bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of microstructural, corrosion, and wear properties of austenite SS304 joints welded by underwater wet automated metal arc welding
Authors: Hajam Mohd Ashraf , Rajendran Dinesh Kumar
Published: January 2025

This study explores the feasibility of using underwater wet automated metal arc welding. A specially designed welding setup was used, providing precise control over the x, y, and z axes to weld the high strength Austenite AISI304 stainless steel in present study. The welding process operated at 145 Amps of current, a voltage of 23 V, a feed rate of 2.5 mm/sec, and utilized a 3.15 mm × 350 mm flux-coated SS304 electrode, ensuring sufficient arc generation for effective welding. Microstructural analysis was conducted using optical microscopy and FESEM, while corrosion performance was evaluated through potentiodynamic tests, and wear characterization was performed using an engine tribometer. The weld zone exhibited a refined, columnar grain structure, which improved corrosion resistance, with a corrosion rate (CR) of 0.01052 mmpy, as determined by Tafel testing. Additionally, wear resistance tests revealed that the weld specimen outperformed the base metal, with a wear rate of 2.352 g/Nm × 10−10 compared to the base metal's 3.201 g/Nm × 10−10. The results emphasize the potential of underwater wet automated metal arc welding in enhancing the structural integrity of marine constructions through improved corrosion and wear performance.
Suicide and suicide behavior: A qualitative study in Telangana, India
Authors: Rawat Suchita , Rajkumari Sunanda , Saraswathy Kallur Nava , Joshi Pooran Chand , Swarna Latha M. , Sravan Kumar Kandagatla , Raghu S. , Mahajan Chakraverti
Published: January 2025

This study aimed to understand the perceptions and experiences of suicide attempters in order to suggest potential initiatives to reduce the suicide burden in rural India. The study is based on 46 in-depth interviews with suicide attempters and 4 focus group discussions with their family members. Interview content analysis revealed information related to four anticipated themes: the characteristics of a suicide attempt are complex; suicide attempters are taken to public hospitals for first aid and treatment; the consequences of suicide attempts are diverse; and quality of life improved after the suicide attempt. There were also two unanticipated themes: suicide attempters sought help from potential rescuers; and the underreporting of suicide attempts. Emergent themes from the focus group discussions were the vulnerable group for suicide; poverty, indebtedness, family conflicts and unemployment are the main reasons for suicide; non-violent methods are used to commit suicide; there were no behavioral changes before suicide; the devastating effects on the families of decedents; positive community support to suicide survivor families; and expectations of preventive measures from both the community and government. The article argues that to reduce the suicide burden, the government should adopt a two-pronged strategy of creating a secure livelihood all-year round and providing psychological counseling at both the household and community levels.
Circadian rest-activity rhythm pattern in the elderly with cerebral small vessel disease: Using multiple estimated methods
Authors: Zhào Hóngyi , Zhang Haiyang , Ding Yu , Li Hong , Huang Yonghua
Published: January 2025

Background: Disruption of circadian rest-activity rhythm (RAR) has been found in many neurological disorders. Objective: In this study, actigraphic data were collected and analyzed to identify the RAR pattern in the elderly with cerebral small vessel disease. Methods: 115 cerebral small vessel disease (CSVD) cases were recruited. The presence of lacune infarct, white matter hyperintensities, and cerebral microbleeds in magnetic resonance imaging (MRI) images were rated independently, as well as using a simple MRI score of 0–3 points. Each subject wore an Actigraph device in their nondominant hand for 4–7 days to collect raw data. RAR parameters were generated using both extended cosinor model (RAR α, RAR β, amplitude, acrophase, up-mesor, down-mesor, and pseudo-F statistic) and non-parametric methods (interdaily stability, intradaily variability, and relative amplitude). Results: Elder patients with a simple MRI score of 2–3 points showed a statistically lower amplitude compared with individuals with a simple MRI score of 0 points in the extended cosinor model. For the non-parametric method, elderly people with a simple MRI score of 1–3 points exhibited higher intradaily variability relative to those participants with a simple MRI score of 0 points. However, no differences were found regarding sleep quality among individuals with different simple MRI scores. White matter hyperintensities, lacune infarct, and cerebral microbleeds were independently associated with RAR β, RAR α, and intradaily variability, respectively. Conclusions: The RAR pattern was disturbed in elderly adults with CSVD. Abnormal RAR parameters were independently associated with CSVD MRI markers.
Hospitality Human Capital process model in crisis management: Managing human capital and revealing employees’ hidden capabilities
Authors: Goll Jagoda , Zieba Krzysztof
Published: January 2025

