bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Sports Media Credibility, Bias, Political Identification, and Fandom Using a Repeated Cross-Sectional Survey
Authors: Brown-Devlin Natalie , Tao Jingyue , Imbrogno Chris , Butterbaugh Nicole , Liu Xiaotong , Memon Leonard , Acaf Yara , Anderson Josh
Published: January 2025

Two studies utilizing a repeated cross-sectional survey were conducted over a three-year period to measure the source credibility and media bias ratings of six sports media brands (i.e., NBC Sports, ESPN, FOX Sports, CBS Sports, Bleacher Report, Yahoo Sports). Study 1 found sports media brands’ source credibility has been rated more positively since 2021 and ratings of media bias have decreased since 2021. Guided by social identity theory, Study 2 analyzed how respondents’ social identity labels (i.e., political identification and sports fandom) affected their media bias and source credibility evaluations, noting the importance of sports fandom. Notably, sports fans report lower levels of media bias when their fandom level is high.
Correlation Between Facet Tropism and Ossification of the Posterior Longitudinal Ligament in the Cervical Spine
Authors: Zhou Hao , Wang Jianxi , Zhang Wenyu , Gao Chenfei , Hu Bo , Zhen Genjiang , Li Xingyu , Wang Hui , Yuan Wen , Chen Huajiang , Liang Lei
Published: January 2025

Study Design

Retrospective cohort study.

Objectives

To explore the correlation between Facet Tropism (FT) and OPLL in cervical spine.

Methods

One-hundred patients with OPLL of cervical spine and one-hundred normal participants without OPLL or cervical disc herniation were included in this study, the patients were matched to the normal participants respectively based on the same sex and similar age (±5). For patients, the cervical levels with and without OPLL were categorized into “OPLL group” and “patient control group,” respectively. Bilateral facet joint angles at C2/3-C6/7 were measured on sagittal, coronal, and axial planes on CT.

Results

On every planes at the level of C2/3-C6/7,the mean difference between left and right facet angles and FT incidence in the most levels of the OPLL group were significantly greater than those in the control groups ( P < 0.001). At the most cervical levels, there was no significant difference in mean difference of facet angles and FT incidence between the 2 control groups. On the axial plane, the incidence of FT in segmental type OPLL patients was significantly higher than that in continuous type OPLL patients ( P = 0.036). On the coronal plane, the incidence of FT in segmental type OPLL was significantly higher than that in the other OPLL types ( P < 0.001), and local type OPLL had a higher incidence of FT compared to mixed type OPLL ( P = 0.016). On the sagittal plane, the incidence of FT in segmental type OPLL was higher than that in continuous type OPLL ( P = 0.019) and mixed type OPLL ( P = 0.036).

Conclusions

There is a significant correlation between OPLL of cervical spine and FT. There are significant differences in the incidence of FT among different cervical OPLL types.
Impact of Antiplatelet Medication Continuation on Surgical Outcomes after Minimally Invasive Posterior Lumbar Decompression Surgery: Retrospective Cohort Study
Authors: Sawada Yuta , Tamai Koji , Toyoda Hiromitsu , Kato Minori , Suzuki Akinobu , Takahashi Shinji , Iwamae Masayoshi , Okamura Yuki , Kobayashi Yuto , Nakamura Hiroaki , Terai Hidetomi
Published: January 2025

Study Design

Retrospective cohort study.

Objectives

Spinal surgeons face a dilemma regarding the continuation or discontinuation of antiplatelet agents during the perioperative period. Guidelines recommend considering the balance between thrombotic and bleeding risks. However, no consensus exists for the use of these agents for patients who undergo minimally invasive lumbar decompression. This study aimed to assess the effect of continued antiplatelet medication on minimally invasive posterior lumbar decompression surgery outcomes, focusing on perioperative outcomes and 1-year postoperative clinical results.

Methods

This study included 106 patients who underwent minimally invasive posterior lumbar decompression between 2017 and 2022 and were taking antiplatelet medications before spinal surgery. Patient characteristics, antiplatelet medication type, and perioperative data were analyzed. Patients were divided into “continuation” and “discontinuation” groups based on preoperative antiplatelet medication status. Univariate and multivariate linear regression analyses were performed.

Results

No significant differences were observed between groups in terms of surgical time, intraoperative blood loss, postoperative drain volume, complication rates, and Japanese Orthopedic Association scores and EuroQoL-5 dimensions 5-level at 1 year postoperatively. Similar results were noted in groups focusing exclusively on patients treated with aspirin. Multivariate linear regression revealed that surgical time per level was significantly associated with total blood loss, whereas antiplatelet medications did not show a significant relationship (operative time per level, P < 0.01; antiplatelet drugs, P = 0.459).

