bluuebunny/crossref_metadata_2025 huggingface dataset:
COULD A DENTAL PUBLIC HEALTH GAME BE EFFECTIVE FOR DIFFERENT LEARNING CULTURES?
Authors: Sipiyaruk K. , Hatzipanagos S. , Reynolds P.A. , Gallagher J.E.
Published: February 2025

The aim of this study was to explore how a serious game, GRAPHIC (Games Research Applied to Public Health with Innovative Collaboration), could be effective for students from different learning cultures.

Methods: Final-year undergraduate students (2015/16) from Kings College London [KCL] and Mahidol University [MU] were invited to use GRAPHIC in their own language; however the scientific evidence was available in English only. GRAPHIC requires students studying Dental Public Health (DPH) to read information of a town and then select the best five oral health promotion programmes to improve oral health of a population in the town. GRAPHIC-IV was developed to enhance aspects of pedagogy and entertainment. The game engine logged the number of submission attempts and the results of the pre- and post-test assessments. After game completion, each student completed a feedback questionnaire. Statistical analysis involved independent t-test of the number of submission attempts between institutions; paired t-test was used to analyse pre- and post-test score differences. Descriptive analysis was used to present the feedback questionnaire data. Ethical approvals were obtained from KCL (BDM/14/15-27) and MU (COA.No.MU-DT/PY-IRB 2015/002.1901).

Results: 151 KCL and 115 MU students used GRAPHIC, of which 146 (96.7%) and 111 (96.5%) respectively completed the game including pre- and post-tests. The average number of attempts for successfully completing students was 6.9 (SD=4.9) for KCL and 15.1 (SD=4.1) for MU (p<0.001). Post-test scores were significantly higher than pre- test at KCL [16.7 (SD=2.5) CF 16.2 (SD=2.3); (p<0.05)] and MU [17.1 (SD=2.2) CF 16.3 (SD=2.4); (p<0.001).

Overall 140 (90.3%) KCL and 109 (94.8%) MU students completed questionnaires: 83 (59.3%) KCL and 55 (50.5%) MU students reported that GRAPHIC could help them understand the content of designing oral health promotion. Although 63 (45.0%) KCL and 38 (34.9%) MU students felt more confident with DPH work, less than one fifth disagreed [25 (17.9%) KCL; 18 (16.5%) MU]. Almost one half of students recommended the development of more scenarios for use with GRAPHIC [65 (46.4%) KCL and 53 (48.6%) MU].

Conclusion: There was a gain in knowledge in students from two learning cultures and there was evidence that the game helped some students with understanding DPH at undergraduate level; however, the use of the game differed in the two institutions.
DENTAL CONDITION OF ORAL SQUAMOUS CELL CARCINOMA PATIENTS IN A HUNGARIAN POPULATION
Authors: IldikÓ T. , Fera M. , SzabÓ A.
Published: February 2025

The prevalence of oral squamous cell carcinoma (OSCC) is higher in Hungary than in most other countries. Predisposing factors such as poor oral health are also quite frequent. The aim of this study was to evaluate the oral condition of OSCC patients, tumour free, age and gender matched controls and healthy young controls before the prevalidation of salivary biomarkers.

Methods: Between 1 January 2013 and 31 December 2013, at the University of Debrecen, Faculty of Dentistry, Department of Periodontology, the oral condition of 33 OSCC patients (27 male, 6 female), 30 agematched tumour free (27 male, 3 female), and 29 healthy young controls (18 male, 11 female) was assessed. Participants provided signed informed consent and the study was given ethics approval from the Ethics Committee of the University of Debrecen . OSCC patients were diagnosed in the Department of Maxillofacial Surgery (Sz.A, R.P), controls were chosen at primary examination office (clinic) and were referred to the examiners (T.I, F.M). Oral examination included panoramic and periapical radiographs and a detailed oral, periodontal charting (Silness- Löe (1964) plaque index (PI), Löe- Silness (1963) gingival index (GI)), and caries charting (localization of caries, fillings, prosthetic devices, canal fillings, roots, missing teeth). DMFT, DT, MT, FT, and DMFS were recorded for all patients. Data were entered into SPSS 22 and statistical evaluation- descriptive statistics involving comparison of variables (ANOVA, and Bonferroni post-hoc analysis) - was performed.

Results: OSCC patients had the following mean scores: PI: 0.8, GI: 1.3, DMFT: 26.4, and DMFS: 119.5. Age- matched OSCC free controls had mean scores of PI: 0.4, GI: 0.6, DMFT: 23.5, DMFS: 100.3. Young controls had mean scores of PI: 0.03, GI: 0.09, DMFT: 4.6, DMFS: 7.8. PI and GI. Values differed significantly (p≤0.05) amongst groups. For DMFT and DMFS the young controls differed from the other two groups in a significant manner.

Conclusions: These findings are in accordance with previous findings that OSCC patients have a worse periodontal condition than matched OSCC free controls. Periodontopathogenic bacteria may directly stimulate tumour cell growth.
MORTALITY BY ORAL AND OROPHARYNGEAL CANCER IN BRAZIL BETWEEN 2000 AND 2013
Authors: Ramos Da , Cunha A. , Prass T. , Neves Hugo F.
Published: February 2025

Oral and Oropharyngeal cancers are public health problems in Brazil and Worldwide. Incidence and mortality have changed in Brazil, but the last publication that evaluated time trends in Oral and Oropharyngeal cancer mortality analysed data between 1980 and 2003, prior to the reorganization and expansion in Brazils Public Oral Health network by the National Oral Health Policy of 2004.

