bluuebunny/crossref_metadata_2025 huggingface dataset:
A NEW FLOW-PATH ENERGY-BASED APPROACH FOR THE PRELIMINARY DESIGN OF DEBRIS FLOW RISK MITIGATION MEASURES: THE REAL CASE OF FAVAZZINA
Authors: Pisano M. , Visalli P. , Tayyebi S.M. , Pastor Manuel , Moraci Nicola
Published: February 2025

This study adopts a flow-path energy-based approach to evaluate the effectiveness of mitigation measures for debris flows, focusing on the Favazzina area. Given the area’s topography, which limits the construction of large debris flow barriers, permeable racks were chosen to dissipate the kinetic energy of the March 2005 landslide. The method continuously quantifies kinetic energy along the flow propagation path, enabling an assessment of how different rack configurations affect energy dissipation. By calculating the variation in the kinetic energy, the number and positioning of permeable racks were determined, considering both the location of exposed elements and the area’s morphology. A two-phase Smoothed Particle Hydrodynamics-Finite Difference (SPH-FD) numerical model was used to simulate the 2005 event, as well as the presence of permeable racks placed at various sections. Results demonstrate the potential of the energy-based approach, as it allows for a rapid assessment of the energy content of a given landslide while simultaneously guiding the selection of the most appropriate mitigation measure.
Role of shear stress-induced red blood cell released ATP in atherosclerosis
Authors: Zhang Yunpei , Sun Haoyu , Gandhi Aayush , Du Yong , Ebrahimi Saman , Jiang Yanyan , Xu Sulei , Uwase Hope , Seidel Alane , Bingaman Sarah S. , Arnold Amy C. , Nguyen Christian , Ding Wei , Woolard Matthew D , Hobbs Ryan , Bagchi Prosenjit , He Pingnian
Published: February 2025

Altered hemodynamics is a key factor for atherosclerosis. For decades, endothelial cell (EC) responses to fluid-generated wall shear stress have been the central focus for atherogenesis. However, circulating blood is not a cell-free fluid, it contains mechanosensitive red blood cells (RBCs) that are also subjected to altered hemodynamics and release a large amount of ATP, but their impact on atherosclerosis has been overlooked. The focus of this study is the role of shear stress (SS)-induced RBC-released ATP in atherosclerosis. Hypercholesterolemic mouse models with and without RBC-Pannexin 1 deletion were used for the study. Results showed that SS-induced release of ATP from RBCs was at μM concentrations, three-orders of magnitude higher than that from other cell types. Suppression of RBC-released ATP via deletion of Pannexin 1, a mechanosensitive ATP-permeable channel, reduced high fat diet-induced aortic plaque burden by 40-60%. Importantly, the location and the extent of aortic atherosclerotic lesions spatially matched with the ATP deposition profile at aortic wall predicted by a computational fluid dynamic (CFD) model. Furthermore, hypercholesterolemia increases EC susceptibility to ATP with potentiated increase in [Ca2+]i, an initial signaling for aortic EC barrier dysfunction, and an essential cause for lipid accumulation and inflammatory cell infiltration. The computational prediction also provides a physics-based explanation for RBC-released ATP-induced sex disparities in atherosclerosis. Our study reveals an important role of RBC-released ATP in the initiation and progression of atherosclerosis. These novel findings provide a more comprehensive view of how altered hemodynamics and systemic risk factors synergistically contribute to atherosclerosis.
Effect of Storage Conditions on Phytochemical Quality and Free Radical Scavenging Potential of Nelumbo nucifera Rhizome
Authors: Nawaz Haq , Mumtaz Farwa , Aosaf Rimsha , Amin Vania , Yousaf Muhammad , Nawaz Mubashir , Tahir Nafeesa
Published: February 2025

The current investigation optimized the impact of storage conditions on the phytochemical quality and free radical scavenging potential of Nelumbo nucifera rhizome using a response surface methodology. A bifactorial central composite design (CCD) was constructed at five levels of each of the storage temperatures (ST: −80, −20, 0, 5, and 10°C) and storage time (St: 1, 2, 3, 4, and 5 weeks) consisting of 29 experimental runs with four factorial and four axial points in triplicate and five center points. The rhizome samples were stored at various combinations of ST and St as selected by CCD. The fresh and stored samples were processed to analyze their phytochemical composition and free radical scavenging potential. The stored rhizome samples showed comparatively lower values (p < 0.05) of phytochemical constituents and free radical scavenging potential than the fresh ones. The response surface optimization showed that the samples’ phytochemical content and free radical scavenging potential changed as a linear positive function of ST and a linear negative function of St. A linear positive effect of ST and a linear negative effect of St were observed on the total phenolic content, total flavonoid content, and tannin content, as well as 2, 2‐diphenyl‐1‐picrylhydrazyl, hydroxyl, azino‐bis‐tetrazolium sulfate cation, and superoxide radical scavenging capacities of N. nucifera rhizome. The optimum levels of ST and St for optimal response of the studied parameters were found to be 8.48°C and 2.0313 weeks, respectively. The study suggests avoiding long‐term storage of plant‐based foods at very low temperatures to preserve their phytochemical and antioxidant quality.
Indispensability of International Law for National Security. Advice to a Prince
Authors: Fife Rolf Einar
Published: February 2025

