bluuebunny/crossref_metadata_2025 huggingface dataset:
What is health education within HPE? A critical analysis of curriculum in Aotearoa New Zealand, China and Japan
Authors: Deng Jiayuan , Fitzpatrick Katie
Published: February 2025

Objective:

With growing international interest in youth mental health as well as the other health issues faced by young people, school health education draws the attention of scholars from both East and West. However, what stands for health education in the context of a ‘health and physical education’ (HPE) curriculum varies widely between locations internationally. This article considers how we might understand what counts as health education as part of HPE in different policy contexts.

Method:

Informed by Foucauldian concepts of discourse, knowledge/power, and truth, we used Fairclough’s textually oriented discourse analysis to conduct a critical discourse analysis of official HPE curriculum policy in three different nation states (Aotearoa New Zealand, China and Japan).

Findings:

In Aotearoa New Zealand, curriculum discourse reflects a socio-critical approach to health education within HPE. In China, physical fitness dominates discourse on health education in HPE. In Japan, health education in HPE is directly connected to notions of safety and disease.

Conclusion:

In each of these three countries’ HPE curricula, we can see how global policy discourses construct particular ‘truths’ about the place and purpose of health education in schools. It is important to understand why different perspectives exist, because these different ‘truths’ are not just variations in policy content, but also reflect each country’s approach to health education as a response to unique challenges and priorities, shaping how health is understood and practised.
The impact of workplace violence on the risk of suicide among Chinese correctional personnel: A chain mediation model with insomnia and depression as mediating variables
Authors: Sun Jingyan , Lin Ruihan , Wang Siyuan , Huang Ying , Lam Sze Tung , Wang Nan , Zhao Yixin , Guo Huijuan , He Yuqiong , Peng Hanrui , Chen Hui , Wang Xiaoping
Published: February 2025

Background:

Prison correctional personnel often experience increased workplace violence (WPV) and higher risk of suicide, but the link between the two is not yet clear. This study aims to explore the specific mediating variables and mediating paths between WPV and suicide.

Methods:

This is a cross-sectional study of 472 Chinese correctional personnel conducted through an online survey. We used the Workplace Violence Scale (WVS), the Athens Insomnia Scale (AIS), the Chinese version of the Depression Anxiety Stress Scale (DASS), and the revised Beck Suicidal Ideation scale (BSI) to quantify the WPV experienced by subjects and their mental health status. Data analysis, including mediation and network analysis, was performed using SPSS and R software.

Results:

Presence of insomnia and/or depression mediated the relationship between WPV and suicide risk, which accounted for 36.62% of the total effect. Insomnia alone accounted for 9.87%, depression alone accounted for 12.73%, whereas both put together accounted for 14.03%. Male personnel experienced more WPV than their female counterparts, and WPV in men had a stronger association with suicide risk. Network analysis indicated that daytime dysfunction and downheartedness were important nodes in mediating pathways.

Conclusions:

Experiencing WPV may lead to an increased risk of suicide among correctional personnel, particularly men, with insomnia and depression mediating the experienced risk. Correctional institutions should take measures to reduce the occurrence of WPV experienced by correctional personnel mitigate the impact of this occupational hazard, and prioritise the mental health of correctional personnel, particularly those already experiencing worrying symptoms.
Dual-Task (Cognitive Plus Sucking) Training for Stroke Patients: A Randomized Controlled Study
Authors: Tang Qiaomin , Sun Yuanyuan , Hu Chen , Wang Qiaoni , Jin Jingfen
Published: February 2025

Our aim in this study was to determine the effect of applying dual-task training of cognitive rehabilitation and sucking activities for stroke patients. We selected 118 stroke patients from the Neurology Department of a class 3, grade A hospital between August 2020 and January 2022; and we randomly assigned them into either a dual-task (DT) training group or a control group. The DT training group received dual-task training of cognition combined with sucking activities based on conventional nursing guidelines; the control group received only conventional neurologic nursing procedures. After a 4-week intervention period, swallowing ability, sucking force, Swallowing Quality-of-Life Questionnaire (SWAL-QOL) scores, and Mini-Mental State Examination (MMSE) scores improved significantly for patients in both groups ( p = .010, p < .001, p < .001, p < .001). And the incidence of clinical aspiration pneumonia was much lower in the DT training group than in the control group ( p = .024). We concluded that short-term dual-task training of cognition combined with sucking activities effectively improved the sucking force, swallowing abilities, SWAL-QOL, and cognition functions of these stroke patients, with important implications for other stroke patients.
Half-Baked by Design? A Four-State Analysis of Gender-Based Occupational Segregation and Pay Inequities
Authors: Rucker Larra , Hunt Valerie H. , Kerr Brinck
Published: February 2025

