bluuebunny/crossref_metadata_2025 huggingface dataset:
‘I’m not a warrior, I’m a basketball player’: A narrative on professional sport in troubled times
Authors: Purdy Laura G , Kohe Geoffery Z
Published: January 2025

Encouraged by work calling for different approaches to examining sport industry issues, a narrative inquiry was adopted to interrogate the relationships between individual experiences and agency, management practices, and a particular sport organisation setting through the most recent turns of the Russia–Ukraine war. Commencing on 24 February 2022, this moment and ensuing consequences for professional Ukrainian basketball players reveal insights into personal sports work experiences within a dynamic, disruptive, and unpredictable setting. The narrative amalgamates data from interviews with two Ukrainian professional basketball players whose lives and careers were disrupted by the war. The narrative includes a chronology of critical moments, reactions, key decisions, and dilemmas and highlights ways the crisis was/is managed and the consequences upon individuals’ lives, well-being, and career decisions. The work contributes to the sociological analysis of crisis management in sport by articulating how individuals might respond to sport systems during times of unprecedented flux.
Disability Identity and Self-Determination for Students With Learning Disabilities
Authors: Milarsky Tracey Kenyon , Stormont Melissa , McGreevy Marina , Morgan A. Reiley
Published: January 2025

Given that self-knowledge is recognized as a key component of self-determined behavior, intentionally teaching students with learning disabilities (LD) about their identified disability can create conditions needed for future self-determined behavior. In the following article, action steps are provided that are useful for fostering development of vital self-knowledge, self-advocacy skills, and self-determination. These steps toward self-determination are built on a foundation of self-knowledge that includes disability, and self-advocacy skill practice that can be implemented with elementary, middle, and high school students identified with LD.
Control of wing aeroelastic system in presence of wind gust using logarithmic sliding mode control
Authors: Mahmood Ahmad
Published: January 2025

In this paper, the suppression of limit cycle oscillations due to the interaction of structure, inertia, and aerodynamics in a wing aeroelastic system in the presence of a combination of graded and sinusoidal gusts is explored. To estimate the wind gust that acts as a matched external disturbance to the wing aeroelastic system, a nonlinear disturbance observer is employed. By imposing bounds on trailing and leading edge deflection, a natural logarithmic (Ln) function–based attractor with a sliding mode control (SMC) scheme is formulated to offer pitch and plunge channel stabilization, and then the stability of LnSMC is confirmed by the Lyapunov criterion. To evaluate the effectiveness of the LnSMC technique, classical SMC and terminal SMC are put into action for comparison. However, outcomes from simulation and numerical analysis demonstrate that the LnSMC approach outperforms the other two referenced control techniques in terms of stabilization and convergence of the wing aeroelastic system.
Analysis of real-world safety, tolerability, and cost efficiency of Sub-Cutaneous administration of Daratumumab in Manitoba
Authors: Quinlan Kaitlin , Geirnaert Marc , Kotb Rami , Dao Vi , Minuk Leonard , Kasian Jayne , Rimmer Emily
Published: January 2025

Introduction

Daratumumab is an anti-CD38 monoclonal antibody used in the treatment of myeloma and other related disorders. To mitigate the risk of infusion related reactions with IV Daratumumab the product monograph suggested a slow administration schedule that extends over several hours. 1 This leads to a significant burden for the outpatients’ treatment administration units and indirect costs to the patients such as time toxicity. Time toxicity is the time spent coordinating care and making frequent visits for follow-up and treatment. 2 In 2020 the COLUMBA trial 3 demonstrated that subcutaneous Daratumumab has a similar efficacy and safety profile as intravenous Daratumumab with considerably less side effects. 1 This retrospective study aims to document our local real-world experience with subcutaneous Daratumumab, with special emphasis on reducing time toxicity.

Methods

Patients with a plasma cell disorder over the age of 18 who had received at least one dose of subcutaneous Daratumumab between March 2022 and March 2023 were included. Data for this retrospective study was collected from Aria, which included: baseline patient demographics (gender, age); prior exposures to intravenous Daratumumab; and, whether a reaction to either intravenous or subcutaneous Daratumumab occurred. Descriptive statistics were used to summarize the data.

Results

A total of 197 patients were included in the analysis. There were no recorded reactions to subcutaneous Daratumumab.

Conclusions

The results of our study were used to eliminate our facility's 3-h post-injection observation period. In the future we plan to publish another study on the cost efficiency of subcutaneous Daratumumab.
Identifying and Understanding Seizure Liability in Drug Development
Authors: Sokolowski Katie , Erwin Laura , Liu Judy , Authier Simon , McMaster Owen , Pressly Brandon , Bolon Brad , Delatte Marcus S.
Published: January 2025

