excluded. The primary outcome of interest was return to the operating room for arthrofibrosis release (either manipulation under anesthesia or lysis of adhesions).

Results:

Of 1726 included patients (1155 receiving a BTB autograft and 571 receiving a QT autograft), 5.2% (n = 60) of BTB recipients and 6.5% (n = 37) of QT recipients required subsequent arthrofibrosis. There was no significant association between graft type and subsequent arthrofibrosis ( P = .275). There was a significant association with graft type and presence of a cyclops lesion (65.0% of BTB grafts and 40.5% of QT grafts; P = .018). After removing those patients with chronic tears who underwent ACLR at >1 year, patients who required arthrofibrosis were found to have a significantly shorter time between injury and ACLR (mean, 59.23 ± 48.46 days) than those who did not require arthrofibrosis (mean, 81.7 ± 72.63 days) ( P≤ .01). Significantly more female patients (9.25%) than male patients (2.79%) required arthrofibrosis (hazard ratio, 3.82; P < .001), and patients who required arthrosis were significantly younger (mean, 22.52 ± 9.35 years) than those who did not (mean, 25.74 ± 10.83 years) ( P = .001).

Conclusion:

Study findings indicated no statistically significant difference in the rate of secondary arthrofibrosis surgery between patients who underwent ACLR with either QT or BTB autograft.
Government CEO pay regulation and corporate innovation performance: The role of CEO’s career horizon and shareholding
Authors: Maqsood Umer Sahil , Li Qian , Wang Shihao , Zahid R. M. Ammar
Published: February 2025

This study investigates the effect of government pay policy for chief executive officer’s (CEO’s) compensation on corporate innovation (CI). Furthermore, it explores the role of the CEO’s career horizon and shareholding in this nexus. Utilizing the difference-in-differences method to analyze Chinese-listed state-owned enterprises from 2010 to 2020, the baseline findings indicate that government pay policies have had a negative impact on CI. In addition, CEOs with shorter career horizons and higher shareholding demonstrate an enhanced ability to counteract the adverse effects of pay policy, thereby sustaining high levels of innovation. Our findings indicate a necessity for regulatory bodies to re-evaluate mandated constraints on CEO compensation. These restrictions lead to a decline in firm innovation, ultimately affecting shareholder interests. Importantly, the study conclusions remain robust even after rigorous analysis using parallel trend assumptions, propensity score matching, alternative pay policy and innovation metrics, and placebo tests.

JEL CLASSIFICATION: J3, M1, K2, O3
First ischemic stroke in young adults: Sex and age-related differences in stroke rates, risk factors, and etiologies
Authors: Schneider Thomas R , Dittrich Tolga D , Kahles Timo , Katan Mira , Luft Andreas R , Mono Marie-Luise , Bolognese Manuel , Arnold Marcel , Heldner Mirjam , Michel Patrik , Dirren Elisabeth , Rodic Biljana , Cereda Carlo W , Peters Nils , Bonati Leo H , Renaud Susanne , Humm Andrea M , Medlin Friedrich , Albert Sylvan , Sturzenegger Rolf , Tarnutzer Alexander A , Siebel Philip , Baumgärtner Markus , Berger Christian , Mordasini Pasquale , Vehoff Jochen , Nedeltchev Krassen , De Marchis Gian Marco
Published: February 2025

Introduction:

Sex differences in stroke incidence, vascular risk factors (VRFs), and etiologies among young adults remain underexplored, particularly regarding age-related patterns.

Patients and Methods:

We retrospectively analyzed young adults (18–55 years) with first-ever ischemic stroke treated at certified acute stroke units/centers between 2014 and 2022, using Swiss Stroke Registry data. Stroke rates (per 100,000 person-years), VRFs, and etiologies were assessed by age and sex.

Results:

Among 3,995 stroke patients, stroke rates were similar between sexes until age 35, after which men showed a more pronounced exponential increase. This rise was particularly notable in patients with elevated BMI and ⩾2 VRFs. The proportion of patients with ⩾2 VRFs rose with age (18–35: 22%; 36–50: 48%; 51–55: 63%). While no statistically significant differences in VRF profiles were observed between men and women aged 18–35, men accumulated VRFs about five years earlier than women, leading to a higher prevalence of multiple VRFs in men aged 36–50, with the gap narrowing in the 51–55 group. Stroke etiologies shifted with age: patent foramen ovale and cervical artery dissection predominated in younger patients, while large artery atherosclerosis, small vessel disease, and strokes of undetermined etiology increased with age, with notable sex differences.