Previous research finds evidence of gender-based occupational segregation and pay inequities in public-sector state agencies. Frequently, this research is based on EEO-4 data from the U.S. Equal Employment Opportunity Commission (EEOC). These data include all municipal and state employers (with over 100 employees) throughout the public sector, except public schools and higher education. EEOC data include information on all state employees in every state, but these data are subject to content, access, and reporting limitations. Our analysis of individual-level data on administrators ( N = 10,331) and professionals ( N = 37,213) provided by four states for 2022—Arkansas, Connecticut, North Dakota, and Texas—finds evidence of gender-based occupational segregation and pay inequities in many occupations and agencies. Women tend to be concentrated in those positions with less policy-making discretion and power. Furthermore, gender-based pay inequities often persist, even after controlling for years of service, state, and policy type.
Refugee Policies and Border Regime in Southern Mexico
Authors: París Pombo María Dolores
Published: February 2025

Based on a critical geopolitical analysis, this paper addresses the convergence of refugee policies and migration control policies in southern Mexico within the framework of border externalization and internalization. I posit that the border process in this region responds to both political and military interests espoused by the U.S. as well as Mexican governments. The refugee system is a device though which mobility is controlled, and the militarization and securitization of Mexico’s southern border can be legitimized. One consequence of this process is the indefinite blocking of migrants and asylum seekers in the city of Tapachula, Chiapas, and its current transformation into a “city-prison.”

A partir de un análisis geopolítico crítico, este artículo aborda la convergencia de las políticas de refugiados y de control migratorio en el sur de México en el marco de la externalización e internalización de las fronteras. Postulo que el proceso fronterizo en esta región responde a intereses tanto políticos como militares propugnados por los gobiernos de Estados Unidos y México. El sistema de refugiados es un dispositivo mediante el cual se controla la movilidad y se puede legitimar la militarización y securitización de la frontera sur de México. Una consecuencia de este proceso es el bloqueo indefinido de personas migrantes y solicitantes de asilo en la ciudad de Tapachula, Chiapas, y su actual transformación en una “ciudad-prisión.”
Peripherally acting anti-CGRP monoclonal antibodies attenuate cortical resting-state connectivity in migraine patients
Authors: Szabo Edina , Bolo Nicolas R. , Borsook David , Burstein Rami , Ashina Sait
Published: February 2025

Background

In about half of migraine patients, anti-calcitonin gene-related peptide monoclonal antibodies reduce monthly migraine days by >50%. In these patients, this class of drugs may change cortical functions by decreasing nociceptive afferent barrage. This prospective study investigated functional connectivity changes in treatment responders after three-month treatment with galcanezumab.

Methods

Resting-state functional magnetic resonance imaging data were acquired for patients with high-frequency episodic or chronic migraine ( N = 36) before and after treatment. Of these, 19 patients were classified as treatment responders (≥50% reduction in monthly migraine days) and 17 were considered non-responders (<50% reduction). Functional connectivity across cortical regions was assessed using a region-of-interest (ROI)-to-ROI analysis approach.

Results

At baseline, there were no significant differences between treatment responders and treatment non-responders. In the treatment responder group, reduced functional connectivity was observed after treatment between regions of the primary somatosensory and motor cortices, insula, and several occipital and temporo-occipital areas (within the visual network). In contrast, no such changes were seen in the non-responder group.

Conclusion

These findings suggest that even a relatively short period of reduced nociceptive signals may be sufficient to initiate a cortical recovery process in which its resting hyperexcitable mode shifts to a less excitable state.
Evaluating State Fiscal Health in the U.S: A New Model and Its Application
Authors: Xu H. Daniel , Andonoska Ljubinka
Published: February 2025

In efforts to better understand the financial condition of state and local government and to be better prepared for fiscal exigencies during crises, practitioners and academics alike strive to find a better way to assess governmental financial condition. Several models have been developed to evaluate state and local government over the past several decades, with significant limitations. We propose a more comprehensive framework to evaluate the fiscal health of state government based on these models. Further, we utilize the data from the annual comprehensive financial reports of state governments in the U.S. for 2003 to 2018 to demonstrate the applicability and usefulness of the modified model. The results are useful for state administrators and financial managers in their efforts to assess financial condition and fiscal administration and add to the literature on state fiscal health.
Electronic Health Records and Family Satisfaction in the ICU: Communication, Care Processes, and Decision-Making
Authors: de Aquino Vivian Wuerges , Vianna Kawoana Trautman , Boniatti Marcio Manozzo , da Silva Terres Mellina
Published: February 2025

Objectives: To evaluate electronic health records and explore associations with the satisfaction of families of critically ill patients. Methods: Exploratory cohort study. Included 94 patients with severe chronic illnesses or chronic critical illness who were admitted to the ICU and their family members. Family satisfaction was assessed using the Family Satisfaction ICU (FS-ICU 24) questionnaire, through the FS-ICU Care score (perception of care itself), FS-ICU Decision Making score (perception of decision-making), and FS-ICU Total score, and queried about the use of a room suitable for communication. Electronic health records were analyzed for elements of communication with family members, care processes, and decision-making. Results: The scores were FS-ICU Care 91.1 (76.8-98.0), FS-ICU DM 90.0 (77.5-97.5), and FS-ICU total 90.7 (78.0-97.0). In 17 (18.1%) of the medical records, there was a documented family meeting within the first 72 hours, and in 9.6%, there was documentation of communication about functionality, wishes and values, and consultation for palliative care. The use of a suitable room for communication was reported as “never” or “rarely” by 45 (47.8%) of the family members. There was a trend towards greater satisfaction with social support and lower satisfaction among family members of deceased patients, with 9 (25.8%) of these family members feeling that the patient was uncomfortable before death, and the records of meetings and communication of poor prognosis were associated with a lower perception of discomfort ( P < .05). Conclusions: The satisfaction of family members of critically ill patients was high and was not significantly associated with the documentation deficiencies found. Deficiencies in communication appear to have influenced the perception of family members. Various perspectives are necessary for analyzing the care provided to patients and families in the ICU.
The Association Between Women’s Empowerment and Physical Intimate Partner Violence in Afghanistan
Authors: Ghafoori Noorulhaq , Yolchi Jamshid , Yolchi Marwa
Published: February 2025