Aim: To estimate coefficients and evaluate mortality trends by Oral and Oropharyngeal cancer between 2000 and 2013 in Brazil.

Method: Mortality coefficients were adjusted by sex and age using the direct method, using the Brazilian population of 2010. Mortality data were obtained from the Mortality Information System (SIM) of the Ministry of Health of Brazil and demographic data were extracted from demographic census and intercensal projections of the Brazilian Institute of Geography and Statistics (IBGE). Mortality trends were evaluated by sex, self-reported race/skin color, and age, by anatomical site of tumour and region of the country, using general linear regressions by Prais-Winsten method.

Results: There were 61,190 deaths by Oral and Oropharyngeal cancer in Brazil between 2000 and 2013, of which 48,301 (78.9%) were males. The male/female ratio was of 3.9:1. Oropharyngeal cancer was the most frequent cause of death at 31.7%. Trend analysis revealed that overall mortality by oral and oropharyngeal cancer was stable between 2000 and 2013 in Brazil, with an annual variation of 1.3% (95% CI: -2.6 to 5.3). Stratification by sex revealed a trend of significant increase for females, with an annual variation of 1.8% (95% CI: 0.1 to 3.5). Stratification by cancer site revealed that there was a trend of significant increase in the annual variation of mortality by cancer of the base of the tongue (0.4%, 95% CI: 0.1 to 0.7), and by cancer of the floor of the mouth (0.3%, 95% CI: 0.1 to 0.5). There was a trend of significant decrease in the annual variation of mortality by tonsil cancer (-0.2, 95% CI: -0.4 to -0.1). Stratification by sex and skin colour revealed a trend of significant increase in the annual variation of overall mortality by oral and oropharyngeal cancer for white women (1.2%, 95% CI: 0.6 to 1.7), for brown women (3.4%, 95% CI: 1.5 to 5.4), and for brown men (8.0%, 95% CI: 4.0 to 12.0). There was a trend of significant decrease for black women (-2.6%, 95% CI: -4.8 to -0.4) and yellow men (-26%, 95% CI: -47.6 to -4.4).

Conclusions: There was an important trend of increase in mortality by oral and oropharyngeal cancer for females in Brazil between 2000 and 2013. In addition, there was an increasing trend for base of the tongue and the floor of the mouth.
Patients with ACL injury have lower and more posterior position of proximal tibiofibular joint than patients with intact ACL
Authors: Iriuchishima Takanori , Goto Bunsei
Published: February 2025

Background

Knees with anterior cruciate ligament (ACL) injury have distinct knee bone morphology. However, the correlation between ACL injury and morphology of the proximal tibiofibular joint has not been investigated.

Purpose

To compare proximal tibiofibular joint morphology in patients with injured and intact ACLs to aid in predicting and preventing ACL injuries.

Material and Methods

A total of 50 patients with ACL injury and 50 individuals without structural knee damage (revealed by magnetic resonance imaging [MRI]) were included in this study. In the anteroposterior knee radiographs, the length between the proximal end of the fibular head and the medial and lateral tibia joint line were measured. In the axial knee MRI scans with the most proximal part of the fibular head, the distance calculation was performed between the most anterior point of the tibia plateau (MATP) and the most anterior point of fibular head (MAFH).

Results

The mean length from the proximal end of the fibular head and the medial and lateral tibial joint lines was 8.7 ± 2.8 mm and 13.2 ± 2.6 mm in the ACL-injured group, and 6.5 ± 2.8 mm and 11.1 ± 2.4 mm in the control group. The length for both medial and lateral sides was significantly greater in the ACL-injured group. The length between the MATP and MAFH was significantly larger in the ACL-injured group than the control group.

Conclusion

A large distance between the proximal end of the fibular head and the tibial joint line and knees with posterior fibular head placement would be another anatomic risk factor of ACL injury.
Analysis, Modeling, and Simulation of Connected and Automated Trucks: State-of-the-Art and Identified Gaps
Authors: Liao Yejia , Liu Haishan , Yao Ruili , Wu Guoyuan , Barth Matthew J. , Huang Zhitong , Osman Osama , Hourdos John , McHale Gene
Published: February 2025

Connected and automated trucks (CATs) have the potential to transform the transportation system and logistics industry. Their unique features, such as operational strategies and truck driving behaviors, can affect transportation system performance. For successful development, testing and deployment of CATs, analysis, modeling, and simulation (AMS) plays an important role, especially in evaluating the impacts of CAT technologies on existing transportation systems. This paper presents a comprehensive review and assessment of up-to-date studies related to CAT AMS, focusing on three correlated elements: CAT applications, data, and tools. The research delves into CAT applications from individual CAT and CAT fleet to CAT-involved traffic. It explores available data sources relevant to CAT system use cases, assessing their potential issues and opportunities. The study also reviews existing AMS tools used to analyze CAT applications at both operational performance and network integration levels, emphasizing research needs in CAT-specific tools development. The findings identify the data needs and point out that existing AMS tools may not capture the complexity of CAT operation, which involves driving behaviors, vehicle-to-everything communications, autonomous capabilities, and response to truck-specific scenarios. The study will lay a solid foundation for further development of the AMS framework for CATs and provide guidance to future research of CAT applications.
A Pilot Trial Evaluating Collaborative Healthcare Encounters With Caregivers: A Checklist-Based Intervention for Primary Care
Authors: Riffin Catherine , Brody Lilla , Wolff Jennifer L. , Pillemer Karl A.
Published: February 2025