This article considers particular aspects of the relationship between national security and the international legal system, against the backdrop of renewed geopolitical tensions. Instead of focusing here on applicable legal norms and relevant international institutions, arguments of indispensability of international law are offered, viewed through the lens of security interests and related communicative processes. Disparate snapshots are provided to foster conversations between international legal advisers and policymakers. Reflecting on ways to communicate a renewed understanding of national security dividends accruing from the international legal order may help bridge perceived contradictions in the analysis of fundamental interests. This may be combined with a realization of the potentially huge transactional and other costs of being seen to attempt weakening or circumventing it. Both benefits and costs are compounded by the increasing complexity, interconnectivity and mutual interdependence brought by globalization with momentous technological and social developments, which may trigger large-scale transformation for the better, but also leads to increased vulnerabilities.
Description of three new cicada species in the genus Yoyetta Moulds (Hemiptera: Cicadidae: Cicadettinae), from eastern Australia
Authors: EMERY DAVID L. , EMERY NATHAN J. , POPPLE LINDSAY W.
Published: February 2025

Three new cicada species from eastern New South Wales and Queensland, Australia, are described in the genus Yoyetta Moulds, 2012. Yoyetta darug sp. nov. is most common in the western Sydney area in New South Wales (NSW); Y. psammitica sp. nov. has been found in the Bylong Valley and Warrumbungle National Park in NSW and Carnarvon Station in central Queensland; Y. fumea sp. nov. has been found principally in the Southern Highlands of NSW. The new species are closely related to Y. humphreyae Moulds & Popple and Y. corindi Popple & Emery in their morphology and song, and are broadly allied to Y. tristrigata (Goding & Froggatt).
Within each species a description, as well as a section on distinguishing features, distribution, habitat and behaviour, and calling song structures are provided and illustrated where appropriate. Additional location records for Y. humphreyae are included. A revised key to species for the genus Yoyetta Moulds is also provided.
New Record of Anapistula (Gertsch 1941) (Araneae: Symphytognathidae) in Europe with the description of a new species
Authors: PERTEGAL CRISTIAN , BARRANCO PABLO
Published: February 2025

A new species of the genus Anapistula Gertsch, 1941, A. delrosalae sp. nov., is described, marking the second record of the family Symphytognathidae in Europe. The new species has, to date, only been found in the Cueva de Nerja, Málaga (Spain). Based on the specimens collected, A. delrosalae sp. nov. appears to be present throughout the cave, from the Tourist Galleries to the New Galleries. Detection of the species is challenging due to its small size, which has likely caused it to go unnoticed until now. The new species is based on both somatic and genitalic morphological characters of females. The male is still unknown. The diagnostic characteristics that have been useful in distinguishing the new species from the already known Anapistula ataecina Cardoso & Scharff, 2009, native to the Frade cave system, Lisbon, Portugal, are discussed.
A new species of the subgenus Bryodemella (s. str.) Yin, 1982 from Gansu, China (Orthoptera: Acridoidea: Oedipodidae)
Authors: ZHANG YU-LONG , WANG WEN-QIANG , YIN ZHAN
Published: February 2025

A new species Bryodemella sunanensis sp. nov. of the genus Bryodemella Yin (Orthoptera, Acridoidea, Oedipodidae) from Gansu, China is described in this paper. The new species is similar to Bryodemella (s. str.) elegans Li, 1997, but differs from the latter by: anterior margin of pronotum protruding in the middle, tegmina longer, reaching to the middle of hind tibiae, hind femur without red on inner side, hind tibiae yellow on inner side and hind wing pale yellow at base part. The type specimens are deposited in the Museum of Hebei University (MHU), China.
Translaminar fracture behavior of hybrid woven-ply peek thermoplastic laminates under isothermal and kerosene flame exposure
Authors: Lin Lanhui , Vieille Benoit , Bouvet Christophe , Davin Tanguy
Published: February 2025

The growing demand to use thermoplastic matrix composites in aeronautic has been confronted with the need to understand the fracture mechanisms under different service conditions. Thus, the present work aims at studying the influence of different thermal stress conditions on the fracture behavior of PolyEther Ether Ketone-reinforced carbon/glass fiber hybrid laminates (CG/PEEK), as a function of heating temperature and fire exposure time. Compact Tensile (CT) specimens are exposed to isothermal (from 350°C to 550°C in a high temperature furnace) and critical service conditions (kerosene flame exposure characterized by a heat flux of 116 kW/m2 and a temperature of 1150°C) exposure conditions. Monotonic tensile tests are then conducted to assess the mode I translaminar fracture toughness (FT) at room temperature. Crack propagation is monitored during mechanical loading using a Digital Image Correlation (DIC) device combined with a binarization algorithm. Then, the G-R curves have been obtained from the compliance method. Under isothermal conditions, the residual mechanical properties degrade as temperature increases, particularly once thermal decomposition is about to start, due to the formation of porosities and extensive delamination. Under flame exposure, the microscopic and tomographic observations reveal thermally- and mechanically-induced damages with a heterogeneous distribution due to temperature gradients within the plies of laminates. Depending on the pyrolysis degree of each ply, the load bearing capabilities of the plies gradually deteriorate from the exposed to the opposed side. The critical FT values shows a decreasing trend (as a function of fire exposure time) with increasing ply number of charred regions through the thickness.
Southern School-to-Work Transition and the Determinants of Becoming Young NEET in China
Authors: Wang Zizhen
Published: February 2025

