bluuebunny/crossref_metadata_2025 huggingface dataset:
Firm performance through green orientation, environmental culture and green absorptive capacity
Authors: Canbul Yaroğlu Aslıhan
Published: February 2025

Purpose

The purpose of this article is to examine the effects of green internal orientation and external orientation on firm performance and to evaluate the mediating role of green absorptive capacity in this effect. It also investigates the moderating role of environmental culture in the relationship between green absorptive capacity and firm performance.

Design/methodology/approach

This study was conducted based on field research with surveys conducted on 343 technology-oriented companies operating in Istanbul. SmartPLS 4 statistical software was used to analyze the data.

Findings

Research results show that green internal and external orientation has a positive and significant effect on firm performance. Additionally, green absorptive capacity has a mediating role in this effect. It has been determined that environmental culture plays a moderating role in the relationship between green absorptive capacity and firm performance.

Research limitations/implications

This study has some limitations; for example, the fact that the data was obtained only from technology-focused companies in Istanbul may limit generalizability. However, this research makes important contributions to our understanding of the effects of green internal and external orientation on firm performance and the mediating effect of green absorptive capacity.

Practical implications

This study shows that strengthening businesses’ green internal and external orientations and improving their green absorptive capacity can increase firm performance. It is also an important warning to businesses that environmental culture can play an important role in these relationships.

Social implications

Strengthening green internal and external orientation and improving green absorptive capacity can provide social benefits through their contributions to environmental sustainability. This study can help businesses take steps to reduce their environmental impact and achieve a sustainable future.

Originality/value

This study is one of the few studies examining the effects of green internal and external orientation on firm performance and the mediating role of green absorptive capacity. Additionally, it makes a unique contribution by focusing on the moderating role of environmental culture in these relationships. This study can be a valuable guide for businesses in developing environmental sustainability strategies.
A dynamic capability perspective on digital transformation: drivers, the process and consequences
Authors: Shu Chengli , Srimuang Keeratinun
Published: February 2025

Purpose

Despite wide awareness of the importance of digital transformation (DT) for emerging market firms, we have limited understanding of the drivers, the process or the outcomes of DT in emerging market firms.

Design/methodology/approach

We conducted a qualitative study on 24 case companies in Thailand and embraced thematic analysis to generate our research findings.

Findings

The framework shows that the DT process in emerging market firms proceeds over three stages—market-opportunity sensing, digital technology acquisition and leading DT—which are driven by technological dynamism, business ties and institutional support. Once DT is successfully implemented, emerging market firms can improve their operational efficiency, customer relationship management, business model innovation and human resources management.

Originality/value

This study thus contributes to the DT literature by offering a three-stage model of DT and identifying important antecedents and consequences of DT, which together specify how emerging market firms transform themselves digitally.
The social life of money for children
Authors: Bandelj Nina
Published: February 2025

Inspired by Nigel Dodd's The Social Life of Money, this article proposes an analysis of entangled economic lives, that is, how meaning, structures and politics jointly shape the flow of monies within households. The past decades have marked a shift from “childrearing expenditures” to “parenting investments” that align with new visions of both children and parents. The new social life of money for children revolves less around what Viviana Zelizer decades ago famously called “a priceless child,” and more in support of human capital development of children and invested parenting identities. The new ideational schemas are scaffolded by financialization, an exploding parenting product industry, and an aloof state offloading provision for children onto individual parents. Leading entangled economic lives, parents engage in relational work in which they match the sacred child‐parent bond with not only culturally appropriate but actually affordable monies for children, creating a new political economy of parenting.
Co‐production of galactonic acid and lactobionic acid from cheese whey using recyclable engineered Pseudomonas putida
Authors: Liu Peng , Hong Liuba , Fu Panchen , Wu Jiawei , Zheng Zhaojuan
Published: February 2025

Whey is a main by‐product generated during cheese manufacture. It contains abundant lactose and proteins and is a valued raw material in many countries. Pseudomonas putida KT2440 is a promising microbial strain for biobased chemical production. In our previous studies, this strain was confirmed owning high ability to oxidise galactose. Besides, we have constructed a recombinant strain P. putida KT2440 (pBB‐GDH1) harbouring a novel glucose dehydrogenase that capable of oxidising lactose. Based on these, the potential of this engineered P. putida in whey utilisation deserves further exploration. This research aimed to establish a bioprocess to convert whey lactose into galactonic acid and lactobionic acid using engineered P. putida. Lactose in cheese whey powder was hydrolysed by Bacillus coagulans β‐galactosidase into glucose and galactose. P. putida KT2440 (pBB‐GDH1) was inoculated into the whey powder hydrolysate and galactose was converted into galactonic acid. Then, the bacterial cells were recovered and employed for lactobionic acid production from fresh whey powder solution. Three independent experiments were performed, and the mean value were taken as the results. Pseudomonas putida KT2440 (pBB‐GDH1) exhibited a higher lactose‐oxidising activity compared with the wild‐type strain. It could utilise glucose and proteins in cheese whey powder hydrolysate for growth and convert galactose to galactonic acid. 25.45 g/L galactonic acid was obtained with a productivity of 1.06 g/L/h. The recovered cells maintained excellent lactose oxidation ability. After optimisation of biocatalytic reactions, 301.58 g/L lactobionic acid was obtained from cheese whey powder containing 300 g/L lactose in a 3 L bioreactor. The lactobionic acid productivity reached 2.28 g/L/h with a yield of 96.67%. This study established a sustainable and economic aldonic acids co‐production strategy from cheese whey powder.
Recruitment and Retention of Rural Health Professionals in Minnesota
Authors: MacDougall Hannah , Woldegerima Selam , Henning‐Smith Carrie , Fritsma Teri , Olson Andrew P. J.
Published: February 2025

Objective

To qualitatively explore the reasons health professionals decide to practice in rural areas.

