bluuebunny/crossref_metadata_2025 huggingface dataset:
Crocs across America
Authors: Tarricone Paul
Published: February 2025

Dozens of new stores in the U.S. from French sportswear company Lacoste use light to create visual impact
New Look Suits H. Stockton
Authors: Tarricone Paul
Published: February 2025

Lighting accessorizes a hip, geometrically themed design at conservative clothier H. Stockton
Reporting for History
Authors: Falzano Rebecca
Published: February 2025

When it came time to illuminate the exhibits at the National Museum of the Marine Corps, theatrical lighting played a major role
The Bowery Boxes
Authors: Tarricone Paul
Published: February 2025

A multi-layer skylight system and fluorescent lamps form an unusual tandem in the New Museum of Contemporary Art
Is Dark the New Black?
Authors: Apfel David
Published: February 2025

Having trouble reading the price tags in those trendy, youth-oriented clothing retailers? It's no accident, as general illumination has been jettisoned in favor of accent lighting
Fancy Footwork
Authors: Tarricone Paul
Published: February 2025

Fashionable lighting helped Payless ShoeSource revitalize its brand
The Global Gamut
Authors: Falzano Rebecca
Published: February 2025

Industry experts weigh in on the state of lighting abroad
Effect of solution-blown polyamide-6 nanofiber interlayer on drilling performance of carbon fiber reinforced composites
Authors: Ayten Ali İmran , Şahbaz Mehmet , Morkavuk Sezer , Polat Yusuf , Seyhan Aybeniz
Published: February 2025

This study examines the effect of solution-blown polyamide-6 (PA6) nanofiber interlayers on the drilling performance of carbon fiber reinforced polymer (CFRP) composites. Results demonstrate that PA6 nanofiber interlayers significantly reduce drilling thrust force and improve surface quality. Specifically, at a spindle speed of 1000 r/min and a feed rate of 1500 mm/min, the maximum thrust force was reduced by 17%, from 683.33 N in neat composites to 583.13 N in nanofiber-reinforced composites. At a higher spindle speed of 8000 r/min and a feed rate of 500 mm/min, thrust force decreased by 18%, from 80.22 N to 65.46 N. Surface roughness analysis revealed that nanofiber interlayers reduced Ra values by up to 44%, with a minimum roughness of 0.529 µm compared to 1.196 µm in neat composites. Optical and SEM analyses confirmed fewer plucking zones, reduced fiber pull-out, and improved fiber-matrix bonding in nanofiber-reinforced samples, particularly at higher spindle speeds. These findings indicate that PA6 nanofiber interlayers enhance drilling performance, offering reduced machining forces and superior hole quality for precision applications in the aerospace and automotive industries.
A novel investigation of shear thickening fluids under continuous high-frequency impact
Authors: Wang Shuqi , Gao Dongliang , Zhang Wenyu , Xu Xiaoqiu , He Chunlei
Published: February 2025

Shear thickening fluid (STF) has unique rheological characteristics, for its viscosity is dependent on the variation in strain rate under specific shear conditions. STF can significantly reduce shocks and vibrations by absorbing a large amount of impact energy during external loads. The dynamic impact characteristics of STFs under high-frequency impact loads are examined in this work. We measured the changes in the energy storage modulus and energy dissipation modulus with angular frequency by performing dynamic rheological tests on STFs. We constructed a high-frequency dynamic continuous impact experiment platform for STFs. It is possible to quantify changes in acceleration and impact force for STFs at varied impact frequencies by this platform. Analysis was done on the changing law of STFs’ high-frequency impact characteristics. The results indicated that an increase in the fraction of STF leads to a decrease in the critical angular frequency, accompanied by a pronounced viscosity of the STF. The critical angular frequency was determined as 0.255 rad/s for silica-polyethylene glycol (SiO2-PEG) STF at a fraction of 23% and 0.349 rad/s for cornstarch-water STF at a fraction of 60%. Under continuous dynamic impact, cornstarch water STFs have a notable thickening effect, while SiO2-PEG STFs can absorb more impact energy.
Empowering Leadership in NABH-accredited Hospitals in India: The Role of Demographic Variables
Authors: Singh Abhishek
Published: February 2025

This study examines the difference in followers’ perception towards leaders’ empowering behaviour due to followers’ age, gender and nature of the job in NABH-accredited hospitals in India. Data were collected from 295 employees working in NABH-accredited hospitals in India through the convivence sampling method. t-Test and one-way analysis of variance were used to test the hypothesis. Followers’ perception differs about leaders’ empowering behaviour due to their age and job nature. But male and female hospital employees were not having a significant difference in perception of leaders’ empowering behaviour. NABH-accredited hospital managers may use this study’s findings to train their leaders to exhibit empowering behaviour as per the need of hospital employees. This is the first study to examine the leaders’ empowering behaviour from followers’ demographic profile perspective.
The “Return” of the People? Understanding Populism by Exploring Citizens’ Conceptions of Peoplehood in Western Europe
Authors: Küppers Roni
Published: February 2025