This pilot trial aimed to evaluate the feasibility, acceptability, and preliminary efficacy of Collaborative Healthcare Encounters with Caregivers (CHEC), a checklist-based intervention designed to enhance caregiver participation in older adults’ primary care visits. N = 52 older patient-caregiver dyads were randomized to CHEC ( n = 28) or usual care ( n = 24). Visits were audio-recorded and analyzed according to a standardized coding procedure. Post-visit questionnaires assessed caregivers’ perceptions of the checklist, efficacy in primary care interactions and knowledge of relevant resources. CHEC caregivers perceived the checklist to be useful and easy to complete. Visit duration was comparable in CHEC and usual care visits (M = 31.4 minutes vs. M = 31.8 minutes; p = .55), but CHEC visits allocated a greater proportion of time to discussing caregivers’ concerns about the patient (32.9% vs. 18.9%; p = .04). CHEC caregivers reported slightly higher post-visit self-efficacy and significantly greater knowledge of relevant resources. Findings suggest CHEC’s potential as a clinically feasible intervention for primary care. Clinical Trials Identifier: NCT04946942.
Environmental Sustainability and Cancer Imaging
Authors: Amin Parthiv , Malik Aleena , Mcinnes Matthew D. F. , Brown Maura J. , Szava-Kovats Andrew
Published: February 2025

The rising global burden of cancer drives increased demands for medical imaging, which is essential throughout cancer care. However, delivering medical imaging presents significant environmental challenges including high energy use, reliance on single-use supplies, and the production of environmental pollutants. Environmental factors, such as ultraviolet radiation, wildfire smoke, and carcinogenic pollutants contribute to rising cancer rates, while extreme weather events driven by climate change disrupt cancer care delivery—highlighting the close connection between patient and planetary health. This review explores opportunities to improve the environmental sustainability of oncologic imaging, emphasizing the importance of patient-relevant outcomes—such as quality of life and overall survival—as a guiding principle in cancer care. Key strategies include optimizing imaging schedules to reduce low-value imaging, selecting modalities with lower environmental impact where clinically appropriate, minimizing waste streams, and adopting energy-efficient practices. Artificial intelligence offers the potential to personalize imaging schedules and improve efficiency, though its benefits must be weighed against energy use. Mobile imaging programs and integrated scheduling reduce patient travel-related emissions while promoting health equity, particularly in underserved communities. Future research should focus on optimizing imaging intervals to address patient-relevant outcomes better, expanding the use of abbreviated imaging protocols, and the judicious deployment of artificial intelligence, ensuring its benefits justify energy use.
The Bidirectional Mediation Roles of Depression and Hostile Attribution Bias in the Relationship between Peer Conflict and Adolescents’ Cyberbullying Perpetration: A Two-Wave Study
Authors: Ding Huimin , Zhao Chengjiao , Huang Feng , Lei Li
Published: February 2025

Previous research has established that the quality of peer relationships significantly impacts adolescents’ physical and mental health. However, the relationship between peer conflict and cyberbullying perpetration remains insufficiently explored. Based on the General Aggression Model and the General Strain Theory, this study investigates the mediating role of depression and hostile attribution bias in the relationship between peer conflict and cyberbullying perpetration, as well as the moderating role of gender, aiming to offer a new perspective on understanding adolescent cyberbullying perpetration. Employing a two-wave survey design, the study encompassed 900 adolescents ( Mage = 13.45, girls = 452), collecting data on peer conflict, depression, hostile attribution bias, and cyberbullying perpetration through self-reported questionnaires. The findings revealed that peer conflict at Time 1 (T1) significantly and positively predicted cyberbullying perpetration at Time 2 (T2). Depression and hostile attribution bias at T2 acted both individually and in a bidirectional chain as mediators between peer conflict at T1 and cyberbullying perpetration at T2. Gender differences were observed in the paths “peer conflict T1 → cyberbullying perpetration T2” and “depression T2 → cyberbullying perpetration T2.” Specifically, compared to girls, boys who experienced peer conflict and depression were more likely to engage in cyberbullying perpetration. These findings not only theoretically expand the application of the General Strain Theory and the General Aggression Model, but also provide practical guidance for the prevention and intervention of cyberbullying perpetration among adolescents.
Investing in Improvement: A Critical Look at Funding for Low-Performing Schools
Authors: Blair Damon , Atchison Drew , Le Floch Kerstin Carlson
Published: February 2025