This study delves into the intricate association between women’s empowerment and physical intimate partner violence (PIPV) in Afghanistan. In this country, nearly half of all women have experienced PIPV at some point in their lifetime. Utilizing data from the Afghanistan Demographic and Health Survey 2015, a nationally representative survey of women and men aged 15 to 49 years, this study employs multiple logistic regression analysis to elucidate the association between women’s empowerment and PIPV prevalence. The findings reveal a compelling association between women’s empowerment and lower PIPV risk. Women with higher levels of education and income, considered empowered individuals, exhibit a lower likelihood of experiencing PIPV. In addition, rural women face a heightened risk of PIPV compared to their urban counterparts. In contrast, women residing in the poorest quintile are twice as likely to endure PIPV compared to those in the wealthiest quintile. Notably, the husband’s educational attainment also bears a significant inverse relationship with IPV occurrence. These findings underscore the transformative potential of education and economic empowerment in safeguarding Afghan women from PIPV. The implications of this study extend to policymakers, particularly the international community and the United Nations, who are actively engaged in PIPV reduction efforts in Afghanistan. Investing in the educational empowerment of Afghan women holds immense promise in alleviating the scourge of PIPV.
Breastfeeding Measurement—What Does It Mean to “Wean?”
Authors: Theurich Melissa A. , Fischer Laura , Gencel-Augusto Jelica , Chetwynd Ellen
Published: February 2025

The term “weaning” is used heterogeneously in scientific and gray literature, with no commonly agreed-upon definition. Weaning can describe the gradual transition in the infant diet, usually from milk feedings to complementary foods, but it is also commonly used to describe any gradual transition between milks, foods, or feeding modalities. In an epidemiological context, it may also refer to changing breastfeeding rates within a cohort. The meaning of weaning has changed over time and may vary by the scientific assumptions applied to this period of human development. For these reasons, we propose that investigators avoid using the term weaning, and substitute it with more precise terminology. We present a series of proposed standard terms with corresponding definitions to guide more precise and accurate reporting of the various potential meanings of the term in the scientific literature. The objective is to improve reporting and reproducibility of research in the field of breastfeeding and human lactation.
Experimental investigation of organic and sintered brake pads for performance and environmental resilience
Authors: Ponnusamy Baskar , Shukla Keshav
Published: February 2025

The brake pad and its material composition plays a pivotal role in the overall braking performance of a vehicle, serving as a critical component that ensures safety and control. A comprehensive assessment of performance and durability characteristics of organic and sintered disc-brake pads investigated through rigorous testing methodologies to assess parameters such as braking efficiency, wear resistance, and thermal stability. Advanced testing protocols ensured thorough data collection, including a pad wear test to gauge long-term performance. Additionally, frictional properties of brake pads were assessed using a friction coefficient test chase machine. The experimental results shows improved lever feel and load handling for sintered pads. Salt Spray and Ozone Layer tests indicate an environmental resilience and Corrosion resistance of sintered brake pads meeting required criteria. There is about 20% improvement in brake effectiveness and 15% increase in coefficient of friction of sintered brake pad compared to organic. Positive outcomes from the experimental investigation support replacing organic pads with sintered ones.
Non-parametric modeling of magnetorheological damper based on MEA-BP neural network
Authors: Jiang Min , Rui Xiaoting , Yang Fufeng , Wang Pingxin , Li Huijun , Wang Wenjie
Published: February 2025

The process of parametric modeling of magnetorheological (MR) damper presents difficulties such as numerous parameters, complicated and time-consuming identification procedures, and difficulty in establishing the inverse model. In order to solve these problems, this paper adopts the mind evolution algorithm backpropagation (MEA-BP) neural network to successfully establish the forward model and the inverse model for prediction of electric current. These models can accurately capture the nonlinear hysteresis characteristics of MR damper. First, the mechanical properties of the MR damper were tested, and then the BP neural network structure of the forward and inverse models was determined according to its working principle. Aiming at the problems of traditional BP neural network which is easy to mature prematurely and converge slowly, the initial weights and thresholds of BP neural network were optimized by using MEA. Utilizing the Mechanical properties test results of the MR damper, the MEA-BP neural network was used to identify the forward and inverse non-parametric models of the MR damper. Compared with the traditional BP neural network model, the forward model and inverse model of the MR damper, based on the MEA-BP neural network, showed an improvement in prediction accuracy by 33.96% and 26.32%, respectively. The forward model based on the MEA-BP neural network demonstrated a 16.67% improvement in accuracy compared to the genetic algorithm (GA) BP neural network. The non-parametric model, developed using the MEA-BP neural network, more accurately captures the dynamic behavior of the MR damper. This advancement provides a robust foundation for research into the dynamics and semi-active control of MR adaptive damping systems.
Picking Up the Call for Reparations: News Coverage Following Three Catalysts
Authors: Pauley Sean P.
Published: February 2025