Despite extensive research on rising populism, we still know little about the relation between populist politics and how ordinary citizens engage with, and act upon, the identities that populism mobilises. To address this blind spot, I develop an inductive approach that moves from a focus on populism to a broader exploration of peoplehood, and from a variable-centred to a person-centred approach employing Latent Class Analysis. The results indicate attitudes towards peoplehood can be grouped into 6 major conceptions across Western Europe, and that support for populism is concentrated among citizens who hold particular conceptions of peoplehood, offering insight into the ideas of the people that underlie support for populism. These findings show peoplehood is a useful theoretical framework for understanding collective belonging, and that it can help to grasp more comprehensively the social grounds of contemporary populism. Finally, using regression analysis, I find the association between conceptions of peoplehood and electoral behaviour is significant in the case of populist right supporters, but not populist left supporters. Overall, I argue these findings offer new hypotheses regarding the meaning and implications of populism, and can also help explain the differing success of right and left populist parties.
Simulation analysis of the dynamics characteristics of battery electric vehicle transmission system under impact condition
Authors: Zhang lijun , Wang Zituo , Meng Dejian , Li Birui
Published: February 2025

This paper analyzes the dynamic characteristics of transmission system of battery electric vehicle through simulations. The research method and conclusions can serve as a theoretical basis and reference for the design of vehicle system architecture. To accurately describe the torsional vibration characteristics of battery electric vehicle’s transmission system, it is necessary to reasonably simplify the system. Furthermore, when subjected to short-wave uneven road surface excitation, the connection between the rigid ring in the SWIFT (Short Wavelength Intermediate Frequency Tire model) tire model and the ground belongs to single-point contact and cannot represent the tire enveloping properties. Around the above issues, a method has been proposed to simplify the gearbox model into a force-coupled model with centralized damping, stiffness, and mass, along with an equivalent road surface model consisting of series-connected elliptical cam that can represent tire enveloping properties. Correspondingly, an evaluation criterion has been established, which utilizes the ratio of the peak torque of the impact force at the rear wheel hub after encountering a step to the maximum output torque of the gearbox as the impact coefficient. In four-wheel-drive vehicle models, the impact coefficient of the front axle is greater than that of the rear axle when going uphill, and when going downhill, the impact coefficient of the rear axle is greater than that of the front axle, for another, in both uphill and downhill scenarios. The impact coefficient of the four-wheel-drive vehicle model is greater than that of the front-wheel-drive and rear-wheel-drive models for both the uphill and downhill scenarios.
Hydroelastic analysis of partially or totally immersed Mindlin plates with a hybrid isogeometric-based approach
Authors: Ardic I Tugrul , Yildizdag M Erden , D’Ovidio Gino , Ergin Ahmet
Published: February 2025

In this study, the dynamic characteristics of a cantilevered Mindlin plate, partially or totally in contact with fluid on both sides, are examined using the proposed hybrid isogeometric finite element – boundary element framework. The interaction problem is divided into two parts through the implementation of the linear hydroelasticity theory, allowing for the independent treatment of structural and fluid problems. In the structural part of the analysis, the thick plate is modeled as first-order shear deformable by adopting Reissner–Mindlin plate theory, with the material assumed to be homogeneous and isotropic. The resulting eigenvalue problem is then solved by the isogeometric finite element method (IGAFEM). In the second part of the analysis, assuming the fluid is ideal and incorporating the in vacuo dynamic characteristics as boundary conditions, fluid-structure interaction effects are determined by the isogeometric boundary element method (IGABEM) in terms of generalized added mass coefficients. Subsequently, parametric studies for various plate thicknesses and submergence depths are conducted. The analysis reveals that wet natural frequencies differ noticeably from their in vacuo counterparts due to the presence of the free surface of the fluid. In addition, the effect of the radiated free surface waves from the vibrating structure are included into the mathematical model by imposing linearized free surface condition, through the frequency-dependent added mass and hydrodynamic damping effects of the fluid. The numerical accuracy of the proposed approach is verified against the commercial finite element software ANSYS, showing favourable agreement in the predicted natural frequencies and corresponding mode shapes.
Signals and noise: How higher music education institutions define popular music
Authors: Calkins Thomas , Coppes Wessel , Berkers Pauwke
Published: February 2025

Research has illustrated how some cultural forms that were once excluded from higher education institutions become incorporated over time through a process known as “cultural legitimation.” While this process has been well documented for arts forms such as jazz and film, less is known about artforms in the middle of this process, as definitional boundaries and educational aims remain in flux. To better understand this, we ask: how do music educators define popular music and what are their perspectives on educational aims? Using data from an original survey, we analyze opinions using a mixed-methods approach, bringing the results of Q methodology and a thematic analysis together using multiple correspondence analysis. The results suggest the existence of four perspectives on institutional popular music: (a) musicians as professional culture producers, (b) popular music as institutionally legitimate, (c) popular music as an aesthetic enterprise, and, finally, (d) a lack of definitional form.
UAV flight path intelligent control based on annealing recurrent neural network extremum search algorithm
Authors: Ni Bin
Published: February 2025