This study contributes to the scant literature on the individual and structural determinants of being young ‘not in employment, education or training’ (NEET) in China. Drawing from six waves of the Chinese General Social Survey (2010–2021), it finds that (a) China’s NEET rate stands at 16% for the studied period, with significant internal regional variations. (b) The common wisdom that education reduces the incidence of becoming NEET is challenged. Analyses showed that only obtaining a third-level educational degree lowers the likelihood of becoming NEET. (c) The differentiated likelihoods of becoming NEET between women subgroups, for example, married vs unmarried women, rural vs urban women, are more stratified than between different genders or household registrations. (d) Provincial government expenditure on education has a gap-closing effect on the NEET likelihood disparities between different genders and household registrations, whereas larger provincial populations exacerbate gender gaps. Policy implications are discussed.
Phenazine Scaffolds as a Potential Allosteric Inhibitor of LasR Protein in Pseudomonas aeruginosa
Authors: Nketia Prisca Baah , Manu Prince , Osei-Poku Priscilla , Kwarteng Alexander
Published: February 2025

Millions of individuals suffer from chronic infections caused by bacterial biofilms, resulting in significant loss of life. Pseudomonas aeruginosa stands out as a major culprit in causing such chronic infections, largely due to its antibiotic resistance. This pathogen poses a considerable threat in healthcare settings, particularly to critically ill and immunocompromised patients. The persistence of chronic and recurrent bacterial infections is often attributed to bacterial biofilms. Therefore, there is an urgent need to discover novel small molecules capable of efficiently eliminating biofilms independent of bacterial growth. In this project, an in silico drug discovery approach was employed to identify nine halogenated-phenazine compounds as allosteric inhibitors of the LasR protein. The LasR is a key transcription factor that triggers other quorum-sensing systems and plays a crucial role in biofilm formation and activation of virulence genes. By inhibiting LasR, specifically targeting its allosteric site, the dimerization of LasR and subsequent biofilm formation could be prevented. Molecular docking and simulations, coupled with binding energy calculations, identified five compounds with potential as anti-biofilm agents. These compounds exhibited higher binding affinities to the distal site, suggesting their structural capability to interact with allosteric site residues of the LasR protein. Based on these findings, it is proposed that these compounds could serve as promising leads for the treatment of biofilm and quorum-sensing-related infections.
Explaining political inactivity. A research on academic youth in Poland
Authors: Przybylski Błażej
Published: February 2025

The article is a report on a qualitative study conducted among 703 students from Warsaw/Poland public universities. The purpose of the study was to identify projected behavior in the face of the threat scenario—the so-called “neo-totalitarianism,” created by experts of the Polish Academy of Sciences. The survey was carried out using a proprietary projection test. Based on the written statements of the participants of the study, the reasons for choosing a strategy of non-engagement in the light of rising neo-totalitarianism were presented. The following ways of justifying the lack of any involvement were distinguished: aversion to politics, lack of adequate competence, lack of necessary personality traits, having other priorities and life goals, pointlessness of social activity, fear of possible consequences, focus on one’s own life, inability to identify the reasons for failures, belief in the unlimited right of others to proclaim their own beliefs, and minimalist understanding of democracy.
Psychological Flexibility, Parental Reflective Functioning, Parental Efficacy and Coping in Parents of Children With Autism
Authors: Reich Ari , Lifshitz Hefziba , Shnitzer-Meirovich Shlomit , Gur Ayelet
Published: February 2025

Parents of children with autism spectrum disorder (ASD) experience stress, potentially affecting parenting and child outcomes. The roles of psychological flexibility and parental reflective functioning in coping strategies of parents of children with ASD are not fully understood. The study aims to examine differences in psychological flexibility, parental reflective functioning, parental self-efficacy, and coping strategies among parents of children with ASD and children with typical development (TD), while considering gender differences. In addition, it seeks to explore whether parental efficacy mediates the association between psychological flexibility, parental reflective functioning, and coping. The sample was comprised of 210 Israeli parents, with 86 having children with ASD and 124 having children with TD. A moderation analysis was conducted to investigate the moderation model. Parents of children with ASD demonstrated lower psychological flexibility, parental self-efficacy, and support-seeking coping strategies and higher proactive and disengagement coping strategies. Mothers reported higher parental reflective functioning and proactive and support-seeking coping strategies than fathers. In parents of children with ASD, parental self-efficacy mediated the association between parental reflective functioning and proactive coping strategies. Policymakers should advance intervention to enhance parental reflective functioning and parental self-efficacy for parents of children with ASD, with a special focus on fathers.
Minimum time control for path tracking problem of intelligent vehicle handling in inverse dynamics
Authors: Guo Shanshan , Liu Yingjie
Published: February 2025