This paper examines the financial resources allocated to Comprehensive Support and Improvement (CSI) schools under the Every Student Succeeds Act (ESSA) in the United States. Our analyses demonstrate that CSI schools do receive additional funding and spend more than comparable non-CSI schools. However, we question whether the magnitude of this support is sufficient to promote meaningful improvement for these schools. Our research reveals that CSI schools receive and spend about $345 more per pupil compared with non-CSI schools, but to elevate low-performing schools to the average performance of non-CSI schools would require a significantly larger investment, between $8,000 and $21,000 per pupil yearly. The existing financial support associated with accountability designations is insufficient to support the improvement activities of low-performing schools. We argue for increased and sustained funding for low-performing schools, coupled with support in decision-making and accountability for resource allocation.
Influence of multi-steps cut on stress evolution and surface integrity in machining of laser cladding layer
Authors: Lv Tao , Zhang Peirong , Du Jin , Su Guosheng , Xia Yan , Liu Zhanqiang
Published: February 2025

In subsequent machining of heterogeneous cladding layers, it is often imperative to employ multi-steps machining to reach the required dimensional and geometrical accuracy. The present study primarily investigated the impact of cumulative effects of stress evolution on surface integrity in multi-steps machining of heterogeneous cladding workpieces by FEM and experimental methods. The FEM findings demonstrated that the stress induced by multi-steps machining was contingent upon the latter machining step, with lower interfacial stress difference when using a smaller thickness ratio for latter machining step compared to that by single-step machining. The experimental results indicated that the surface morphology was significantly affected by plowing when the total removal thickness ratio or the thickness ratio of latter cutting step is small. With larger total thickness ratio, otherwise, the surface morphology would be affected by larger interfacial stress difference. Also, great work-hardening was generated on the machined surface. Meanwhile, the cutting heat will promote gradient evolution of micro-hardness between cladding and substrate. In addition, the larger the thickness ratio in latter cutting step, the slightly lower of the tensile residual stress along the cutting speed direction is, while the residual stress in feed direction is mainly in a compressive residual stress state. Finally, the maximum surface integrity can be achieved by multi-steps machining with proper thickness ratio combinations. The study reveals the cumulative effects of stress arising from multi-steps and its effect on surface integrity, while offering theoretical guidance for the subsequent machining of heterogeneous cladding layers.
Active suspension control strategy with the high adaptability of multi-axle vehicles based on the body attitude stabilization
Authors: Dong Zilong , Gong Mingde , Diao Shuzhi , Sun Tianshuo , Zhang Ence
Published: February 2025

A control strategy with the strong adaptability is crucial to maintain the stable body attitude, when the vehicle is encountering various complex road inputs. This article is based on the theory that the centroid of the cheetah's body always moves in a straight or curved line when running in the wild, and studies the control strategy of the vehicle’s active suspension. Firstly, the relationship matrix between control forces of actuators and virtual control forces that maintains the stabilization of the body attitude is derived, which is the Moore Penrose inverse matrix. Secondly, due to numerous nonlinearities, uncertain factors in the entire vehicle system and complex road conditions, a variable universe fuzzy controller for the stabilization of the vehicle body attitude is proposed. Finally, experiments are conducted with a three-axle heavy emergency rescue vehicle. Experimental results show that compared with the RMS of the vehicle with the passive suspension, the RMS of the pitch angle and the roll angle of the body with the active suspension are reduced by 27.04% and 25.84%, respectively; the RMS of the pitch angular acceleration, the roll angular acceleration and the vertical displacement acceleration of the body with the active suspension are reduced by 20.05%, 27.12% and 20.03%, respectively. The proposed controller has the high adaptability to the road input excitation, thereby improving the adaptability of vehicles to various road conditions effectively, maintaining the stable body attitude while driving, improving the “comfort” and the “safety” of passengers and on-board rescue equipment, and greatly improving the rescue efficiency of the vehicle.
A bypass valve-based cooperative controller of air supply flow and pressure for vehicular PEM fuel cell system
Authors: Hu Binfei , Zhou Yafu , Lian Jing
Published: February 2025

The performance and efficiency of the fuel cell stack is impacted by the management of air subsystem, which also prevents it from degrading due to oxygen starvation and pressure fluctuations. For complex onboard conditions, a cooperative control strategy for air mass flow and pressure of the air subsystem based on bypass valve is proposed in this paper. Firstly, a 120 -kW vehicular fuel cell air subsystems bench was constructed and its mathematical model is established based on experimental data. Secondly, a novel control strategy for correcting the target air flow rate based on oxygen excess ratio feedback is proposed, where to meet the air flow requirements for actual vehicle environment of the stack. Furthermore, the transfer function model of the air subsystem is fitted according to the experimental data. Inverted decoupling combined with active disturbance rejection control is adopted to independently manage the air mass flow and pressure, where the external disturbance and model uncertainty are evaluated and recompensed. Then, a fuzzy control strategy based on the bypass valve is proposed to suppress the pressure fluctuations and overshoot during load variation. Simulation and experimental studies show that the proposed cascade decoupling control framework can quickly track the target value of the oxygen excess ratio within 1.2 s, optimize the stack net power, and increase it by up to 3%. The effectiveness and robustness of the decoupling control for air mass flow and pressure has been confirmed. The proposed fuzzy control strategies that utilize bypass valves can suppress pressure fluctuations and reduce the coupling effects for the air supply systems. It contributes to optimizing the dynamic performance of fuel cell systems and extending its service life.
Coerced into Subsistence: Deprivation of Liberty in the EU Reception and Identification Centres in Greece
Authors: Slingenberg C.H. (Lieneke)
Published: February 2025