Discussion and Conclusions:

This study highlights sex and age differences in ischemic stroke rates, VRFs, and etiologies among adults under 55 years. After 35, stroke rates rose more sharply in men, paralleling their higher VRF burden. These findings emphasize the importance of early management of VRFs—including overweight—to mitigate stroke risk.
Do urban digital twins need agents?
Authors: Marçal Russo Letícia , Dane Gamze , Helbich Marco , Ligtenberg Arend , Filomena Gabriele , Janssen Christian P , Koeva Mila , Nourian Pirouz , Patuano Agnès , Raposo Paulo , Thompson Kristina , Yang Senqi , Verstegen Judith A
Published: February 2025

The urban digital twin (UDT) is derived from the original digital-twin concept of a representation of physical assets. This has left the social component of the city underrepresented in UDTs. Here, we discuss what this means for the current maturity stage of UDTs and why better representing human behaviour in UDTs may diversify possibilities to support different types of planning. We contemplate operationalizing the representation of human behaviour by means of agent-based models (ABMs) integrated with UDTs and illustrate this with two concrete examples of simulating stress and safety perception in public spaces. One example shows the idea of the UDT as a live data repository for ABMs, with the ABM adding dynamism, and the other of live feedback between the city, the ABM and UDT. We discuss several epistemological, conceptual, technical, and ethical challenges that may be involved in this integration. We conclude with a future agenda to promote (1) the abandonment of the vision of a UDT as the highly detailed mirror of the city, (2) UDTs fit for sectoral (strategic) in addition to operational planning, (3) the inclusion of behavioural and social processes in UDTs by incorporating ABMs, (4) a culture of cumulative research using structured guided frameworks and reusable building blocks, (5) ABMs with explicit purposes to allow fit-for-purpose selection in UDTs, and (6) explicitly addressing epistemic, normative, and moral responsibilities. Thus, though including agents may at some point be a solution for the (currently lacking) perspective on the role of humans in shaping and being shaped by the city, several reconsiderations in the UDT and ABM communities need to take place first.
Artificial intelligence and machine learning models for predicting the metallurgical performance of complex sulfide ore flotation process
Authors: Ali Danish , Hayat Muhammad Badar , Alagha Lana , Monyake Keitumetse Catherine , Khalid Hammas
Published: February 2025

This research study proposed a novel approach utilising AI models to predict the metallurgical performance of complex sulfide ore flotation. Five machine learning and artificial intelligence models were employed in this study, that is, Random Forest (RF), Artificial Neural Networks (ANN), Adaptive Neuro Fuzzy Interference System (ANFIS), Mamdani Fuzzy Logic (MFL) and Hybrid Neural Fuzzy Interference System (HyFIS). Sixty-two flotation tests were conducted on samples containing galena, chalcopyrite and sphalerite as the main valuable minerals, and pyrite as the main gangue mineral. Different variables were used as inputs in the AI studies including physiochemical and operational parameters. The flotation recovery of lead and copper and their corresponding grades in the bulk concentrate were the primary dependent variables (outputs). The input variables included the dosages of sodium cyanide (pyrite's depressant), sodium isopropyl xanthate (collector), zinc sulfate (sphalerite's depressant) and Methyl isobutyl carbinol (MIBC, frother); air flow rate; flotation time; and the speed of the impeller in the flotation cell, which is indicative of the energy input. For the purpose of AI model development, datasets were divided into two subsets. The first subset was primarily used for the training phase, and it comprised 80% of the total data. The second subset, consisting of 20% of the total data, was used for testing. The models’ performance was assessed using two main indicators: R-squared (R2) for the proportion of explained variation and RMSE for the average prediction error. The Hybrid Neural Fuzzy Interference System demonstrated superior performance in predicting the recovery and grade of copper and lead, with R² and RMSE of 0.9895 and 1.069 for the training phase, respectively, whereas for the testing step the respective values were 0.9128 and 2.859.
Knowledge, Self-Efficacy, and Correlates in Palliative and End-of-Life Care: Quantitative Insights from Final-Year Nursing and Medical Students in a Mixed-Methods Study
Authors: Natuhwera Germanus , Namisango Eve , Ellis Peter
Published: February 2025

Introduction:

About a decade after the introduction of palliative care teaching for undergraduate nurses and medical students in Uganda, no research has examined students’ knowledge and self-efficacy to provide palliative and end-of-life care and their correlates.

Aims:

To: (1) estimate final-year undergraduate nursing and medical students’ knowledge of and self-efficacy to provide palliative and end-of-life care, (2) identify correlates of knowledge and self-efficacy to provide palliative and end-of-life care.

Design:

A multicentre cross-sectional quantitative study.

Setting/participants:

Final-year undergraduate medical and nursing students in eight medical and nursing schools in Uganda. Instruments included biodata sheet, the Palliative Care Quiz for Nursing questionnaire and the Palliative Care Self-Efficacy scale. Statistical analyses were performed using STATA version 14.0.

Results:

The mean age of the participants ( n = 466) was 24.45 ± 3.31 years. Participants’ knowledge of palliative care scores was low in all domains ‘Philosophy and principles of palliative care’ 1.46 ± 0.93 (range: 0–4), ‘Psychosocial and spiritual care’ 0.61 ± 0.73 (range: 0–3) and ‘Management of pain and other symptoms’ 6.32 ± 1.75 (range: 0–13). Predictors of knowledge were Gender ( p = 0.0242), course of study ( p = 0.0001) and religion ( p = 0.0338). Participants had very low self-efficacy scores in the three domains of the Palliative Care Self-Efficacy scale.