Conclusions

This study suggests that minimally invasive posterior lumbar spine decompression can be performed safely and effectively under continuous antiplatelet medication. Further studies with more evidence are required to validate our findings.
Characterization of swallowing biomechanics and function in untreated infants with spinal muscular atrophy: A natural history dataset
Authors: McGrattan Katlyn Elizabeth , Graham Robert J , Mohr Alicia Hofelich , Miles Anna , Allen Jacqui , Ochura Juliet , Hernandez Kayla , Walsh Katie , Rao Vamshi , Stevens Melanie , Alfano Lindsay , Coker Mackenzi , Leon-Astudillo Carmen , Smith Leann Schow , Brandsema John , Farah Hiba , Welc Julia , Levy Deborah Salle , Clements Miranda , Tang Whitney J , Duong Tina , Rocha Carolina Tesi , Schenck Graham , McGhee Heather , Nichols Keeley , Brown Ashley , Brown Allison , Castro Diana , Darras Basil T
Published: January 2025

Background:

Spinal Muscular Atrophy (SMA) is a progressive neuromuscular disorder that in its most severe form, causes profound swallowing deficits. There remains a paucity of research systematically elucidating the biomechanical and functional correlates. This void limits the ability to evaluate the effects of disease-modifying treatments on swallowing.

Objective:

Elucidate characteristics of swallowing biomechanics and function among untreated patients with SMA.

Methods:

Infants with SMA who had not received disease modifying therapy when they underwent a videofluoroscopic swallow study (VFSS) were retrospectively identified from 13 international children's hospitals. Infants were eligible if they exhibited symptoms by six months old, or in cases where they detected prior to symptom onset, if they had two copies of SMN2. Eligible infants underwent medical record review to gather oral intake status and need for suctioning for secretion management. Digital files of VFSS’ were extracted and analyzed using BabyVFSSImP™. Non-parametric t-tests were used to compare swallowing biomechanics based on viscosity and the presence of dysphagia symptoms.

Results:

62 infants were included in this investigation with average age at initial VFSS 4.4 ± 3.11 months. A high proportion of infants exhibited profound deficits in swallowing biomechanics that impeded extraction of the bolus from the nipple, clearance of the bolus from the pharynx, and prevention of the bolus from entering the airway. Deficits were significantly more prevalent in infants referred for VFSS due to dysphagia symptoms than asymptomatic infants referred as part of high-risk referral (t ≤ 2.5, p ≤ 0.03). A high proportion of infants relied on suctioning for secretion management (34%; N = 21) and alternative nutrition (39%; N = 24), with those relying on these supports exhibiting significantly worse swallowing biomechanics than those who did not (t ≤ 2.8, p ≤ 0.01).

Conclusions:

Profound deficits in swallowing biomechanics and function are common in infants with SMA. Though clinical symptoms may aid in identifying infants with the most profound swallowing deficits, their absence in cases of more mild deficits inhibits the ability to use these clinical markers as a valid metric of swallowing integrity.
Weighted Approaches to Assessing Injury Burden in Team Sports
Authors: Glazer Amanda , Binney Zach , Seth Tej
Published: January 2025

Injuries have a large impact on a team’s success during the season. Typically teams with more injuries, especially those affecting the most valuable players, will perform worse than similar teams with fewer injuries. A common way to quantify a team’s injury burden is by simply counting the number of injuries or games missed due to injury. However, these measures do not account for the individual value of the players injured. We assess two frameworks for how injuries may be weighted by player value. We propose a new position-weighted metric based on franchise tag values to measure injury burden in American football, called weighted Adjusted Games Lost (wAGL), and we test another player-level metric, Wins Above Replacement-Adjusted Injuries Lost (WAIL). WAIL uses a proprietary calculation of player Wins Above Replacement from Pro Football Focus. By comparing these measures to a gold standard of injury burden using pre- versus end-season betting lines and team strength estimates, we find that wAGL is a better measure of injury burden than current alternatives across all team-seasons considered.
Ranking Surgeon Performance After ACL Reconstruction Using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Subscales
Authors: Floyd Sarah B. , Ahearn Briggs , Kissenberth Michael J. , Brooks John M. , Thigpen Charles A.
Published: January 2025

Background:

Patient-reported outcomes (PROs) are considered the gold standard for evaluating value-based care in orthopaedics. However, there is little evidence to guide implementation of PROs for surgeon performance evaluation.

Purpose:

To develop a risk-adjusted surgeon performance measure using the Knee injury and Osteoarthritis Outcome Score (KOOS) for patients undergoing anterior cruciate ligament reconstruction (ACLR).

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Patients (N = 1248; 662 men; mean age, 30 ± 13 years) who underwent ACLR performed by 40 surgeons between 2010 and 2018 were identified from a large, nationally representative sports medicine clinical data registry. Linear regression was used to predict change scores for each KOOS subscale (Pain, Symptoms, Activities of Daily Living [ADL], Function in Sports and Recreation, and Knee-Related Quality of Life) while adjusting for patient baseline characteristics. A risk-adjusted performance measure was calculated for each KOOS subscale as the difference between the unadjusted and the risk-adjusted predicted change score across all patients treated by a single surgeon. Surgeon-relative quartile ranking was compared across outcome subscale scores.