In 2021, new reception centres for asylum seekers were established in Greece. These centres are remotely located, highly surveillanced and asylum seekers living there are subjected to stringent conditions, including a curfew, that obliges them to be in the centre between 8 pm. and 8 am. Such curfews are a traditional method of social control and fit a broader trend of excluding certain categories of people from public space. This article analyses the gap between the lived experiences of asylum seekers staying in these centres and the protection provided by human rights law. It shows how these centres are generally experienced as prisons by its inhabitants, whereas they are not qualified as such in human rights law. The article uses the notion of ‘subsistence exchange contracts’ to bridge this gap. The article argues that if this notion would be used for the legal qualification of deprivation of liberty, state power would be more effectively constrained, which is crucial for the rule of law.
What Makes an Elite Unit Elite? The Case of the British 2nd Independent Parachute Brigade, June 1944 to January 1945
Authors: Jones Mark L.
Published: February 2025

The British 2nd Independent Parachute Brigade should be characterised as elite due to its adaptability. An advanced level of training made paratroopers into high-quality, elite soldiers who were able to adapt both during an operation and between operations. This adaptation was successful during its period of offensive actions, specifically Operations Hasty, Dragoon, and Manna. The piece contributes to the military effectiveness debate through an analysis of a single elite unit. It further challenges the overemphasis of studying Second World War British airborne operations in North-Western Europe alone, adding to the underdeveloped study of the Mediterranean theatre's Allied airborne units.
Effects of Cognitive Training on Balance and Motor Symptoms in Parkinson's Disease: An Exploratory Randomized Controlled Trial
Authors: Arroyo-Ferrer Aída , Moreno-Verdú Marcos , Sánchez-Cuesta Francisco José , González-Zamorano Yeray , Ugalde-Canitrot Arturo , Romero Juan Pablo
Published: February 2025

Background

Cognitive rehabilitation is a potential intervention for cognitive but also motor disorders in Parkinson's disease (PD).

Objective

To investigate the effects of cognitive rehabilitation on balance and motor symptoms in PD.

Methods

A randomized controlled trial in a community setting, in people with mild-to-moderate PD (Hoehn and Yahr ≤ III) without cognitive impairment (MoCA ≥ 24) was conducted. Thirty-nine participants were randomly allocated to receive a cognitive intervention (Experimental Group, n = 20) or no intervention (Control Group, n = 19). The experimental protocol involved self-administered cognitive rehabilitation using the NeuronUP platform, focusing on sustained attention and information processing speed training (30 min/day, 3 days/week, 4 weeks). The Berg Balance Scale (BBS) was the main outcome. Motor variables included UPDRS-III, Percentage of Limits of Stability (%LOS) and Timed Up and Go Test (TUG). Neuropsychological variables included TMT-A, TMT-B, Processing Speed (Digit Symbol-Coding and Symbol Search) and Stroop test.

Results

At post-intervention, marginal improvements were observed in BBS (Mean Difference = 2.23 points, 95%CI [−0.03, 4.49], p = 0.053) and significant improvements in the UPDRS-III (Mean Difference = −4.02 points, 95%CI [−7.82, −0.23], p = 0.039). No significant improvements were found in the rest of the motor and cognitive variables.

Conclusions

Self-administered cognitive training did not improve balance or cognition but significantly reduced motor symptom severity in PD. The effect of more intensive or in-person cognitive rehabilitation protocols on balance needs to be evaluated.
Is the Future of Cleft Care Financially Sustainable? An Economic Analysis of Inflation-Adjusted Reimbursements
Authors: Chaij Jasmine M. , Hammond Jacob B. , Palmer Skyler K. , Lee Anna D. , Gomez Diego A. , French Brooke M. , Nguyen Phuong D. , Mathes David W. , Khechoyan David Y.
Published: February 2025

Objective

As Medicaid continues to expand, it remains unclear if reimbursement rates for cleft care are keeping up with the national economy. The purpose of this study is to determine how financial trends in cleft lip and palate repair reimbursements compare to annual changes in the U.S. economy.

Design

Current Procedural Terminology (CPT) codes for cleft lip and palate repair were retrospectively reviewed between 2018 and 2023. Reimbursements were adjusted for inflation to 2023 U.S. dollars using Medicaid physician fee schedules. Annual percentage changes in inflation-adjusted reimbursements, and reimbursement Compounded Annual Growth Rate (CAGR) were compared to the annual change in the U.S. Consumer Price Index (CPI).

Setting

Multi-state, Medicaid.

Participants

Medicaid reimbursements of 6 U.S. states, 5 with highest birthrates: California, Texas, Florida, New York, and Pennsylvania. Colorado, the study institution, was evaluated.

Main Outcome(s)

Primary outcomes included annual changes in overall and inflation-adjusted reimbursement rates for cleft lip and palate surgical procedures as compared to annual changes in CPI.