As the hospitality industry is highly human-dependent, proper Human Capital management is crucial for responding to these challenges and becoming resilient in the long-term perspective. This study aims to verify the Value-Driven Process Model of Hospitality Human Capital management in the context of Crisis Management in restaurant SMEs, which is an under-researched part of the industry. The authors adjust the model by Young et al. (2005) concerning two phases of a crisis – crisis event and post-crisis phases. Additionally, we aimed to expand the model by showing what values for businesses emerge from Human Capital management practices. As a methodology, we used semi-structured interviews conducted with restaurant owners or managers who experienced the COVID-19 pandemic crisis. The obtained results were analyzed using content analysis. Our findings revealed that some managerial actions concerning Human Capital may result in quick and successful adaptation to new and unknown conditions. Moreover, we uncovered hidden and unique capabilities of restaurant employees that, if properly managed, may become a substantial additional value for businesses and enhance their competitive advantage and resilience. The study may be food for thought for all practitioners in the hospitality industry, especially in restaurant SMEs that are an under-researched part of the industry. Our findings also fill the gap concerning Human Capital and Crisis Management frameworks in hospitality. This study delivers new knowledge in the field of Human Capital management in hospitality during a crisis.
French Juvenile Justice Social Workers’ Perceptions of Youth Offenders
Authors: De Boer Savannah , Testé Benoit , Guarnaccia Cinzia
Published: January 2025

Staff’s representations of offenders are known to impact their interactions with the offenders they work with, but settings involving justice-involved youth remain understudied. This study addressed this research gap by using reflexive thematic analysis to explore French juvenile justice social workers’ representations of justice-involved youth. Semi-structured interviews with 24 participants revealed a diversity of representations. Most participants saw youth offenders’ adverse childhood experiences as mitigating factors in the acts committed and as justification for adopting a welfare-based approach to juvenile justice. We discuss the consequences of the lack of a shared rehabilitation model to guide youth justice interventions.
Randomized Controlled Trial to Compare AmnioExcel Human Amniotic Allograft in Weekly Versus Biweekly Treatment of Diabetic Foot Ulcers
Authors: Lavery Lawrence A. , Suludere Mehmet A. , Raspovic Kathryn , Crisologo Peter Andrew , Johnson Matthew J. , Tarricone Arthur N.
Published: January 2025

Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel® applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse. Patients received amniotic tissue either once a week or every other week. We used a 3D measurement device (inSight, eKare, Fairfax, Virginia)”. There was no difference in the incidence of healing (AMX1 30.0% vs AMX2 50.0%, p = 0.20), time to heal (69.3 ± 30.3 vs 45.8 ± 25.6 days, p = 0.15), or incidence of infection (AMX1 35.0% vs AMX2 25.0%, p = 0.49). The mean wound area reduction was 0.18 ± 0.48 cm2 per week for AMX1 and 0.15 ± 0.63 cm2 week for AMX2 (p = 0.42). When we compared wound healing trajectories in healers and non-healers. There were no differences in the mean wound area reduction for healers (0.26 ± 0.40 cm2 per week) and non-healers (0.14 ± 0.52 cm2 per week, p = 0.20). Our results suggested there is no difference in the incidence of healing, time to heal or incidence of infection based on weekly or biweekly application of amniotic tissue.
Leg Ulcer and Venous Symptoms Related to Lower Extremity Arteriovenous Access for Hemodialysis: A Retrospective Review with Emphasis on Wound Complications
Authors: Arworn Supapong , Apichartpiyakul Poon , Reanpang Termpong , Chansakaow Chayatorn , Orrapin Saranat , Oo Myo Zin , Rerkasem Kittipan
Published: January 2025

Lower extremity arteriovenous (AV) access serves as a crucial alternative for hemodialysis when upper extremity options are no longer viable. While there are numerous reports on functional patency, limited information exists regarding complications related to venous insufficiency and postoperative quality of life. This study aims to assess the actual incidence of such complications and provide evidence-based insights for clinical decision-making. We retrospectively analyzed 121 end-stage renal disease patients who underwent lower extremity AV access at Maharaj Nakorn Chiang Mai Hospital from 2006 to 2023. Among them, 105 patients (86.8%) had lower extremity AV grafts, while 16 patients (13.2%) had lower extremity AVF. Primary and secondary patency rate were 69.4% and 81.8% at one year, respectively. The mortality probability was 50.4% with a mean follow-up of 58 months. Mortality predictors included age (P = .001), aspirin use (P = .022) and statin use (P = .005). Primary failure occurred in 8 patients (6.6%) and vascular graft infection is the primary cause. There were no occurrences of venous leg ulcers developed, suggesting that the risk of this complication may be lower than previously thought in the short to medium term. However, 13.3% of patients experienced leg swelling and 21.7% had hyperpigmentation. The mean revised venous clinical severity score was 1.22 and the average EQ-5D-5L quality of life score was 0.99. Our findings suggest that the risk of venous leg ulcers in patients with lower extremity AV access may be lower than previously thought, at least in the short to medium term. This should encourage surgeons to consider this technique when upper extremity options are exhausted, while maintaining vigilance for early signs of venous insufficiency. Continued research into the detrimental effects of the hyper-dynamic blood flow rate on AV access and preventive strategies will enhance the benefit of lower extremity AV access in the future.
Correlation Between Relative Value Units and Operative Time for Peripheral Nerve Surgeries
Authors: Desai Anshumi , Wang Yujie , Chen Cheng-Bang , Akcin Mehmet , Xu Kyle Y. , Tadisina Kashyap Komarraju
Published: January 2025

Background:

The work relative value unit (wRVU) system quantifies surgeons’ effort and resources for procedures. Studies have shown its inaccuracy in capturing the complexity of certain plastic and upper extremity surgeries. Analysis for peripheral nerve surgery (PNS), a growing niche within hand and plastic surgery, has not been performed. The authors aim to evaluate the PNS wRVUs by correlation to their operative time.