Study Setting and Design

Exploratory, cross‐sectional, semi‐structured qualitative interview and focus group study using thematic analysis with a convenience sample of health professionals in rural Minnesota. Interviews and focus groups were conducted virtually and in person, respectively, between August 2023 and March 2024.

Data Sources and Analytic Sample

Primary interview and focus group data were collected from 19 individual interviews and 3 focus groups (n = 16) with health professionals in rural Minnesota. Interview and focus group recordings were transcribed, deductively coded, and analyzed using constant comparison.

Principal Findings

Rural health professionals cited autonomy and breadth of practice and patient connection as rewarding and challenging components of practice that were distinctly rural. Barriers to recruitment and retention of rural health professionals included lack of housing (especially rental and short‐term) and accessible childcare. Potentially promising considerations when recruiting and retaining health professionals include loan forgiveness programs, the appeal of increasing racial and ethnic diversity in rural areas, and the ease of community health advocacy efforts.

Conclusion

Our findings suggest that to recruit and retain rural health professionals, stakeholders could highlight autonomy and patient connection, reduce childcare and housing barriers, and explore community strengths such as racial/ethnic diversity and opportunities for advocacy.
Immature Granulocyte: A Novel Inflammatory Biomarker in Familial Mediterranean Fever
Authors: Biyik Zeynep , Yavuz Yasemin Coskun , Altintepe Lutfullah , Cizmecioglu Ahmet , Yakşı Esra , Korez Muslu Kazım , Yılmaz Sema
Published: February 2025

Aim

Our study aimed to evaluate the significance and clinical utility of immature granulocyte (IG) count (IGC) and IG percentage (IG%) in predicting attacks in patients with familial Mediterranean fever (FMF).

Methods

This retrospective study included 100 FMF patients and 50 healthy controls. Data from 24 patients during the attack period and 76 patients during the attack‐free period in the FMF group were obtained from medical records. Complete blood count analyses were carried out with the Mindray BC‐6200 automated hematology analyzer following standard laboratory protocols. Receiver operating characteristic (ROC) curve analysis was conducted to differentiate FMF patients in the attack period from those in the attack‐free period.

Results

In FMF patients, levels of WBC (p = 0.032), neutrophils (p = 0.001), C‐reactive protein (CRP) (p = 0.002), IG count (p < 0.001), and IG percentage (p < 0.001) were significantly higher compared to healthy controls. During the attack period, IG count and IG percentage levels were significantly elevated compared to the attack‐free period (p < 0.001 for both). Based on ROC analysis, IG count and IG percentage showed significant diagnostic potential in FMF patients, with AUC values of 0.841 and 0.766, respectively.

Conclusion

IGC and IG% serve as indicators of inflammation in FMF patients and may facilitate the differential diagnosis of FMF attacks, with respective cut‐off values of 0.04 × 109/L and 0.4%. Given their accessibility and lack of additional cost, these parameters have the potential to enhance clinical practice by augmenting the diagnostic utility of conventional inflammatory biomarkers.
Content analysis of substance use disorder recovery discourse on Twitter: From personal recovery narratives to marketing of addiction treatment
Authors: Russell Alex M. , Valdez Danny , Wang Mingxuan , Allem Jon‐Patrick , Bergman Brandon G. , Kelly John F. , Litt Dana M. , Massey Philip M.
Published: February 2025

Background

Substance use disorder (SUD) is a prodigious public health issue characterized by a substantial treatment gap. Despite challenges, millions have resolved a prior significant alcohol or drug problem, increasingly using online supports as a part of their recovery efforts (e.g., virtual mutual‐help group meetings, traditional social networking sites [SNS]). However, the content surrounding SUD recovery‐related discussion on SNS such as Twitter remains largely unexamined. To fill this gap, we explored public tweets using SUD recovery‐related hashtags.

Methods

From January 1, 2022, to December 31, 2022, 455,968 public tweets were collected using SUD recovery‐related hashtags. Natural language processing was used to identify and remove irrelevant groupings of tweets from the dataset, resulting in a final corpus of 186,460 tweets. A random subsample of 1800 tweets was extracted for content analysis, involving codebook development, manual annotation by trained coders, and inter‐rater reliability assessment (average Cohen's κ = 0.77).

Results

Nearly half (41.7%) of SUD recovery‐related posts were from individuals in or seeking recovery, while 21.3% originated from addiction treatment industry accounts. Common themes included addiction treatment marketing (27.4%; some of which promoted scientifically unsupported products or services), emotional support (15.6%), celebrating a recovery milestone (15.4%), alcohol/drug‐related sociopolitical commentary (14.7%), expressions of gratitude (11.5%), and mutual‐help group participation (8.7%).