Results

The U.S. CPI increased by 20.9% from 2018 to 2023, while the overall total percentage change in reimbursement rates for all cleft lip and palate procedures increased by 7.23%. The inflation-adjusted overall percent change in reimbursements for all procedures decreased by −12.81%. For all procedures, the average CAGR was −2.66%.

Conclusions

Inflation-adjusted reimbursement rates for cleft lip and palate repair have significantly decreased in contrast to the annual growth in U.S. CPI. These findings show a potential lack of financial sustainability for surgical cleft care, indicating the need for healthcare policy reform.
Extragastrointestinal Gastrointestinal Stromal Tumor Presenting as Paratesticular Mass - A Diagnostic Conundrum
Authors: Velayutham Bakialakshmi , Malla Hari Siddardha , Ali S Manwar , Sahoo Ashok Kumar , Chaudhary Shalini , Ayyanar Pavithra
Published: February 2025

Extragastrointestinal gastrointestinal stromal tumors are uncommon in the paratesticular region and pose a diagnostic challenge. A 47-year-old man presented with a painless testicular mass for three months. Ultrasonography showed a solid lesion in the right distal spermatic cord region. Excision of the mass showed an encapsulated solid, firm tumor of size 5 cm. Microscopic examination showed a spindle cell tumor arranged in fascicles, nodular and storiform patterns. The mitotic rate was 17–19/5 mm². The mesothelial lining of the tunica vaginalis was noted. Using immunohistochemistry, the tumor cells were positive for KIT, DOG1, and CD34, while negative for SMA, desmin, S100, STAT6, and EMA. H3K27me3 was retained in the tumor cells. The MIB-1 labeling index was 25% in the area of greatest labeling. We report an additional example of paratesticular EGIST and discuss the diagnostic approach and literature review. Knowledge about this tumor at rare sites and the clinicopathological features are needed for the definitive diagnosis and prognosis.
Coupled vibration analysis of tooth wear in internal herringbone gear pair
Authors: Linlin Liu , Sanmin Wang , Haoran Zou , Peng Chen
Published: February 2025

Tooth wear is one of the most common failures during gearing, which seriously affects the transmission performance and life of gears. However, gear wear affects meshing excitations, such as meshing stiffness and contact pressure, and further increases vibration and noise levels. The aim of this paper is to develop a coupled vibration wear model to reveal the tooth wear characteristics of an internal herringbone gear pair. A new geometrical model of the gear wear meshing relationship is proposed for assessing the effect of gear wear on the meshing stiffness and the effect of the changed meshing stiffness on gear wear. Combining Archard's wear theory and the idea of slicing method, the wear model of internal herringbone gear sub-drive is established, the tooth normal load and contact pressure are obtained by using kinetic equations, the correctness of the established model is verified by numerical calculations. The results show that an increase in tooth wear is often accompanied by a decrease in mesh stiffness, but appropriate minor wear can help improve the poor original fit and mesh quality. As the number of cycles increases, the dominant wear region shifts from the lower half of the tooth face to the upper half, but there are still a few regions in the lower half of the tooth face region that still lead in wear. The study provides a theoretical basis for improving the precision and efficiency of internal meshing herringbone gear transmission, slowing down wear, and improving life.
Advanced tribological solutions for sustainable future
Authors: Pintaude Giuseppe , Katiyar Jitendra Kumar
Published: February 2025

This special issue contains the research articles from the 4th International Brazilian Conference on Tribology (TriboBR 2023), held in Vitória, Brazil, on 26–30 November 2023. Profs Henara Lilian Costa and Cherlio Scandian chaired the conference. This special issue contains 10 selected research articles from TriboBR 2023. The great majority was presented at two sessions, in which Professor Giuseppe Pintaude had acted as Chairman: Automotive Tribology and Tribology in Manufacturing. These two sectors require more attention from tribologists because they deal with energy, efficiency, reliability, and economy. A brief description of all the research articles is presented here.
Enhancing beam structural damage detection using spectral moment values and spectral moment cumulative function models
Authors: Nguyen Thanh Q. , Nguyen Thuy T. , Nguyen Phuoc T.
Published: February 2025

Evaluation and identification of structural damage play a crucial role in ensuring the safety and reliability of structures. This study explores the application of spectral moment value analysis as a robust tool to assess and detect structural damage. Spectral moment values provide detailed information on how a structure responds to load, helping to accurately identify the location, type, and extent of the damage. By monitoring changes in spectral moment values using experimental data on damaged and undamaged steel beams under moving loads, early signs of hidden damage can be detected, allowing timely implementation of repair or maintenance measures before the condition worsens. Moreover, spectral moment value analysis supports the evaluation of structural reliability based on load bearing capacity and resistance to damage, aiding in decision-making processes regarding the repair, improvement, or replacement of the structure. The methodology used in this research provides a cost-effective and efficient approach to the evaluation and identification of structural damage, with potential applications in various engineering fields.
Enhancement of structural integrity of stitched sandwich panels: Investigation by flexural, low velocity impact, compression after impact, and machine learning methods
Authors: Dhanesh E , Nagarajan VA , Vinod Kumar KP , Jayaram RS
Published: February 2025