The continuous development of vehicle intelligence and electronic technology has greatly promoted the vigorous development of the automotive industry. The improvement demand of the trajectory tracking, driving safety, and stability of intelligent vehicles has become a hot issue. In order to solve the path tracking problem of vehicle, a high-precision approach for the vehicle path tracking optimization of based on the adaptive sparse collocation method (ASC) is presented. Firstly, a nonlinear 4-DOF vehicle model is established. Then the problem of path tracking with minimum time is transformed into an optimal control problem by the ASC method. Finally, the sequential quadratic programming (SQP) is used to solve the optimal control problem. The simulation results show that the proposed method can solve effectively the problem of vehicle path tracking. And also, the proposed controller can significantly improve the vehicle path tracking performance. It can further improve the path tracking accuracy and lateral stability of vehicles, providing a certain reference for the research on path tracking control of intelligent connected vehicles.
A Processing Algorithm to Address Real-World Data Quality Issues With Continuous Glucose Monitoring Data
Authors: Williamson Walter , Lee Joyce M. , Gaynanova Irina
Published: February 2025

Continuous glucose monitoring (CGM) data stored in data warehouses often include duplicated or time-shifted uploads from the same patient, compromising data quality and accuracy of resulting CGM metrics. We developed a processing algorithm to detect and resolve these errors. We validated the algorithm using two weeks of CGM data from 2038 patients with diabetes. Duplication errors were identified in 528 patients, with 25.7% showing significant differences in at least one metric (Time in Range, Coefficient of Variation, Glycemic Management Indicator, or Glycemic Episode counts) between raw and processed data. Eleven patients crossed clinically meaningful thresholds in one or more metrics after processing. Our results underscore the importance of real-world CGM data processing to maintain accurate and reliable CGM metrics for research and clinical care.
Rehabilitation Strategy Should Not Be a Pretext for Suboptimal Repair for Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries
Authors: Desai Manan H. , Tongut Aybala , d’Udekem Yves
Published: February 2025

Pulmonary atresia, ventricular septal defect, and major aortopulmonary collaterals are a challenging congenital anomaly to manage surgically with different centers and strategies producing wide-ranging outcomes. Over the past few decades despite diverging treatment pathways, there is an emerging consensus of how these patients “should” be treated. Quite often a combination of rehabilitation strategy and a unifocalization approach has to be tailored to each patient to address the anatomic and physiological variations that characterize this congenital heart defect. Irrespective of the surgical approach, the goal should be to have a complete repair with acceptable right heart pressure ensuring survival and a good quality of life.
Impact of DNA repair deficiency on sensitivity to antibody-drug conjugate (ADC) payloads in bladder cancer
Authors: P Shanmugam Surish , Zhou Yuzhen , Stelter Isabella , Hanlon Timothy , Bekele Raie T , Bellmunt Joaquim , Szallasi Zoltan , Mouw Kent W
Published: February 2025

Background

Enfortumab vedotin (EV) and Sacituzumab govitecan (SG) are antibody-drug conjugates (ADCs) with demonstrated activity in advanced bladder cancer. A subset of bladder tumors harbors a DNA repair deficiency in either the homologous recombination (HR) or nucleotide excision repair (NER) pathway that has the potential to impact sensitivity to specific classes of therapeutics.

Objective

Define the impact of HR or NER deficiency on sensitivity to ADC payloads alone or in combination with DNA repair targeted agents in bladder cancer.

Methods

Isogenic cell pairs with versus without HR or NER deficiency were profiled using DNA repair and drug sensitivity assays. Sensitivity to the ADC payloads monomethyl auristatin E (MMAE) and SN-38 alone or in combination with small molecule inhibitors of poly(ADP-ribose) polymerase (PARP), ATR, or USP1 were measured using cell viability assays.

Results

BRCA2 loss was sufficient to confer an HR deficient phenotype and increase sensitivity to cisplatin and PARP inhibition in bladder cancer cell lines. HR deficiency, but not NER deficiency, increased sensitivity to MMAE and SN-38 in bladder cancer cells. The combination of SN-38 and PARP inhibition displayed synergistic cell killing independent of HR or NER status.

Conclusion

HR and NER deficiency have distinct impacts on sensitivity to cisplatin and ADC payloads in bladder cancer preclinical models.
Effect of Becoming Unemployed on Affordability of Oral Health Care among Australian Adults
Authors: Kaur G. , Tsakos G. , Yap T. , Karahalios A. , Chen Z. , Singh A.
Published: February 2025

Introduction:

Oral health care impacts of unemployment are not well understood. This is particularly important as many people, even in high-income countries, lack publicly funded oral health care, creating a financial burden for working-age individuals. This study aims to investigate the short-term effect of becoming unemployed on affordability of oral health care among working-age Australian adults.

Methods:

Longitudinal data from the Household, Income and Labour Dynamics in Australia Survey facilitated analysis of those employed in 2016 and examined the effect of becoming unemployed in 2017 on affordability of oral health care in 2018, adjusted for confounding with inverse probability weighting.

Results:

Individuals who became unemployed were 2.95 (95% CI, 1.88 to 4.63) times more likely to not receive dental treatment when needed due to a lack of affordability as compared with individuals who remained employed ( N = 6,529). On an absolute scale, the aforementioned difference in probability was 9% (95% CI, 3% to 15%).