This study analyzes how mainstream and Black newspapers covered reparations after the Black Lives Matter protests and two other catalysts in reparations discourse: Ta-Nehisi Coates’s “The case for reparations” and the 2019 commission to reexamine H.R. 40. Using ARIMAX models of articles discussing reparations over two decades, this analysis tests how coverage changed and uses Google Trends data to test how the public’s agenda responded. Mainstream newspapers were more receptive to legislative action, whereas the Black press gave more attention to reparations after the 2020 protests. Search behavior was responsive to mainstream coverage of reparations.
Our Spatial Orientation: Positionality, Relationality, and Learning Through the Body
Authors: Germinaro Kaleb
Published: February 2025

Components of place and sites of where we know from are pertinent to positionality, particularly in its importance for education research with and for communities. However, conversations discussing the relations of place a researcher brings to their work are limited. In this conceptual paper, I center and build with the contributions of Black geographies as both a theoretical and methodological shift to consider spatial orientations and the spatial knowledge we bring to qualitative inquiry, connecting our prior time in spaces to our current approaches. Relations to space through Black spatial knowledge, imagination, futures, and carceralities are core features that frame how we come to understand “where we know from.” Boveda and Annamma provide an approach to positioning attending to “(1) the onto-epistemic that recognizes how embodied experiences shape understandings of intersectional oppressions, (2) the sociohistorical that engages historicity, and (3) the sociocultural that concedes whiteness and ability as property” (p. 310). My experience is framed through these theories by adding an explicit spatial dimension to detail curricular inquiry guided by Blackness, decoloniality, and disability justice. This piece aims to provide insight and approach to learning from our bodies and their interactions with places we have been to as a process to engage our positionality. Black geographies coupled with disability justice approaches to curriculum design and inquiry allows us to reshape and reorganize geographies through pedagogies that position us to learn the world anew. This approach also provides a perspective that centers Blackness as a means of disrupting coloniality through identifying the role of place (and spatial beliefs) in pedagogy and learning. This promotes the remembering of carrying places across time as we come to teach, build, cultivate, and research. I argue cultivating spatial relations and knowledge—core to community research and qualitative inquiry—provides new possibilities for disrupting geographical power dynamics and emplacing knowledge of place in our research process.
Kind Enough to Vax? Decoding the Relationship Between Prosociality and COVID-19 Vaccination Intent in American Adults
Authors: Noor Zeeshan , Moore Paige L.
Published: February 2025

Vaccination is considered a prosocial behavior, protecting both the individual and society at large. However, many Americans choose to remain unvaccinated for multiple reasons relating mainly to religious and personal autonomy. To assess individual readiness for COVID-19 vaccination, this quantitative study includes a survey of a nationally representative sample of adults in the United States ( n = 992) to explore willingness to engage in vaccination as a prosocial behavior. This study operationalizes prosocial behavior using the indicators empathic concern, monetary donations, and volunteering as predictors. Using ordinal and logistic regression models, the findings indicate that individual prosocial behavior is positively associated with vaccination and vaccination intent. Further, findings show that COVID-19 vaccination is positively correlated with the demographics of age, income, and education level, demonstrating that older adults (over 65), individuals with higher incomes, and the college-educated have higher vaccination intent. Vaccination intent was found to be the highest among African-Americans who were twice as likely to be vaccinated, and lowest among female participants.
Implementing reablement for community dwelling people with dementia: A formative evaluation using single-case experimental design
Authors: Campbell Alexis , Poulos Christopher J , Takla Caroline , Allen Joy , Lemsing Kylie , O’Connor Claire MC
Published: February 2025

Background

Reablement is recommended to maximise functioning in people with dementia, yet in Australia, is not routinely available. This study aimed to provide insight into the implementation and program outcomes of reablement in real-world practice for a person living with dementia.

Methods

Reablement was implemented for a client with dementia. In parallel, a formative mixed-methods pilot evaluation was performed, using single-case experimental A-B-A design ( n = 1), supplemented by routinely collected pre-post program clinical measures. Implementation was evaluated qualitatively via clinical notes for fidelity, feasibility and client engagement.

Results

Single-case experimental design outcomes indicated the program positively impacted the participant’s physical functioning. Additionally, most routinely collected pre-post clinical measures demonstrated improvement. Intervention fidelity varied, with differences in length and client engagement.

