bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial Correlates of Dementia and Disability After Intracerebral Hemorrhage
Authors: Chen Yutong , Rivier Cyprien A. , Mora Samantha A. , Torres Lopez Victor , Payabvash Sam , Sheth Kevin , Harloff Andreas , Falcone Guido J. , Rosand Jonathan , Mayerhofer Ernst , Anderson Christopher D.
Published: February 2025

Background

Dementia and disability are highly prevalent after spontaneous intracerebral hemorrhage (ICH). Previous studies categorizing ICH by large anatomic boundaries have demonstrated that lobar ICH is associated with dementia, while ICH in the basal ganglia is associated with disability. This study aims to refine our understanding of the association between ICH location and post‐ICH dementia and disability at a voxel level, which could improve the prognostic accuracy of these outcomes and provide mechanistic insights into post‐ICH functional outcomes.

Methods and Results

In this cohort study, we segmented the ICH lesions from the noncontrast computed tomography scans from 882 patients from the MGH‐ICH (Massachusetts General Hospital ICH Study) as the discovery data set and from 146 patients from the Yale‐ICH cohort as the validation data set. Using electronic health records and follow‐up telephone interviews, incident dementia (
International Classification of Diseases
,
Ninth Revision
[
ICD‐9
] codes of dementia or modified telephone interview for cognitive status <20) and disability (modified Rankin Scale score >2) were identified. The median follow‐up times of the MGH‐ICH and Yale‐ICH cohorts were 2.9 (interquartile range, 1.0–5.8) years and 1.0 (interquartile range, 0.6–1.0) years, respectively. Two techniques of lesion symptom mapping were applied on the ICH lesions: sparse canonical correlation analysis for neuroimaging and voxel‐based lesion symptom mappings. Dementia conversion after ICH was associated with ICH in the left temporo‐occipital region (mean hazard ratio [HR], 3.62 [95% CI, 2.71–4.63]) and left superior longitudinal fasciculus (mean HR, 2.91 [95% CI, 2.40–3.52]). Development of disability after ICH was linked to the right cerebral peduncle (mean HR, 3.10 [95% CI, 2.44–3.94]), right pallidum (mean HR, 2.96 [95% CI, 1.99–4.25]), and right posterior limb of the internal capsule (mean HR, 2.54 [95% CI, 1.88–3.96]).

Conclusions

Specific distribution of ICH lesions is linked to development of dementia and disability after ICH. These insights have the potential to enhance clinical prognostic models for patients with ICH, facilitating more precise predictions of outcomes based on hemorrhage location.
The cost of dehumanization: How political rhetoric shapes public resistance to cooperation with adversaries
Authors: Ghosn Faten , Bayram A. Burcu
Published: February 2025

Policymakers evoke dehumanizing images when talking about their country’s traditional adversaries. Despite tough rhetoric, when national security interests are at stake, politicians do change their discourse and are willing to engage in pragmatic strategic cooperation with adversaries. To date, no study has analyzed how politicians’ use of dehumanizing images affects the public’s preferences for strategic security cooperation. We argue that politicians’ use of dehumanizing images of enemies in public discourse creates a psychological barrier to strategic thinking in security policy at the public level, and this barrier is greater when they are used by Republican politicians. Using data from a survey experiment of a nationally representative sample of Americans, we show that once politicians have used dehumanizing images to describe an adversary, the American people are more likely to oppose cooperating with that country. We also show that enemy images invoked by Republicans are stickier than those used by Democrats.
Experimental and numerical study on the low velocity impact response of plain-woven CFRTP corner region
Authors: Zhao Zhikai , Liu Linghui , Zheng Zhouyu , Chen Xiuhua
Published: February 2025

Although corner regions exist in many composite structures, such as the wingbox, research in impact engineering is largely focused on the impact performance of plates. Corner regions are subjected to low-velocity impact frequently throughout their life cycle, making it essential to investigate the impact response of these structures to enhance their design and reliability in service. In this paper, the behavior of plain-woven carbon fiber reinforced thermoplastic composites (CFRTP) corner regions under low‐velocity impact loads is studied both numerically and experimentally. Low-velocity impact tests were performed using drop-weight impact equipment at three different energies (15 J, 30 J, and 50 J). Distributed damage and the impacted region of the specimen were determined using high-resolution X-ray CT scans. The experimentally obtained material properties were incorporated into the Viscoelastic User Material (VUMAT) subroutine within ABAQUS to simulate low-velocity impact phenomena. A finite element model (FEA) for plain-woven CFRTP was developed to simulate impact, where six intralaminar damage variables depend on the underlying damage mechanisms, and effective stresses and strains are solved using the backward Euler algorithm. The reliability of FEA was verified through a mesh sensitivity study and model validation. The investigation revealed the relationships of the damage size with the different impact energies. The FEA successfully predicted the force-time and energy-time response, as well as plastic deformation, intralaminar damage, and interlaminar damage.
The Rise of National Security in the 1930s: An Australian Case Study
Authors: Martin Hobbs Mia , Lowe David , Holbrook Carolyn
Published: February 2025