Discussion:

Becoming unemployed had a considerable and immediate negative impact on the affordability of oral health care among working-age Australian adults. Adequate welfare support services are needed to address the immediate financial hardship and consequences that may result due to unemployment.

Knowledge Transfer Statement:

Using large population-based cohort data, we established that becoming unemployed hampers the ability to afford oral health care. Our study showed that this impact occurs within a year of unemployment, highlighting how quickly unemployment can create ripple effects for oral health care utilization, cascading into a potential lack of timely treatment or preventive therapies. Our findings highlight the need for adequate welfare support policies to address the immediate financial hardship and consequences that may result due to unemployment.
The absent-presence of the offence in prisons in Norway and England & Wales
Authors: Laursen Julie , Mjåland Kristian
Published: February 2025

A prison sentence is imbued with moral meaning about the offence which led to the punishment. However, based on interviews with prisoners serving typical sentences in England & Wales and Norway, we found that the offence was largely absent as a theme in staff-prisoner interactions during imprisonment. For some interviewees, the offence remained an absent- presence, which they tried to make sense of on their own, while others preferred to ‘get on with it’ and simply complete their sentence. We explore how the ‘absent-presence’ of the offence sometimes made punishment feel empty and meaningless, especially for prisoners who struggled to come to terms with their convictions. Drawing on the sociology of ‘nothing’ and the anthropology of ethics, we describe how the absent-presence of the offence can lead to confusion and misplaced shame, but at the same time foster positive relationships between the people who live and work in prisons.
Do all anatomic stems perform equally at long-term survival? A regional registry-based study on 12,010 total hip arthroplasty implants according to stem length and neck modularity
Authors: Di Martino Alberto , Rossomando Valentino , Bordini Barbara , Brunello Matteo , Ferri Riccardo , Faldini Cesare
Published: February 2025

Background

Anatomic stems for total hip arthroplasty (THA) have been developed to achieve a precise geometric fit between the implant and the surrounding femoral bone, aiming at the improvement of primary stability of cementless implants until osteointegration occurs. The aim of the current study is to go over the regional Registry of Orthopaedic Prosthetic Implants (RIPO) to analyze survivorship of THA implants when anatomic stems are used; moreover, separate analysis for modular and nonmodular stems, and in standard and short implants, is presented.

Materials and methods

This retrospective registry study involved the analysis of data collected by the RIPO registry between 2000 and 2019. The study focused on THAs performed for primary hip osteoarthritis (OA) between 2000 and 2019. All patients treated by THA within this time frame and officially registered in the RIPO registry were included in the study. Exclusion criteria were: revision THAs, cemented implants, hemiarthroplasties, resurfacing procedures, megaprostheses for neoplastic and non-neoplastic conditions, and THAs performed on patients residing outside the region.

Results

A total of 12,010 cementless primary THAs using curved anatomic stems were performed in Emilia-Romagna between 2000 and 2019 and formally registered in the RIPO registry. The overall survival rate for anatomic standard stems was 96.7% at 10 years (96.1–97.3%); at 15 from the surgery, the survival rate dropped to 95.1% (93.9–96.1%). A total of 473 out of 12,010 recorded THA with anatomic stems (3.93%) experienced failure requiring revision surgery. The fixed standard stem showed the lowest failure rate (0.6%), while modular short stems had the highest (7.4%) at long-term follow-up. The most common stem-related complication was periprosthetic fracture (PF) in short stems (2.0% of cases) while in standard stems it was implant breakage (0.9% of cases); PFs were significantly more frequent in female patients (p = 0.0082), with a relative risk (RR) of 1.59 compared with male patients. Implant breakage demonstrated the highest rate of incidence among standard-modular stems (1.1% of cases).

Conclusions

This registry-based study highlights that stem length and modularity significantly affect the long-term survival of anatomic femoral stems in THA. Fixed standard stems had the lowest failure rates, while modular short stems showed the highest failure rates and complications.

Level of evidence: 3.
The employment preferences of young people in Canada: a discrete choice experiment
Authors: Woodgate Roberta L. , Isaak Corinne A. , Witt Julia , Tennent Pauline , Bell Ashley
Published: February 2025

Background

Young people across the world are facing numerous challenges, with unemployment and precarious employment being substantial issues, impacting young people with all levels of education. For many young people, the pandemic exacerbated their employment precarity. While efforts were made to ameliorate these pandemic related challenges for young people, information about the employment preferences of Canadian young workers (YW) is limited. The aim of this study was to understand the employment needs, challenges and preferences of Canadian YW in the COVID-19 era and beyond.

Methods

Using discrete choice experiment, YW from across Canada aged 18–29 years old were recruited to participate in an online survey October 2022 to April 2023 which was offered in both English and French. Nine job attributes were identified based on findings from the qualitative component of this mixed methods project: wage, earnings stability, job flexibility, vacation, sick time, health insurance, and workplace policies (respectful workplace, and being valued and understood as an employee). Respondents were presented with nine choice sets, each representing two scenarios that differ on policies or actions (attributes) related to their employment during the COVID-19 pandemic.