Conclusion

Implementation of evidence-informed reablement has been shown to be feasible in real-world practice for a community-dwelling person living with dementia. Larger implementation trials are needed to build on preliminary outcomes to ultimately improve access to these important programs.
A safe route planning method for aircraft carriers based on improved Dijkstra algorithm
Authors: Zhen Chong , Qu Xiaolei , Zhou Yangyu , Dong Bohao
Published: February 2025

A novel method for safe route planning has been developed to enhance the safety of aircraft carrier navigation and carrier-based aircraft landings. This method considers critical factors such as water depth, islands, wind, and wave conditions that affect carrier navigation safety. The adaptability of carrier-based aircraft landings to dynamic marine environments has been systematically analyzed. Then a framework has been proposed for detecting suitable landing areas for carrier-based aircraft. A dynamic ocean environmental field was constructed to support route planning by integrating numerical ocean models and reanalysis data. An improved Dijkstra algorithm was employed to generate safe navigation routes, further refined using Bézier curve smoothing techniques. The proposed method was validated through simulations of an aircraft carrier’s route planning task in the northwest Pacific during a typhoon event. The results demonstrate that the method ensures safe navigation for the aircraft carrier while meeting the operational requirements for carrier-based aircraft landings. These findings provide valuable support for enhancing the safety and reliability of aircraft carrier operations.
Compound fault feature separation with frequency segmentation and improved sparse filtering for rolling bearings
Authors: Gong Siqi , Li Shunming , Xia Min
Published: February 2025

Due to variable and complex working conditions, rolling bearings are susceptible to compound faults. However, because a single fault plays a leading role, the weaker fault in the compound fault is difficult to monitor. If the weak fault in the compound fault can be found and identified, it is conducive to a more accurate judgment of the health state of the bearing. Several approaches have been proposed to detect compound bearing faults, but most of them are complex, inefficient and may require prior knowledge about fault characteristics such as fault period. In this article, the improved approach based on sparse filtering is proposed to detect the compound faults in rolling bearings. The proposed approach utilizes the wavelet decomposition method to divide the original vibration signal with compound faults into several segments in the frequency domain. All segmentations are employed to construct the Hankel matrix. Improved sparse filtering (ISF) is then employed to enhance the fault features by attenuating the noise. ISF performs autocorrelation on input samples (column of Hankel matrix) to improve the expressiveness of features. The penalty term is used to improve the performance of the sparse characteristic expressions of the weight matrix. The envelope spectral analysis is then finally used to detect the compound faults. The ability of sparse filtering to separate the multi-fault signal into different components is discussed in the simulation. Both simulation and experimental data with compound faults verify the effectiveness of the developed approach. The ability to distinguish different fault modes without prior knowledge of fault periods makes the proposed method advanced and suitable for compound fault diagnosis in rolling bearings. Compared with the existing methods, results show superior feature extraction performance of the proposed method.
Generative Artificial Intelligence in Instructional System Design
Authors: Chai Dae Seok , Kim Hee Sun , Kim Kyung Nam , Ha Yob , Shin Simon Sang Hoon , Yoon Seung Won
Published: February 2025

The current study aims to present and synthesize extant studies across various fields that have discussed the use of generative artificial intelligence (GAI) in instructional procedures or processes. This study adopted the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model since it is the most widely used instructional and training design model. An integrative literature review of 71 articles was conducted as the primary methodology. We analyzed and summarized information about (a) the integration and implementation of GAI in each stage of the ADDIE model and (b) suggested uses of GAI based on the model to further leverage what it can offer. Potential ethical concerns and recommendations are also examined for future research and practice using GAI in ADDIE. The study concludes with a discussion and implications for future research and practice.
Stone-free rate of laser lithotripsy for large pediatric stones: 15-year experience from a tertiary endourology pediatric center
Authors: Dassanayake Sohani N. , Jahrreiss Victoria , Griffin Stephen , Somani Bhaskar K.
Published: February 2025

Background:

Pediatric urolithiasis, while less common than in adults, is increasing in incidence. However, current guidelines on the optimal management of this condition vary. Technological advances have led to improvements in the quality and size of ureteroscopes, thus enabling their use in children. Despite this, there remains some hesitancy about using ureteroscopic lithotripsy in the pediatric population, particularly in cases of large stones ⩾10 mm.

Objectives:

In this study, our aim was to evaluate the efficacy and safety of ureteroscopy and laser stone fragmentation (URSL) for managing pediatric patients with a cumulative stone burden of ⩾10 mm in our tertiary referral center.

Methods:

A dataset was collected of pediatric renal tract stone patients treated at a single tertiary urological center between June 2010 and May 2024 (15 years). Pediatric patients undergoing URSL procedures for a minimum cumulative stone burden ⩾10 mm were included. A retrospective analysis of the dataset was conducted. The primary outcomes measured were stone-free rates (SFR), complications classified according to the Clavien-Dindo classification, and hospital length of stay.

Results:

A total of 61 pediatric patients with a mean age of 10 years (range: 2.3–16) underwent 83 URSL procedures in a tertiary endourology pediatric center over a 15-year period (2010–2024). The median initial stone burden was 17 mm (IQR: 12.5–24 mm), acquired from preoperative ultrasonography (USS). Results showed a first-pass SFR of 63.9% and a cumulative SFR of 93.4% (on USS) following one or multiple URSL procedures (1.4 procedures/patient). Immediate postoperative complications were minimal, with 6% experiencing complications classified as Clavien-Dindo I or II. The average hospital length of stay was 1.4 days.