Unmanned aerial vehicle (UAV) is an intelligent equipment, which is invented with the development of information technology and artificial intelligence technology. UAV is an intelligent equipment with the wireless remote control and brings its own power of unmanned aircraft, and it has small volume, and is easy to use and easy to carry. Due to its small size, it cannot carry large batteries, and with the shortage of poor load ability and short sustained flight distance. In order to overcome the shortage of the short flight distance of UAV, the research work about intelligent controlling for UAV flight path is studied in this paper, aiming to improve the level of UAV flight control and endurance. The characteristics of UAV and the algorithm are studied to guide the control and optimization for the UAV flight path design. The research results in this paper show that the algorithm plays a positive role in UAV flight path intelligent controlling, and it is helpful to improve its endurance. This research is significant as it explores intelligent control algorithms to optimize UAV flight paths, aiming to enhance their flight endurance and overall performance.
Tourist attraction image recognition and intelligent recommendation based on deep learning
Authors: Wei CongCong
Published: February 2025

The rapid development of the economy has also increased people’s purchasing power, and many young people choose to reward themselves with a trip. The inspiration for such trips often comes from diverse recommendations and sharing on the internet, and image recognition technology plays a key role in this process, helping users confirm the specific location of the shared content. However, the accuracy and adaptability of current online tourist attraction image recognition and recommendation systems are still insufficient, making it difficult to fully meet user needs. In response to this issue, this study adopted neural collaborative filtering technology to conduct in-depth research on the intelligent tourist attraction recommendation system. By constructing a deep convolutional neural network, this study automatically extracted advanced features from images and combined multimodal data fusion and user portrait analysis techniques to achieve high-precision recognition and customized recommendation of tourist attractions. Research shows that this method can maintain high image recognition precision, with a precision of 89%, which is significantly improved compared to traditional methods. In terms of recommending travel attractions, its precision has also reached a satisfactory 85%, proving its excellent performance and broad application potential. This study demonstrates the potential of neural collaborative filtering and deep convolutional neural networks in improving the accuracy and adaptability of tourist attraction image recognition and recommendation systems, offering a more personalized and efficient travel experience.
Benevolent Leadership as an Antecedent and Moderator of Ostracism: A Moderated Mediation Model with Employee Performance
Authors: Ge Shucheng , Gardner William L. , Karam Elizabeth P. , Cogliser Claudia C. , Yan Zhen , Lu Maxine
Published: February 2025

Despite three decades of ostracism research, scholars have rarely examined its antecedents or benevolent leadership's role in workplace ostracism. Drawing on benevolent leadership theory, we propose that leader benevolence and employee neuroticism serve as predictors of perceived ostracism, with benevolent leadership also moderating the neuroticism-ostracism relationship. Using a three-wave sample of 172 matched superior-subordinate dyads from the United States, our findings reveal benevolent leadership's dual functions. After controlling for LMX and authentic leadership, benevolent leadership shows unique effects on ostracism and follower performance through its emphasis on care. We also advance research by introducing the Negative Perception-Behavior-Spiral framework to explain the neuroticism-ostracism association and establish ostracism as a mediating mechanism linking benevolent leadership to employee performance.
Lifestyle Attitudes and Habits in a Case Series of Patients With Cancer and Metabolic Syndrome
Authors: Siu Kimberly , Martinez Leal Isabel , Heredia Natalia I. , Foreman Jessica T. , Hwang Jessica P.
Published: February 2025

Metabolic syndrome (MetS) is associated with increased cancer risk and poor cancer prognosis. The current study applied a mixed methods approach to better understand attitudes about making lifestyle changes and current dietary and physical activity behaviors among cancer patients with MetS at a cancer center and to explore the suitability of brief lifestyle questionnaires to help providers understand their patients’ lifestyle attitudes and habits. Qualitative interviews were used to obtain patients’ perspectives about lifestyle changes, and 3 quantitative questionnaires—the Readiness Ruler, Rate Your Plate, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF)—were used to measure patients’ readiness for lifestyle change, dietary habits, and physical activity levels, respectively. Nineteen patients participated in interviews, and 18 patients completed the questionnaires. Interview findings indicated that patients generally prioritized lifestyle changes over medication use, desired collaboration and coordination between multidisciplinary care teams and patient, and desired tailored interventions and practical implementation strategies to manage MetS. Questionnaire findings indicated that most patients agreed with the importance of lifestyle changes and expressed confidence in making them, reporting healthy food choices and high physical activity levels. A multidisciplinary approach tailored to patients’ readiness, preferences, and constraints is recommended for effective MetS management in patients with cancer.
Venous sinus stenting for management of spontaneous skull-base CSF leaks: A systematic review and meta-analysis
Authors: Rasmussen Jordan M. , Patel Kautilya R. , Surdell Daniel L. , Thorell William E. , Borg Nicholas , Opperman Patrick J. , Casazza Geoffrey , Maxwell Anne K. , Barnes Christie , Pate Samuel , Schmidt Cindy M. , Sattur Mithun G.
Published: February 2025

Background

Idiopathic intracranial hypertension (IIH) is strongly associated with spontaneous skull-base cerebrospinal fluid (CSF) leaks. Venous sinus stenting (VSS) has proven effective for the treatment of IIH. Hence, its role in spontaneous skull-base CSF leaks is being explored actively.

Methods

We performed a systematic literature search across EMBASE, MEDLINE, Scopus, The Cochrane Library, and Google Scholar to identify studies reporting the use of VSS for spontaneous skull-base CSF leaks. Studies with pediatric patients, non-English articles, and nonspontaneous leaks were excluded. Failure of treatment (persistence / recurrence of CSF leak) was regarded as the primary outcome.