This article traces the evolution of ‘national security’ from a rarely used phrase to a central concept within Australian political life. Where existing genealogies have located the origins of ‘national security’ in the United States, this article reveals that the principal genesis of ‘national security’ was in the international disarmament debates of the early 1930s. Taking Australia as a case study, we show how the concept was utilized to express national identity, debate key issues, and expand federal power in a critical period of nation-building. Surveying uses of the concept across the decade, we found that issues became ‘national security’ problems when they threatened the nation in more than one way. Such dynamics manifested in two of the central security issues of the decade. In the national insurance debate, the capacious language of security gave expression to deep-seated anxieties that emerged from the Depression, while the National Security Act of 1939 that legislated emergency war powers tapped a broader sense of insecurity to centralize federal powers. By the end of the decade, ‘national security’ in Australia was closely associated with military strength, preoccupations around White identity, and entrenching political authority – an early precursor to its uses and abuses today.
Mountains of Gold: The Alpine Vaults of the Swiss National Bank, 1939–46
Authors: Groen Ludo
Published: February 2025

It is widely believed that banks in Switzerland keep their hoards of gold safely in vaults in the city, but during the Second World War, the banks discovered a more efficient, secure, and spacious place for their gold: the Alps. Using built objects as evidence, this article describes how, in 1939, a military ammunition depot in the Bernese Alps was converted into a mountain vault, for the Swiss National Bank to store its domestic gold reserves. What started as an evacuation site, along the way changed purpose from protection against the enemy to catering to them. As the gold reserves of the National Bank grew, its vaults in Bern and Zurich were no longer large enough to store all the incoming precious metals. Only by its decentralization to the Alps could Switzerland keep up the gold trade with, amongst others, Nazi Germany. Based on extensive research in the Swiss National Bank's archives, the article discloses, for the first time, evidence of the wide-ranging infrastructures and bureaucracies that facilitated the storage of gold in the Alps – a history that until today has been dominated by popular myths rather than critical historical inquiry.
Right to refuse treatment upheld while advance directive failed
Authors: Andoh Benjamin
Published: February 2025

The right to refuse treatment and the advance decision were two major issues that came up in Re J (Blood Transfusion: Older Child: Jehovah’s Witnesses) [2024] EWHC 1034. This paper discusses that case in relation to (a) the meaning of the right to refuse treatment, (b) why the term, “right”, should be replaced with “immunity” in the expression, “right to refuse treatment”, (c) the limitations of that right and (d) what the advance decision is and why it was not effective in Re J. The paper concludes that, although the right to refuse treatment and the advance decision are important facilities under the law, they do have limitations.
A critical analysis of the impact of early marriage on girls based on published autobiographies and a contemporary scholarly text – Īḍāḥ al-bayān fī nikāḥ al-ṣibyān
Authors: Mayberry John F
Published: February 2025

Background

This work emerged from a need to better understand the “lived experience” of early marriage for girls and how it should impact on contemporary attitudes in the Muslim community and encourage it to support the international movement with the aim of a minimum common age of 18 years for marriage of young people.

Objective

To identify from contemporary published literature, including autobiographies and religious texts dealing specifically with early marriage, the effects of early marriage on individuals and to set this as a background to the extensive literature on its medical, psychological and social impact. Participants and setting: The setting is the published words of two women and a man who were involved in early marriages and a commentary on the topic by an Ibadi theologian.

Methods

The documents were identified through searching a range of databases using various search engines. Texts were then analysed for key terms describing the impact of early marriage and these were then grouped into themes.

Findings

The extracts raise questions linked to the issue of consent and the role of adult coercion, including physical force and threat of harm. In practice girls are given in marriage by their guardians against their wishes and international conventions on the rights and care of children, as well as that outlined in Qur’an 4 v6.