Seizures are complex electrophysiological disturbances affecting one or more populations of brain neurons. Seizures following test article (TA) exposure pose significant challenges in drug development. This paper considers the diverse neurological manifestations, mechanisms, and functional and structural assessments needed to investigate TA-related seizure liabilities, with a particular focus on nonclinical species. Accurate discrimination of seizures from convulsions (irregular involuntary body and/or limb movements) and the nuanced presentation of different seizure types (partial vs. general) and phases (prodromal, ictal, and postictal) are essential for discerning their clinical implications. In nonclinical safety testing, the most direct evaluation method to confirm existence of seizures is electroencephalography (EEG) while clinical endpoints (e.g., functional observational batteries [FOB], comprehensive neurological examinations) and neuropathological findings (e.g., neuronal necrosis in tissue sections, raised biomarker levels in cerebrospinal fluid or serum) can indicate a seizure liability and provide additional guidance to identify the origin, frequency, and severity of seizures needed to align nonclinical effects with clinical relevance. In general, the regulatory perspective is that seizures identified in nonclinical species as well as potential risk management strategies (e.g., safety margin considerations, dosing paradigms, and clinical monitoring) translate effectively for purposes of clinical risk assessment.
Signalment, clinicopathological findings, management practices and comorbidities in cats with diabetes mellitus in Germany: cross-sectional study of 144 cases
Authors: Guse Bente , Langenstein Judith , Bauer Natali , Hazuchova Katarina
Published: January 2025

Objectives

The aim of this study was to describe signalment, clinicopathological findings, management practices and the occurrence of comorbidities in feline diabetes mellitus (DM) in Germany.

Methods

This was a cross-sectional study using questionnaires and laboratory submissions to a commercial laboratory, Antech Lab Germany, between May 2021 and July 2022. Inclusion criteria were diagnosis of DM by the attending veterinarian and submission of a completed questionnaire besides blood samples. Laboratory testing included haematology, serum biochemistry, concentration of total thyroxine (TT4), insulin-like growth factor 1 (IGF-1), cobalamin (COB), fructosamine, b-hydroxybutyrate and DGGR (1,2- O-dilauryl- rac-glycero-3-glutaric acid-[6′-methylresorufin] ester) lipase activity. Data are presented as the median (range) and analysed by non-parametric tests. P <0.05 was considered statistically significant.

Results

The median (range) age of the 144 diabetic cats at diagnosis was 11 years (0.9–18.7), 66.4% were male, 84.6% were domestic shorthair, 50.4% were currently overweight and 61.5% were previously overweight (body condition score >5/9). Most cats were treated with insulin (84%), most commonly protamine zinc insulin (57.5%). Blood glucose curves or continuous glucose monitoring alone or in combination with other methods were performed to adjust insulin therapy in 70.6% of cats. Based on questionnaires, 78.6% were poorly controlled and 21.4% were well controlled. Increased TT4 occurred in 3/139 and hyperthyroidism was known in 5/139 cats (frequency of known/suspected hyperthyroidism: 5.8% [n = 8/139]); 17.5% (n = 17/97) had increased IGF-1 (IGF-1 >746 ng/ml, cut-off for hypersomatotropism with the chemiluminescence assay used in this study); 24.5% (n = 34/139) had COB <295.2 pmol/l and 54.2% (n = 78/144) had increased DGGR. Cats with IGF-1 >746 ng/ml were receiving a higher insulin dose than cats with IGF-1 ≤746 ng/ml (median 1.63 vs 0.86 U/kg/day, P = 0.018).

Conclusion and relevance

Increased DGGR and increased IGF-1 indicating hypersomatotropism are common in diabetic cats and should be tested for. Almost one-quarter of diabetic cats might require COB supplementation.
Vibration and uncertainty analysis of MWCNT reinforced composite sandwich beam with a biomimetic dual core
Authors: Thanikasalam Narayanan , Vasudevan Maiarutselvan , Ramamoorthy Manoharan , Gunasegeran Muthukumaran
Published: January 2025

In this present work, the vibration characteristics and uncertain parameters of the biomimetic dual core sandwich beam under different boundary conditions are studied using MATLAB-ANSYS Interface methodology. The elastic properties of the MWCNT reinforced composite laminates are calculated using a modified Halpin Tsai model and the mechanical properties of the biomimetic core were evaluated using an Alternative dynamic approach. The natural frequencies obtained from the developed methodology have been compared with values from available literature and experimental results, showing acceptable agreement. The uncertainty analysis was performed for different uncertain parameters using the Monte Carlo simulation technique. Finally, the global sensitivity analysis was carried out for uncertain conditions and the most influencing parameters were identified. The longitudinal young’s modulus ( E 1), density ( ρ), length ( L), top layer angle ( t 1) and bottom layer angle ( t 4) are the most influencing parameters for dual core sandwich beam. This research provides valuable insights for advancing uncertainty quantification in biomimetic composite sandwich structures, contributing to the practical application in the fields that demand high strength-to-weight ratio conditions.
Dose Escalation of Adalimumab in Patients with Hidradenitis Suppurativa: A Retrospective Case Series
Authors: Caudrelier Nicolas , Veillette Hélène
Published: January 2025

Background:

Adalimumab is a central treatment for moderate-to-severe hidradenitis suppurativa (HS). However, half of patients treated with adalimumab for HS do not achieve a clinically significant response. Data on non-immunological factors correlating clinical response and adalimumab blood concentration are scarce.

Objectives:

To determine whether increasing adalimumab dose to 80 mg weekly can improve the clinical outcome of patients unresponsive to adalimumab 40 mg weekly. To identify parameters influencing disease activity and those modifying serum adalimumab concentration.