Conclusions

SUD recovery‐related content on Twitter reflected individuals seeking social support during efforts to initiate or maintain recovery. However, these accounts may be met with marketing material from entities that misrepresent their services or promote products based on unsubstantiated claims. Stricter (or enforcement of existing) regulations may be warranted to protect vulnerable SNS platform users from entities seeking to exploit them for financial gain.
Greater alcohol intake predicts accelerated brain aging in humans, which mediates the relationship between alcohol intake and behavioral inflexibility
Authors: Battista Jillian T. , Vidrascu Elena , Robertson Madeline M. , Robinson Donita L. , Boettiger Charlotte A.
Published: February 2025

Background

Hazardous use of alcohol is associated with cognitive‐behavioral impairments and accelerated aging. To date, however, accelerated brain aging has not been tested as a mediating factor between alcohol use and associated task‐based behavioral deficits, such as behavioral inflexibility. Here, we evaluated hazardous alcohol use as a predictor of machine learning‐derived brain aging and tested if this measure accounted for the relationship between hazardous alcohol use and a task‐based measure of behavioral flexibility.

Methods

In this secondary analysis, we applied brainageR, a machine learning algorithm, to anatomical T1‐weighted magnetic resonance imaging (MRI) images to estimate brain age for a sample of healthy adults (ages 22–40) who self‐reported alcohol use with the alcohol use disorder identification test (AUDIT) and performed the hidden association between images task (HABIT), a behavioral flexibility task. Behavioral inflexibility was quantified as the proportion of perseverative errors performed on the HABIT as a measure of habitual action selection. We then analyzed AUDIT score as a predictor of brain aging, and brain aging as a predictor of behavioral inflexibility. Lastly, we conducted a mediation analysis to evaluate brain aging as a mediator between alcohol use and behavioral inflexibility.

Results

Controlling for chronological age and sex, a higher AUDIT score predicted significantly more accelerated brain aging, which was further associated with more perseverative errors on the HABIT. Moreover, brain aging significantly mediated the association between AUDIT scores and behavioral inflexibility.

Conclusions

Our findings demonstrate that alcohol use is a significant predictor of accelerated brain aging, even in young adulthood. In addition, our findings suggest that such brain changes may mechanistically link more hazardous alcohol use to impaired behavioral flexibility. Future studies should also explore factors, such as other lifestyle behaviors, that may mitigate alcohol‐ and age‐related processes.
Human rights and the comprehensive geriatric assessment: Is the standard of care compatible with a human rights approach?
Authors: Wee Rohan
Published: February 2025

The comprehensive geriatric assessment is a key tool of geriatricians. It encompasses a holistic approach to care and is now the standard of care for the provision of geriatric medical care for older, vulnerable people across multiple areas of practice. In this article, I argue that the CGA is a tool that allows respect for and support for a human rights' focused approach. This support for human rights has developed incidentally with the development of the CGA. As a result, there are risks to older people's human rights even with a well‐applied CGA. The development of a specific human rights convention focused on older people would help focus attention on the rights of older people.
Pilot implementation of an electronic diagnostic support tool (AiD‐DST) designed to identify the cause(s) of delirium
Authors: Leong Elizabeth , Chang Stephane , Yearwood Kristi , Eeles Eamonn , Yerkovich Stephanie , Ling Carolina , Teodorczuk Andrew , Dissanayaka Nadeeka
Published: February 2025

Objective(s)

The identification of cause(s) of delirium remains a clinical challenge within medicine. Our group have previously successfully developed and tested the Aetiology in Delirium—Decision Support Tool (AiD‐DST). The AiD‐DST is designed to help medical professionals close the gap on the detection of cause(s) of delirium. Here, we report on use of AiD‐DST in the real‐world setting.

Methods

A real‐world implementation study of the AiD‐DST within a general medical ward of a metropolitan hospital was conducted over a 10‐week period. A mixed method evaluation was performed based upon the RE‐AIM Framework that incorporates reach, effectiveness, adoption, implementation and maintenance of an intervention.

Results

Reach: fifty‐three out of 87 (61%) eligible doctors consented to participation in the study. Effectiveness: A mean of 4.3 diagnoses were generated per patient with no difference in frequency when compared with historical control (z = 1.36; p = .17). Average usability score was 5.86 (SD = 1.15) on a 7‐point scale, with 93% of respondents being satisfied with the AiD‐DST. Free text feedback comprised themes of accessibility, ergonomics, diagnostic accuracy and applicability of AiD‐DST to related conditions. Implementation: Instrument completion rate was 98% (n = 49/50), with a median completion time of 90 s. Maintenance: Sixty‐seven % of uses of AiD‐DST occurred in the second half of the study (p = .3). Following the initiation period there was an increase in use (r = .79; p = 02).

Conclusion

Proof of principle was demonstrated for local implementation of a diagnostic support tool (AiD‐DST).
The Role of Medical Student Quality Improvement Projects in Health Care: A Scoping Review
Authors: Stubbs Casey , Ward Bernadette
Published: February 2025

Introduction

Across Australia, there is considerable variation in the quality of health care and the risk of associated complications. Hence, many patients are receiving poor‐quality care. This may be exacerbated in rural and remote areas where the availability of health care is relatively limited. Addressing this requires a multipronged approach that supports the workforce. Involving medical practitioners in medical students' quality improvement (QI) scholarly projects may be one strategy to assist with bridging this gap. The aim of this review was to synthesise the evidence relating to medical students' compulsory curriculum‐based quality improvement projects and associated practice outcomes.