Results

Eight studies with 62 patients undergoing VSS for spontaneous skull-base CSF leaks were included. Mean age of the patients was 51.9 years; 87.5% were females. Obesity was highly prevalent, with a mean body mass index of 33.9 kg/m2 (4 studies). IIH was noted in 74.6% patients (7 studies). Twenty-six patients (41.9%) underwent VSS alone whereas 36 patients (58.1%) underwent surgical repair + VSS. Seven patients (11.3%) had a failure of treatment. Three failures from one study could not be definitively ascribed to either of the groups. Hence, the estimated failure rate for VSS alone ranged from 18.6% (95% CI [0.02 – 0.46]) to 26.4% (95% CI [0.11 – 0.46]), whereas that for surgical repair + VSS ranged from 5.5% (95% CI [0.00 – 0.16]) to 12.2% (95% CI [0.01 – 0.32]). Furthermore, the estimated rate for resolution of concomitant IIH-related symptoms was 88.7% (95% CI [0.75 – 0.98%]). Majority of the studies did not report any serious complications or mortality related to VSS.

Conclusion

VSS has a potential role in the management of spontaneous skull-base CSF leaks. Its exact indications as a standalone treatment versus as an adjuvant to surgical repair, and the predictors for successful treatment remain to be defined.
EXPRESS: Prospective reward in dual task induces a bias toward action at the cost of less accurate Task 2 performance
Authors: Mahesan Devu , Fischer Rico
Published: February 2025

In dual tasks, with a visual-manual choice reaction time task in Task 1 and a go/no-go task in Task 2, not responding to Task 2 can have adverse effects on Task 1 performance, as demonstrated by no-go backward crosstalk effects (no-go BCE). Here, the response inhibition required to not respond to Task 2 spills over and slows response execution in Task 1. Over three experiments, we investigated whether the prospect of reward, which is a potent cognitive control modulator, influences no-go BCE. In Experiment 1, reward for fast and accurate responses in both tasks was modulated as a within-subject factor, and in Experiments 2 and 3, as a between-subject factor. The results revealed three major insights. In all three experiments, reward led to faster Task 1 and Task 2 performance. Secondly, despite this speeding, the no-go BCE was not modulated by reward. Finally, the reward led to more errors in Task 2 no-go trials. These results reveal a reward-induced bias for action, suggesting better preparedness to respond and, consequently, larger commission errors in Task 2 no-go trials. The absence of a reward-based modulation of the no-go BCE indicates that the reward-induced bias for action does not necessarily translate into larger response inhibition. These findings point towards the complex interactions between reward and inhibitory control and shed light on the potentials and limitations of reward-based modulation of dual-task interference.
A Layering of Selves: Bias, Subjectivity, and Paper Dolls
Authors: Shelton Stephanie Anne , Jones April M.
Published: February 2025

This paper examines the ways that artful inquiry affords qualitative research students newly creative and embodied opportunities to understand and engage with subjectivity and bias—important concepts in the field of qualitative inquiry. Moving beyond the inadequacy of traditional teaching practices, such as student-generated written subjectivity statements, we share here an artful methodological approach using paper dolls to disrupt conventional engagements with these concepts. Inspired by Donna Haraway’s emphasis on layer(ing)s of subjectivity and Karen Barad’s discussion of cutting together-apart as a creative process, we draw from collaging in/as research to offer this paper doll activity as a constructive and disruptive way to invite students to consider themselves as complex, messy, and inevitable aspects of the research process.
User-Generated Translation Community in Online Video Streaming: The Social-Digital Dynamics of YouTube-Focused Fansubbing Channels on Bilibili
Authors: Lu Sijing
Published: February 2025

This article is inspired by the considerable popularity of subtitled translations of YouTube videos in Mandarin on Bilibili, one of the largest online video streaming sites in China. Drawing on Bourdieu’s field theory reframed for digital media, this article uses Youzimu, a YouTube-focused fan subtitling channel on Bilibili, as a case study to explore how Youzimu fosters a self-mediating network for translating YouTube videos into Mandarin, and the extent to which fan translators reproduce the original YouTube videos through their autonomous endeavors. The results indicate that Youzimu’s self-mediated network is predicated upon the ongoing exchange of diverse forms of capital, affording fan translators within the platform a degree of productive autonomy in their translation efforts. Nevertheless, the channel’s adherence to regulatory frameworks governing online streaming and the unofficially sanctioned status of YouTube within China imply a heteronomous principle of hierarchy within the fan subtitling ecosystem.
Comparison of Clinical, Radiologic, and Arthroscopic Outcomes Between the Microfracture and Microdrilling Techniques for Articular Cartilage Defects in Medial Opening-Wedge High Tibial Osteotomy
Authors: Park Ji-Soo , Jung Se-Han , Jung Min , Chung Kwangho , Kim Jae Hong , Choi Chong Hyuk , Kim Sung-Hwan
Published: February 2025

Background:

Microfracture is the most common procedure for cartilage lesions during medial opening-wedge high tibial osteotomy (MOWHTO), but microdrilling has recently been introduced as an alternative technique.