Methods:

A retrospective analysis with current procedure terminology (CPT) codes for PNS (2005-2021) from the American College of Surgeons National Surgical Quality Improvement Program database was performed. Efficiency was determined by wRVU per operative time. Correlation was performed between operative time with wRVU and wRVU/minute.

Results:

A total of 2402 procedures across 21 CPT Codes were included and categorized into neuroplasty, nerve repair, and nerve grafting/transfers with the median operative time being 63.75, 100, and 153.78 minutes respectively. Nerve graft/transfer generated the maximum wRVU (mean 16.35). Neuroplasty generated the minimum wRVU (mean 7.24). Nerve grafts/transfers generated the least wRVUs per minute (0.09). Longer operative times were associated with higher wRVUs. Neuroplasty ( R = .86) and nerve repairs ( R = .84) had a strong correlation to the operative time. Nerve grafts/transfer had a positive but moderate correlation with the operative time ( R = .67). All procedures had a negative correlation between operative time and wRVU/minute.

Conclusions:

Nerve grafts/transfers had reduced compensation compared to neuroplasty or nerve repairs. Compensation did not reflect the procedure efficiency. This disparity in wRVU allocation for complex PNS underscores the need for remuneration reform.
Community Consultations to Support Scoping Review Knowledge Dissemination
Authors: Canham Sarah L. , Weldrick Rachel , Siantz Elizabeth , Rose Jeffrey N. , Littman Danielle Maude , Cruz Erisman Morgan , Rehn Kyle , Jones Shannon , Anderson Sumiko , McNamara Anne , Greenwood Emma
Published: January 2025

Scoping reviews are a valuable form of literature review used to synthesize many types of evidence found in academic literature. Amidst the recommended best practices for conducting scoping reviews, little attention has been given to how to conduct community consultations as part of scoping review processes. The objective of this article is to describe one form that community consultation can take. As the final step in a scoping review project examining the stigmatization and discrimination of persons experiencing homelessness, our research team conducted a community consultation, designed as a Knowledge Café workshop, with 25 participants who had lived experiences of homelessness (past and present) or were service providers in the homelessness sector. The 3-hour workshop was conducted in a central public library with participants seated at different roundtables. The workshop was divided into four discussion periods during which participants described experiences, outcomes, or interventions related to the stigmatization and discrimination of persons experiencing homelessness. At the end of the workshop, participants completed a brief survey about the quality of the workshop, aspects that worked well, and what could be improved. Participants reported appreciating that the workshop provided a forum for combining research findings with personal stories, as well as opportunities to make or revive professional connections. Participants also reported that tangible event outcomes, a more future-oriented focus on solutions, and a longer event would have improved their experience. Study findings contribute to the literature on how to engage with community around collaborative problem-solving and the importance of incorporating diverse perspectives, fostering empathy and inclusivity, and translating ideas into actionable steps.
From criminalization to erasure: Project 2025 and anti-trans legislation in the US
Authors: Quinan CQ
Published: January 2025

The past two decades have largely been characterized by mainstream media as emancipatory for LGBTQ communities; indeed, queer and trans people have achieved many legal wins. But despite what has appeared to be a slow march to acceptance and inclusion, the post-marriage equality era has ushered in a virulent form of backlash wherein trans communities are demonized and criminalized through an abundance of anti-trans laws and policies, many of which target trans youth and access to healthcare, schools, and sports. After sketching the broader landscape of trans criminalization, this article moves to an analysis of the conservative initiative termed Project 2025 and their flagship text Mandate for Leadership: The Conservative Promise (2023). This comprehensive blueprint outlines a series of far-reaching policies targeting marginalized populations, with trans people at the very center. Drawing on queer criminology and trans theory, this article argues that Project 2025 and emerging anti-trans legislation pivot from punishment and criminalization of gender-diverse people to erasure and dehumanization of trans life in all its forms. Against the backdrop of broader trends of anti-trans politics and conservative agendas that seek to erode progress made in advancing trans rights and equality, this article is also a call to build upon queer criminology to establish a more robust body of work in trans criminology.
Tribological characteristics of HVOF sprayed Fe-based composite coatings at elevated temperatures
Authors: T V Chandramouli , Joladarashi Sharnappa , Ramesh M R
Published: January 2025