Method

Scoping review of peer‐reviewed literature (January 2000–June 2024).

Results

Of the 239 articles, six empirical studies from Australia, New Zealand, the UK and the USA were included. Half of these were based in community settings and the rest in hospitals. Only one was in a rural setting. The time allocated to projects was between 5 and 12 weeks. Five of the six studies reported that student project recommendations had been implemented. One study reported that the process enhanced doctors' adherence to best practice guidelines.

Discussion

Much of the research about the outcomes of medical student curriculum‐based projects focuses on research outputs. These relatively short student QI projects are one strategy to improve evidence‐based practice while upskilling clinicians. Further work is needed to examine their impact, particularly in rural areas.

Conclusion

Integrating medical students into ‘real‐world’ QI health service projects can enhance the quality of health care whilst building the skills of the medical workforce.
Is No difference a good outcome? Equity evaluation of the general surgery prioritization tool
Authors: Wood Douglas , Findlay Nohoana , Kim Alice Hyun Min , Behar Kfyr‐Eyal , Lin Anthony
Published: February 2025

Background

The general surgery prioritization tool (GSPT) was implemented in 2018 to equitably prioritize non‐cancer elective general surgery waitlists. It combines patient‐reported Impact On Life (IOL) scores and clinician‐reported values for a total score which determines access to the waitlist. In New Zealand there are inequities in surgical access and outcomes, particularly for Māori, and this study evaluates whether the GSPT may contribute.

Method

A retrospective review of general surgery prioritization events at Capital & Coast District Health Board, New Zealand, between May 2018 and August 2022 was conducted. The patient‐reported IOL score (6–36), total score (0–100), waitlist access, and time to surgery in days were recorded and analyzed for ethnic, age and gender differences.

Results

4527 events were included. Median IOL score and total score were 20 and 68. 4231 (90.8%) met the waitlist threshold with a median time to surgery of 99 days. Higher average IOL scores were associated with being female (P = 0.005), Pacific Peoples (P = 0.007) and Other Ethnicity (P = 0.006). The average total score for Māori was 1.13 points higher than Europeans (P = 0.013). There was no evidence of associations between the odds of surgery booking and patient age, ethnicity and gender when adjusted for deprivation and procedure type.

Conclusion

This study shows that despite differences in the IOL and total scores across ethnicity, no evidence of difference was found in the odds of surgical booking based on patient ethnicity, age or gender. Amendments to weighting of IOL scores and ethnicity score adjustment could be considered to remedy this.
How I treat iron‐refractory iron deficiency anaemia—An expert opinion‐based treatment guidance for children and adults
Authors: Hoving V. , Donker A. E. , Schols S. E. M. , Swinkels D. W.
Published: February 2025

Iron‐refractory iron deficiency anaemia (IRIDA) is a rare hereditary microcytic anaemia characterized by partial or complete resistance to oral iron supplementation, caused by elevated plasma hepcidin levels resulting from pathogenic variants in the TMPRSS6 gene. Although intravenous iron supplementation is often effective, patient responses can vary significantly due to various factors, and potential side effects of this treatment remain unclear. Additionally, evidence‐based international guidelines for diagnosing and managing IRIDA are lacking. This review aims to provide patient‐tailored treatment strategies, informed by case studies and expert opinion, to address the specific therapeutic needs of both children and adults with IRIDA.
Stratigraphic Controls on CO2 Migration at Sleipner: An Example From a Basin‐Floor Fan of the Utsira Formation
Authors: Warchoł Michał Jakub , Pontén Anna , Furre Anne‐Kari
Published: February 2025

For nearly three decades, Equinor's Sleipner Carbon Capture and Storage project has demonstrated how the application of geological principles, modelling techniques and analysis of repeated time‐lapse (4D) seismic data has helped to characterise the CO2 plume migration within the late Miocene–early Pliocene Utsira Formation. However, the influence of stratigraphic complexity on fluid migration has been rather poorly understood. This has resulted in a significant degree of uncertainty in the geological characterisation of the storage formation, including the distribution of mudstone‐rich elements, which may serve as baffles and barriers for migration of fluid, and elements that allow for their bypass. Our study, utilising high‐quality 3D seismic data integrated with wireline‐logs, time‐lapse seismic and regional contextual information, has shown that the Utsira Formation in the South Viking Graben represents a confined, channelized submarine fan system characterised by a complex stratigraphic architecture. The study has highlighted that the intricate interplay between fan lobes, channel erosion, channel infill and draping of lobes, lobe‐complexes and channel incision surfaces by mud‐rich layers, provides a first‐order control on CO2 storage compartments and exerts a substantial influence on vertical and lateral fluid flow pathways. The latter is well expressed by the morphology of several mapped CO2‐filled layers. Both generally discontinuous channel‐base mud‐rich drapes and more continuous lobe‐complex and fan mudstone drapes have been locally compromised by processes linked to channel erosion and sand injection, in some cases combined with faulting and fracturing. This complex stratigraphic pattern has probably been exacerbated by post‐depositional deformation that triggered fluid and sediment expulsion from the Utsira Formation and the underlying early‐Miocene Skade Formation. These factors allowed for increased vertical connectivity between originally disconnected sandstone bodies and fluid migration from deeper to shallower layers, prior to injection of CO2, thus serving as preferred pathways post‐injection.
Integrating early response biomarkers in pharmacokinetic models: A novel method to individualize the initial infliximab dose in patients with Crohn's disease
Authors: Samuels Abigail , Irie Kei , Mizuno Tomoyuki , Reifenberg Jack , Punt Nieko , Vinks Alexander A. , Minar Phillip
Published: February 2025