Methods:

This is a retrospective case series from a tertiary dermatology clinic, comprising 40 patients with moderate-to-severe HS with suboptimal response to the FDA-approved dose of adalimumab. All patients had a measurement of blood adalimumab concentration. Depending on their dosage, some patients had their adalimumab dose increased to 80 mg weekly while others stayed at 40 mg dose weekly. Chi-squared and ANOVA tests were used for data analysis.

Results:

43.8% of patients who increased to a weekly dose of 80 mg clinically improved at their follow-up, compared with 33.3% of those who stayed at a weekly dose of 40 mg. The dose increase led to a statistically significant increase in serum concentration of adalimumab ( P < .001). Higher serum adalimumab concentration is associated with lower disease activity ( P = .043). Normal-weight patients had significantly higher concentrations than overweight patients ( P = .011).

Conclusions:

An increase in the weekly dose of adalimumab led to a nonstatistically significant improvement in clinical response but led to a statistically significant increase in serum concentration.
A new coupled dynamic model to study the vibration and lubrication characteristics of slipper/swash-plate interface in an axial piston pump
Authors: Ye Shaogan , Sun Yintong , Zhang Junhui , Chen Jian , Xu Bing , Zhao Shoujun , Liu Huixiang
Published: January 2025

A new integrated dynamic model is developed by examining the motion equations and kinematics of the slipper and piston, coupled with the lubrication properties of the oil film. This model simultaneously addresses the dynamic vibrations of the slipper and piston along with the characteristics of the oil film lubrication. To validate this model, a test apparatus is constructed. It is found that the power loss simulated from the slipper pair comprises approximately 20–65% of the measured power loss, while the simulated leakage flow rate generated by the slipper pair constitutes around 30–50% of the measured leakage flow rate. The vibration responses of the slipper and piston, as well as the oil film lubrication characteristics, are analyzed under various load pressures and speeds. The first several harmonics of the differences in the vibration responses of the piston and slipper and the central oil film thickness between the slipper and swash plate are in the magnitude of micrometer. The relative motions between the piston and slipper influence the oil film thickness, and the nonlinear attributes of the oil film impact the vibration behaviors of the piston and slipper. The dynamic central oil film thickness at harmonic frequencies decreases with increasing load pressure, while most harmonic-related oil film thickness increases with rising speed.
Discrimination, sleep, and physical health: Moderation by respiratory sinus arrythmia reactivity
Authors: McWood Leanna M , Erath Stephen A , Hinnant Ben , El-Sheikh Mona
Published: January 2025

Discrimination (unfair treatment due to group membership) is relatively common among adolescents and has been linked to poor sleep and physical health. Individual differences in physiological functioning may moderate these associations. A sample of 323 youth (48% boys, 52% girls; 58.5% White, 40.9% Black, Mage = 17.38 years, SD = 10.18 months) participated. Adolescents reported on discrimination and health, wore actigraphs to measure sleep, and came to the laboratory to assess respiratory sinus arrythmia reactivity (RSA-R) to two stressful tasks. Results indicate that discrimination was directly associated with health. Furthermore, discrimination interacted with RSA-R to predict sleep and health. Discrimination was related to more sleep activity and poorer health when RSA increased relative to baseline (augmentation), and better sleep quality (higher efficiency, fewer long wake episodes), when RSA decreased relative to baseline (suppression). Findings support the importance of examining physiological regulation as a protective/vulnerability factor when attempting to explicate relations between discrimination and health.
The perceived usefulness of pedagogical genres in EMI settings: A learner-informed comparative analysis of Engineering and Economics courses
Authors: Edo-Marzá Nuria
Published: January 2025

English is increasingly reinforcing its worldwide well-established position as facilitator of cross-cultural communication. This status has enhanced the use of English as a medium of instruction (EMI) in European universities. As a result, a deeper understanding of all the elements participating and converging in the teaching–learning process (T-L) in EMI settings seems necessary and beneficial in tertiary settings. One of these elements is pedagogical genres and their perceived use, utility, and efficiency as teaching/learning tools in EMI contexts. This study aims to explore, from the learners’ perspective, the incidence and perceived usefulness of different pedagogical genres at play both in Economics and Engineering courses taught in English. By means of a questionnaire created ad hoc to be responded to by non-native English students from Economics and Engineering degrees, both descriptive and comparative results (statistically-generated and focused on significance) were obtained as regards, for instance, those pedagogical genres that students may find more problematic or less useful in their teaching–learning process. These results, which include a series of specific pedagogical suggestions, may serve to reconsider the actual usefulness or adequacy of some genres with the final objective of better adapting their use to real students’ needs and demands.
Matriarchy in practice: Lessons from Anishinaabe Kweok in community programming
Authors: Moses-O’Donnell Ophelia , Wemigwans Nicole , Pitawanakwat Paula
Published: January 2025