This study evaluates the tribological performance of Fe-based composite coatings for aerospace and automotive applications, focusing on wear resistance at elevated temperatures. The coatings, comprising 15% WC-Co and Cr3C2 in an SS316L matrix, were deposited onto maraging steel via HVOF spraying. Microstructural analysis and adhesive strength testing confirmed strong particle bonding, with the coatings achieving a hardness of 711 ± 14 HV. Dry sliding wear behaviour was assessed using a ball-on-disc tribometer with alumina as the counterface under 10 N and 30 N loads at 25 °C, 300 °C, and 600 °C. Results indicated a decrease in the coefficient of friction and specific wear rate with increasing load and temperature. At 600 °C, wear rates were reduced by ∼97.56% (10 N) and ∼97.12% (30 N) than uncoated steel. Abrasive wear dominated at room temperature, while adhesive and oxidative wear mechanisms emerged at 600 °C, attributed to protective glaze layer formation.
Surgical outcomes of radial polydactyly according to a modified Wassel–Flatt classification: A retrospective study of 211 patients with 223 thumbs
Authors: Lee Wonsun , Shin Young Ho , Kim Jae Kwang
Published: January 2025

We previously introduced the modified Wassel–Flatt classification to overcome the limitation of the traditional classification for radial polydactyly. This study aimed to evaluate this modified classification in terms of surgical planning and clinical outcomes using the Japanese Society for Surgery of the Hand scoring system. A retrospective review of 211 patients with 223 thumbs treated for radial polydactyly between October 2017 and November 2022 was conducted. Patients were classified using the modified Wassel–Flatt classification, which further differentiated between hypoplastic proximal (HP) and hypoplastic distal (HD) types. The results indicated that simple excision was feasible only for the HP type, while the HD type and non-hypoplastic types required more complex procedures. In addition, hypoplastic types generally had better outcomes, with the HP type achieving better appearance scores than the HD type. Comparisons among non-hypoplastic types revealed no significant differences. The modified Wassel–Flatt classification appears to enhance surgical planning and predict clinical outcomes effectively.

Level of evidence: IV
Intrinsic neonatal limb ischaemia: A systematic review
Authors: Singal Aayushi , Ma Yangmyung , Singh Manwi , Jester Noemi , Rao Avula Aishwarya , Jester Andrea
Published: January 2025

This systematic review aimed to analyse the factors associated with intrinsic neonatal limb ischaemia (INLI), its causes and its management. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, and 115 articles were identified for analysis. For INLI detected at birth, most newborns presented with upper limb ischaemia (72%), with thrombus being the most common cause (66%). Higher rates of positive outcomes were observed when INLI was treated with medical management alone, although this could reflect a less severe manifestation. The data did not demonstrate any causative factors for the development of INLI. Depending on the timing of the in-utero insult and the degree of tissue involvement and loss, different primary interventions may be selected for management. A classification system is proposed to help guide the choice of management, in which the different clinical manifestations of INLI are divided into four grades.
The forced small finger abduction test for assessing the strength of intrinsic muscles innervated by the ulnar nerve
Authors: Kittipongphat Nut , Vinitpairot Chaiyos , Jianmongkol Surut
Published: January 2025

The study evaluates the forced small finger abduction test for assessing the strength of intrinsic muscles innervated by the ulnar nerve. The test was performed on healthy and ulnar neuropathy patients. Results demonstrate its ability to detect intrinsic weakness, which may enhance diagnosis of ulnar neuropathy.
Effectiveness of adjuvant leukocyte-poor platelet-rich plasma in carpal tunnel release: a randomized controlled trial
Authors: Mekariya Korawish , Monteerarat Yuwarat , Chotiyarnwong Chayaporn , Limthongthang Roongsak , Vathana Torpon , Laohaprasitiporn Panai
Published: January 2025

This study assessed the effectiveness of adding leukocyte-poor platelet-rich plasma (PRP) during carpal tunnel release surgery for patients with moderate to severe carpal tunnel syndrome. In a randomized controlled trial, 70 patients were assigned to either standard carpal tunnel release (control group) or release with leukocyte-poor PRP applied to the median nerve (PRP group). Primary outcomes were measured using the Boston Carpal Tunnel Questionnaire at 3 months, and secondary outcomes included pain, strength, sensation and electrodiagnostic examinations at multiple time points. Both groups showed similar improvements in pain, function, grip and pinch strength and electrophysiological recordings. However, the PRP group had better resolution of numbness at 3 months. These findings suggest that local PRP augmentation does not provide significant additional benefits beyond those of carpal tunnel release alone, apart from some improvement in patients’ perception of numbness.