Results:

One-third of the patients (34%) displayed acute cartilage damage, and 56% had a meniscal injury. In the risk adjustment models, older age, presence of diabetes, current smoking status, acute cartilage damage, concurrent cartilage treatment, lower baseline Veterans RAND 12-Item Health Survey mental and physical component scores, and lower baseline Marx and KOOS subscale values all had a significant negative influence on the predicted KOOS subscale change values ( P < .05 for all). Surgeon performance, ranked in quartile groups, was the same for 10 surgeons but varied by 1 to 2 quartiles for the other 30 surgeons across the different KOOS subscales.

Conclusion:

These results showed that surgeon performance varies widely when evaluated using different KOOS subscales for patients undergoing ACLR. Based on the preliminary results and clinical perspective, the authors recommend the ADL and Symptoms subscales as the best options to differentiate surgeon performance for these patients. However, evaluation of surgeon performance may require consideration or use of a set of PROs or the development of a single index PRO that is sensitive to the range of outcome dimensions important to patients.
The Right to Peace and the Right to Stay: Insights From Approaches to Peace and Migration in Colombia
Authors: Prada Ramírez Maria , Murphy Emma
Published: January 2025

Executive Summary

This paper examines the right to peace and the right to stay in the context of Colombia. Colombia’s status as a nation that experienced extraordinary levels of violence, human rights violations, internal and external displacement, and conflict between state, guerilla, paramilitary, and cartels over at least five decades, makes it a critical site for understanding and responding to migration and forced displacement. The article describes the 2016 peace agreement and outlines the work of its Truth Commission in moving toward an adoption of the right to peace and the connection between these rights and the right to remain in one’s home country. The Truth Commission was devoted to:

• Examining, explaining, and identifying collective responsibilities for the armed conflict, atrocities, and marginalization;

• Offering redress to millions of victims;

• Restoring human rights, promoting peaceful coexistence, and contributing to the non-recurrence of the armed conflict.

The paper highlights the strategies and core findings of Colombia’s Truth Commission at a time when Colombia does not constitute a success story, but is in the process of trying to build an inclusive, rights-respecting, peaceful, and cohesive society, which is the fundamental work of the “right to stay” and not to have to emigrate.

The article also documents the transition of Colombia from a relatively modest migrant host country through much of its history, to a country which since 2016 has become home to three million immigrants, most of them from Venezuela. It explores the paradox of Colombia’s embrace of immigration from Venezuela while the administration slowed implementation of the 2016 Peace Agreement. This agreement itself has strong connections to migrants and persons in exile, as is clear from the work of the Colombian Truth Commission (CTC). The paper argues for addressing the root causes of armed conflict and embracing the CTC’s finding that the right to stay is linked to the right to peace.
Leadership in Pediatric Surgical Nursing: Combating Microaggressions, Nurse Burnout, and Cultivating Effective Teams
Authors: Sullivan Debra , Frazer Christine , Lopez Lois , Frazer Emily A.
Published: January 2025

The perioperative setting is one of the most demanding areas in healthcare, requiring precise coordination for optimal patient outcomes. However, this environment is susceptible to disruptions from microaggressions and burnout, which can negatively impact communication, collaboration, teamwork, and care quality. These issues can create a toxic work culture, heighten patient anxiety, and lead to poorer patient outcomes. Pediatric surgical nurses face heightened burnout due to emotional overload, increasing workloads, and lack of managerial support. Leadership plays a critical role in addressing these challenges by fostering an inclusive and supportive workplace. Leadership styles must include an authentic commitment to equity, belonging, and representation is essential to improving nurse well-being, job satisfaction, and patient outcomes. Leaders must engage with staff through open dialogue, implement strategies such as education and stress reduction programs, and promote a work-life balance to combat burnout and microaggressions. However, barriers such as limited resources, resistance to change, and generational differences may impede progress. Overcoming these obstacles requires a multifaceted approach, including comprehensive education, stakeholder engagement, and phased adaptation. By leveraging technology and tailoring strategies to suit various generational needs, nurse leaders can foster an environment that supports professional satisfaction, reduces burnout, and promotes excellence in pediatric surgical care.
Nurses’ Experience With End-of-Life Care in Geriatric Centers: A Systematic Review
Authors: Dakka Falah Jamal
Published: January 2025

Background

Geriatric nurses provide end-of-life care based on the five pillars of aging. This systematic review assesses the emotions and feelings of geriatric nurses during end-of-life care. It considers the prevalence, triggers, and intensity of emotional responses among geriatric nurses. It also expounds on the strategies for overcoming the emotional challenges.

Methods

The study embarked on a systematic review of literature materials on nurses’ emotions and feelings. The eligibility criteria involve literature materials published in the past 5 years, peer reviews, English language, geriatric nurses, and nurses in emergency department, primary care, and intensive care unit. Three databases (Cochrane Library, PubMed, and CINAHL) and Google Scholar were used.

Results

Using a PRISMA flow chart, the literature search led to the discovery of nine significant writings on the emotions and feelings of nurses attending to geriatric patients. Sample sizes in these studies varied from 6 to 126 nurses while three articles involved integrated, scoping, and literature review of published studies. The common emotions and feelings among nurses caring for elderly patients in the geriatric center are compassion fatigue, burnout, grief, and moral distress.