Conclusion

Modern Muslim states face a real challenge in implementing 18 as the minimum age for marriage, especially in how to manage opposition to appropriate new legislation from some traditionalist groups.
Development of flexible electrothermal fabrics based on silver-nanowire-modified polyacrylonitrile nanofiber yarns for wearable heating applications
Authors: Shao Qingqing , Xing Bo , Liu Xiang , Du Zhaoqun , Yu Weidong , Greiner Andreas
Published: February 2025

This paper describes the development of advanced electrothermal fabric constructed from electrospun polyacrylonitrile (PAN) nanofiber yarns, modified with silver nanowires (AgNWs) and polyethylenimine (PEI). The nanofiber yarns, with an average diameter of 53.7 µm, were woven into fabrics using conventional textile fabrication techniques. The incorporation of PEI significantly improved the hydrophilicity of the fabric, thereby enhancing the adhesion of the AgNWs and boosting the electrical conductivity of the fabric. Electrothermal characterization revealed that the fabric demonstrated a rapid heating response, reaching a steady-state temperature of approximately 37.5°C within 35 s under an applied voltage of 1.2 V. A strong linear correlation ( R2 = 0.999) was observed between the steady-state temperature and the applied power, indicating the potential for precise thermal management at low operating voltages. The AgNW–PEI–PAN nanofiber yarn fabric shows great promise as a flexible, efficient electrothermal material for applications in wearable technologies and smart textiles.
An Alternative Index for Measuring Financial Inclusion: A Study of Scheduled Tribes in Kerala
Authors: Varkey Jins , Mathew Jomon , Sujathan P. K.
Published: February 2025

The degree of financial inclusion within the tribes in Kerala is being assessed here through a newly developed metric called the Individual Financial Inclusion Index (IFII). Apart from examining the regressors of financial inclusion, the study underscores the profoundly inadequate levels of financial inclusion observed among the tribes. The article advocates for a fundamental re-evaluation in the determination of financial inclusion strategies, emphasising the need for diligent intervention by governing bodies to facilitate sustained and comprehensive access to enable informed financial services decisions among tribes.
Group-based emotional regulation training for adolescents in primary health care settings: a proof-of-concept study of its utility to improve mental health
Authors: Randeree Hasan A , Shayi Boitumelo , Van Wijk Charles H
Published: February 2025

Providing mental health care in high-demand but resource-limited settings requires creative approaches. Group-based emotional regulation training has shown promise in other contexts, but its usefulness among South African adolescents in primary health care settings has not been fully examined. Emotional regulation is crucial for long-term health, psychological wellbeing, and reducing common mental disorders. The study aimed to evaluate the potential utility of a 6-week group-based emotional regulation training programme designed for adolescents in South Africa and to provide recommendations for future application in related contexts. Participants aged 15 to 17 years attended the 6-week programme consisting of weekly 90-min sessions that focussed on self-care, emotional awareness, mindfulness, cognitive restructuring, interpersonal effectiveness, and goal setting. Measures of clinical depression and anxiety, and emotional regulation, were administered before, after, and at 3 months following the programme. Parental and participant feedback were subjected to thematic analysis. Significant improvements were observed in depression, anxiety, and emotional regulation among the participants, compared to controls. Depression and anxiety symptoms decreased from pre-programme to post-programme, with sustained improvements at the 3-month follow-up. In addition, parental feedback highlighted positive changes in children’s empathy and self-awareness. This proof-of-concept study demonstrated the potential utility of a structured, group-based programme to enhance emotional regulation and improve mental health among adolescents in South Africa. It also offered recommendations for refinement in primary health care settings, based on themes identified in the qualitative analysis.
Serving the Greater Good With Less: Survey Experiment on How Public Service Motivation Shapes Perception of Staff Shortages
Authors: Kim Phil , Cho Wonhyuk , Kim Daewook
Published: February 2025

Personnel shortages are presenting significant challenges for many municipalities, as well-qualified civil servants in smaller cities and non-urban areas leave their positions. Given this dynamic, understanding how local government employees perceive staff shortages is key to designing effective strategies for promoting staff well-being and productivity. This article analyzes the influence of public service motivation (PSM) on shaping the perceptions of job demand and resources in local governments, through an experimental design ( n = 120) and a survey of local government employees ( n = 414), and further interprets the findings through semi-structured interviews. The experiment results show evidence of bi-directional effects—activating PSM heightened the perceived severity of staff burnout, while simultaneously lowering the perceived need for increased manpower. These findings suggest that PSM may raise an individual’s expectations of their job, which is possibly associated with feelings of frustration with current demands in local government. Conversely, the reduced perception of the need for additional manpower may show an increased sense of responsibility toward the job and willingness to overstretch for the local communities they serve. The employee survey results show that perceptions of the causes and solutions of staff shortages vary depending on their managerial rank, years of experience, and marital status.
Everyday narrative skills in autistic adolescents
Authors: Harvey Anna , Spicer-Cain Helen , Botting Nicola , Henry Lucy
Published: February 2025