Level of evidence: II
Aronia mitschurinii – New generation of super fruits with multiple health benefits
Authors: Sharma Preeti , Bratley Keith , Ford Travis , Ristvey Andrew G , Volkis Victoria V
Published: January 2025

Aronia mitschurinii is a cultivated, intergeneric, fruit-bearing plant presently being grown throughout the world for its nutritious berry-like fruit. This fruit is made into various consumable products like juices, wine, and jams, or for extracts and dry powders. Researchers have extensively studied the chemical composition and nutritional attributes of this fruit, including a comparison between its wild parent-plant A. melanocarpa, and cultivars within the intergeneric species of A. mitschurinii. Studies revealed that fruit of both species boast one of the highest levels of phenolic antioxidants, particularly anthocyanins. Fruit like blueberries ( Vaccinium sp), blackberries ( Rubis sp.), açai palm ( Euterpe oleracea), and more that are considered today as a good source of anthocyanins, all have much less than fruit from either A. melanocarpa or A. mitschurinii. We attribute them to a new generation of super-fruits. Over the past 17 years, Drs. Ristvey and Volkis have been at the forefront of an in-depth investigation into cultivars of A. mitschurinii grown in Maryland. Their comprehensive study encompasses aspects such as cultivation methods, practical applications, comparative analysis, and the extraction of antioxidants. In this short review, we will delve into the historical trajectory of A. mitschurinii in both the United States and Eastern Europe, explore its cultivation techniques and phytochemical composition, investigate its phenological anthocyanin and sugar maturation during the ripening process, examine its potential health benefits, and explore its diverse applications.
Polyphenolic Profiling and Wound Healing Potential of Hammada scoparia (Pomel) Iljin: Preclinical Evaluation of a Novel Topical Formula
Authors: Chaima Benine , Boutlelis Djahra Ali , Touhami Laiche Ammar , Amara Djilani Ghemam , Atoki Ayomide Victor , Zahnit Wafa , Messaoudi Mohammed
Published: January 2025

Objective

Hammada Scoparia (Pomel) as an endemic plant from the Amaranthaceae family, holds a significant position in the Saharan region of southern Algeria's traditional medicine. The aerial parts of Hammada scoparia was used to cure inflammation and wound healing management. The aim of this study was to determine the phytochemical constituents of the aqueous extract obtained from the aerial parts of Hammada scoparia (AEHs)and assess its effectiveness in wound healing.

Methods

Formulation of Wound healing cream were prepared from Hammada scoparia aerial parts aqueous extract then the wounds were applied on the skin of the dorsal region of each Wistar albino for 13 days. Hematological, inflammation and histological parameters were evaluated. Different bioactive compounds were identified within AEHs using HPLC analysis.

Results

High-Performance Liquid Chromatography (HPLC) analysis identified 21 phenolic compounds, with rutin being the most abundant, followed by naringenin, gallic Acid, valinin, and hydroxy-comarin. The formulated AEHs cream exhibited superior wound healing properties, with a 96.54% healing rate by day 13, outperforming the DOUCE PLUS cream and control groups. Physical analyses indicated the cream's white color, neutral odor, humid texture, pH of 6.8, and excellent stability. Hematological parameters revealed the AEHs cream influenced red blood cells (RBCs), white blood cells (WBCs), and platelet (PLT) levels positively. Inflammation markers, including C-reactive protein (CRP) and sedimentation rate (ESR), were also favorably modulated by the treatment. Histological studies indicated that H. scoparia cream promoted re-epithelialization, fibroblast activity, collagen deposition, and angiogenesis, thus facilitating an effective healing process.

Conclusion

The study concludes that Hammada scoparia possess significant wound healing properties, corroborating their traditional medicinal use.
Editorial – Natural Antioxidant Phytochemicals: Anticancer Impacts, Mode of Action, and Recent Biotechnological Applications
Authors: Gouda Mostafa M.
Published: January 2025

The recent advances in phytochemicals have led scientists to explore deeply the scientific principles of these functional molecules, precursors of essential pathways, and chemical processes. The current manuscript highlights the importance of the published studies in this collection for advanced applications in immune-related diseases.
Polycyclic Aromatic Hydrocarbons (PAHs): Environmental Persistence and Human Health Risks
Authors: Feng Yahui , Li Zhuo , Li Wenjing
Published: January 2025

Polycyclic aromatic hydrocarbons (PAHs) are a class of organic compounds generated during the incomplete combustion of organic materials, such as coal, oil, and biomass. PAHs are highly persistent in the environment and pose significant health risks due to their genotoxic, mutagenic, and carcinogenic properties. This review provides an overview of PAH formation, environmental accumulation, and the main human exposure pathways, including inhalation, ingestion, and dermal contact. It highlights the toxicological effects of PAHs on various systems of the human body, such as the nervous, respiratory, reproductive, immune, and cardiovascular systems. Acute exposure to PAHs can cause symptoms such as eye irritation, nausea, vomiting, and diarrhea, while chronic exposure is associated with cancer, cardiovascular diseases, respiratory issues, and reproductive dysfunction. Although most research relies on animal studies, the findings suggest that PAHs may cause severe harm to humans through mechanisms like DNA damage. Due to the limitations of extrapolating animal-based studies to human health, future researches should more thoroughly explore the specific mechanisms by which PAHs affect human health to address the challenges posed by PAH pollution.
Evaluation of the Patient Global Impression of Symptom Severity (PGISS) Score as a Subjective and Objective Measure of Disease Activity in Chronic Rhinosinusitis
Authors: Lim Subin , Trotier Daniel , Karpov Matvey , Han Joseph , Lam Kent
Published: January 2025

Background

The Sino-nasal Outcome Test (SNOT-22) is a 22-question survey that is utilized to evaluate health-related quality of life of patients with chronic rhinosinusitis (CRS). The Patient Global Impression Symptom Severity (PGISS) is a similar yet versatile instrument that combines features of both a Likert scale and a visual analog to assess symptom severity in CRS patients. While previous studies have evaluated the validity of SNOT-22 as an instrument to measure CRS patients’ symptom severity, no studies have evaluated PGISS scale's ability to evaluate and guide treatment plans for CRS patients.