The use of model‐informed precision dosing to personalize infliximab has been shown to improve both the acquisition of concentration targets and clinical outcomes during maintenance. Current iterations of infliximab pharmacokinetic models include time‐varying covariates of drug clearance, however, not accounting for the expected improvements in the covariates can lead to indiscriminate use of higher infliximab doses and imprecise drug exposure. The aim was to identify changes in the four biomarkers associated with infliximab clearance (Xiong et al. model) and determine if integration of these dynamic changes would improve model performance during induction and early maintenance. We analyzed two cohorts of children receiving infliximab for Crohn's Disease. The Emax method was used to assess time‐varying changes in covariates. Model performance (observed vs. predicted infliximab concentrations) was evaluated using median percentage error (bias) and median absolute percentage error (precision). The combined cohorts included 239 Crohn's disease patients. We found from baseline to dose 4, the maximum changes in weight, albumin, erythrocyte sedimentation rate, and neutrophil CD64 were 4.7%, +11.7%, −62.4%, and −26.5%, respectively. We also found the use of baseline covariates alone to forecast future trough concentration was inferior to the Emax time‐varying method with a significant improvement observed in bias (doses 2, 3, and 4) and precision (doses 2 and 4). The integration of the four time‐varying biomarkers of drug clearance with pharmacokinetic modeling improved the accuracy and precision of the predictions. This novel strategy may be key to improving drug exposure, minimizing indiscriminate dosing strategies, and reducing healthcare costs.
The epilepsy–autism phenotype associated with developmental and epileptic encephalopathies: New mechanism‐based therapeutic options
Authors: Specchio Nicola , Di Micco Valentina , Aronica Eleonora , Auvin Stéphane , Balestrini Simona , Brunklaus Andreas , Gardella Elena , Scheper Mirte , Taglialatela Maurizio , Trivisano Marina , Curatolo Paolo
Published: February 2025

Epilepsy and autism often co‐occur in genetic developmental and epileptic encephalopathies (DEEs), but their underlying neurobiological processes remain poorly understood, complicating treatment. Advances in molecular genetics and understanding the neurodevelopmental pathogenesis of the epilepsy–autism phenotype may lead to mechanism‐based treatments for children with DEEs and autism. Several genes, including the newly reported PPFIA3, MYCBP2, DHX9, TMEM63B, and RELN, are linked to various neurodevelopmental and epileptic disorders, intellectual disabilities, and autistic features. These findings underscore the clinical heterogeneity of genetic DEEs and suggest diverse neurobiological mechanisms influenced by genetic, epigenetic, and environmental factors. Mechanisms linking epilepsy and autism include γ‐aminobutyric acidergic (GABAergic) signaling dysregulation, synaptic plasticity, disrupted functional connectivity, and neuroinflammatory responses. GABA system abnormalities, critical for inhibitory neurotransmission, contribute to both conditions. Dysregulation of the mechanistic target of rapamycin (mTOR) pathway and neuroinflammation are also pivotal, affecting seizure generation, drug resistance, and neuropsychiatric comorbidities. Abnormal synaptic function and connectivity further underscore the epilepsy–autism phenotype. New treatment options targeting specific mechanisms linked to the epilepsy–autism phenotype are emerging. Genetic variants in potassium channel genes like KCNQ2 and KCNT1 are frequent causes of early onset DEEs. Personalized treatments like retigabine and quinidine have been explored with heterogeneous responses. Efforts are ongoing to develop more effective KCNQ activators and KCNT1 blockers. SCN1A genetic variants, particularly in Dravet syndrome, show potential for treatment of autistic symptoms with low‐dose clonazepam, fenfluramine, and cannabidiol, although human trials have yet to consistently replicate animal model successes. Early intervention before the age of 3 years, particularly in SCN1A‐ and tuberous sclerosis complex‐related DEEs, is crucial. Additionally, targeting the mTOR pathway shows promise for seizure control and managing epilepsy‐associated comorbidities. Understanding the distinct autism spectrum disorder phenotype in DEEs and implementing early behavioral interventions are essential for improving outcomes. Despite genetic advances, significant challenges persist in diagnosing and treating DEE‐associated epilepsy–autism phenotypes. Future clinical trials should adopt precision health approaches to improve neurodevelopmental outcomes.
Pharmacokinetic variability and use of therapeutic drug monitoring of cannabidiol in patients with refractory epilepsy
Authors: Johannessen Landmark Cecilie , Sætre Johan , Gottås André , Wolden Martha , McQuade Tao Angell‐Petersen , Kjeldsen Signe Flood , Våtevik Anne , Sætre Erik , Svendsen Torleiv , Burns Margrete Larsen , Øiestad Elisabeth Leere , Johannessen Svein I.
Published: February 2025

Objective

Cannabidiol (CBD) (Epidyolex) is a new antiseizure medication (ASM) for rare and severe epileptic syndromes. We aimed to investigate the pharmacokinetic variability of CBD to elucidate relationships between doses, serum concentrations, metabolites, and biochemical markers of toxicity by using therapeutic drug monitoring (TDM) data.