Spoken narrative skills are crucial to the social and academic success of young people; however, research indicates that this may be an area of challenge for autistic adolescents. Most previous studies have used narrative elicitation tasks that incorporate visual support, and little is known about how autistic adolescents perform on less structured narrative tasks that more closely approximate everyday instances of communication. Autistic participants aged 11–15 years ( N = 53) and a non-autistic group ( N = 57) were asked to recount the events of two 3–4 minute video clips. Narratives were coded for both macrostructure (‘story grammar’) and coherence. Group differences were explored using multiple regression analyses, after controlling for age, non-verbal cognitive ability, and both receptive and expressive language skills. Autistic adolescents produced spoken narratives that were rated as less well-structured and less coherent than those of the non-autistic comparison group. However, controlling for narrative length in exploratory analyses virtually eliminated group differences, suggesting that further research into this relationship is warranted.
Plain Sailing or Choppy Water? Maintaining Interpersonal Trusting Relationships in Times of Uncertainty
Authors: Kelly Sian , van der Werff Lisa , Freeney Yseult
Published: February 2025

Interpersonal trusting relationships frequently experience relational threats that require both parties to engage actively in trust maintenance efforts. Yet, trust research has tended to focus on trust formation, or trust repair in the case of a violation, and offers us little insight regarding how these more ambiguous threats to trusting relationships are experienced and overcome relationally. To provide novel insight on this topic, this exploratory study gathers dyadic interview data from 26 manager–employee trusting relationships regarding their experience of relational threats and their proactive efforts to overcome these negative relational experiences. Findings show that the experience of a relational threat triggers a three-stage trust maintenance process that includes an assessment phase, an active maintenance phase, and an outcome phase. Threats are assessed at the individual level via cognitive and affective sensemaking, while trust maintenance efforts (creating a shared mental model, cognitive and structural reassurance, and dyadic problem solving) require dyadic counterparts to act with mutual agency to overcome the relational threat and avoid a loss of trust. Trust maintenance processes support dyads to either maintain or strengthen their existing trusting relationships. Our findings advance our theoretical understanding of interpersonal trust maintenance by demonstrating that this process unfolds across three phases and can lead to different outcomes for dyads’ trusting relationships. We offer practical guidelines to safeguard existing trusting relationships, as well as a new agenda for trust scholars to extend our theorizing.
Associations Between Ecological Determinants and Weight Status Changes Among Children from Vulnerable Populations: Empirical Findings from a National Panel Survey in South Korea
Authors: Park Jiyoung , Ten Hoor Gill A. , Hwang Gahui , Ryu Soorack
Published: February 2025

Background:

Pandemic-related weight gain disproportionately has affected children from socioeconomically disadvantaged backgrounds. However, key determinants of childhood obesity among these vulnerable children remain relatively underexplored.

Methods:

In a secondary data analysis using a longitudinal dataset, the relationships between child weight status and its individual and environmental influences among vulnerable children were examined based on an ecological model. We analyzed three-point time-series data for 1308 participants from a Korean national panel survey of vulnerable children. Adiposity estimates were calculated using body mass index (BMI) z-scores.

Results:

The panel regression analysis revealed that 2 factors, namely “lack of adequate sleep time” at the individual level and “suboptimal relationships with childcare teachers” at the interpersonal level, had a significant impact on the BMI z-scores of vulnerable children.

Conclusions:

It is crucial to develop strategies that ensure sufficient sleep time and to actively involve childcare centers in implementing place-based interventions and initiatives to prevent obesity among vulnerable children. Moreover, it is essential to continue efforts in identifying the significant determinants of childhood obesity among vulnerable populations by considering the major environments in which these children live and grow.
Systematic Development, Validation, and Implementation of a Workshop Module “Suicide Prevention Program” for Pre-University College Teachers
Authors: Borah Kallabi , Jose Tessy Treesa , Nagaraj Anil Kumar Mysore , Bhandary P V
Published: February 2025

Background:

Death by suicide is a global health concern and is one of the top three causes of death among people aged between 15 and 29 years. Teachers are the key professionals in educational institutes to identify symptoms of suicide among students. The present article aimed to develop, validate, and implement a workshop module on the suicide prevention program (SPP).

Methods:

The workshop module was developed using the “curriculum development for medical education framework”. Subject experts from the psychiatric field validated the module. A total of 72 Pre-University College (PUC) teachers participated in the workshop. A self-structured feedback questionnaire was used to evaluate the participants’ satisfaction.

Results:

The workshop content areas were identified with a thorough literature review. The workshop module (content, case scenarios for role play, topics for group activities, and diary) was developed in the English language and validated with a content validity index of one. Participants reported high satisfaction with the workshop module. Feedback reported a positive attitude toward suicide prevention.

Conclusion:

The “Suicide Prevention Program” was developed and validated based on various experts’ suggestions for PUC teachers. It can be implemented in educational institutes.