Conclusion:

Participants generally demonstrated limited knowledge and insufficient self-efficacy in providing palliative and end-of-life care. There is a need to integrate and strengthen practical, pedagogical and experiential teaching, review the palliative care curriculum. Future evaluative, longitudinal and interventional as well as qualitative studies are needed to gain deeper insights into this topic.
Key challenges in providing assisted dying in Belgium: a qualitative analysis of health professionals’ experiences
Authors: Archer Madeleine , Willmott Lindy , Chambaere Kenneth , Deliens Luc , White Ben P.
Published: February 2025

Background:

Assisted dying or ‘euthanasia’ has been legal in Belgium since 2002. Extensive research has been conducted which investigates Belgian euthanasia practice, however, the current challenges that health professionals face when providing euthanasia are not well known. This knowledge is important for evaluating the current system, especially in light of recent developments in Belgian euthanasia law and practice including judicial decisions, legislative amendments and research highlighting the complexity of its governing regulatory framework.

Objectives:

This study investigates the key challenges that health professionals experience when providing euthanasia in Belgium.

Design:

A qualitative interview study with reflexive thematic analysis.

Methods:

Twenty interviews were conducted between September 2022 and March 2024 using Microsoft Teams videoconferencing. Eligible participants were physicians and nurses who spoke English or Dutch and who had been involved in the euthanasia assessment of at least two patients in the past year.

Results:

Four themes were generated: (1) the framing of the euthanasia legislation poses challenges; (2) providing euthanasia can place considerable burdens on health professionals; (3) clashing views about euthanasia can hamper opportunities for balanced discussions and (4) euthanasia and processes relating to euthanasia are not always well-understood.

Conclusion:

This study highlights the numerous and varied challenges physicians and nurses experience when providing euthanasia in Belgium, even 20 years after its law passing. This study contributes to a wider understanding of universal challenges associated with providing assisted dying and sheds light on issues specific to Belgium. The results provide an opportunity for policymakers to take action to better support providers to manage these challenges, including through a formal review of the legislation and the broader system.
Venetoclax plus Daunorubicin and Cytarabine for Newly Diagnosed Acute Myeloid Leukemia: Results of a Phase 1b Study
Authors: Mantzaris Ioannis , Goldfinger Mendel , Uriel Matan , Shastri Aditi , Shah Nishi , Gritsman Kira , Kornblum Noah , Shapiro Lauren C , Sica Alejandro , Munoz Anne , Chambers Nicole , Dhawan Aradhika , Verceles Jhannine Alyssa , Fehn Karen , Tirone Balda , Shah Lamisha , Clark Shaunmonique , Zhang Chenxin , Kim Mimi Y , Cooper Dennis L , Verma Amit , Konopleva Marina Y. , Feldman Eric J
Published: February 2025

Venetoclax combined with intensive chemotherapy shows promise for untreated acute myeloid leukemia (AML), but its integration with the '7+3' regimen remains underexplored. In a phase 1b study (NCT05342584), we assessed the safety and efficacy of venetoclax with daunorubicin and cytarabine in newly diagnosed AML patients. Thirty-four patients (median age 59 years; 62% non-white) received venetoclax at escalating durations (8, 11, or 14 days). Adverse events included febrile neutropenia (100%), sepsis (29%), and enterocolitis (23.5%), with no induction deaths. Median recovery times for neutrophils (>1.0K/uL) and platelets (>100K/uL) were under 30 days. Composite complete remission (CRc) was achieved in 85.3% of patients, with 86.2% being measurable residual disease (MRD)-negative. Responses spanned all ELN2022 risk categories. With a median follow-up of 9.6 (2-20) months, median duration of response, event-free survival and overall survival were not reached. Venetoclax (400 mg) combined with '7+3' chemotherapy was safe and effective in achieving MRD-negative remissions across all durations. Ven dose optimization is being explored in the expansion phase of this trial. Future multicenter studies should confirm our findings.
Association of co-existing vitamin B6 and B12 deficiency with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome: a case report
Authors: Hu Stephan , Brown-Kunin Sharon , Martin Paul , Wang Yujie
Published: February 2025

Background

Both vitamin B6 deficiency and vitamin B12 deficiency can present with symptoms that appear like polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome, with painful peripheral neuropathy and sensorimotor dysfunction. There are rare reports of an association between vitamin B12 deficiency and POEMS syndrome, and even rarer reports of an association between vitamin B6 deficiency and POEMS syndrome. To our knowledge, this is the first described case with deficiencies in both vitamin B6 and vitamin B12 in association with POEMS syndrome.

Case presentation

A man in his 40s presented with fatigue, imbalance, and painful numbness and tingling. Initial evaluation revealed low vitamin B12 level, and he received oral and IV supplementation for one month with an improvement in vitamin B12 levels, but without improvement in symptoms. Further evaluation revealed both a vitamin B6 deficiency and an IgA lambda monoclonal spike, prompting further investigation and an eventual diagnosis of POEMS syndrome. He underwent an autologous stem cell transplant and has had improvement in his symptoms.

Conclusions

Patients with POEMS syndrome may have symptoms that are difficult to distinguish from deficiencies in vitamin B6 or vitamin B12. Management of POEMS should include screening of vitamin B6 and B12 to ensure other possible associated causes of symptoms are appropriately treated.