Methods

Data on serum concentrations of all ASMs, CBD, and the active metabolite 7‐hydroxy‐cannabidiol (7‐OH‐CBD) were collected (January 2022 to June 2023) at the Section for Clinical Pharmacology, National Centre for Epilepsy, Oslo University Hospital.

Results

Data from 52 patients were included: 122 serum concentration measurements (1–7 per patient); 48% female, mean age 23 (range 3–55) years. At maintenance (n = 34), the mean daily dose was 535 (SD 224) mg, that is, 10.03 (standard deviation [SD] .49) mg/kg/day, serum concentration .26 (SD .14) for CBD and .13 (SD .10) μmol/L for 7‐OH‐CBD. Reference ranges of .15–.50 μmol/L for CBD and .04–.25 μmol/L for 7‐OH‐CBD are proposed, which included 80% of measurements. There was a linear correlation between CBD dose to concentration and CBD to CBD‐7‐OH concentrations (r2 = .39 and .38) (p < .05). The hepatic marker alanine aminotransferase (ALT) increased on average 37%, demonstrating a moderate effect on liver function. Intra‐individual coefficients of variation (CVs) were 32% (SD 17) for CBD and 48% (SD 24) for 7‐OH‐CBD (n = 15, ≥3 measurements). Twenty different ASMs were used: clobazam (n = 24), valproate (n = 17), and stiripentol (n = 8) were most common. The mean concentration ratio of desmethyl‐clobazam/clobazam increased by 140% (7.29–17.5; p < .05) but was variable, pointing to enzyme inhibition by CBD.

Significance

This observational study with TDM data revealed extensive pharmacokinetic variability of CBD in patients with refractory epilepsy. The results demonstrate the need for close follow‐up and use of TDM, including biochemical markers of toxicity, for individualized treatment with CBD.
Enlarged perivascular space in the temporal lobe as a prognostic marker in temporal lobe epilepsy with hippocampal sclerosis
Authors: Cho Soomi , Song Seungwon , Yum Jungyon , Kim Eun Hwa , Roh Yun Ho , Kim Won‐Joo , Heo Kyoung , Na Han Kyu , Kim Kyung Min
Published: February 2025

Objective

This study was undertaken to investigate the regional burden of enlarged perivascular spaces (EPVSs) in patients with temporal lobe epilepsy with hippocampal sclerosis (TLE‐HS) and explore its prognostic relevance.

Methods

In this retrospective observational study, EPVSs in the temporal lobe (T‐EPVS), centrum semiovale (CS‐EPVS), basal ganglia (BG‐EPVS), midbrain, and hippocampus were visually rated in 68 treatment‐naïve patients with TLE‐HS. Regional EPVS burden was dichotomized into high and low degrees (cutoff: >10 for BG‐EPVS/T‐EPVS; >20 for CS‐EPVS). Cox proportional hazards models were used to determine the potential predictors of seizure freedom (SF; no seizure for >1 year) and delayed SF (SF achieved >6 months after initiating antiseizure medication [ASM]). Multivariate logistic regression using stepwise variable selection based on the Akaike information criterion was performed to investigate whether EPVS burden was associated with medical refractoriness (never achieving SF).

Results

Of the 68 patients, 20 were classified into the refractory group (29.4%). The high T‐EPVS group had an older epilepsy onset (37.3 ± 12.3 vs. 26.5 ± 13.0 years, p = .005), higher pretreatment seizure density (median = 12.0, interquartile range [IQR] = 5.0–20.0 vs. 4.0, IQR = 2.0–10.5, p = .008), and lower focal to bilateral tonic–clonic seizure prevalence (13.3% vs. 73.6%, p < .001) than the low T‐EPVS group. High T‐EPVS burden (odds ratio [OR] = 10.908, 95% confidence interval [CI] = 1.895–62.789) was an independent predictor of medial refractoriness, along with female sex (OR = 12.906, 95% CI = 2.214–75.220) and ASM treatment duration (OR = .985, 95% CI = .971–.999). The low T‐EPVS group had higher probability of achieving delayed SF than the high T‐EPVS group (pLog‐rank = .030, pCox regression = .038), whereas the probability of achieving SF was comparable between the two groups (pLog‐rank = .053, pCox regression = .146).

Significance

Increased T‐EPVS burden may serve as an imaging marker of unfavorable prognosis in patients with TLE‐HS, underscoring the potential role of perivascular dysfunction in diminished ASM response.
The Role of Fibroblasts in Chronic Inflammatory and Proliferative Skin Diseases
Authors: Zang Rui , Xu Chen‐Chen , Fan Zhu , Wang Qing‐Nan , Guo Zi‐Jian , Liu Li , Cui Bing‐Nan , Huang Yuan‐Yuan , Yang Jiao
Published: February 2025

Fibroblasts (FBs) are crucial mesenchymal cells that preserve the skin's natural structure and physiological processes. They can build dense connective tissue by remodelling the extracellular matrix (ECM) and control immunological activity by secreting cytokines. This indicates that the development of chronic inflammatory and proliferative skin disorders is significantly influenced by fibroblasts. In order to provide new ideas for clinical research and treatment with a clearer perspective, this study thoroughly compiles the involvement of fibroblasts in various chronic inflammatory and proliferative skin diseases such as psoriasis, hypertrophic scar (HS), keloid, atopic dermatitis (AD), oral lichen planus (OLP), chronic eczema, and rosacea.
Study on laser ablation quality and removal mechanism of SiCf/SiC composites by wavelength and thermal effect equation
Authors: Song Juan , Wang Bangfu , Jiang Qingyang , Hao Xiaohong
Published: February 2025