Conclusion:

The findings in this study support that URSL is effective in treating pediatric urolithiasis, even for larger stone burdens. Further research is needed to standardize guidelines and optimize management strategies in this population.
Are There Differences Between Sexes in Performance-Related Variables During a Maximal Intermittent Flywheel Test?
Authors: Salse-Batán Jorge , Torrado Priscila , Marina Michel
Published: February 2025

Background:

Isometric and dynamic tasks of low-to-moderate intensities have been used to study sex differences in fatigability; however, maximal exertions with flywheel devices (FDs) have not been used. This study aimed to (1) detect sex differences in fatigue-related performance in a maximal intermittent fatiguing protocol on a FD, and (2) investigate the most sensitive dynamometric and mechanical variables for assessing fatigue in both sexes.

Hypothesis:

No sex differences should exist when performing this protocol on a FD.

Study Design:

Cohort observational study.

Level of Evidence:

Level 3.

Methods:

A total of 34 young adults (17 female/17 male) performed 10 sets of 10 repetitions with 3 minutes of passive recovery of a half-squat exercise on a FD. Inter- and intraset analysis of force, power, velocity, work, and impulse, together with their relative change and slope, were calculated during concentric and eccentric phases. Raw data were also normalized to body mass in the interset analysis. The relative changes in each variable were compared.

Results:

Men showed greater and earlier decreases in performance throughout sets ( P < .05; ηp2 ≥ 0.08), but these differences were not consistent after normalization for body mass ( P > .05; ηp2 ≤ 0.05). Irrespective of sex and phase, the intraset analysis revealed that relative change was higher in the last set ( P ≤ .03; ηp2 ≥ 0.14), with power being the most sensitive variable for detecting performance decline ( P ≤ .04; ηp2 = 0.49).

Conclusion:

Women experienced slower and delayed fatigue kinetics than men during a maximal intermittent fatiguing protocol with FD if body dimensionality is not considered. For training purposes, power seems to be the most sensitive and discriminative variable for detecting decreases in performance.

Clinical Relevance:

Body dimensionality is a key factor that must be considered when comparing both sexes in FDs.
Predictors of Skilled Nursing Facility Length of Stay and Discharge After Aneurysmal Subarachnoid Hemorrhage
Authors: Porto Carl M. , Wolman Dylan N. , Feler Joshua R. , Chuck Carlin C. , Karayi Gnaneswari , Torabi Radmehr , Moldovan Krisztina , Furie Karen L. , Mahta Ali
Published: February 2025

Background and Purpose

Aneurysmal subarachnoid hemorrhage (aSAH) carries high morbidity and mortality with survivors often requiring extended care at skilled nursing facilities (SNF). Predictors of SNF discharge to home (SNFdcH) remain unclear.

Methods

Retrospective review of a single-center prospectively maintained aSAH database from June 2016-March 2024 was conducted. Patients discharged to SNF were grouped by subsequent discharge to home. Predictors of discharge to home and facility length of stay (LOS) were determined using t-tests, Fisher analyses, and cumulative link modeling.

Results

Of 450 aSAH patients, 61 (13.5%) were discharged to SNFs. 49 (80.3%) returned home, with 61% achieving mRS <3 at discharge. Discharged patients were younger (mean 63.3 ± 11.5 vs 70.2 ± 9.3 years, P = .040) with lower median modified Fisher scores (3 [IQR 3-4] vs 4 [4-4], P = .046). Tracheostomy (OR = .14, 95% CI [.02, .75], P = .023) and gastrostomy tube (PEG) placement (OR = .13, 95% CI: .03-.51, P = .003) decreased the odds of SNFdcH. Discharged patients had shorter hospital LOS (26 ± 10 vs 39 ± 15 days, P < .001) and lower median modified Rankin scores (mRS) at hospital discharge (4 [4-5] vs 5 [4-5], P = .028) and at 90 days post-discharge (4 [3-5] vs 6 [5-6], P = .001). Multivariable regression identified age, PEG, and hospital LOS as predictors of SNFdcH. Tracheostomy and PEG predicted SNF LOS.

Conclusions

Most aSAH patients discharged from SNFs returned home, with 61% achieving mRS <3. Patients not discharged were medically complex with neurological deficits. These findings may guide care discussions and highlight the role of SNFs in bridging hospitalization and independence.
Mendelian randomisation to uncover causal associations between conformation, metabolism, and production as potential exposure to reproduction in German Holstein dairy cattle
Authors: Schwarz Leopold , Heise Johannes , Liu Zengting , Bennewitz Jörn , Thaller Georg , Tetens Jens
Published: February 2025

Background

Reproduction is vital to welfare, health, and economics in animal husbandry and breeding. Health and reproduction are increasingly being considered because of the observed genetic correlations between reproduction, health, conformation, and performance traits in dairy cattle. Understanding the detailed genetic architecture underlying these traits would represent a major step in comprehending their interplay. Identifying known, putative or novel associations in genomics could improve animal health, welfare, and performance while allowing further adjustments in animal breeding.