The performance of the developed Stitched Foam-filled Honeycomb Sandwich (SFHS) panels with two different stitches spacing were compared to the Foam-filled Honeycomb Sandwich (FHS) panel. The adjacent Stitched Foam-filled Honeycomb Sandwich (SFHS1) panel exhibited a peak flexural load of 1672 N at a strain rate of 100 mm/min, achieved a velocity of 4.031 m/s during Low Velocity Impact (LVI) testing, and demonstrated a compressive strength of 14.19 N/mm² in Compression After Impact (CAI) tests performed with a maximum drop height impactor of 700 mm. Matlab image processing was utilized to detect damaged areas that were invisible to the human eye after the LVI test. The experimental data of CAI tests were subjected to a Machine Learning (ML) third-order regression algorithm that predicted SFHS1 and alternate Stitched Foam-filled Honeycomb Sandwich (SFHS2) panel would withstand up to a drop height of 1300 mm at 885 N and 845 N respectively, whereas value is far less for FHS panel. The results showcased the effectiveness of through-thickness stitching reinforcement in improving the panel's interfacial, flexural, residual compressive, and impact strengths compared to unstitched panel. The study emphasized the advantage of implementing the SFHS1 panel, which is affordable and lightweight, which makes it appropriate for a wide range of structural applications.
Evaluating emotional regulation and comorbidities in multiple sclerosis: Insights from a unified protocol treatment case study
Authors: San Martín María Consuelo , Beltrán Rodrigo , Pardo-Garrido Luis , Soto Marcela , Matus Paulina , Quezada-Scholz Vanetza E. , Pino Paulina , Osma Jorge , Guevara Carlos
Published: February 2025

This case study presents the application of the Unified Protocol (UP) in a patient dealing with emotional regulation problems in the context of physical health challenges like overweight or obesity, who also was diagnosed with Relapsing-Remitting Multiple Sclerosis (RRMS). The patient, identified as MK, participated in sessions that employed cognitive-behavioral techniques aimed at improving emotional regulation. This intervention was chosen due to its potential to influence MK’s anxiety and depression symptoms, which were presumed to be exacerbated by emotional dysregulation. The treatment proved effective in enhancing MK’s emotional regulation of her anxiety and depressive symptoms. The UP sessions were tailored to address emotional challenges and the physical complexities associated with RRMS. This case study is part of an ongoing Randomized Controlled Trial (RCT) testing the efficacy of the UP in patients with RRMS and obesity using a group intervention approach. The pre-registration for this Randomized Controlled Trial (RCT) can be found at the following link: https://osf.io/sr4bx/?view_only=bcbcff9e43ac4f00b557313442739dca This study highlights the versatility of the UP in managing patients with multiple transdiagnostic symptoms, particularly those involving complex interactions between physical and emotional health issues. Findings suggest that integrating the UP can significantly benefit patients with neurological conditions, offering an integral approach that considers both mental and physical health components. This case study provides valuable insights into the adaptability of cognitive-behavioral interventions in complex clinical scenarios, suggesting further exploration into their broader application in similar contexts.
From General Anesthetic to Designer Antiepileptic: Propofol's Mechanism of Action Reveals Hope for Precision Treatment of HCN1-Related Epilepsy
Authors: Glasscock Edward
Published: February 2025

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Occupational Therapy Assessment Practice Patterns for Core Domains in Adult Populations
Authors: Roberts Pamela , Ouellette Debra , Giles Gordon Muir , Mroz Tracy M. , Furniss Jeremy , Malloy Julie , Mallinson Trudy
Published: February 2025

Practitioners need to demonstrate the value of occupational therapy services in achieving effective patient outcomes. To intervene effectively, we must have adequate assessment practices. This study examines variation in occupational therapy assessment practices by facility type, areas addressed, and types of instruments. The study characterizes commonly and frequently used assessment practices in core occupational domains and identifies potential practice gaps related to assessment. A cross-sectional online survey across six domains central to adult occupational therapy practice (activities of daily living [ADL], instrumental activities of daily living [IADL], fear of falling, functional cognition, psychosocial, and vision) was administered to practitioners in various settings. Surveys were obtained from 1,198 respondent. Survey responses identified differences in domains being assessed and assessment methods used by occupational therapy practitioners across hospital inpatient post-acute care facilities and community settings. There is variability in the methods used to assess domains critical to occupational therapy practice and the degree to which occupational therapists evaluate domains in practice settings.
Verified facts for people in the 21st century - how can professional ethics contribute?
Authors: Radermacher Walter J
Published: February 2025

Ethics play an important role in the practice of all professions. The best known of all is probably the Hippocratic oath in medicine. But what if a doctor relies on data and statistics to diagnose and treat his patients? If his work involves collecting, analysing, interpreting and drawing conclusions from data, the doctor becomes a statistical practitioner and is expected to follow the values and principles that apply to this profession. Professional ethics for statistics is application-oriented and committed to the goal of guiding statistical practitioners to act responsibly and to ensure the trustworthiness of statisticians and thus also of the statistics they produce. Alongside integrity and professionalism, the third value of professional statistics is respect, both in dealing with confidential data and with the impact of statistics on the communities affected. Respect, professionalism and integrity are the three components of the ‘statistical oath’. However, there is a long way to go from theory to practice. In this article, we will explore different paths we can take towards improving the knowledge and application of these professional ethics in areas of applications and forms of statistical practice. We will focus on one specific area, official statistics.
Complete remission in a rare pelvic angiosarcoma with liposomal doxorubicin: A comprehensive case report and review of literature
Authors: Gråberg Truls , Papakonstantinou Andri , de Flon Felix Haglund , Shabo Ivan , Morgell Ann , Linder-Straglitto Christina , Nilsson Inga-Lena , Karlsson Fredrik , Bränström Robert
Published: February 2025