Objective

The primary objective of this study was to analyze the clinical utility of PGISS in assessing subjective symptom severity and objective disease status in CRS patients. We additionally aimed to investigate if PGISS scores could serve as predictors for treatment strategies in CRS patients.

Methods

Electronic medical records of CRS patients were retrospectively reviewed between January 2020 and January 2021 from Eastern Virginia Medical School and Sentara Healthcare. Information on demographics, objective disease metrics, treatment, and labs were collected. Statistical analyses were conducted using SAS 9.4 software.

Results

A total of 150 patients were included in our study. A statistically significant positive correlation was found between PGISS and SNOT-22 scores (r(131) = 0.701, P < .0001). Patients with moderate to severe PGISS scores had significantly higher odds of changing their treatment course (odds ratio [OR] = 6.813, P = .001, and OR = 5.491, P = .018, respectively). Additionally, patients with severe PGISS scores had decreased odds of receiving biological intervention (OR = 0.048, P = .043), but they had considerably higher odds of pursuing surgery (OR = 15.939, P = .046). No significant associations were seen between PGISS scores and receiving topical steroids, systematic steroids, nonsteroidal medical treatment, or imaging interventions ( P > .05).

Conclusion

Clinicians may consider using the PGISS scale as an alternative method to the SNOT-22 to evaluate subjective symptom severity and guide treatment plans for patients with CRS.
The holistic and local perspectives in teaching spinal arteriovenous malformations
Authors: Lv Xianli
Published: January 2025

Background

The spinal arteriovenous malformations (sAVMs) have been challenging entities to diagnose and treat. The small structure, important function, and complex vascular anatomy of the spinal cord increase the difficulty of treating sAVMs.

Objective

The combining holistic and local perspectives in the diagnosis and treatment of sAVMs were provided to teach spinal vascular anatomy and AVMs.

Methods and Results

A holistic view is to fully understand the anatomical and physiological effects of intracranial vascular lesions on the spinal cord circulatory system, as well as the anatomical and physiological effects of local sAVM on the entire spinal cord circulatory system, such as the relationship between lesions and surrounding blood vessels. The local view is to fully understand the macroscopic and microscopic vascular architectural characteristics of the lesion. The local view is closely related to the treatment of lesions and the holistic view is closely related to the effectiveness and side effects of treatment, which should be given attention in current clinical practice. The early diagnosis and treatment of sAVMs may improve outcomes.

Conclusion

A holistic and local perspective is essential to developing an understanding of the angioarchitecture, pathophysiology, natural history, treatment options, and classification of the different types of sAVMs.
The potential role of machine learning and deep learning in differential diagnosis of Alzheimer’s disease and FTD using imaging biomarkers: A review
Authors: Mirabian Sara , Mohammadian Fatemeh , Ganji Zohreh , Zare Hoda , Hasanpour Khalesi Erfan
Published: January 2025

Introduction

The prevalence of neurodegenerative diseases has significantly increased, necessitating a deeper understanding of their symptoms, diagnostic processes, and prevention strategies. Frontotemporal dementia (FTD) and Alzheimer’s disease (AD) are two prominent neurodegenerative conditions that present diagnostic challenges due to overlapping symptoms. To address these challenges, experts utilize a range of imaging techniques, including magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT). These techniques facilitate a detailed examination of the manifestations of these diseases. Recent research has demonstrated the potential of artificial intelligence (AI) in automating the diagnostic process, generating significant interest in this field.

Materials and Methods

This narrative review aims to compile and analyze articles related to the AI-assisted diagnosis of FTD and AD. We reviewed 31 articles published between 2012 and 2024, with 23 focusing on machine learning techniques and 8 on deep learning techniques. The studies utilized features extracted from both single imaging modalities and multi-modal approaches, and evaluated the performance of various classification models.

Results

Among the machine learning studies, Support Vector Machines (SVM) exhibited the most favorable performance in classifying FTD and AD. In deep learning studies, the ResNet convolutional neural network outperformed other networks.

Conclusion

This review highlights the utility of different imaging modalities as diagnostic aids in distinguishing between FTD and AD. However, it emphasizes the importance of incorporating clinical examinations and patient symptom evaluations to ensure comprehensive and accurate diagnoses.
A nomogram based on InLDH and InNLR for predicting disseminated intravascular coagulation in patients with heat stroke
Authors: Wan Lulu , Lin Gan , Yang Jiale , Liu Anwei , Shi Xuezhi , Li Jinhu , Xie Lian , Chen Ronglin , Tong Huasheng
Published: January 2025

Background:

Heat stroke (HS), a potentially fatal heat-related illness, is often accompanied by disseminated intravascular coagulation (DIC) early, resulting in a poorer prognosis. Unfortunately, diagnosis by current DIC scores is often too late to identify DIC. This study aims to investigate the predictors and predictive model of DIC in HS to identify DIC early.