Registration:

CTRI registration is done (CTRI/2022/09/045819).
Digital transformation in the SME context: The nexus between leadership, digital capabilities and digital strategy
Authors: Gyamerah Samuel , Afshari Leila , Asante Dennis
Published: February 2025

Digital transformation (DT) fundamentally disrupts enterprise operations presenting both unprecedented opportunities and complex challenges for organisational leadership. Drawing upon dynamic capability theory, we develop a model exploring the dynamics of digital transformational leadership (DTL) and its effects on DT within small- and medium-sized enterprises (SMEs). Specifically, we investigate the mediating roles of digital capabilities and digital strategies. Data from 256 SMEs in Ghana were analysed using structural equation modelling techniques to test hypotheses. The findings reveal a positive relationship between DTL and DT, demonstrating that the former positively influences digital IT capabilities (ITDC), employee digital capabilities, and digital strategies. ITDC and employee digital capabilities partially mediate the relationship between leadership and DT, while digital strategy shows a weaker mediating effect. The findings enhance understanding of how transformational leadership influences DT in SMEs, emphasising the role of digital capabilities and the nuanced impact of digital strategies.
A single injection of neuropeptide QRFP in the lateral hypothalamus decreased food intake
Authors: Zagorácz Olga , Ollmann Tamás , Péczely László , László Kristóf , Kovács Anita , Berta Beáta , Kállai Veronika , Kertes Erika , Vörös Dávid , Dusa Daniella , Szábó Ádám , Lénárd László
Published: February 2025

Background and aim:

Severe eating disorders, such as obesity, bulimia, and anorexia, keep increasing to epidemic proportions worldwide. Understanding of neuropeptides’ role in complex hunger/satiety mechanisms may allow new prospects for treatment and prevention. Pyroglutamylated arginine-phenylalanine-amide peptides (QRFPs) are thought to enhance feeding following the central administration.

Methods:

In our study, QRFP-26 was delivered into the lateral hypothalamic area of male Wistar rats by direct microinjections, as QRFP-26 expressing neurons and binding sights are densely present in this neural structure. The consumption of liquid food was measured over 60-min.

Results:

Both doses (100 and 200 ng) significantly decreased food intake compared to the control treatment. Neuropeptide Y Y1R/NPFF (neuropeptide FF) antagonist BIBP3226 eliminated the anorexigenic effect caused by QRFP-26 administration. QRFP-26 affects neither general locomotion, behavioral patterns examined in the Open Field Test, nor anxiety.

Conclusion:

This study is the first to report the anorexigenic action of QRFP-26 following direct administration into the hypothalamus, emphasizing steady locomotion and anxiety levels. We have shown that the effect of QRFP can be linked to the neuropeptide Y (NPY) Y1 or NPFF receptors.
Transforming Marketing Creative Capacities: The Role of Artificial Intelligence in Minimizing Creative Constraints
Authors: Brocato E. Deanne , Davis Cassandra
Published: February 2025

Artificial intelligence (AI) is poised to transform the way marketing activities are conducted and, as such, how educators prepare students for the ever-changing marketing landscape. As AI becomes increasingly integrated into marketing practices, it is crucial to examine its potential impact on marketing education. This research investigates the use of AI in a marketing Promotions Strategy course, a key component of marketing curriculum and one that poses challenges to students who struggle with creativity. Drawing on literature concerning creative anxiety, this research empirically examines how AI can shape students’ perceptions, experiences, and outcomes when faced with projects that demand creativity. The results of this study suggest that AI can serve as a valuable tool in assisting students to overcome the obstacles and challenges often stemming from a deficiency in creative expertise and proficiency in creative technologies.
Tracking cloth deformation: A novel dataset for closing the sim-to-real gap for robotic cloth manipulation learning
Authors: Coltraro Franco , Borràs Júlia , Alberich-Carramiñana Maria , Torras Carme
Published: February 2025

Robotic learning for deformable object manipulation—such as textiles—is often done in simulation due to the current limitation of perception methods to understand cloth’s deformation. For this reason, the robotics community is always on the search for more realistic simulators to reduce as much as possible the sim-to-real gap, which is still quite large especially when dynamic motions are applied. We present a cloth dataset consisting of 120 high-quality recordings of several textiles during dynamic motions. Using a Motion Capture System, we record the location of key-points on the cloth surface of four types of fabrics (cotton, denim, wool and polyester) of two sizes and at different speeds. The scenarios considered are all dynamic and involve rapid shaking and twisting of the textiles, collisions with frictional objects, strong hits with a long and thin rigid object and even self-collisions. We explain in detail the scenarios considered, the collected data and how to read it and use it. In addition, we propose a metric to use the dataset as a benchmark to quantify the sim-to-real gap of any cloth simulator. Finally, we show that the recorded trajectories can be directly executed by a robotic arm, enabling learning by demonstration and other imitation learning techniques.