Biindigen families is a grassroots group in Sudbury that offers community programming that is culturally grounded with language, ceremonies, activities, crafts that focus on Indigenous resurgence of cultural knowledge in Sudbury for Indigenous parents, children and families. Led by two powerful matriarchs, Nicole Wemigwans and Paula Pelletier, and supported by an all Ikwewag- women (women) staff, Biindigen Families has made great strides in restoring traditional matriarchal leadership in community health and development through community programming. In Anishnabemowin (Ojibwe language), the word for old women (leader, clan leader, seed source/carrier), ‘mindimooyenh’, the one who carries, or holds it together. With great respect to the women that came before us, the goal of this paper is to illustrate lessons learned in the conception, growing and being stages of Biindigen families for social workers that are rooted in traditional Anishinaabe matriarchy.
In between the fields of research of special educational needs and multilingual education – Swedish heritage language teachers’ perspectives on special educational needs in multilingual students
Authors: Sparreskog Christa Roux
Published: January 2025

For most multilingual students, knowledge and language development takes place without major difficulties. However, if this development deviates from what is expected, the difficulties need to be investigated, and support measures implemented. Complex causes interact when multilingual students need special educational support. The research fields of multilingual education and of special needs education must be taken into consideration. Unfortunately, because of the gap between these two fields, many multilingual students in need of special educational support fall between the cracks. For these students, heritage language teachers (hereafter HLTs) constitute an important link between Swedish school culture and home culture and they bear responsibility in defining the special educational support measures for these students. Therefore, through the narratives of HLTs, this study aims to gain a deeper understanding of their perception of multilingual students in need of special educational support. The present study is based on qualitative methods for collecting and analysing data. After a purposeful selection, 13 individual in-depth interviews were conducted. Thereafter, the transcriptions of the interviews were analysed thematically. The results indicate that the HLTs characterise multilingual students whose behaviour or language development deviates from the norm regarding the need of special educational support. The HLTs define linguistic deviations, the underlying causes, and the support measures needed similarly. However, behavioural deviation and the underlying causes are perceived differently, depending on the individual HLTs’ personal experiences, backgrounds and levels of education. To meet the multilingual students’ SEN in a more scientifically based approach and a more holistic way, the study discusses the need for structural changes facilitating interdisciplinary collaboration between HTL and SEN teachers, a more uniform educational path for HLTs as well as better information to special needs teachers about the roles and tasks of HLTs. In conclusion, the gap between the research fields of multilingual students’ learning and special needs education should be tightened.
Critical Insights Into Public Health Interventions: Partnership, Cultural and Racial Tensions, and Vaccine Hesitancy Within Somali Communities in the Upper Midwest, USA, and Western Norway
Authors: Pernat Claire A. , Pratt Rebekah , Ottemöller Fungisai Gwanzura , Corbin J. Hope
Published: January 2025

As the COVID-19 pandemic recedes, SARS-CoV-2 vaccination is crucial for reducing transmission and severity, but vaccine hesitancy remains a challenge. The study explored community actions and initiatives addressing vaccine hesitancy among Somali immigrant communities in cities in the Upper Midwest, USA, and Western Norway, focusing on trust factors and comparing members of the Somali diaspora in two distinct social and cultural contexts. Qualitative collective case studies were conducted, involving 14 semi-structured interviews with key informants from the Upper Midwest and Western Norway knowledgeable about initiatives designed to address SARS-CoV-2 vaccine hesitancy. Data were coded in NVivo 12 and analyzed thematically, guided by the Bergen Model of Collaborative Functioning and the Socioecological Model to identify basic and organizational themes. The findings illustrate critical sociopolitical influences on vaccine hesitancy, like racial tensions following George Floyd’s murder in Minneapolis and mistrust toward the government in Norway. Effective strategies in the Upper Midwest included maintaining long-term community relationships and culturally tailored outreach and communication to reduce hesitancy. Conversely, Western Norway’s less community-centric approach, focusing on translation services without deeper engagement, faced challenges in trust-building. The study highlights the essential role of culturally affirming and community-centric approaches in addressing health challenges in immigrant communities. Trust, fostered through community involvement and understanding sociopolitical contexts, is pivotal in addressing vaccine hesitancy. This research offers insights into designing and implementing effective health promotion strategies tailored to immigrant populations’ unique needs. It emphasizes the necessity of integrating socioecological perspectives and community-specific interventions in health promotion practice and policy.
Parallel Plights in Advancing Menstrual Equity: A Scoping Review of Period Poverty in India and the United States
Authors: Bourne Mary Pope , Ahsan Karar Zunaid
Published: January 2025

As calls for improved menstrual health management have gained momentum in sociopolitical contexts, period poverty and menstrual equity have gradually been established and recognized in the discipline of public health. These conversations typically take place in the context of low- and middle-income countries (LMICs) where donor-sponsored projects are already underway. Nevertheless, research on period poverty in high-income countries (HICs) is seldom performed. In addition, current literature on the topic tends to generalize HICs and LMICs, thereby ignoring crucial cultural and socioeconomic distinctions that necessitate a more detailed comparison of individual countries facing period poverty. This case examines the current body of research on period poverty in the United States and India, and compares the causes, effects, and approaches toward ameliorating this phenomenon. Through performing a scoping review of the current literature on period poverty, this case illustrates that—as opposed to the breadth of research available on period poverty in LMICs—research on period poverty in HICs is underrepresented. In addition, the findings demonstrate a stunning parallel between the contributing factors of period poverty in India and the United States, suggesting that the current approach to isolate conversations on the topic based on regional economic incongruencies is inappropriate. Finally, this case identifies dismantling the stigmatization of periods, investing in water or hygiene infrastructure, promoting the economic mobilization of females, and reforming menstrual health curricula in schools as essential to ending period poverty.
Short-term WB-EMS in Cancer Patients: Positive Effects After 2 Weeks of Exercise—A Single-arm Trial
Authors: Kersten Jane , Niels Timo , Tomanek Annika , Baumann Freerk T.
Published: January 2025