Conclusion

These emotions and feelings affect the performance of nurses. They also influence their physical and mental wellbeing. This situation calls for developing effective coping strategies to address this challenge.
Useful Learning From Bachelor's Thesis to Professional Nursing Practice: A Qualitative Interview Study
Authors: Henttonen Ani , Teräs Marianne , Scheja Max , Fossum Bjöörn , Westerbotn Margareta
Published: January 2025

Introduction

It is well-established in research that clinical learning during nursing education is a foundational preparation for future practice. However, the role of academic tasks, such as writing a bachelor's thesis, is less recognized for its contributions to nurses’ working lives and overall professional development.

Objective

This study aimed to explore registered nurses’ perceptions of the process of bachelor's thesis and its perceived usefulness in professional nursing careers.

Methods

Semistructured interviews with ten registered nurses was employed. A thematic analysis of the data and the framework of sustainable learning were used.

Results

The findings showed that the process of writing a bachelor's thesis during nursing education was perceived as a valuable learning experience and a source of continuing development. The main themes, professional knowing and professional agency, demonstrate the knowing applied in the healthcare contexts and for understanding nurse-patient relationships. The nurses stated that professional agency in research dissemination and a critical approach in their daily patient care was important and that the bachelor's thesis had provided a foundation for these practices.

Conclusion

Writing a bachelor's thesis during nursing education is justified as it may contribute to a critical understanding of nursing phenomena and the care taking place in clinical contexts. Bachelor's theses align with sustainable learning and are one of the prerequisites for readiness for change and development in professional practice.
Barrios 4D: Semi-automated morphology analysis of human settlements using mobile laser scanning
Authors: Castaño-López Jason Alejandro , Perafán-Villota Juan C , Llanos-Neuta Nicolas , Mora Simone , Romero-Cano Victor
Published: January 2025

Civil or government organizations base human settlement transformation decisions on limited and sparse data. However, broader and denser information is necessary. Camera and LiDAR data processing is a more effective, automatic, and affordable method to fully characterize the morphological structure of human settlements. This work presents a system for estimating metrics about relevant morphological characteristics of human settlements using LiDAR data. We provide a quantitative analysis of these metrics obtained in the city of Cali, Colombia. Additionally, we enable the automatic calculation of urban metrics such as the street canyon ratio, which relates building height to street width, a metric highly correlated with air quality. Moreover, we extrapolate findings from existing literature to compare our results and understand how indirectly measured variables, such as thermal sensation and perceived beauty of the environment, might behave Our system can potentially be used by civil and government organizations to develop informed and precise urban planning and transformation strategies, including land use zoning, infrastructure development, and addressing issues related to housing, transportation, and environmental sustainability.
Generating conceptual landscape design via text-to-image generative AI model
Authors: Ye Xinyue , Huang Tianchen , Song Yang , Li Xin , Newman Galen , Wu Dayong Jason , Zeng Yijun
Published: January 2025

This study explores the integration of text-to-image generative AI, particularly Stable Diffusion, in conjunction with ControlNet and LoRA models in conceptual landscape design. Traditional methods in landscape design are often time-consuming and limited by the designer’s individual creativity, also often lacking efficiency in the exploration of diverse design solutions. By leveraging AI tools, we demonstrate a workflow that efficiently generates detailed and visually coherent landscape designs, including natural parks, city plazas, and courtyard gardens. Through both qualitative and quantitative evaluations, our results indicate that fine-tuned models produce superior designs compared to non-fine-tuned models, maintaining spatial consistency, control over scale, and relevant landscape elements. This research advances the efficiency of conceptual design processes and underscores the potential of AI in enhancing creativity and innovation in landscape architecture.
Living as a Victim: Experiences of Women Raped During Farmers– Pastoralists’ Conflict in Delta State, Nigeria
Authors: Favour Ogwumike Alaba
Published: January 2025

In Nigeria, the issue of rape has become a very worrisome matter. Many victims refuse to speak out due to the stigma attached. Most available pieces of literature on the issue of rape focus on the act (first stage of stigma) and the reactions (second stage of stigma). This article adopts the historical and exploratory design to examine the third stage of stigma, which is the self-imposed stigma on pastoralists’ rape victims in Delta state, Nigeria. It is a qualitative study which includes interviews, focus group discussions (FGD) and newspaper reviews. The data were analysed using content analysis. Findings revealed that there is a stigma attached to rape victims, but community experience has shown that there is another level of stigma attached to women who are raped by pastoralists. The study argues that such victims are further stigmatized because pastoralists are seen as ‘dirty’, and the fact that they are ‘strangers’ makes it even worse for the victims. Such women are noticed to suddenly withdraw from their fellow women in the community, and they avoid other women gathering. The study contributes to the literature on rape victimization and the stigma in interethnic relations and violence.
Individual characteristics influencing the general population’s level of knowledge of end-of-life practices: a cross-sectional study
Authors: Tapp Diane , Bravo Gina , Filion Catherine , Couture Vincent , Dupéré Sophie , Beaulieu Marianne , Chouinard Audrey , Roos Pauline , Gagnon Marie-Pierre , Bérubé Anouk , Plaisance Ariane
Published: January 2025

Background:

Informed end-of-life decision-making requires a high level of death literacy. We still know little about the general population’s level of knowledge and its determinants.