Methods:

This retrospective study analyzed clinical data of patients with HS in a tertiary hospital from January 1, 2008 to December 31, 2020. Univariate and multivariate logistic regression analyses were employed to identify the risk factors for DIC in HS. The predictive models based on these risk factors were constructed and externally validated, and their predictive efficacy was evaluated using receiver operating characteristic curves.

Results:

A total of 219 HS patients, including 49 with DIC, were included. The independent risk factors for DIC were identified as follows: neutrophil percentage (Neu%), lymphocyte count, lymphocyte percentage (Lym%), creatine kinase-MB (CKMB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), neutrophil–lymphocyte ratio (NLR), monocyte–lymphocyte ratio (MLR), and rhabdomyolysis (RM). After logarithmization, the final predictive model based on the logarithm of lactate dehydrogenase (InLDH; odds ratio (OR) = 9.266, 95% confidence interval (95%CI; 4.379–19.607), p < 0.0001) and the logarithm of neutrophil–lymphocyte ratio (InNLR; OR = 3.393, 95%CI (1.834–6.277), p < 0.0001) was constructed with the largest area under the curve (0.928). A nomogram incorporating InLDH and InNLR was developed and showed excellent discrimination and calibration capabilities.

Conclusion:

Nine independent risk factors were identified for the occurrence of DIC in HS patients. The predictive model based on InLDH and InNLR can effectively predict the incidence of DIC. A nomogram based on InLDH and InNLR was developed to facilitate early identification and timely treatment of DIC in HS patients.
A modified technology acceptance model for digital learning in Chinese universities
Authors: Qi Zitong
Published: January 2025

This research introduces a customized Technology Acceptance Model (TAM) for digital learning technology in Chinese comprehensive universities, employing surveys and interviews to combine quantitative and qualitative approaches. The findings reveal widespread adoption of digital learning technology among students and teachers, highlighting its potential for transformation. The study identifies key relationships between Perceived Ease of Use, Perceived Usefulness, Attitude, Policy, Perceived Interpersonal Interaction, Actual Usage, and Intention to Continue Usage, validating the TAM framework. Challenges remain in the areas of data privacy and network security, necessitating continuous refinement. Recommendations are provided for universities, administrative bodies, developers, teachers, and students. This research highlights the acceptance and usage of digital learning technology in Chinese universities. It presents a tailored TAM framework to enhance understanding and contribute to the evolution of digital education.
Factors associated with ABCDEF bundle implementation for critically ill patients: An international cross-sectional survey in 54 countries
Authors: Haruna Junpei , Unoki Takeshi , Liu Keibun , Nakamura Kensuke , Inoue Shigeaki , Nishida Osamu
Published: January 2025

Objectives:

This study investigated the implementation of the ABCDEF bundle and the factors associated with its implementation according to national income levels.

Methods:

This study is cross-sectional research. We conducted a secondary analysis of an international 1-day point-prevalence study that investigated the implementation of the ABCDEF bundle in critically ill patients. All patients admitted to the ICU were eligible. This study was conducted across 135 ICUs in 54 countries, including data from 664 patients. Outcomes were categorized according to the income level of the country (high-income, middle-income, and low-income countries) in which each ICU was located. A multilevel generalized linear model was developed to identify the factors associated with ABCDEF bundle implementation for each income level.

Results:

We identified 664 patients in 79 high-income countries, 278 in 26 middle-income countries, and 287 in 30 low-income countries ICUs. Implementation rates of the ABCDEF bundle were low for all income levels but varied. Few individuals completed the entire bundle on the survey date. Common factors associated with the implementation among all income levels were a multidisciplinary team approach for Element A (pain) and mechanical ventilation use for Element C (sedation), which were also associated with lower Element E (mobility). The existence of a protocol was frequently identified as a promoting factor associated with ABCDEF bundle implementation. The associated factors varied by income level; for example, dedicated intensivists were only identified in high-income countries, but not in middle-income countries or low-income countries.

Conclusions:

The overall low ABCDEF bundle implementation rates necessitate action. As factors associated with its implementation vary according to national income level, tailored strategies are essential for improving ICU care quality.