Context

Due to therapeutic side effects and physical weakness, patients are not always able to carry out strenuous and lengthy exercises. Hence, this study investigated the effectiveness and feasibility of a short-term Whole-body electromyostimulation (WB-EMS) for oncological patients during and after anticancer treatment. The primary aim was to ensure the feasibility of WB-EMS training. Furthermore, the effects of WB-EMS training were investigated over a period of 2 weeks on parameters such as quality of life, body composition and physical performance.

Method

Thirteen cancer patients with different diagnosis, disease stages and treatment state were included. They participated in supervised WB-EMS sessions 4 times over a 2-week period. Physical functioning, body composition, depression, fatigue, and quality of life were measured before and after the intervention period. Moreover, a pre-post measurement of the patients’ perceived body constitution was conducted in every exercise session.

Results

All included patients (n = 13) were able to complete the 4 WB-EMS sessions. At the end of the 2 weeks, a significant increase of the muscle strength could be observed. Additionally, patients improved their cardiovascular fitness. The body composition analyses showed significant reductions in body lean mass and extracellular water. Muscle mass remained unchanged. Furthermore, patients reported an improved perceived body constitution reduced pain and discomfort following all 4 WB-EMS sessions.

Conclusion

This study suggests that WB-EMS is safe and feasible for cancer patients. Furthermore, it showed that even after 2 weeks, improvements concerning the physical performance and patient-reported outcomes can be achieved. This study indicates benefits of WB-EMS as short-term exercise methode in cancer patients, that could be utelised in fields such as cancer prehabilitation.

Trial Registration

This trial has been registered with the ISRCTN-Registry (ISRCTN68069634).
Do We Practice What We Preach? Examining Barriers to Timely Epilepsy Surgery Referrals
Authors: Yardi Ruta
Published: January 2025

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Realist Needs Assessment Investigating the Factors Affecting Implementation of Guideline-Based Care for Chronic Pain in Rural Australia: Program Theory Generation
Authors: Grant Ashley R , Westhorp Gill , Mardon Amelia , Karran Emma L , Hibbert Peter D , Roeger Christopher , Moseley G. Lorimer
Published: January 2025

We developed a realist program theory describing factors that affect healthcare professionals’ delivery of guideline-based pain care in rural Australia as part of a realist-informed needs assessment. To our knowledge, this project is the first to apply a realist research approach to conducting a needs assessment. We conducted and analysed realist informed teacher-learner cycle interviews with rural healthcare professionals to inform our program theory. In these interviews, we presented participants with a summary of guideline recommendations for the assessment and management of chronic pain. We asked participants which recommendations they found easy and challenging to implement in their local setting, and discussed why, how, and in what circumstances this was the case. We detail how we analysed interview transcripts retroductively in NVivo and how the authorship team abstracted from the clinical scenarios provided by interviewees to generate theories at a ‘middle level’ of abstraction. Our discussion details lessons learned from the utilised methods with recommendations for how we would adapt these methods in the future.
A concept analysis of the recurrence-related to diabetic foot ulcers
Authors: Ahmed Bootan Hasan , Voss Joachim G. , Griggs Stephanie , Naif Ahmed A. , Aggarwal Sugandha , Ruksakulpiwat Suebsarn , Schiltz Nicholas K.
Published: January 2025

Background and Purpose

There is inconsistency and lack of conceptual clarity regarding the concept of “recurrence” in diabetes-related foot ulcers. Therefore, the purpose of this concept analysis is to analyze the concept of recurrence-related to diabetes-related foot ulcer after the healing of a previous foot ulcer.

Method

The Rodger's evolutionary concept analysis method was employed to analyze the concept of recurrence in diabetes-related foot ulcers. Eight databases, including PubMed, EMBASE, CINAHL Plus with Full Text, MEDLINE with Full Text (EBSCO), Web of Science, Cochrane Library, PsychoINFO, and Scopus, were searched. Additionally, Google Scholar, bibliographies, and hand searching were conducted. The search spanned from inception through August 13, 2023, yielding 3290 studies. Among these, 3242 did not meet the inclusion criteria, leaving 46 articles that fulfilled the criteria.

Findings

In a majority of the studies (n = 20, 43%), diabetes-related foot ulcer recurrence occurred at the same site after the healing of previous foot ulcers. In contrast, in fourteen (20%) studies, the diabetes-related foot ulcer recurrence was described as not at the same site as the previous foot ulcer. In the other twelve (26%) studies, the attribute of recurrence was not identified.