Dataset: https://doi.org/10.5281/zenodo.14644526

Video: https://fcoltraro.github.io/projects/dataset/
Role of the CHA2DS2-VASc score in predicting hospital stay and 90-day readmission among patients with atrial fibrillation in Syria
Authors: Antoun Ibrahim , Alkhayer Alamer , Alkhayer Alkassem , Mahfoud Yaman , Kotb Ahmed , Somani Riyaz , André Ng G , Zakkar Mustafa
Published: February 2025

Objectives

We assessed the CHA2DS2-VASc score for predicting hospital readmission risk and length of stay (LOS) in patients admitted with primary atrial fibrillation (AF).

Methods

This retrospective cohort study included patients with index admission for AF to Latakia’s tertiary center (May 2021–November 2023). Patients were followed 90 days to assess readmission. CHA2DS2-VASc was correlated with 90-day readmission, inpatient all-cause mortality, and LOS during index admission.

Results

In total, 717 patients were included; 320 (45%) were readmitted to the hospital within 90 days (58% men, 65% aged <65 years). Inpatient mortality was 4%; the median LOS was 2 days. There was an increase in the incident rate ratio (IRR) of LOS starting from a CHA2DS2-VASc of 2 (IRR: 2, 95% confidence interval [CI]: 1.7–2.2) to a score of >6 (IRR: 5, 95% CI: 1.8–10.7), compared with a score of 0. There was an incremental increase in the hazard ratio (HR) of readmission from a score of 1 (HR: 2.3, 95% CI: 1.3–4.1) to a score of >6 (HR: 41, 95% CI: 31–72) compared with a CHA2DS2-VASc of 0.

Conclusion

CHA2DS2-VASc could predict 90-day hospital readmission and LOS during the index admission in patients admitted with primary AF.
Vaginal bleeding during pregnancy: a retrospective cohort study assessing maternal and perinatal outcomes
Authors: Matar Maroun , Yared Georges , Massaad Christopher , Ghazal Kariman
Published: February 2025

Objective

Vaginal bleeding is a relatively common problem during pregnancy, with up to 25% of women experiencing some level of bleeding or spotting during pregnancy. Although not always a concern, pregnancy-related vaginal bleeding may detrimentally impact maternal and fetal health, and can arise at any stage during the pregnancy, usually linked with preterm labor, miscarriage, placental abnormalities, or implantation bleeding. As vaginal bleeding may compromise newborn health outcomes, for example, leading to low birth weight and neonatal intensive care unit (NICU) hospitalizations, it is imperative to understand the etiology of the bleed and effectively manage the patient’s condition. Thus, the aim of this study was to evaluate the prognostic value of vaginal bleeding as an indicator for at-risk pregnancies, aiming to elucidate its association with perinatal outcomes and pregnancy complications.

Methods

Consecutive pregnant female patients, aged 16–47 years, were included in this retrospective cohort study, and categorized into those with or without pregnancy-associated bleeding. Between-group differences and correlations in pregnancy complications and perinatal outcomes were statistically analyzed.

Results

Among a total of 441 patients, the incidence of vaginal bleeding was 74.4%, predominantly occurring in the first trimester (67.1%). No significant association was found between bleeding and maternal age, parity, abortion history, or total number of pregnancies. Educational level varied, with 64.9% of moderate education level experiencing bleeding. Pre-pregnancy comorbidities, such as diabetes, hypertension, and hypothyroidism, were not significantly correlated with bleeding. However, a history of infertility and progesterone treatment during pregnancy was significantly associated with bleeding episodes. An increased risk for NICU admissions and conditions such as respiratory distress in neonates was found, alongside a significant association with post-delivery bleeding and premature labor in the later trimesters.

Conclusions

Vaginal bleeding during pregnancy was not found to be significantly associated with maternal age, parity, abortion history, or total pregnancies. Nonetheless, the findings suggest a significant relationship between bleeding episodes and a history of infertility or progesterone treatment during pregnancy. Additionally, pre-pregnancy comorbidities, including diabetes, hypertension, and hypothyroidism were not associated with pregnancy bleeding. However, the latter was associated with increased risk of post-delivery bleeding, premature labor, and neonatal complications, such as respiratory distress and NICU admissions.
A randomised trial to assess the impact of midodrine on early mobilisation after elective primary hip replacement surgery
Authors: Cammerman Adam C , Haslam Daniel WL , Currigan Dale A , Lennon Mark J
Published: February 2025