Angiosarcoma, an aggressive sarcoma subtype originating from lymphatic or vascular endothelial cells, is rare, constituting less than 2% of all soft tissue sarcomas. Predominantly affecting adult and elderly patients, it manifests diversely across various anatomical locations, with cutaneous lesions being the most common, particularly in the head and neck region. Noteworthy for its infiltrative nature, angiosarcoma demonstrates high rates of local recurrence and metastasis, leading to poor overall survival. The diagnosis may be difficult due to nonspecific clinical symptoms, and histological examination is essential in this disease. Treatment typically requires radical surgery, with addition of either chemo- or radiotherapy, or occasionally both, but there is a lack of formal evidence for the order of the modalities employed. Emerging therapies, such as targeted medicines and immunotherapy, show promising results in improving outcomes. This report presents a comprehensive analysis of a rare case of a young male with pelvic angiosarcoma. The patient underwent multiple operations, chemotherapy, and radiation, which highlights the complexities in management and the need for a multidisciplinary approach. Despite challenges, the patient achieved complete remission and is disease-free over 16 years after pelvic exenteration, demonstrating the potential for successful long-term outcomes. The case underscores the importance of personalized, multimodal treatment plans and close collaboration between surgeons and oncologists. Continued research into tailored therapies offers hope for improved prognosis and quality of life for individuals facing this uncommon sarcoma.
WHO declares Mpox a public health emergency: “you haven’t closed borders with Africa, the epicenter?”—YouTube reactions highlight geopolitical tensions
Authors: Pitua Ivaan , Bongomin Felix
Published: February 2025

Background:

Mpox was declared a Public Health Emergency of International Concern by the World Health Organization in August 2024, following an outbreak in Africa. Public engagement on YouTube provides insights into public perceptions during such crises.

Objectives:

We analyzed public discourse and sentiments related to Mpox, focusing on thematic trends in YouTube comments.

Design:

A qualitative synthesis employing thematic content analysis of YouTube comments.

Methods:

The YouTube API retrieved 50 videos each for “Mpox” and “Monkeypox.” After exclusions, 50 relevant videos remained, and the top 10 by views were analyzed. From 10,567 comments extracted, 2826 were analyzed using Latent Dirichlet Allocation modeling to identify themes.

Results:

Key themes included geopolitical concerns, disease spread, conspiracy theories, public health measures, and religious interpretations. Comments revealed mixed views on vaccines, lockdowns, and mistrust in authorities.

Conclusion:

Effective health communication must address scientific, cultural, and geopolitical dimensions while countering misinformation and fostering trust.
(L)earning to Teach: Financial Inequities Facing Trainee Teachers in England
Authors: Casey Ashley , Maidment David W. , Lynch Shrehan
Published: February 2025

Teacher shortages are a global issue. England chose to address this by offering financial incentives (in the form of bursaries and scholarships) to postgraduates in shortage subjects. The impact of these incentives, however, on those training in non-shortage areas remains unclear. A survey of 439 trainee teachers in England (2019–2020) revealed that those without financial incentives often took up additional paid work, primarily during holidays and weekends. Most of these working students were young, female, single, lived with their parents, and traveled more than 10 miles to their universities and placements. This study highlights the unintended consequences of the current policy to offer financial incentives to postgraduates in shortage subjects, including financial inequalities and a divide among trainees based on the subject they chose to teach. It suggests the need for policies that ensure long-term support and equal opportunities for all trainee teachers, irrespective of their teaching specialty.
A Cognitive Onomastics Study of Traditional Chinese Herb Names
Authors: Jiang Xiangyong , Deng Haini
Published: February 2025

Herb names not only facilitate identification but also convey crucial information regarding the potential uses and benefits of traditional Chinese herbs. However, the names of herbal medicines have received scant systematic study previously, especially from a cognitive onomastics perspective. By investigating the motivation for the nomenclature of 217 common Chinese herbs selected from the herbology section of Compendium of Materia Medica, we found that 160 herbs were named based on a single salient characteristic such as shape, efficacy, color, nature & flavor, place of origin, folklore, harvesting season, habitat, and odor, ranked in descending order. The remaining 57 herbs were named by integrating two or more characteristics. We contend that giving priority to shape and color in naming aligns with the gestalt principle and the human optic nerve’s sensitivity to color. Efficacy, nature & flavor, origin, harvesting season, and odor are crucial factors determining the quality and efficacy of herbs, thus being included in the herb names. We conclude that names for Chinese herbs can be attributed to the cognitive metonymy pattern CHARACTERISTICS FOR HERB. However, both conceptual blending and conceptual metaphor play significant roles in the naming of herbs, as conceptual blending integrates characteristics in naming and conceptual metaphor links herbs to familiar entities in naming.