Aim:

To assess knowledge of the general population regarding the legal status and definitions of various end-of-life practices, and to compare the level of knowledge according to individual characteristics known to influence death literacy.

Design:

A self-administered questionnaire featuring two evolving vignettes was used to assess participants’ knowledge relating to the legal status of various end-of-life practices and whether these practices are Medical Aid in Dying (MAiD), which is legal in Canada. The questionnaire also assessed participants’ individual characteristics such as their experience as caregivers for someone who received palliative care, their perception of health, and their financial situation.

Setting/participants:

Participants were community-based community-based Canadian adults able to read French or English.

Results:

In total, 27% of the participants associated the description of care withholding with MAiD, 39% incorrectly associated the description of continuous palliative sedation with MAiD, and 34% incorrectly indicated that the described intervention was illegal. Having cared for someone who received palliative care, at a younger age, a higher level of education, and having participated in advance care planning were associated with better knowledge regarding end-of-life practices.

Conclusion:

Gaps in knowledge about end-of-life practices exist in the general population, they are associated with different individual characteristics and may limit citizens’ capacity to engage in informed end-of-life decision-making. Community-based interventions adapted to different audiences are essential to ensure a quality end-of-life for all.
Implementing Food as Medicine During COVID-19: Produce Prescriptions and Integrative Group Medical Visits in Federally Qualified Health Centers
Authors: Thompson-Lastad Ariana , Ruvalcaba Denise , Chen Wei-Ting , Espinosa Patricia Rodriguez , Chiu Dorothy T. , Xiao Lan , Rosas Lisa G. , Chen Steven
Published: January 2025

Background

Food as Medicine is a rapidly developing area of health care in the United States, aimed at concurrently addressing nutrition-sensitive chronic conditions and food and nutrition insecurity. Recipe4Health (R4H) is a Food as Medicine program with an integrative health equity focus. It provides prescriptions for locally grown produce (‘Food Farmacy’) with or without integrative group medical visits, alongside training for clinic staff.

Objectives

To describe the initial implementation of R4H in four Federally Qualified Health Centers in Northern California, using a convergent mixed-methods approach.

Methods

We used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) implementation science framework to assess the first two years of R4H (2020-2022). We draw from 40 interviews (26 partner organization staff, 14 patients) and program data on reach and adoption. Qualitative data were analyzed using codebook thematic analysis.

Results

Reach: From January 2020 to August 2022, 3255 patients were referred to the program; 1997 of those referred (61%) enrolled in the Food Farmacy only ( N = 1681) or Food Farmacy + integrative group medical visits ( N = 316). Participating patients included a wide range of ages (mean age 41.4, [SD 20]; 18% < 18 years old) and racial and ethnic backgrounds (3% American Indian or Alaska Native, 6% Asian or Pacific Islander, 19% Black, 57% Hispanic/Latine, 7% white). 69% were female; 43% primarily spoke Spanish. Adoption: 84% of trained clinic staff referred two or more patients to R4H. Implementation: Elements of successful implementation included: (1) support from county government leadership, (2) centralized coordination of the multi-sector partnership, and (3) a flexible approach responsive to organizational and COVID-related shifts. R4H implementation informed statewide Medicaid policy changes. Maintenance: To date, all four clinics continue to participate in R4H.

Conclusion

Centralized implementation, training, and administration of Food as Medicine programs can strengthen community health centers’ capacities to concurrently address chronic conditions and food insecurity. Multi-sector partnerships can support Food as Medicine program sustainability.
A review of plant-derived gums and mucilages: Structural chemistry, film forming properties and application
Authors: Shiam Md. Azizul Hakim , Islam Mst Sadia , Ahmad Iftakhar , Haque Sumaiya Sadia
Published: January 2025

Plant-based gums and mucilages are versatile biopolymers with significant industrial, environmental, and biological applications. Derived from various plant sources such as seeds, roots, leaves, and exudates, these polysaccharides comprise proteins, bioactive substances, and neutral sugars like arabinose, galactose, and galacturonic acid. Their unique structural and functional properties, such as high viscosity, water retention, and heat stability, make them valuable in the food, pharmaceutical, and cosmetic industries. Due to their hydrophilic nature and ability to form hydrogen bonds with water, these materials serve as emulsifiers, film-forming agents, gelling agents, and stabilizers. Recent studies have highlighted their potential in sustainable applications, including biodegradable packaging materials, whose film-forming properties are crucial. The inclusion of bioactive properties such as antibacterial, antioxidant, and immune-modulating effects has expanded their use in functional foods and nutraceuticals. Gums and mucilages also play essential roles in pharmaceuticals as tablet binders, drug carriers, and controlled-release excipients. Moreover, nanotechnology has enhanced its applications in environmental remediation and drug delivery through hydrogels and mucilage-coated nanoparticles. Despite their potential, challenges remain due to variability in extraction and processing methods. This analysis underscores the transformative potential of plant-derived gums and mucilages in promoting sustainable development, addressing key environmental challenges and integrating scientific innovations with industrial needs.
Selection of sampling sites in Germany for the International Moss Survey 2020 using statistics and decision modelling
Authors: Nickel Stefan , Schröder Winfried
Published: January 2025

Background

After 1990, 1995, 2000, 2005 and 2015, Germany participated in the International Moss Monitoring 2020 (MM2020). The German contribution to MM2020 aimed at pilot studies on the suitability of bioindication with mosses for recording the atmospheric deposition of persistent organic pollutants and microplastics.