Early mobilisation following elective total hip arthroplasty (THA) facilitates quicker rehabilitation, and reduces complications and hospital length of stay. Reasons for delayed mobilisation are multifactorial, but the most common cause is orthostatic intolerance. Midodrine, an oral alpha-1 agonist, is used off-label for perioperative hypotension. However, there are few randomised trials assessing its use in the perioperative setting to improve patient outcomes. The aim of the study was to determine whether midodrine improves early mobilisation following primary THA, and whether this relates to reduced orthostatic intolerance. This prospective, triple-blinded, multicentre study involved 42 patients randomised to either placebo or 20 mg midodrine, 2 h before physiotherapy, on Day 1 postoperatively. The inclusion criteria were adults undergoing elective unilateral THA under spinal anaesthesia. The primary endpoint was the ability to walk 5 m with physiotherapists. Secondary endpoints included the incidence of orthostatic intolerance and hypotension. A preplanned interim analysis showed no statistical difference in ability to mobilise 5 m (78.26% vs 78.95%, P = 1.0). There was no statistically significant difference in the incidence of orthostatic intolerance between the groups 17.4% vs 31.6% ( P = 0.45). Pre-emptive use of midodrine did not improve patient mobilisation the morning after elective primary THA and had no significant effect on the incidence of orthostatic hypotension.
Working Elements in Interventions to Reduce Problematic Alcohol Use According to Older Adults: A Realist Evaluation
Authors: van den Bulck Fieke A. E. , Rozema Andrea D. , van de Mheen Dike , Knijff Rikste , Bovens Rob H. L. M. , Stutterheim Sarah E. , Crutzen Rik
Published: February 2025

This study explored working elements (E) and mechanisms (M) in interventions within different contexts (C), contributing to the outcome (O) of reducing (problematic) alcohol use among older adults. Guided by a realist evaluation approach, interviews with older adults participating in interventions ( N = 20) were conducted. In different contexts, several working elements were identified: (1) receiving information about alcohol and health (risks); (2) paying attention to abstinence; (3) being in contact with and receiving support from peers and relatives; (4) maintaining contact with a practitioner or peer/buddy who is always or flexibly available for communication; and (5) learning to manage drinking behavior, and one important mechanism was identified: motivation. From the older adults’ perspectives, there was a need to focus on social contact and support from peers and relatives, tracking and reflection, and motivation to reduce problematic alcohol use.
Sense of Community and Social Participation Underlying Active Aging Among Senior Housing Residents
Authors: Siltanen Sini , Rantakokko Merja , Lahti Anna-Maria , Levonmaa Helena , von Bonsdorff Mikaela B.
Published: February 2025

Sense of community (SoC) and social participation are considered resources for active aging but there is sparse empirical knowledge on the topic. We investigated these associations among senior housing residents. Data were derived from the cross-sectional BoAktiv senior housing survey ( N = 278). Active aging was measured with the (blinded) Active Aging scale including subscales of will, ability, and possibility to act, and the frequency of activity. SoC was assessed with the revised Sense of Community Index and social participation was self-reported. Data were analyzed with linear regression and stratified by sex. We found that in both men and women, SoC and social participation were associated with the will to act and frequency of activity subscores. Additionally, SoC was associated with the active aging total score. The associations were slightly stronger in men than in women. These findings suggest that strengthening social engagement supports senior housing residents’ active aging.
Chronotype and Sleep Timing by Race-Gender: The CARDIA Sleep Study
Authors: Knutson Kristen L. , Reid Kathryn J. , Wong Mandy , Alexandria Shaina J. , Thomas S. Justin , Lewis Cora E. , Schreiner Pamela J. , Sidney Stephen , Kershaw Kiarri , Carnethon Mercedes R.
Published: February 2025

Chronotype indicates a person’s “circadian preference,” that is, the time of day when they prefer to perform certain activities (e.g. a “morning” vs “evening” person). Sleep timing is related to chronotype but is also constrained by social requirements. When sleep timing does not align with chronotype, circadian disruption can occur, and circadian disruption impairs cardiometabolic health. There are well-known racial disparities in cardiometabolic health whereby Black adults are at higher risk. It is not well-known, however, whether sleep timing within each chronotype varies between Black and White adults, which was the focus of these analyses. These data are from a cross-sectional sleep study conducted in 2020 to 2023 as an ancillary to the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, in the United States. The Morningness-Eveningness Questionnaire (MEQ) captured chronotype in 2,373 participants aged 52–70 years. Chronotype was based on both overall MEQ score and question 19 categories. A subset of participants wore a wrist actigraphy monitor for ~7 days to assess sleep timing ( n = 720). Our sample included 27% Black women, 17% Black men, 33% White women, and 24% White men. Mean MEQ score and chronotype distribution did not differ among race-gender groups. Among morning types, Black women and men had a later sleep start and midpoint than White women (23–34 minutes later for Black women, 32–53 minutes for Black men). Among intermediate types, Black women had significantly later sleep start (55 minutes later) and midpoint (44 minutes later), and Black men had a later sleep start (50 minutes later) than White women adjusting for age and study site. In summary, regardless of chronotype, Black adults had later sleep timing than White adults.
Fixed vs Weight-Based Dosing of Four-Factor Prothrombin Complex Concentrate for Factor Xa Inhibitor Reversal in Patients With a Non-Neurologic Hemorrhage
Authors: Stokes Tyson , Johnson Christopher , Fish Tyler , Mishler Aimee
Published: February 2025