Purpose:

To compare the clinical, radiologic, and arthroscopic outcomes of microfracture and microdrilling during MOWHTO.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 92 patients who underwent MOWHTO with either microfracture (n = 46) or microdrilling (n = 46), with a minimum follow-up of 24 months. Clinical outcomes included visual analog scale (VAS) for pain, Lysholm score, International Knee Document Committee (IKDC) subjective score, Western Ontario and McMaster Universities index (WOMAC), and objective IKDC grade. Medial femoral condyle (MFC) cartilage repair status was evaluated at 12 months postoperatively using the MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 and the International Cartilage Regeneration & Joint Preservation Society (ICRS) Cartilage Repair Assessment (CRA) grade.

Results:

At 6 months postoperatively, the microdrilling group exhibited higher minimal clinically important difference achievement rates than the microfracture group for VAS pain (63.1% vs 41.3%; P = .04), Lysholm (61.2% vs 41.3%; P = .02), and IKDC subjective score (78.3% vs 45.7%; P = .001). At 12 months postoperatively, the microdrilling group exhibited significantly better VAS pain (33.7 ± 17.6 vs 25.7 ± 18.1; P = .03), Lysholm (57.8 ± 12.2 vs 67.9 ± 21.4; P = .007), and IKDC subjective score (52.9 ± 13.5 vs 61.9 ± 10.4; P = .001) compared with the microfracture group, but this difference was not observed at 24 months. WOMAC scores were superior in the microdrilling group at 6 months (32.1 ± 16.7 vs 48.4 ± 16.2; P = .004), 12 months (25.4 ± 15.4 vs 38.1 ± 17.0; P = .03), and 24 months (21.4 ± 13.9 vs 37.3 ± 14.6; P = .02). MFC cartilage repair status was superior in the microdrilling versus microfracture group (ICRS CRA grade, 8.2 ± 2.2 vs 6.7 ± 2.1 [ P = .005]; MOCART 2.0 score, 56.3 ± 12.8 vs 49.7 ± 8.9 [ P = .02]). At 24 months postoperatively, the microdrilling group had a higher proportion of IKDC A or B grades (84.8% vs 50.0%; P = .001).

Conclusion:

Combining MOWHTO with microdrilling for MFC defects resulted in earlier clinical recovery and superior functional outcomes over 24 months postoperatively compared with microfracture and demonstrated excellent cartilage repair on postoperative evaluation.
Racial Concordance Between NBA and MLB Players and Their Team Physicians
Authors: Gaetano Andrew , Shivdasani Krishin , Chen Andrew , Garbis Nickolas , Salazar Dane
Published: February 2025

Background:

Recent efforts aim to determine whether patient-provider race concordance improves health outcomes for minority patient populations. Patient-physician race discordance is uniquely elevated in professional athletics.

Purpose:

To evaluate racial concordance between rostered players and their respective team physicians in 2 major professional sports leagues in the United States—the National Basketball Association (NBA) and Major League Baseball (MLB).

Study Design:

Cross-sectional study.

Methods:

Publicly available data were collected in June of 2023 to identify NBA and MLB players and team physicians. The sex and reported or perceived race of the players and team physicians were determined by 2 independent observers who analyzed reported demographic data, photographs, and names of these individuals, with disagreements resolved by a third independent observer. Team physicians’ medical training, medical specialty, languages spoken, and years in practice were obtained using publicly available internet-based sources or by contacting the clinical staff directly.

Results:

In both the NBA and the MLB, there was a statistically significant difference in racial composition between players and team physicians ( P < .0001 for both). In addition, despite a high percentage (30.7%) of Hispanic/Latino players in the MLB, just 11.6% of MLB team physicians spoke Spanish, and >50% (18/30) of MLB organizations lacked a team physician who spoke Spanish.

Conclusion:

Substantial race discordance was found between professional athletes and head team physicians. Physicians more closely mirroring the patient populations that we treat—including professional athletes—may positively affect health care relationships and improve patient/provider barriers.
Effects of Integrating Lower-Leg Exercises Into a Multimodal Therapeutic Approach on Medial Tibial Stress Syndrome Management Among Recreational Runners: A Randomized Controlled Study
Authors: Naderi Aynollah , Fallah Mohammadi Mohammad , Heidaralizadeh Aida , Moen Maarten H.
Published: February 2025

Background:

Medial tibial stress syndrome (MTSS) can impair training and daily activities, underscoring the need for effective treatment. However, there’s limited evidence on using lower-leg exercises for MTSS in recreational runners.

Purpose/Hypothesis:

The purpose of the present study was to determine whether adding lower-leg exercises to a multimodal therapeutic intervention improves the recovery from MTSS in recreational runners. It was hypothesized that adding lower-leg exercises to a multimodal therapeutic intervention would enhance its effect on foot posture and make MTSS recovery more effective than multimodal therapeutic interventions alone.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 40 recreational runners diagnosed with MTSS using history and physical examination (40% women; mean ± SD age, 23.9 ± 3.9 years) were then randomly divided into intervention (n = 20) and control (n = 20) groups. Both groups underwent a multimodal therapeutic intervention involving ice massage, foot orthoses, and extracorporeal shockwave therapy. The intervention group additionally received a tailored lower-leg exercise protocol involving stretching, strengthening, sensorimotor exercises, and foam roller myofascial release. Pain intensity, MTSS severity, perceived treatment effect, quality of life (QoL), and static and dynamic foot posture were assessed at baseline, 6-week, and 12-week follow-up evaluations.