Results

This investigation was based on moss samples collected at 25 sites in Germany: Eight sites at which concentrations of persistent organic pollutants were determined in the Moss Survey 2015 were included. In addition, twelve sites were selected from the pool of the total of 400 moss collection sites in 2015. Further five sites of the German moss monitoring network 2015 were added, at which moss samples were collected in 2020 for developing the sample preparation and for preliminary investigations. The selection of the five test sites was based on the same criteria as for the 20 target sites of the 2020 monitoring to make the analysis data of the test phase usable for later evaluations. To ensure methodological transparency and objectivity, a procedure based on statistical methods and decision modelling was developed for this purpose. The decision algorithm enabled taking into account a large number of technical criteria. Selected features of the three subsamples comprising 8, 20 and 25 sites were compared with those of the full sample (n = 400 sites of Moss Survey 2015) and inferentially tested whether the thinning of the 2015 sampling network (n = 400) to 8, 20 and 25 sites, respectively, leads to significant changes in its information quality or not.

Conclusions

Methods of decision modelling and inferential statistics have proven their worth for transparently restructuring the moss monitoring network.
Meta Analysis of Methylenetetrahydrofolate Reductase (MTHFR) C677T polymorphism and its association with folate and colorectal cancer
Authors: Ye Meng , Xu Guojie , Zhang Liming , Kong Zhihui , Qiu Zhenhua
Published: January 2025

Background

DNA hypomethylation and uracil misincorporation into DNA, both of which have a very important correlation with colorectal carcinogenesis. Folate plays a crucial role in DNA synthesis, acting as a coenzyme in one-carbon metabolism, which involves the synthesis of purines, pyrimidines, and methyl groups. MTHFR, a key enzyme in folate metabolism, has been widely studied in relation to neural tube defects and hypertension, but its role in colorectal cancer remains underexplored. Therefore, understanding the role of folate and MTHFR genes in colorectal cancer may be helpful for potential preventive or therapeutic interventions. In this meta-analysis, the effects of MTHFR genotype and folate intake on colorectal cancer incidence were analyzed.

Methods

We searched PubMed,Embase, Web of Science, and CNKI database to identify relevant studies up to January 2024. We included a series of studies on the association of MTHFR C677T genotype and folate intake with colorectal cancer incidence. The meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). It included 100 studies (39702 cases and 55718 controls),that investigated the association between the MTHFR C677T polymorphism and colorectal cancer (CRC). Additionally, the analysis incorporated further stratification by ethnic population and geographical region. Furthermore, Six of the studies which clarified high amount of folate might be a protective factor for CRC in all three MTHFR C677T genotype, especially in TT genotype.

Results

MTHFR 677TT genotype was negatively associated with CRC incidence compared with CC genotype (OR = 0.89; 95% CI: 0.85–0.93; P < 0.00001; Z = 5.17). MTHFR 677CT genotype was not significantly associated with colorectal cancer incidence (OR = 1.00; 95% CI: 0.98,1.03). A negative correlation between TT genotype and CRC was observed in ethnics of Asians (OR = 0.83, 95% CI: 0.76, 0.91), Caucasians (OR = 0.93, 95% CI: 0.88, 0.99) and the region of USA (OR = 0.77, 95% CI: 0.71, 0.85), Asia (OR = 0.93, 95% CI: 0.86, 1.00) and Europe (OR = 0.93, 95% CI:0.87, 1.00),but not in Indian (TT: OR = 1.67, 95% CI: 1.06, 2.63; CT: OR = 1.31, 95% CI: 1.00, 1.73)). Amount folate intakes might reduce the morbidity of CRC for people in MTHFR 677TT genotype (OR = 0.68; 95% CI: 0.48,0.96; P = 0.03).

Conclusion

The analysis showed that the incidence of colorectal cancer was reduced among individuals with TT genotype. The individuals with TT genotype and amount folate intake may collectively improve the incidence of colorectal cancer. While the MTHFR 677TT genotype is associated with a reduced risk of CRC, especially in certain populations, these findings should be interpreted with caution due to the limitations of retrospective studies.
Fully automated segmentation and classification of renal tumors on CT scans via machine learning
Authors: Han Jang Hee , Kim Byung Woo , Kim Taek Min , Ko Ji Yeon , Choi Seung Jae , Kang Minho , Kim Sang Youn , Cho Jeong Yeon , Ku Ja Hyeon , Kwak Cheol , Kim Young-Gon , Jeong Chang Wook
Published: January 2025

Background

To develop and test the performance of a fully automated system for classifying renal tumor subtypes via deep machine learning for automated segmentation and classification.