Results

We conducted genome-wide association studies for 25 different traits belonging to four different complexes, namely reproduction (n = 13), conformation (n = 6), production (n = 3), and metabolism (n = 3), using a cohort of over 235,000 dairy cows. As a result, we identified genome-wide significant signals for all the studied traits. The obtained summary statistics collected served as the input for a Mendelian randomisation approach (GSMR) to infer causal associations between putative exposure and reproduction traits. The study considered conformation, production, and metabolism as exposure and reproduction as outcome. A range of 139 to 252 genome-wide significant SNPs per combination were identified as instrumental variables (IVs). Out of 156 trait combinations, 135 demonstrated statistically significant effects, thereby enabling the identification of the responsible IVs. Combinations of traits related to metabolism (38 out of 39), conformation (68 out of 78), or production (29 out of 39) were found to have significant effects on reproduction. These relationships were partially non-linear. Moreover, a separate variance component estimation supported these findings, strongly correlating with the GSMR results and offering suggestions for improvement. Downstream analyses of selected representative traits per complex resulted in identifying and investigating potential physiological mechanisms. Notably, we identified both trait-specific SNPs and genes that appeared to influence specific traits per complex, as well as more general SNPs that were common between exposure and outcome traits.

Conclusions

Our study confirms the known genetic associations between reproduction traits and the three complexes tested. It provides new insights into causality, indicating a non-linear relationship between conformation and reproduction. In addition, the downstream analyses have identified several clustered genes that may mediate this association.
The ability to race barefoot is a heritable trait in Standardbred and Coldblooded trotters
Authors: Berglund Paulina , Andonov Sreten , Jansson Anna , Olsson Christina , Lundqvist Therese , Strandberg Erling , Eriksson Susanne
Published: February 2025

Background

In equine sports, shoes are used to protect the hooves from wear and tear. In Swedish trotting races, pulling off the shoes to race barefoot is popular because it improves racing time. Good hoof quality is essential for high-performance horses, but not all trotting horses have hooves that tolerate barefoot racing. The ability to race barefoot is a complex trait that is known to be influenced by environmental factors, but the genetic basis of this trait has not been studied. The aim of this study was to estimate genetic parameters and correlations between estimated breeding values for three novel traits: two related to the proportion of barefoot races and “barefoot status”, a binary trait that reflects the probability of racing unshod in a race, in Swedish Standardbred trotters (SB) and Swedish-Norwegian Coldblooded trotters (CB).

Results

For the two traits describing the proportion of barefoot races, single-trait mixed linear animal models were used to estimate variance components for up to 24,958 SB and up to 4050 CB. Estimates of heritability ranged from 0.17 to 0.28. For barefoot status, a binary trait with repeated measurements, 875,056 observations from 25,973 SB, and 93,376 observations from 3384 CB were included. Using a single-trait mixed animal threshold model estimates of heritability for barefoot status were 0.07 and 0.08. The Pearson correlation coefficient between the estimated breeding values for barefoot status and each of the traits describing the proportion of barefoot races for breeding stallions was 0.63 and 0.64 for SB and 0.82 and 0.76 for CB.

Conclusions

The traits analyzed reflecting the ability to race barefoot are heritable, with the traits for the proportion of barefoot races showing higher heritability estimates for both breeds than barefoot status. Estimated breeding values for breeding stallions were moderately to strongly correlated for the three traits. The average accuracy of estimated breeding values for breeding stallions was moderate to high for all traits. To breed for the ability to race barefoot, further studies on the genetic correlation of the ability to race barefoot with performance traits and the impact of racing barefoot on career length, are necessary.
Acute tubulointerstitial nephritis (ATIN) including drug-induced, tubulointerstitial nephritis and uveitis (TINU), ANCA-associated vasculitis (AAV), kidney- limited sarcoidosis, and hemolysis: a case series from Syria
Authors: Alsultan Mohammad , Kliea Marwa , Hassan Qussai
Published: February 2025

Background

This study aimed to detail acute tubulointerstitial nephritis (ATIN) patients, from relevant clinical manifestations to outcomes.

Methods

We reviewed ATIN patients between 2018 and 2022. All demographic data, labs, biopsy findings, treatment protocols, and outcomes were reported.

Results

ATIN was diagnosed in nine patients, eight by kidney biopsy and one clinically. Drug-induced ATIN (DI-ATIN) was reported in five patients, including rifampin (RIF), allopurinol, mesalamine, and two with cephalosporins. Severe ATIN resulted after the first dose of RIF aligned with liver injury, hemolysis, and thrombocytopenia. Also, mesalamine and allopurinol induced gradual kidney failure a few months after the drug initiation. A patient with Tubulointerstitial nephritis and uveitis (TINU) syndrome showed refractory uveitis presenting during glucocorticoids (GCs) tapering, which resolved quickly with azathioprine (AZA) when not responding to GCs reescalation. Among the rarest cases, ATIN induced by a kidney-limited sarcoidosis, G6PD patient with hemolysis induced ATIN, and isolated ATIN induced by ANCA-associated vasculitis (AAV) with positive C-ANCA, which the latter representing the first case in our country and the fourth case worldwide. Labs showed anemia (88.8%), ESR elevation (85.7%), microscopic hematuria (in all patients), pyuria (44.4%), and proteinuria (77.7%). Biopsies showed interstitial infiltrations mainly with lymphocytes and monocytes. Eosinophils were found in one biopsy and neutrophils showed in 4 biopsies (50%).