Trial registration:

NA.
Organizational factors impacting the implementation of a digital mental health tool in Alberta's mental health care of youth and young adults
Authors: Barker Marianne , Hews-Girard Julia , Pinston Karina , Daniel Sarah , Volcko Lauren , Norman Lia , Bassi Emilie , Bright Katherine , Hickie Ian , Iorfino Frank , LaMonica Haley , Moskovic Karen , Fersovitch Melanie , Bradley Jessica , Stamp Leanne , Gondziola Jason , Johnson David , Dimitropoulos Gina
Published: January 2025

With mental health concerns on the rise among youth and young adults (age 12–24), increased mental health options include virtual care, apps and online tools, self-management and tracking tools, and digitally-enabled coordination of care. These tools may function as alternatives or adjuncts to face-to-face models of care. Innovative solutions in the form of digital mental health (dMH) services not only provide support, resources and care, but also decrease wait times and waitlists, increase access, and empower youth. However, organizational factors may impact the extent of dMH interventions are that accepted, used, and sustained in clinical settings. This qualitative study explores organizational barriers and facilitators surrounding the implementation of a digital platform (Innowell), which uses measurement-based care (MBC) to track youth progress and outcomes. Data was collected from 154 mental health care providers participating in 23 focus groups across Alberta, drawing on school and community settings, specialized mental health services, and primary care networks. A thematic analysis revealed the following: barriers included incompatibility with current systems and workflows, lack of inter-organizational collaboration, time commitment, perceived sustainability and lack of digital literacy. Facilitators included positive attitudes towards using dMH to optimize clinical practices by empowering youth and improving continuity of care, transitions in care, and quality of care, as well as workplace culture and leadership. The study highlights a critical need for decision makers and clinical leaders to address organizational factors by integrating training and support, establishing interoperability between digitized and in-person healthcare systems, and leveraging support for MBC and youth-centred care.
Construction of a health literacy prediction model for diabetic patients: A multicenter study
Authors: Wang Zepeng , Shi Junyi , Jiang Fangyuan , Jiang Kui , Chen Yalan
Published: January 2025

Objectives

To achieve a rapid assessment of health literacy (HL) levels among diabetic patients.

Methods

A questionnaire survey was conducted among diabetic patients from nine communities in Nantong City, Jiangsu Province, China, using convenient sampling. Based on the survey results, data from three communities were randomly selected as the test set, with the remaining data used as the training set. Feature selection was performed using recursive feature elimination. Predictive models were established and compared using logistic regression (LR), random forest (RF), and support vector machine (SVM). Calibration curves, decomposition plots, and partial dependence plots were drawn to evaluate and interpret the models.

Results

In November 2023, a total of 802 valid questionnaires were received. Eight variables were selected for modeling: educational level, exercise habits, average monthly household income, dietary control, age, medication for blood sugar control, duration of diabetes, and number of cohabitants. The recall for LR in the three communities was 0.778, 0.800, and 0.862 [area under the curve (AUC): 0.810, 0.792, and 0.775]. For RF, the recall values were 0.879, 0.877, and 0.923 (AUC: 0.781, 0.710, and 0.710). For SVM, the recall values were 0.859, 0.862, and 0.877 (AUC: 0.813, 0.759, and 0.770). Model evaluation showed that as the data volume increased, the calibration curves became more ideal.

Conclusions

As one of the few HL prediction models for diabetic patients in mainland China that is built based on multi-center survey data and evaluated through multi-center assessment, this model can quickly identify patients with insufficient HL using a small amount of objective personal information.
The Influence of Workforce Diversity on Organizational Performance in the UAE Hospitality Sector: The Moderating Role of HR Practices
Authors: Khassawneh Osama , Mohammad Tamara
Published: January 2025

The aim of this paper is to investigate the impact of workforce diversity on organizational performance (OP) from the perspective of resource-based view (RBV) theory in the context of the hospitality sector in the United Arab Emirates (UAE). We suggest training and performance appraisal as moderators. Sequential regression analysis was applied, including information from directors, unit managers, supervisors, low-level workers, and customers, as well as financial outcomes from 167 organizations in the UAE (683 full-time employees) in the hospitality sector, including hotels, restaurants, theme parks, travel agents, recreational centers, and museums. This analysis assisted in supporting the hypotheses. The findings confirm that there is a positive relationship between diversity and OP. Additionally, the emphasis on training and performance appraisal will strengthen this relationship and lead to higher organizational performance. This improvement is expected to increase customer satisfaction and sales growth. Researchers have emphasized the necessity of conducting a comprehensive investigation to fully understand the impact of diversity on OP. In this regard, we propose that training and performance appraisal serve as potential tools to enhance OP through diversity.
News Literacy and Public Service News Broadcasting: Is There a Connection? Evaluating News Literacy Among Viewers and Non-Viewers of PSB News Programming in Austria
Authors: Callecod-Weinrich Kimberly , Krek Janez
Published: January 2025

News literate individuals have the requisite knowledge, skills, and motivation to navigate today’s complex news ecosystems and participate in civic life. This study’s objective was to use survey research to evaluate news literacy and its attitudinal dimensions among viewers and non-viewers of television news programming on public service broadcasters (PSBs), drawing on an existing measurement model developed by Maksl, Ashley, and Craft. Results obtained from a representative sample of adult news consumers in Austria ( n = 492) suggest that regular PSB news viewers are significantly more likely to exhibit the characteristics of more highly news literate individuals, even when controlling for age and educational level. Establishing a baseline measurement of news literacy in this cohort in the midst of a transforming media landscape fills a research gap in the nascent discipline and provides a useful point of reference for future scholarship.