Conclusions

The concept of recurrence-related to diabetes-related foot ulcer should be reserved for diabetes-related foot ulcers at the same site after the healing of previous foot ulcers.
Nested surrogate model for discrete parameter optimization of structural reliability analysis
Authors: Kim Hongseok , Lee Dooyoul , Kim Do-Nyun
Published: January 2025

The dynamic Bayesian network which is widely used for efficient reliability analysis, requires random variable discretization. To estimate the accuracy of the discretization results, the Kullback-Leibler (KL) divergence and reliability index errors are used as metrics. Since both errors have a trade-off relationship in a combined discretization method, determining the optimal discrete parameters is crucial to accurate and efficient reliability analysis. However, the optimization process is significantly time-consuming, so we proposed the nested surrogate model for the discrete parameter optimization in structural reliability analysis. The first-stage surrogate model based on the Gaussian process regression (GPR) method calculated the stress intensity factor (SIF). The sample points for GPR were obtained by using the finite element analysis (FEA) method. The artificial neural network for the nested surrogate model is then trained using the data generated from the first-stage surrogate model, to determine the SIF range for the crack growth behavior. The nested surrogate model was implemented to optimize the discrete parameters of the crack length distribution. The proposed method considerably reduced the computation time in obtaining the optimal discrete parameters that capture the features of regions with low probability.
Calibration of a novel instrumented mounting screw for monitoring sport climbing on artificial climbing walls
Authors: Pernus Weber Nina , Docherty Paul , Munro Deborah
Published: January 2025

Sport climbing has become an Olympic sport, which has fostered interest in advanced monitoring of climber performance. Our research focuses on developing an unobtrusive sensor within an instrumented mounting screw (IMS) for assessing climber performance in real-world conditions. The IMS comprises single or double triplet configuration strain gauges bonded to modified mounting screws. Calibration of force magnitude, using known weights, was compared between an analytical approach and a machine learning neural network (NN) algorithm approach. Additionally, force directions in the coronal (frontal) and sagittal (side) planes relative to the climbing hold were determined analytically and compared to reference angles. Results demonstrated that the IMS could measure force magnitude and direction on climbing holds. In the double triplet configuration (six strain gauges), NN-based calibration showed more accurate results in estimating force magnitude compared to the analytical solution, with a relative error of 6% and 20%, respectively. For the single triplet configuration (three strain gauges), the NN method showed an accuracy of 14%. Similar trends were observed when the center of pressure (COP) was varied on the climbing hold, with higher root mean squared error (RMSE) for configurations with fewer strain gauges. In the coronal plane, force direction errors in angle were below 5°, while in the sagittal plane, errors reached 10° for angles above 25°. Thus, larger sagittal plane angles only indicate direction, and do not provide precise measurement. In conclusion, the developed unobtrusive IMS presents a promising method for assessing climbing performance on existing climbing walls.
Comparing immunotherapy effectiveness for unresectable hepatocellular carcinoma: infiltrative versus non-infiltrative types in real-world settings
Authors: Chiang Chien-Ming , Huang Kuan-Kai , Lee Chun-Te , Hong Tzu-Chun , Wu Juei-Seng , Wu Hung-Tsung , Chang Ting-Tsung , Liu Yi-Sheng , Chen Wei-Ting , Wang Chung-Teng , Chang Chen , Chen Po-Jun , Hsieh Ming-Tsung , Chen Chiung-Yu , Chuang Chiao-Hsiung , Lee Ching-Chi , Lin Sheng-Hsiang , Lin Yih-Jyh , Kuo Hsin-Yu
Published: January 2025

Background:

Infiltrative hepatocellular carcinoma (HCC) is often associated with an unfavorable prognosis, posing a challenge in determining the optimal therapeutic approach. Immunotherapy, employing immune checkpoint inhibitors (ICIs), has become a preferred first-line treatment for advanced HCC. However, the overall effectiveness of ICIs in patients with infiltrative HCC remains unclear. This study aims to compare the effect of ICI treatment on clinical outcomes between patients with infiltrative and non-infiltrative HCC.

Materials and methods:

A retrospective cohort consisting of unresectable HCC patients who underwent immunotherapy with ICIs, categorized into infiltrative and non-infiltrative groups was studied. Primary outcomes comprised treatment response according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria, progression-free survival (PFS), and overall survival (OS).

Results:

Of 198 patients, 60 (30.3%) had infiltrative HCC, while 138 (69.7%) had non-infiltrative HCC. In the infiltrative group, the objective response rate (ORR) was 36.7% and the disease control rate (DCR) was 55.0%. For the non-infiltrative group, the ORR was 33.3% and the DCR was 56.5%, showing no significant difference between the two groups. However, patients in the infiltrative group had significantly shorter median of PFS and OS following immunotherapy, with a PFS of 4.1 months (95% CI: 2.5–6.7; p = 0.0409) and an OS of 10.4 months (95% CI: 6.7–14.4; p = 0.0268), compared with the non-infiltrative group, which had a PFS of 5.5 months (95% CI: 3.2–7.6) and an OS of 17.0 months (95% CI: 12.8–21.8).