Materials and methods

The model was developed using computed tomography (CT) images of pathologically proven renal tumors collected from a prospective cohort at a medical center between March 2016 and December 2020. A total of 561 renal tumors were included: 233 clear cell renal cell carcinomas (RCCs), 82 papillary RCCs, 74 chromophobe RCCs, and 172 angiomyolipomas. Renal tumor masks manually drawn on contrast-enhanced CT images were used to develop a 3D U-Net-based deep learning model for fully automated tumor segmentation. After segmentation, the entire classification pipeline, including feature extraction and subtype classification, was conducted without any manual intervention. Both conventional radiological features (Hounsfield units, HUs) and radiomic features extracted from areas predicted by the deep learning models were used to develop an algorithm for classifying renal tumor subtypes via a random forest classifier. The performance of the segmentation model was evaluated using the Dice similarity coefficient, while the classification model was assessed based on accuracy, sensitivity, and specificity.

Results

For tumors larger than 4 cm, the Dice similarity coefficient (DSC) for automated segmentation was 0.83, while for tumors smaller than 4 cm, the DSC was 0.65. The classification accuracy (ACC) for distinguishing RCC subtypes was 0.77 for tumors larger than 4 cm and 0.68 for tumors smaller than 4 cm. Additionally, the accuracy for benign versus malignant classification was 0.85.

Conclusions

Our automatic segmentation and classifier model showed promising results for renal tumor segmentation and classification.
Are medical school preclinical tests biased for sex and race? A differential item functioning analysis
Authors: Dale Esther Dasari , Abulela Mohammed A. A. , Jia Hao , Violato Claudio
Published: January 2025

Background

A common practice in assessment development, fundamental for fairness and consequently the validity of test score interpretations and uses, is to ascertain whether test items function equally across test-taker groups. Accordingly, we conducted differential item functioning (DIF) analysis, a psychometric procedure for detecting potential item bias, for three preclinical medical school foundational courses based on students’ sex and race.

Methods

The sample included 520, 519, and 344 medical students for anatomy, histology, and physiology, respectively, collected from 2018 to 2020. To conduct DIF analysis, we used the Wald test based on the two-parameter logistic model as utilized in the IRTPRO software.

Results

The three assessments had as many as one-fifth of the items that functioned statistically differentially across one or more of the variables sex and race: 10 out of 49 items (20%), six out of 40 items (15%), 5 out of 45 items (11%) showed statistically significant DIF for Anatomy, Histology, and Physiology courses, respectively. Measurement specialists and subject matter experts independently reviewed the items to identify construct-irrelevant factors as potential sources for DIF as demonstrated in Appendix A. Most identified items were generally poorly written or had unclear images.

Conclusions

The validity of score-based inferences, particularly for group comparisons, requires test items to function equally across test-taker groups. In the present study, we found DIF of some items for sex and race in three content areas. The present approach should be utilized in other medical schools to address the generalizability of the present findings. Item level DIF should also be routinely conducted as part of psychometric analyses for basic sciences courses and other assessments.

Clinical trial number

Not applicable.
Determinants of rural practice among a cohort of dental professionals in Australia
Authors: Tadakamadla Santosh Kumar , Balla Sudheer Babu , Tadakamadla Jyothi , Semmens Libby , Down Sarah , McKinstry Carol , Mills Jane
Published: January 2025

Background

Most research on tracking practice locations of health students has focused on medical students, particularly the factors influencing their choice to work in rural and remote areas. However, there is limited research on how rural origin and training in regional or rural settings affect the employment destinations of dental and oral health graduates. This paper explores the practice locations of dentistry and oral health therapy (OHT) graduates from rural backgrounds compared to those from metropolitan areas in Australia.

Materials and methods

The target population was dental and OHT graduates from La Trobe University’s Rural Health School (Australia) who completed their studies between 2009 and 2023. The graduates’ primary place of practice was sourced from the Australian Health Practitioners Regulation Agency (AHPRA) data. The 2019 Modified Monash Model (MMM) was used to categorise the students’ original place of residence by rurality and practice locations. Multivariable analyses were conducted to explore the association between home and practice locations while controlling for the effect of socio-demographic characteristics collected from students at enrolment.

Results

Data were available for 819 graduates matched to the AHPRA register. Of these, 541 (66.1%) were dentists, and 278 (33.9%) were OHTs. The majority were female (56.7% dentists and 81.7% OHTs), 11.3% (dentists) and 21.6% (OHTs) of the graduates originated from rural and remote areas, 16.6% (dentists) and 18% (OHTs) from regional areas, and 72.1% (dentists) and 60.4% (OHTs) from metropolitan areas. Multinomial logistic regression analyses for dentists and OHTs identified that , having a regional background, or having a rural or remote background were the most significant predictors for regional, rural/remote practice over metropolitan areas.