Results:

A mixed model analysis of variance found no significant differences in pain intensity ( P = .17) or MTSS severity ( P = .30) between the intervention group and the control group. However, there were significant improvements in QoL ( P = .003), static foot posture index (FPI) ( P = .02), and dynamic arch index (DAI) ( P < .001), for the intervention group. After 6 and 12 weeks, the intervention group displayed lower DAI scores than controls ( P = .04 and P = .02, respectively). By week 12, the intervention group exhibited significantly higher QoL scores ( P = .02) and lower FPI scores ( P = .04) compared with controls.

Conclusion:

The study demonstrated that lower-leg exercises within a multimodal treatment positively affected foot posture and QoL, although they did not significantly alleviate pain or affect MTSS severity in recreational runners. Therefore, health care providers are encouraged to integrate these exercises into rehabilitation programs to improve foot posture and QoL for individuals with MTSS. However, future research should focus on larger sample sizes, objective measures, resting control groups, and longer follow-up periods to enhance the understanding of the effects of lower-leg exercises on MTSS management.

Registration:

IRCT 20170114031942N5 (Iranian Registry of Clinical Trials).
Investigating the Ligament Involvement in High-Energy and Polytraumatic Multiligament Knee Injuries Compared With Low-Energy or Isolated Injuries
Authors: Hunter Collin D.R. , Featherall Joseph , McNamara Natalya , Greis Patrick E. , Maak Travis G. , Aoki Stephen K. , Klasan Antonio , Ernat Justin J.
Published: February 2025

Background:

Multiligament knee injuries (MLKIs) due to high-energy (HE) or polytraumatic (PT) mechanisms result in worse patient outcomes after surgery versus low-energy (LE) or nonpolytraumatic (NPT) mechanisms. There remains a paucity of research in the literature investigating MLKIs resulting from these mechanisms of injury.

Purpose:

To characterize differences in ligamentous injury/surgery patterns between different mechanism groups: HE versus LE and PT versus NPT.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This is a retrospective chart review of consecutive surgical MLKIs from a single institution. Demographics, clinical/radiographic findings, and intraoperative variables were obtained. HE versus LE mechanisms were stratified. Patients with inadequate data were excluded. PT versus NPT classifications were based on presence of concurrent nonknee injuries. Subgroup comparisons were made based on body mass index, age, sex, number/type of ligaments injured, and surgeries performed.

Results:

From a total of 226, 176 (78%) patients were included (41 PT [23%] and 135 NPT [77%]; 62 HE [35%] and 114 LE [65%]). PT mean age was 30.7 ± 13.7 years (male, 32 [78%)], while NPT mean age was 27.1 ± 12.3 years [male, 91/135 [67%]). HE mean age was 31.4 ± 13.1 years (male, 49/62 [79%]), and LE mean age was 25.6 ± 11.8 years (male, 73/114 [64%]). Posterior cruciate ligament (PCL) injuries were higher in PT (27/41 [66%]) and HE (42/62 [68%]) versus NPT (58/135 [43%]) and LE (44/114 [39%]), respectively. Lateral collateral ligament (LCL) injuries were higher in PT (29/41 [71%]) and HE (41/62 [66%]) versus NPT (66/135 [49%]) and LE (55/114 [48%]), respectively. The mean number of ligaments injured was higher in PT versus NPT (2.9 vs 2.4) and in HE versus LE (2.8 vs 2.4). LCL surgical interventions were more common in PT (23/41 [55%]) versus NPT (49/135 [36%]) and in HE (33/62 [53%]) versus LE (39/114 [34%]). No other differences in injuries/surgeries existed between PT and NPT or HE and LE, in anterior cruciate, medial collateral, or medial patellofemoral ligaments.

Conclusion:

PT and HE MLKIs are characterized by increased rates of PCL and LCL injuries compared with LE and NPT. HE and PT patients experience more injured ligaments than LE and NPT and are more likely to require reconstruction/repair of the LCL. These findings suggest injury severity and mechanism may facilitate clinical decision making in MLKIs.
Evaluating the Statistical Fragility of Comparative Studies on Autografts for Pediatric ACL Reconstruction
Authors: Singh Gurbinder , Alexeev Sergei O. , Haugh Patrick , Halvorson Ryan T. , Wang Dean , Pandya Nirav K. , Feeley Brian T.
Published: February 2025

Background:

The literature presents conflicting findings regarding outcomes after pediatric anterior cruciate ligament reconstruction (ACLR) with various autograft options, reflecting a lack of consensus on the standard of practice. Fragility analyses may assist in evaluating the statistical robustness of these studies.

Purpose:

To evaluate the statistical fragility of comparative studies in pediatric ACLR through the fragility index (FI) and fragility quotient (FQ), as well as qualitative factors such as outcome type, outcome significance, and patients lost to follow-up.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines identified 1139 studies in the PubMed and Embase databases that met the search criteria; ultimately, 6 studies were selected for inclusion. A total of 32 comparative outcomes were assessed for fragility across the 6 studies. Descriptive statistics were employed to summarize the fragility data and generate subgroup comparisons.