Conclusion:

For immunotherapy, infiltrative HCC exhibits treatment responses similar to non-infiltrative HCC. Nonetheless, infiltrative HCC is associated with shorter survival outcomes, compared with non-infiltrative type. Our findings emphasize the essential of considering type discrepancies when developing management strategies for immunotherapy.
Different Times for Different Metrics: Predicting 90 Days of Intermittently Scanned Continuous Glucose Monitoring Data in Subjects With Type 1 Diabetes on Multiple Daily Injection Therapy. Findings From a Multicentric Real-World Study
Authors: Csermely Alessandro , Borella Nicolò D. , Turazzini Anna , Pilati Martina , Sheiban Sara S. , Bonadonna Riccardo C. , Trevisan Roberto , Trombetta Maddalena , Lepore Giuseppe
Published: January 2025

Aims:

According to the 2023 International Consensus, glucose metrics derived from two-week-long continuous glucose monitoring (CGM) can be extrapolated up to 90 days before. However, no studies have focused on adults with type 1 diabetes (T1D) on multiple daily injections (MDIs) and with second-generation intermittently scanned CGM (isCGM) sensors in a real-world setting.

Methods:

This real-world, retrospective study included 539 90-day isCGM data from 367 adults with T1D on MDI therapy. For each sensor metric, the coefficients of determination ( R2) were computed for sampling periods from 2 to 12 weeks versus the whole 90-day interval. Correlations were considered strong for R2 ≥0.88.

Results:

The two-week sampling period displayed strong correlations for time in range (TIR, 70-180 mg/dl; R2 = 0.89) and above range (TAR, >180 mg/dl; R2 = 0.88). The four-week sampling period showed additional strong correlations for time in tight range (TITR, 70-140 mg/dl; R2 = 0.92), for the coefficient of variation (CV; R2 = 0.88), and for the glycemia risk index (GRI; R2 = 0.92). The six-week sampling period displayed an additional strong correlation for time below range (TBR, <70 mg/dl; R2 = 0.90). After stratification by clinical variables, lower R2 values were found for older age quartiles (>40 years), higher CV (>36%), lower sensor use (≤94%), and higher HbA1c (>7.5%).

Conclusion:

In patients with T1D on MDI, two- to six-week intervals of isCGM use can provide clinically useful estimates of TIR, TAR, TITR, TBR, CV, and GRI, which can be extrapolated to longer (up to 90 days) time intervals. Longer intervals might be needed in case of older age, higher glucose variability, lower sensor use, and higher HbA1c.
Apparent diffusion coefficient and magnetic resonance imaging characteristics in predicting response to radiosurgery in patients with vestibular schwannomas
Authors: Pitukkitronnagorn Nattapon , Chakkabat Chakkapong , Jittapiromsak Nutchawan
Published: January 2025

Objective

Predicting treatment response in patients with vestibular schwannomas (VSs) remains challenging. This study aimed to evaluate the use of pre-treatment normalized apparent diffusion coefficient (nADC) values and magnetic resonance (MR) imaging characteristics in predicting treatment outcomes in patients with VSs undergoing radiosurgery.

Methods

The MR images of 44 patients with VSs who underwent radiosurgery at our institution were retrospectively reviewed, and the patients were categorized into tumor control ( n = 28) and progression ( n = 16) groups based on treatment response after treatment initiation, with a median follow-up duration of 29.5 (13–115) months. Pre-treatment nADC values for the whole tumor and solid portion of the tumor were assessed for predictive significance. MRI characteristics were analyzed, including hemorrhage status, tumor morphology, and post-treatment loss of central enhancement. Interobserver reliability was also evaluated.

Results

Early post-treatment enlargement was associated with tumor progression ( p = .024). The mean pre-treatment nADC values for the solid part of the tumor were significantly higher in the tumor control group than in tumor progression group (1.32 vs 1.05, p = .005). The receiver operating characteristic curve analysis revealed a mean nADC of 1.18 as an optimal cutoff, with sensitivity and specificity of 76.2% and 86.7%, respectively, in predicting treatment response.

Conclusion

The mean nADC values for the solid part of the tumor demonstrated predictive value for treatment response, with implications for treatment planning. Notably, early post-treatment enlargement was correlated with tumor progression. Incorporating these findings into clinical practice may refine treatment strategies for patients with VSs undergoing radiosurgery.
Distribution and antifungal susceptibility of Candida species causing vulvovaginal candidiasis and urinary tract infection in Medlatec healthcare system, Ha Noi city, Vietnam in 2023
Authors: Ngai Pham Van , Dat Tran Huu , Nhi Luu Yen , Linh Tran Thi Khanh , Thu Nguyen Thi , Anh Vu Lan , Dung Bui Thi Thu , Tran Pham Van , Hien Nguyen Thi , Son Nguyen Thai , Que Trinh Thi , Anh Do Ngoc
Published: January 2025

Background:

Vulvovaginal candidiasis and urinary tract infections caused by Candida are common diseases. While the most common causative agent is C. albicans, other species, such as non- C. albicans, can also be responsible. Susceptibility to antifungal drugs varies among Candida species, but there is very limited information available from Vietnam.

Objectives:

To determine the species distribution and antifungal susceptibility patterns of Candida isolated from urine and vaginal samples of patients tested at the Medlatec healthcare system in 2023.

Design:

Cross-sectional study.