Conclusion

ATIN is a disease with a diagnostic challenge, thus clinicians should maintain a high suspicion for diagnosis. The combination of AKI with positive tests (especially abnormal urine sediment, ESR elevation, and anemia) may suggest ATIN diagnosis and further support the treatment initiation, particularly when kidney biopsy is unable to be performed or when the inciting agent is predictable.
The association between Ki-67 expression and survival in breast cancer subtypes: a cross-sectional study of Ki-67 cut-point in northern Thailand
Authors: Wongmaneerung Phanchaporn , Chitapanarux Imjai , Traisathit Patrinee , Prasitwattanaseree Sukon , Rottuntikarn Wisanu , Somwangprasert Areewan , Ditsatham Chagkrit , Watcharachan Kirati , Klunklin Pitchayaponne , Onchan Wimrak
Published: February 2025

Background

Breast cancer is a major health concern worldwide, and Ki-67 level index is a prognostic factor that indicates tumor proliferation and predicts survival outcomes. However, the standard Ki 67 cut-off level varies between local laboratories, and in Thailand, there is no established optimal cut-off level.

Objective

This study aimed to determine the optimal cut-off point for Ki-67 expression and investigate the association between Ki-67 levels and other prognostic factors with 8-year overall survival.

Method

A retrospective review of Ki-67 levels was conducted in non-metastatic breast cancer patients treated at Maharaj Nakorn Chiangmai hospital from January 2013-December 2015, including 507 breast cancer patients.

Results

The ROC curve analysis identified the optimal Ki-67 cut-point as ≥ 30%, with 75% sensitivity and 48.85% specificity. Age over 60 was associated with higher mortality regardless of cancer stage. Locally advanced staging, nodal involvement, Ki-67 ≥ 30%, and triple-negative subtype correlated with poorer survival. Even after adjustments, these factors remained significant in prognostic evaluation. Chemotherapy notably improved survival, especially in high Ki-67 (≥ 30) patients. However, this effect was not seen in low Ki-67 patients. High Ki-67 patients receiving chemotherapy showed improved survival in early-stage, node-negative cases compared to those who did not receive chemotherapy. HER2-positive patients with high Ki-67 benefited from chemotherapy, but statistical significance was not reached in hormone-positive patients.

Conclusion

This study identified the optimal cut point for Ki-67 in Northern Thailand as 30%. Patients with KI-67 above 30% show significantly lower 8-year survival rates. This is especially relevant for low-risk patients, like those with hormonal subtypes or early-stage nodal negativity. In these cases, KI-67 becomes crucial for treatment decisions. Our study not only aids Northern Thailand’s understanding but also aligns with broader research, emphasizing KI-67’s vital role in planning treatment for low-risk breast cancer patients.
Detection of COPD exacerbations with continuous monitoring of breathing rate and inspiratory amplitude under oxygen therapy
Authors: Alves Pegoraro Juliana , Guerder Antoine , Similowski Thomas , Salamitou Philippe , Gonzalez-Bermejo Jesus , Birmelé Etienne
Published: February 2025

Background

Chronic Obstructive Pulmonary Disease (COPD) is one of the main causes of morbidity and mortality worldwide. Its management represents real economic and public health burdens, accentuated by periods of acute disease deterioration, called exacerbations. Some researchers have studied the interest of monitoring patients’ breathing rate as an indicator of exacerbation, although achieving limited sensitivity and/or specificity. In this study, we look to improve the previously described method, by combining breathing variables, using multiple daily measures, and using an artificial intelligence-based novelty detection approach.

Methods

Patients with COPD were monitored with a telemedicine device during their stay in a rehabilitation care center. Daily measures are compared to individually trained reference models based on: i. oxygen therapy duration ii. mean breathing rate, iii. mean inspiratory amplitude, iv. mean breathing rate and mean inspiratory amplitude, v. average distribution of breathing rate and inspiratory amplitude, vi. hidden Markov model (HMM) from a time series of breathing rate and inspiratory amplitude.

Results

A set of 16 recordings with exacerbation and 23 recordings without exacerbation was obtained. When using a daily measure of breathing rate, pre-exacerbation periods were identified with a specificity of 50% and a sensitivity of 55.6%. The method based on daily oxygen therapy usage and the method based on time series obtain a sensitivity of 76.8% and 73.2%, respectively, for a fixed specificity of 50%.

Conclusion

A single daily measure of breathing rate alone is not sufficient for the detection of pre-exacerbation periods. More complete models also achieve limited performance, equivalent to models based on changes in the duration of therapy usage.