Results:

The mean FI was 1.5, and the mean reverse FI was 3.19 ( P < .01); the mean FQ was 0.0064, and the mean reverse FQ was 0.028 ( P≤ .0001). No significant difference was found in the FIs between objective outcomes and patient-reported outcomes ( P = .418). These findings suggested that a comparable number of patients would need to transition from a nonevent to an event to alter a statistically significant result to a nonsignificant one. The FI was lower than the estimated number of patients lost to follow-up for 30 of the 32 outcomes (93.7%).

Conclusion:

Comparative studies on pediatric ACLR autograft outcomes displayed vulnerability when assessed using fragility metrics, indicating a lack of statistically robust data. The findings revealed that many reported outcomes are fragile and may require further investigation. Future research should incorporate fragility analyses—especially in studies with long-term follow-ups—to enhance the reliability of conclusions regarding optimal graft selection in pediatric ACLR.
Incidence and Risk Factors for Posttraumatic Osteoarthritis After Primary ACL Reconstruction in Pediatric Patients: A National Database Study
Authors: Moran Jay , Gouzoulis Michael J. , Kunze Kyle N. , LaPrade Christopher M. , Grauer Jonathan N. , Hewett Timothy E. , Chahla Jorge , Jimenez Andrew E. , McKay Scott D. , Fabricant Peter D. , LaPrade Robert F. , Franklin Corinna C.
Published: February 2025

Background:

The development of posttraumatic osteoarthritis (PTOA) of the knee after anterior cruciate ligament (ACL) reconstruction (ACLR) leads to additional morbidity in adults.

Purpose:

To determine the 5-year incidence of and risk factors for PTOA diagnoses after primary ACLR in pediatric patients.

Study Design:

Case control study, Level of evidence, 3.

Methods:

A United States-based insurance database was used to identify patients aged ≤16 years who underwent primary ACLR from 2010 to 2019 and had at least 5 years of follow-up data. Patients with multiligament knee injuries, tibial eminence avulsion fractures, congenital/syndromic ACL absence syndrome, juvenile idiopathic arthritis, previous knee osteoarthritis or PTOA diagnoses, or previous knee injuries/surgeries were excluded. Demographic factors and concomitant meniscal and cartilage procedures at the time of primary ACLR were recorded. Delayed ACLR was defined as ≥3 months between initial ACL injury diagnosis and ACLR. We also recorded the presence of subsequent motion restoration reoperations, including lysis of adhesions and/or manipulation under anesthesia, after primary ACLR but before PTOA diagnosis. Risk factors for PTOA were evaluated using multivariable logistic regression.

Results:

Included were 16,935 patients (mean age at surgery, 15.1 ± 1.2 years; 62% women). PTOA was diagnosed in 267 patients (1.6%) within 5 years after ACLR; 148 of these patients (55.4%) were diagnosed within 2 years after ACLR. Independent risk factors associated with PTOA diagnosis included subsequent motion restoration procedures (odds ratio [OR], 5.03 [95% CI, 3.31-8.25]; P < .001), age ≥12 years at the time of ACLR (OR, 4.82 [95% CI, 1.54-29.20]; P = .027), delayed ACLR (OR, 1.87 [95% CI, 1.43-2.43]; P < .001), obesity (OR, 1.40 [95% CI, 1.01-1.94]; P = .046), and male sex (OR, 1.36 [95% CI, 1.06-1.74]; P = .015). Performing concomitant partial meniscectomy, meniscus repair, and cartilage restoration at the time of ACLR was not significantly associated with PTOA.

Conclusion:

The incidence of PTOA diagnoses was low within 5 years after primary ACLR in patients ≤16 years old with no subsequent cartilage, meniscus, and/or revision ligament procedures. The need for subsequent motion restoration procedures, age ≥12 years at the time of ACLR, delayed ACLR, obesity, and male sex were significant risk factors associated with a PTOA diagnosis.
Missed Nuances in Tuberculosis Research: Reflections from a Tibetan Scholar
Authors: Yanga Nawang
Published: February 2025

Acknowledging and valuing the lived experiences of scholars from the Global South is crucial for more nuanced, refined, and equitable approaches to and interpretations of research. The sheer lack of Tibetan scholars authoring and leading studies within the Tibetan diaspora is especially concerning. The paucity of Tibetan scholars in tuberculosis (TB) discourse is a marker and product of the colonization of academic global health and of global inequities in opportunity and credibility. The lack of Tibetan voices, advocates and scholars alike, in the TB discourse creates ambiguities and misinterpretations, and a general unwillingness to dig deeper into the social, cultural, economic, and historical contexts under which TB thrives in this community. It also symbolizes the lack of opportunity faced by many scholars based in the Global South. Efforts to decolonize global health must also parallel efforts to address other related injustices.
Targeting cell surface VISTA expression on allospecific naïve T cells promotes tolerance
Authors: Koehn Brent H , Nowak Elizabeth C , Skopalja-Gardner Sladjana , Saha Asim , Zaiken Michael C. , Allred Jeremy R , Peng Yiyung , Davis Wilson Lloyd , Le Mercier Isabelle , Schwertner Nicholas , Molloy Michael J , Rothstein Jay , Carriere Catherine , Riddle Megan J , Eide Cindy , Tolar Jakub , Panoskaltsis-Mortari Angela , Smith Kyle D , Hippen Keli L. , Kim Tae Kon , Noelle Randolph J , Blazar Bruce R
Published: February 2025