SiCf/SiC composites exhibit exceptional material properties, rendering them ubiquitous in aerospace, high‐end automotive, and other advanced applications. However, these composites pose processing challenges due to their high hardness, brittleness, anisotropy, as well as heterogeneity. To investigate the material removal mechanisms and processing quality during picosecond laser ablation of SiCf/SiC composites, this study conducted linear scanning ablation experiments employing picosecond pulse lasers. The experiments were followed by a detailed analysis of the surface morphology, and elemental composition of the grooves under varying laser parameters. The findings reveal that laser power, scanning speed, repetition rate, and scanning duration exert a profound influence on the postablation groove characteristics. Specifically, as laser power increases, the groove width and depth broaden, accompanied by an expansion in both the ablation area and the heat‐affected zone. During laser irradiation of SiCf/SiC composites, the chemical bonds within the matrix and fibers undergo disruption, initiating oxidation reactions, and the formation of oxides. The oxides primarily manifest as solid SiO, SiO2, and gaseous CO and CO2. Furthermore, this article introduces a graphical model that elucidates the material removal mechanism by using laser. Collectively, this research provides a theoretical foundation and technical guidance to achieve high performance cutting of SiCf/SiC composites.
Impact of heat treatment on microstructure and tensile strength of monofilaments and bundles of aluminosilicate fibers
Authors: Liu Yang , Wu Yadan , Chen Xiaofei , Sun Xun , Liu Haitao
Published: February 2025

Continuous alumina fiber serves as the reinforcement phase within the Al2O3/oxide composite system, and its behavior at elevated temperatures significantly influences the mechanical properties of the composite. This study focuses on a novel type of continuous aluminosilicate fiber (AF18) to investigate the effects of heat treatment temperature (ranging from 1100°C to 1400°C) and duration (2/4/8 h) on the microstructure and mechanical properties of the monofilament. Acknowledging that fibers typically exist in bundles within the composite material, the study further examines the changes in tensile strength of these bundles following heat treatment at various temperatures. The findings indicate that both the heat treatment temperature and duration contribute to an increase in grain size and an enhancement in the surface roughness of the fiber, with the temperature having a more pronounced effect than the duration. The tensile strength of the original fiber monofilament is measured at 2.08 GPa, while the tensile strength of the tow exhibits a reduction of approximately 10% compared to the monofilament, with the degree of attenuation correlating with the heat treatment conditions. Notably, with 8 h of heat treatment at 1200°C, the fiber retains approximately 70% of its tensile strength, demonstrating its capacity for long‐term temperature resistance.
Development and Validation of a User‐Friendly Predictive Model Using Demographic and Complete Blood Count Data to Facilitate Early Diagnosis on Suspicion of Myeloproliferative Neoplasms
Authors: Jin Lilan , Li Lei , Lu Yiyi , Cai Gang , Lin Lin , Lin Jiafei
Published: February 2025

Objective

To develop a novel predictive model based on demographics and complete blood count (CBC) parameters to quickly identify suspicious features of myeloproliferative neoplasms (MPN), enabling prompt initiation of further investigations and referrals.

Methods

426 patients with elevated peripheral blood cell counts were referred to the Hematology Department of Ruijin Hospital from 2017 to 2023. Among them, 215 patients were diagnosed with MPN, while the remaining 211 patients formed the non‐MPN group. The patients were randomly divided into a training cohort and a validation cohort. Demographic characteristics, CBC data, and other relevant laboratory information were collected. By univariable and multivariable logistic regression, significant indicators independently associated with MPN were identified and included in the nomogram. The model was evaluated by measuring the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) curve.

Results

Five indicators were identified as independently associated with MPN, including onset age, monocyte fraction, basophil fraction, red blood cell distribution width, and platelet count. The AUC values for the training and validation cohorts were 0.912 and 0.928, respectively. The calibration curves showed good agreement between the predicted risk by the nomogram and the actual outcomes. The DCA for the training and the validation datasets revealed net benefits of 0.9026 and 0.9303, respectively.

Conclusion

We have developed and validated a prediction model for MPN based on demographics and CBC data. The model could assist general practitioners in quickly identifying patients with potential MPN and in initiating timely further investigations and referrals.
Corruption and Default Risk: Global Evidence
Authors: Nadarajah Sivathaasan , Atif Muhammad , Tawiah Vincent , Liu Jia , Wood Geoffrey
Published: February 2025

The extant literature explores the consequences of corruption on firms’ growth and survival. However, its impact on default risk remains unexplored. On the basis of a sample of 189,109 firm‐years from 2004 to 2021 across 47 countries, our study reveals that a one standard deviation increase in corruption is associated with an 11.3% increase in default risk. Our channel analysis identifies information asymmetry and managerial risk‐taking as key mechanisms through which corruption influences default risk. This adverse effect is particularly pronounced in countries with opaque information environments, weak governance frameworks and inadequate external monitoring of firms. We further highlight the detrimental impact of corruption on firms’ borrowing costs and banks’ loan performance. Our study emphasizes the importance of enhancing information transparency and implementing stringent control mechanisms as a basis of mitigating corruption's detrimental effects across a range of different socio‐political contexts.
The Mission (Im)possible of Climate Action through Quixotic Institutional Work
Authors: Delmestri Giuseppe , Schuessler Elke S.
Published: February 2025