Results

Based on the respondent (N = 231) sample, analysis revealed that of YW aged 18–29 years, most valued having employment benefits along with workplace policies. These values were strongest for women and 18–21-year-olds. Overall, the employment preferences of Canadian YW in the current study align with four of five attributes considered by the International Labour Organization as minimum standards for decent work. These include adequate compensation, adequate access to health care, adequate free time and rest, and organizational values that support one’s [own and] family values. More specifically, study findings show that within the cohort there are strong gendered and aged-based preferences for non-monetary over monetary job attributes. These include employment benefits along with equitable, supportive employment policies.

Conclusions

The findings suggest that health and wellbeing are highly valued by YW and are among key drivers of employment preferences for Canadian YW during and after the pandemic, and therefore call for policies in the workplace that support the health and well-being of YW.
Evaluating the quality and equity of patient hospital discharge instructions
Authors: Austad Kirsten , Lee Joo Hyun , Lanney Howard , Rapoport Victoria Oliva , Wornhoff Rebecca , McDaniel Katherine , Li-Garrison Lindsay , Jack Brian W.
Published: February 2025

Background

Written discharge instructions improve patient understanding and self-management after hospitalization. While a small number of studies have evaluated the quality of hospital discharge instructions, none have focused on patients with a non-English language preference (NELP) or looked for potential disparities. Our goal was to compare the quality of patient discharge instructions between those with English language preference and NELP, including whether instructions were in the patient’s preferred language, included all content domains recommended by professional groups, and followed best practices for health literacy.

Methods

We analyzed 200 discharge records from inpatient adult medicine discharges at one hospital across a range of diagnoses using case matching by diagnosis and age to construct an English and NELP cohort (each n = 100). We assessed the percentage of discharge instructions written in the patient’s preferred language, measured word count, and calculated readability scores. Lastly, two individual raters used a scale—the Quality of Discharge Instructions-Inpatient (QDI-I) scale—to rate them across six domains of content quality.

Results

Only 8% of patients with NELP received discharge instructions in their preferred language compared to 100% in the English cohort (p < 0.001). The mean overall QDI-I score was similar for the NELP and English cohorts (71.1% of perfect versus 71.3% of perfect, p = 0.92), but the domain of return precautions was inferior among those with NELP (80.5% of perfect vs. 88.8% of perfect, p = 0.013). Instructions in both groups were written at an eighth- to ninth-grade reading level (age 13–15).

Discussion

We found disparities in quality of written discharge instructions for patients with NELP. Recommended next steps include replication of our methods across health systems and larger sample sizes to examine differences between non-English language groups.
Prospective associations between muscle strength and genetic susceptibility to type 2 diabetes with incident type 2 diabetes: a UK Biobank study
Authors: Wang Mengyao , Collings Paul James , Jang Haeyoon , Chen Ziyuan , Shi Qiaoxin , Ho Hin Sheung , Luo Shan , Au Yeung Shiu Lun , Kim Youngwon
Published: February 2025

Background

This study explored whether the prospective associations between muscle strength and incident type 2 diabetes (T2D) differ by varying levels of genetic susceptibility to T2D.

Methods

This study included 141,848 white British individuals from the UK Biobank. Muscle strength was expressed as the relative value of grip strength (measured by a hand dynamometer) divided by fat-free mass (measured via bioelectrical impedance analysis). Three categories of muscle strength (low, medium and high) were generated based on the sex- and age-specific tertiles. Genetic risk of T2D was estimated using a weighted polygenic risk score based on 138 independent single-nucleotide polymorphisms for T2D. During a median 7.4-year follow-up, 4,743 incident T2D cases were accrued. Cox regression with age as the underlying timescale was fit.

Results

High muscle strength was associated with a 44% lower hazard of T2D (HR:0.56, 95%CI:0.52–0.60), compared with low muscle strength, after adjustment for genetic risk of T2D. The inverse association between muscle strength and incident T2D was weaker in individuals with high genetic susceptibility. There was evidence of interaction between muscle strength and genetic susceptibility to T2D (p-additive = 0.010, p-multiplicative = 0.046). The estimated 8-year absolute risk of T2D was lower for high genetic risk—high muscle strength (2.47%), compared with low (2.89%) or medium (4.00%) genetic risk combined with low muscle strength.

Conclusions

Higher muscle strength was associated with lower relative risk of developing T2D, irrespective of genetic susceptibility to T2D, while such association was weaker in the high genetic risk group. Individuals at high genetic risk of T2D but with high muscle strength may have a lower 8-year absolute risk of developing T2D, compared with those at low or medium genetic risk but with low muscle strength. Our findings inform future clinical trials to prevent or delay the onset of T2D by implementing muscle-strengthening interventions among individuals of varying levels of genetic susceptibility to T2D, including those with high genetic risk.
Whole exome sequencing identified mutations of forkhead box I 1 (FOXI1), keratin 6 C (KRT6C) and gap junction protein delta 2 (GJD2) in a low-grade oncocytic tumor of the kidney: a case report
Authors: Kakumoto Akinari , Nishimura Koichi , Toki Daisuke , Kasajima Rika , Kuroda Hajime , Nagashima Yoji , Kondo Tsunenori , Miyagi Yohei , Masunaga Atsuko
Published: February 2025

Background

Low-grade oncocytic tumor (LOT) of the kidney is an emerging entity among renal oncocytic tumors. While the histological features of LOT of the kidney are similar to those of renal oncocytoma, LOT immunohistochemically expresses keratin 7 (KRT7) but not KIT while renal oncocytoma expresses KIT. Molecular analyses of LOTs of the kidney using next generation sequencing revealed those tumors harbor mutations of mTOR-related genes.