Methods:

The study describes a cross-sectional analysis of over 102 Candida isolates obtained from urine and vaginal samples of patients using the testing services at Vietnam Medlatec healthcare system from January to December 2023. Species identification of Candida isolates was performed using germ tube test and Vitek® 2 systems. Antifungal susceptibility testing was carried out using the VITEK® 2 card for yeast fungi. Minimum inhibitory concentrations for these isolates were classified according to the Clinical and Laboratory Standards Institute guidelines (M27-A3 and M27M44S-ED3).

Results:

In this investigation, five different Candida species were identified. Among these isolates, C. albicans (78.43%) was the most frequent, followed by C. tropicalis (11.76%), C. glabrata (4.91%), C. parapsilosis (1.96%), and C. krusei (0.98%). The resistance rates to fluconazole, voriconazole, caspofungin, micafungin, and amphotericin B were 7.7%, 4.2%, 4.0%, 1.0% and 1.0%, respectively.

Conclusion:

The most common species found in this population was C. albicans. Our findings also showed a high frequency of non- albicans Candida species causing fungal urinary tract infections. The resistance rates of isolated Candida strains to echinocandins and amphotericin B were low, while some strains were found to be resistant to fluconazole and voriconazole.
Severe atopic dermatitis treated with Dupilumab in a CTLA-4-deficient patient: A case report and review of the literature
Authors: Park Ye-Jean , Grossman Jennifer , Robertson Lynne
Published: January 2025

Atopic dermatitis is a chronic inflammatory skin disease associated with immune dysregulation, particularly overexpression of T helper 2 cytokines. Cytotoxic T lymphocyte-associated antigen 4 deficiency, a primary immune disorder, can exacerbate atopic dermatitis. Dupilumab, an IL-4 and IL-13 receptor antagonist, has demonstrated efficacy in controlling severe, recalcitrant atopic dermatitis by mitigating T helper 2-driven inflammation. We present a case of a 24-year-old male with cytotoxic T lymphocyte-associated antigen 4 haploinsufficiency and severe atopic dermatitis successfully managed with Dupilumab. The patient showed marked improvement in eczema severity scores, including a sixfold reduction in the Eczema Area and Severity Index and a threefold reduction in the Dermatology Life Quality Index over 6 months, highlighting Dupilumab’s potential role in cytotoxic T lymphocyte-associated antigen 4-deficient patients experiencing atopic dermatitis.
Refining breast cancer classification: Customized attention integration approaches with dense and residual networks for enhanced detection
Authors: Alam Mohammad Sakif , Efat Anwar Hossain , Hasan SM Mahedy , Uddin Md Palash
Published: January 2025

Objective

Breast cancer detection is critical for timely and effective treatment, and automatic detection systems can significantly reduce human error and improve diagnosis speed. This study aims to develop an accurate and robust framework for classifying breast cancer into benign and malignant categories using a novel machine learning architecture.

Methods

We propose a dense-ResNet attention integration (DRAI) architecture that combines DenseNet and ResNet models with three attention mechanisms to enhance feature extraction from the BreakHis dataset. The attention mechanisms focus on regionally important features, improving classification accuracy. A triple-level ensemble (TLE) method combines the performance of multiple models, further enhancing prediction accuracy.

Results

The proposed DRAI architecture with TLE achieves an accuracy of 99.58% in classifying breast cancer into benign and malignant categories, surpassing existing methodologies. This high accuracy demonstrates the effectiveness of the fusion architecture and its ability to reduce manual errors in breast cancer diagnosis.

Conclusion

The DRAI architecture with TLE provides a robust, automated framework for breast cancer classification. Its exceptional accuracy lays a solid foundation for future advancements in automated diagnostics and offers a reliable method for aiding early breast cancer detection.
Impact of AI and big data analytics on healthcare outcomes: An empirical study in Jordanian healthcare institutions
Authors: Al-Dmour Rand , Al-Dmour Hani , Basheer Amin Eatedal , Al-Dmour Ahmed
Published: January 2025

Artificial intelligence (AI) and big data analytics are transforming healthcare globally and in Jordan. This study investigates the effects of AI and big data analytics on healthcare outcomes in Jordanian healthcare institutions. A comprehensive model is proposed to understand the antecedents of healthcare outcomes, including the impact of perceived ease of use, perceived usefulness, and organizational capabilities. Data were collected from 400 structured questionnaires, with a final sample size of 288 respondents, and analyzed using partial least squares structural equation modeling. The findings reveal that AI technologies significantly improve diagnostic accuracy and treatment planning, while big data analytics enhances operational efficiency and patient care. However, the comparative influence of AI on different healthcare processes was less significant. Additionally, robust organizational capabilities effectively enhanced the adoption and impact of AI and big data analytics. The study highlights the mediating roles of perceived ease of use and usefulness in the relationship between technology adoption and healthcare outcomes. Understanding the interplay between AI, big data analytics, and healthcare delivery is crucial for policymakers, healthcare administrators, and technology developers to develop effective strategies that improve patient care and operational efficiency. This study recommends investing in user-friendly AI and big data analytics tools, enhancing organizational capabilities, and providing comprehensive training for healthcare professionals. Future research should extend this study to different cultural contexts to validate the findings and contribute further to the literature on AI and healthcare.