The ‘iron cage’ of the (neo‐) liberal‐capitalist system prioritizes economic returns over climate protection. Formerly powerful nation‐states are subordinated to the rule of markets, whereas business elites have been freed from substantial responsibility for social and environmental concerns. While we agree in principle with the Point that a reassertion of state power may facilitate more decided climate action, our Counterpoint adopts a cultural institutionalist perspective that highlights the embeddedness of actors in a broader cultural order. From this perspective, actors enact scripts while often lacking substantive agency towards protecting the natural environment. Cultural change in meanings, myths, practices, and rituals is needed to remodel the currently dominant scripts and templates of modern, liberal‐capitalist ‘world society’, including the script of state actorhood. We suggest the notion of ‘quixotic institutional work’ as a way of envisioning and prefiguring alternative cultural templates when both the physical and the social reality start showing cracks due to the climate crisis. Quixotic institutional work follows the logic of appropriateness rather than consequential purposiveness, and thus constitutes a different, often overlooked and mocked, form of agency for systems change relevant in the light of powerful forces towards maintaining an unsustainable world order.
Identification of Elite Wheat Genotypes for Leaf Rust Resistance in a Geographically Diverse Wheat Panel Using Line × Tester Analysis
Authors: Ullah Farhan , Shah Liaqat , Saeed Muhammad , Can Chen , Hongqi Si , Chuanxi Ma
Published: February 2025

Leaf rust (LR) poses a global threat to wheat crops and can lead to severe yield losses if environmental conditions favour its spread. Using resistant wheat cultivars offers a sustainable approach to managing LR. This study aimed to identify promising wheat lines for LR‐resistance breeding using classical analytical methods to screen for LR tolerance. We evaluated 10 parental lines, comprising 6 lines and 4 testers, crossed into 24 combinations using a line × tester mating design. These germplasm were grown in a triplicate RCB design under both optimal and LR‐stress conditions. We recorded data on various morphological, physiochemical, yield and component traits at key growth stages. The analysis of combining ability indicated significant variations among genotypes, with non‐additive gene action influencing most traits. Four promising parents (AN179, AN1687, PR123 and PR127) and two crosses (AN179 × PR127 and AN179 × PR123) showed high combining ability for yield traits under LR‐stress. Cluster analysis revealed divergent groups among the genotypes, with shifting clustering under LR‐stress suggesting varied genotypic responses. Factor analysis identified genotypes that performed consistently well under LR‐stress. These genotypes are suitable for use in LR‐resistance breeding programs. We also recommend peduncle length and tillers per plant as phenotypic markers for wheat selection and breeding due to their positive correlation with grain yield. The findings of this study can contribute valuable insights to sustainable wheat breeding research.
Unveiling Hidden Trauma: A Cross‐Sectional Study of Violence Exposure and Its Impacts on Entrapment, Self‐Stigma and Empathic Care Among Psychiatric Nurses
Authors: Atta Mohamed Hussein Ramadan , Eweida Rasha Salah , Albzia Ali , El‐Monshed Ahmed Hashem , Barakat Mona Mohamed Abdelaziz
Published: February 2025

Background

Psychiatric nurses often work in high‐stress environments where they are frequently exposed to various forms of violence and aggression from patients. While the immediate physical consequences of violence are usually recognised, the psychological impacts, such as feelings of entrapment, self‐stigma and diminished empathy, are less understood but equally critical.

Aims

This study aimed to fill this gap by examining how different forms of violence exposure affect entrapment, self‐stigma and empathic care among psychiatric nurses, providing insights that can inform both practice and policy.

Design

This study utilised a descriptive correlational research design.

Method

This study was conducted in two prominent psychiatric hospitals in Egypt, namely the Mental Health Hospital and Addiction in Benha City and Elmaamora for Psychiatric Medicine and Addiction in Alexandria. A convenience sample of 246 psychiatric nurses who filled out the Perception of Prevalence Aggression Scale, the Impact of Event Scale‐Revised, the Empathetic Care Scale, the Scale for Assessing the Stigma of Mental Illness in Nursing and the Entrapment Scale was used for the study. Data collection spanned 3 months, from June to August 2024.

Findings

The findings reveal that perceived aggression is positively correlated with the impact of events (r = 0.513, p < 0.001) and entrapment (r = 0.160, p = 0.012) and negatively correlated with empathy (r = −0.232, p < 0.001). The regression analyses show that verbal aggression, threatening verbal aggression, aggressive splitting behaviour, severe self‐directed violence and suicides are significant predictors of empathy, increasing its levels (R2 = 0.509, p < 0.001). Stigma is negatively influenced by threatening verbal aggression, provocative aggressive behaviour, severe physical violence, mild violence against self and suicides but positively by passive‐aggressive behaviour (R2 = 0.377, p < 0.001).

Conclusion

These results underscore the importance of addressing aggression in psychiatric settings to promote the well‐being and professional functioning of nurses.

Reporting Method

STROBE is the relevant reporting method that has been adhered to.