Case presentation

An 80-year-old Japanese man with a history of clear cell renal cell carcinoma and prostatic cancer underwent resection of the tumor of the right kidney, 10 mm in diameter, which was monitored for six years. The tumor was histologically composed of oncocytic cells that expressed KRT7, vimentin, SDHA, SDHB and fumarate hydratase, but not KIT, GATA3 and alpha-methylacyl-CoA racemase. We diagnosed the tumor as LOT of the kidney. Whole-exome sequencing of the LOT revealed single nucleotide variants in the DNA-binding region of forkhead box I1 (FOXI1), the coil 1B domain of keratin 6 C (KRT6C) and the intracytoplasmic region of gap junction delta 2 (GJD2), which encodes connexin 36. However, there was no mutations in mTOR-related genes. No copy number alterations were detected in the tumor.

Conclusions

We report three mutations in genes that have not been previously reported in LOT of the kidney. The genes are not related to the mTOR pathway. Therefore, LOT of the kidney might occur through several mechanisms and/or include several types of renal oncocytic tumors.
The economic impact of caregiving for individuals with Angelman syndrome in the United States: results from a caregiver survey
Authors: Jarvis John , Chertavian Elizabeth , Buessing Marric , Renteria Taylor , Tu Lufei , Hoffer Lauren , Fischer Ryan , Moore Amanda , Cross Meagan , Tones Megan
Published: February 2025

Background

Angelman syndrome (AS) is a rare neurogenetic disorder characterized by persistent cognitive and functional impairments that necessitate lifelong care. Caring for individuals with AS leads to substantial household costs, as well as impacts on work productivity, leisure time, and quality of life for caregivers. The economic value of these impacts in the United States (US) has not been well studied. We conducted a survey of US caregivers for persons with AS to quantify the annual economic impact of caregiving. Information on AS-related economic impacts was gathered, including household costs, employment impacts, leisure time loss, and caregiver healthcare costs. The survey did not gather information on direct medical care costs borne by healthcare insurers or other economic impacts to the US government and other stakeholders.

Results

A total of 105 caregivers completed the survey and 105 individuals with AS were represented. Most caregivers were female (89.5%), white (83.8%), and identified as the primary caregiver (75.2%). Most individuals with AS represented in the sample were age < 18 (82.9%). The annual economic impact of caregiving for persons with AS averaged $79,837 (SD $55,505). Costs related to employment impacts and lost work productivity in the past 12 months accounted for most (53%) of this impact and averaged $42,697 (SD $28,309). Household costs incurred in the past 12 months for goods and services to better accommodate individuals with AS were $29,680 (SD $47,753). Leading contributors included vehicle purchases and modifications (mean $6,717; SD $17,791), professional caregiving (mean $6,123; SD $17,335), home modifications and repairs (mean $4,387; SD $15,734), and supportive therapy (mean $3,269; SD $7,564). Economic impacts in the past 12 months from lost leisure time and incremental healthcare costs for caregivers were estimated to be $6,634 (SD $4,652) and $827 (SD $2,072), respectively.

Conclusions

Caregivers incur substantial costs to accommodate individuals with AS, as well as substantial impacts related to employment and leisure time. This study’s findings may be utilized in future research to better estimate the value from therapeutic advances in AS and direct resources toward mitigating economic impacts for households.
Teicoplanin pharmacokinetics in critically ill patients on extracorporeal organ support: a retrospective analysis
Authors: Camen Giovanni , Wendel-Garcia Pedro David , Erlebach Rolf , Müller Mattia , John Caroline , Buhlmann Alix , Andermatt Rea , Schuepbach Reto A. , David Sascha , Hofmaenner Daniel A.
Published: February 2025

Background

Extracorporeal membrane oxygenation (ECMO) can alter the pharmacokinetics of diverse antimicrobials, posing challenges in achieving therapeutic drug levels. Some literature suggests that teicoplanin may require higher dosing in ECMO patients, however the respective evidence is scarce. The aim of this study was to assess teicoplanin trough levels in critically patients on ECMO support and to compare patients with and without additional continuous renal replacement therapy (CRRT). We conducted a retrospective study at the Intensive Care Unit (ICU) of the University Hospital Zurich, Switzerland. Teicoplanin trough levels and doses were analyzed in critically ill patients during ECMO support by means of a non-parametric local estimated polynomial regression. Outcomes included the proportion of patients with insufficient or toxic teicoplanin trough levels, dosage adjustments, and differences in teicoplanin trough levels between patients with and without additional CRRT during ECMO support.

Results

After screening 172 patients receiving teicoplanin therapy during their ICU stay from 1.1.2020 to 19.07.2023, a total of 23 adult patients were included. The proportion of patients with insufficient teicoplanin levels was notably higher during ECMO support compared to patients with toxic levels (78.3% vs. 13% of patients, respectively). Teicoplanin dosages mostly were increased during the first few days of ECMO treatment. Concomitant CRRT led to a further increase in the proportion of patients with insufficient levels.