Conclusion

Regional background is the strongest predictor for graduate dentists and OHTs practicing in Australia’s regional or rural and remote locations. Similarly, students from rural and remote locations were highly likely to practice in rural/ remote locations. Increasing the recruitment of students with rural backgrounds may positively impact graduates’ decisions to practice in rural areas.
Screening high-risk Veterans for cirrhosis: taking a stepwise population health approach
Authors: Dounel Jonathan , Lamorte Carolyn , Patton Heather , Perumalswami Ponni , McCurdy Heather , Kim Nicole J. , Beste Lauren A. , Scott Dawn , Casey Jessimarie , Spoutz Patrick , Chia Linda , Yao Yiwen , Lowy Elliott , Gibson Sandra , Morgan Timothy R. , Rogal Shari S.
Published: January 2025

Background

Because cirrhosis is often unrecognized, we aimed to develop a stepwise screening algorithm for cirrhosis in the Veterans Health Administration (VHA) and assess this approach’s feasibility and acceptability.

Methods

VHA hepatology clinicians (“champions”) were invited to participate in a pilot program from June 2020 to October 2022. The VHA Corporate Data Warehouse was queried to identify Veterans with possible undiagnosed cirrhosis using Fibrosis-4 (FIB-4) ≥ 3.25 and at least one risk factor for liver disease (e.g., obesity), and generate an age-stratified sample. Champions at four sites reviewed charts to confirm eligibility and contacted Veterans to offer further evaluation with elastography. Feasibility was defined as protocol implementation with completion of at least one elastography test and acceptability was defined based on Veteran- and clinician-reported surveys. Participation in the program, patient outcomes, adaptations to the protocol, and implementation barriers were also assessed.

Results

Four sites were able to implement the screening protocol. Adaptations included type of outreach (primary care vs. hepatology, phone vs. mail) and type of elastography used. One site chose to refer patients with clear evidence of cirrhosis directly to hepatology (n = 12) rather than to elastography. Key implementation barriers included staffing, primary care provider (PCP) comfort with interpreting and communicating results, and appointment availability during the COVID-19 pandemic. Of 488 patients whose charts were reviewed, 230 were excluded from outreach based on predefined criteria (e.g., advanced cancer, prior or current referral to hepatology). Champions and PCPs attempted to contact 165 of 246 Veterans who were deemed eligible for evaluation with elastography. Among 53 Veterans who completed elastography, 22 (42%) had findings consistent with significant fibrosis and were referred to hepatology. Clinicians and Veterans reported high acceptability of the program on surveys (80% of Veterans who completed survey).

Conclusions

This pilot demonstrated the feasibility, acceptability, and challenges of a multisite approach to cirrhosis screening.
Evaluation of Lyso-Gb1 as a biomarker for Gaucher disease treatment outcomes using data from the Gaucher Outcome Survey
Authors: Zimran Ari , Revel-Vilk Shoshana , Dinur Tama , Istaiti Majdolen , Botha Jaco , Lukina Elena , Giraldo Pilar , Deegan Patrick , Dahl Stephan vom
Published: January 2025

Background

Patients with Gaucher disease (GD) require continual monitoring; however, lack of specific disease biomarkers was a significant challenge in the past. Glucosylsphingosine (lyso-Gb1) has been shown to be a reliable, key, specific, and sensitive biomarker for diagnosis, prognosis, and treatment response in clinical studies of patients with GD. We evaluated the change in lyso-Gb1 concentration over time following enzyme replacement therapy in patients with confirmed GD using real-world data from the Gaucher Outcome Survey disease registry.

Methods

Data for patients aged ≥ 18 years with a confirmed diagnosis of GD and at least two lyso-Gb1 assessments were analyzed retrospectively. Patients were stratified by treatment status at baseline (time of first lyso-Gb1 assessment). Lyso-Gb1 concentrations were measured from dried blood spot (DBS) samples by Centogene AG. Assessments included change in lyso-Gb1 concentration, hemoglobin concentration, platelet counts, and spleen and liver volume from baseline to the last lyso-Gb1 assessment.

Results

Of 2007 patients enrolled in the Gaucher Outcome Survey as of February 25, 2022, 435 met the inclusion criteria and were included in the study: 318 treated (‘all treated’; 277 receiving treatment at baseline, 41 treatment naive at baseline), 38 receiving treatment at baseline who stopped treatment before the last lyso-Gb1 assessment, and 79 untreated. Lyso-Gb1 concentrations decreased from baseline to the last lyso-Gb1 assessment for all treated patients (median change − 8.6 ng/mL), and increased for untreated patients (median change 25.0 ng/mL) and those who stopped treatment (median change 19.5 ng/mL). Decreases were greater for all treatment-naive than previously treated patients (median change − 120.5 vs. − 3.3 ng/mL) and for velaglucerase alfa–treated patients vs. the overall treated cohort (–32.6 vs. − 8.6 ng/mL). Small improvements in hemoglobin concentrations, platelet counts, and spleen volume were observed for treated patients but not untreated/stopped treatment cohorts.

Conclusions

In this study, changes in lyso-Gb1 concentrations from DBS were reflective of responses to enzyme replacement therapy initiation or withdrawal in most patients. These findings confirm that the use of DBS samples for routine monitoring of lyso-Gb1 concentrations in patients with GD is feasible in real-world settings and may be useful to assess treatment response.