The success of allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be limited by graft-versus-host disease (GVHD). T-cell activation is a key factor in GVHD progression. Costimulatory signals can be counterbalanced by co-inhibitory signals such as the checkpoint molecule VISTA (V-domain Ig-containing suppressor of T-cell activation)/PD-1H that restrains activation and maintains donor T-cell quiescence. A single dose of anti-VISTA mAb prevents acute GVHD lethality in multiple models. Naïve donor T-cells express moderate VISTA levels, which transiently increase in allo-HSCT recipients in association with TCR signaling, leading to heightened susceptibility to anti-VISTA mAb-mediated depletion, in contrast to donor T-cells transferred to syngeneic recipients. Anti-VISTA mAb donor T-cell depletion was compatible with rapamycin but incompatible with peri-transplant tacrolimus GVHD prophylaxis. Targeting VISTA exclusively on host cells or donor CD8+ T-cells was not protective against GVHD lethality. Instead, anti-VISTA mAb mediated deletion of alloreactive donor T-cells depended on targeting a third (non-T) cell type. Further mechanistic studies indicated that donor T-cells concurrently exposed to anti-VISTA mAb in vivo but not preincubated in vitro before adoptive T-cell transfer were eliminated via FcR-mediated phagocytosis. In a lymphoma challenge model, a graft-versus-lymphoma effect was fully retained when anti-human VISTA mAb exclusively targeted donor CD4+ T-cells and delayed but mostly retained when unseparated donor T-cells were infused. In a xenogeneic GVHD model, anti-human VISTA mAb reduced donor T-cell expansion, VISTA T-cell expression levels, and recipient lethality. Together, these data support a novel clinical translational pathway in which acute GVHD lethality can be mitigated without negating the GVL effect.
Lactoferrin alleviates the adverse effects of early-life inflammation on depression in adults by regulating the activation of microglia
Authors: Wang Wenli , An Qin , Zou Yunxia , Dai Yunping , Meng Qingyong , Zhang Yali
Published: February 2025

Lactation is a crucial phase of brain development, and the events and nutrients during this period have long-term consequences for the occurrence of depression. This study investigated the effect and mechanism of lactoferrin (LF) deficiency during lactation on depression in adulthood. Lactation LF-deficient mice were established by nursing wild-type mice using LF systemic knockout mother mice. Additionally, 14-day-old mice were injected with lipopolysaccharide (LPS) and subjected to chronic unpredictable mild stress when they reached 6 weeks of age. The results show that lactation lactoferrin deficiency increases depression-like behavior in adult mice, and the mechanism is associated with heightened neuronal damage, abnormal microglial activation, and decreased BDNF in the hippocampus. In contrast, recombinant human lactoferrin promotes neuronal proliferation by upregulating ERK 1 and 2 phosphorylation and attenuates LPS-induced neuronal injury and microglial activation by inhibiting the activation of Toll-like receptor 4—nuclear factor-kappa B pathway in vitro. Our findings suggest that lactoferrin intake during lactation protects neurons by regulating microglial activation, thereby effectively reducing depressive symptoms in adults.
Tolerability and efficacy of Mycobacterium avium complex pulmonary disease treatment in elderly patients
Authors: Shinfuku Kyota , Hara Hiromichi , Okuda Keitaro , Miyagawa Hanae , Takasaka Naoki , Ishikawa Takeo , Araya Jun
Published: February 2025

Background

Mycobacterium avium complex pulmonary disease (MAC-PD) is considered to be increasing worldwide. In Japan, the number of elderly MAC-PD patients requiring treatment is also expected to increase due to the aging society. However, reduced organ function in elderly patients makes it often difficult to continue or complete multidrug treatment due to adverse drug reactions (ADRs). Therefore, this study aimed to identify clinical factors associated with treatment tolerability, efficacy, and ADRs in elderly MAC-PD patients.

Methods

We retrospectively reviewed the medical records of 102 patients with MAC-PD aged ≥ 75 years between January 2014 and March 2023. Forty-six patients were treated with multidrug regimens (treatment group), and 56 were observed without treatment (observation group). The treatment group was divided into the treatment continuation group (n = 28) who were treated without interruption for ≥ 12 months, and the treatment interruption group (n = 18). A comparative study was conducted in each group to examine tolerability, efficacy, and ADRs.

Results

A two-drug regimen of ethambutol (EB) and macrolides without rifampicin (RFP) was associated with treatment continuation (p = 0.026). The treatment continuation group was superior to the observation group regarding symptoms change, sputum conversion rate, and chest computed tomography scores. The most common ADRs were gastrointestinal disorders, which may be related to RFP. Treatment efficacy of the two-drug regimen was non-inferior, and no cases of macrolide resistance were observed.

Conclusions

The two-drug regimen of EB and macrolide without RFP may be a tolerable and effective treatment for elderly MAC-PD patients.