Conclusions

Teicoplanin trough levels using standard dosing tend to be low in patients on ECMO support, especially in the early days of therapy. Higher doses than the standard regimen are often necessary to achieve therapeutic levels, particularly in patients receiving additional CRRT.
Early sepsis recognition: a pilot study using a rapid high-multiplex host-response mRNA diagnostic test
Authors: Lu Jingyi , ter Voert Michèle A. , Ünal Mehtap , Whitfield Natalie N. , Liesenfeld Oliver , ter Maaten Jan C. , Sweeney Timothy E. , Bouma Hjalmar R.
Published: February 2025

Background

Early sepsis diagnosis is essential to allow timely initiation of adequate care. The TriVerity™ Test, performed on the Myrna™ Instrument, is the first rapid high-multiplex host-response mRNA diagnostic test that supports clinical decision-making by evaluating the likelihood of bacterial and/or viral infections and severity of illness. We present findings of the first, proof of concept, real-world evaluation in an emergency department (ED).

Methods

Blood was collected in PAXgene® Blood RNA tubes from adult patients visiting the ED with suspicion of infection between 4th December 2023 and 22nd January 2024. TriVerity was performed within 1 h (RNA extraction and amplification of 29 host mRNAs using LAMP technology on the Myrna Instrument within approximately 30 min). TriVerity generates three diagnostic scores (likelihood of bacterial infection, viral infection, and illness severity), each classified into five discrete interpretation bands (very low, low, moderate, high, and very high). Post hoc chart reviews were performed after hospital discharge to clinically adjudicate the infection status (consensus and forced adjudication).

Results

Among 60 patients, there were 20 (33%) bacterial infections, 15 (25%) viral infections, 11 (18%) bacterial–viral coinfections and 14 (23%) did not have an infection under forced adjudication. Under consensus adjudication, bacterial results demonstrated 95% rule-in specificity and 95% rule-out sensitivity. Viral results demonstrated rule-in specificity 100% and 92% rule-out sensitivity. Since only three patients were admitted to the ICU or died in this cohort, we cannot draw firm conclusions about the predictive value of the test for severe endpoints.

Conclusions

TriVerity is a rapid whole-blood host-response test to reliably detect the presence or absence of bacterial and/or viral infections, as well as to assess illness severity in patients presenting to the ED. Its quick turnaround time aligns with the ED workflow, offering timely insights for clinical decision-making. Results from upcoming large-scale validation studies will provide more detailed results on the diagnostic and prognostic accuracy of the test.
Barriers and facilitators to tuberculosis service access for patients in Bajhang, Nepal: a qualitative study based on focus groups with patients, screening camp visitors, community volunteers and medical doctors
Authors: Malla Emil , Shahi Sachin , Forsberg Birger
Published: February 2025

Background

Efforts to achieve global tuberculosis (TB) targets, especially in lower- and middle-income countries, such as Nepal, require urgent attention. Challenges persist, including TB-related social stigma and catastrophic costs incurred by affected households. Socioeconomically vulnerable individuals, particularly those residing in rural, mountainous and remote areas, face limited access to TB care. To explore the barriers and facilitators to accessing TB care, this study was conducted in Bajhang, one of the most underdeveloped and socioeconomically vulnerable districts in Sudurpaschim Province of far-western Nepal.

Methods

Focus group discussions (FGDs) were held with TB patients, TB camp visitors, community mobilizers and medical doctors.

Results

Thirty-five barriers and 21 facilitators were identified by thematic analysis of the eight FGDs. Key barriers included economic burdens, social stigma leading to concealment and isolation, limited resources in local healthcare and geographical inaccessibility. Notable facilitators included TB volunteer programs, screening camps, economic support, and awareness campaigns.

Conclusions

Prioritizing actions should target early care cascade stages and address individual, community, infrastructure, and health policy levels.
Learning about causal relations that change over time: primacy and recency over long timeframes in causal judgments and memory
Authors: Rottman Benjamin M. , Zhang Yiwen
Published: February 2025

Being able to notice that a cause–effect relation is getting stronger or weaker is important for adapting to one’s environment and deciding how to use the cause in the future. We conducted an experiment in which participants learned about a cause–effect relation that either got stronger or weaker over time. The experiment was conducted with a typical procedure in which the learning cases were presented rapidly, and with a mobile phone procedure, in which participants experienced the cause–effect relation over 24 days. First, we found that people could detect the change in contingency. They were better at doing so in the artificial short timeframe task, but still could do so in the more realistic long timeframe task. Second, when making summary judgments about the cause–effect relation, participants exhibited a recency effect for most measures in the long timeframe, but did not exhibit a primacy or recency effect in the short timeframe. Third, though participants’ episodic memories for individual cause–effect events in the learning sequence were quite poor, they did exhibit primacy and recency effects in the short timeframe; these were attenuated in the long timeframe. These findings raise fundamental questions about causal learning; they suggest that people automatically recognize changes and store representations of the contingency during different phases of learning, but this ability is not predicted by most existing theories of causal learning.