Background: There is a growing body of evidence to support that utilizing fixed dose vs weight-based dosing of Four-Factor prothrombin complex concentrate (4F-PCC) for Factor Xa inhibitor (FXaI) reversal is safe and efficacious. Objectives: The primary objective of this study was the rate of hemostatic efficacy of weight-based (50 units/kg) vs fixed dose (2000 units) 4F-PCC for FXaI reversal in patients presenting with a non-neurologic hemorrhage. Methods: This was a multi-center, retrospective chart review from January 21, 2020, to January 21, 2022. Patients were included if they were greater than or equal to 18 years of age and received one dose of 4F-PCC for FXaI reversal for a non-neurologic bleed. Hemostatic efficacy for this study was defined as the absence of hemorrhagic progression confirmed with imaging, >2 g/dl decrease in Hgb within 6 hours of 4F-PCC administration, reports of further significant bleeding in chart note documentation within 48 hours and a maintained or increased anti-factor Xa level from baseline. Results: Fifty-nine patients were included in this study (29 in the weight-based group and 30 in the fixed dose group). Rate of hemostatic efficacy was similar between fixed and weight-based dosing (93.3% vs 93.1% P = 1). Conclusions: This study adds to current evidence suggesting that a fixed dose 4F-PCC is both safe and efficacious for FXaI reversal in non-neurologic bleeds.
Hypertension is associated with global and renal damage accrual in patients with systemic lupus erythematosus. Data from the Almenara Lupus Cohort
Authors: Díaz-Ramírez Fernando Piero , Saldaña-Alvarado Fiorella Vanessa , Gamboa-Cárdenas Rocío V. , Pimentel-Quiroz Victor , Reategui-Sokolova Cristina , Elera-Fitzcarrald Claudia , Noriega Erika , Rodriguez-Bellido Zoila , Pastor-Asurza Cesar , Perich-Campos Risto , Alarcón Graciela S. , Ugarte-Gil Manuel F.
Published: February 2025

Objectives

To determine the association between the occurrence of hypertension and damage accrual in patients with systemic lupus erythematosus (SLE).

Materials and methods

From January 2012 to January 2020, we evaluated 314 SLE patients, all members of the Almenara Lupus Cohort. We applied the American College of Cardiology/American Heart Association (ACC/AHA) guidelines to define hypertension, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) to determine organ damage, and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) to assess disease activity. We performed univariable and multivariable analysis using generalized estimating equations, adjusting for potential confounders (demographic factors, disease-related factors and treatment).

Results

314 patients and 1695 visits were included; 93% of the patients were women. Their mean disease duration was of 6.8 years (SD: 6.4), and their age at diagnosis of 35.7 (SD: 13.4) years. Baseline damage was 0.8 (SD: 1.2) at the first visit, increasing by 0.15 points at the subsequent follow-up visit (SD: 0.46). The prevalence of hypertension in these patients was 56.4% at least once during their follow-up. In the multivariable analysis, hypertension remained associated with damage accrual (IRR: 1.645, 95% CI: 1.187–2.280, p = 0.003) after adjusting for confounders. In the analyses performed per domain, hypertension was associated with renal damage in the multivariable model (OR: 4.331, 95% CI 1.547–12.126, p = 0.005).

Conclusion

Hypertension was associated with subsequent greater damage in our SLE patients. Thus, providers involved on the care of these patients should monitor their blood pressure at all clinic visits.
Determinants of Sustainability Reporting Through the Lens of Green Loans Disclosure: Evidence From the Indian Banking Sector
Authors: Patel Siddharth , Desai Rajesh
Published: February 2025

This study examines the factors influencing the sustainable reporting practices of commercial banks, focusing on green loan disclosures. Employing balanced panel data from 26 banks over 12 years (2012–2023), the binary logistic regression method is used to analyze sustainability disclosure practices, with validation provided by the system’s generalized method of moments estimation to address potential endogeneity. The findings reveal that a bank's asset size positively influences green lending disclosures, while the market value ratio and non-performing assets exert a negative impact. These results suggest that larger banks with lower market valuations and higher levels of bad loans are more inclined to disclose their green lending activities. The study enriches sustainability reporting literature by identifying key drivers of green lending disclosures in India, offering valuable insights for policymakers and stakeholders. It also provides a novel contribution to the under-explored area of green loan disclosures, particularly in the context of developing countries. By focusing on the Indian banking industry, the study fills a critical gap in the existing body of knowledge and sheds light on the disclosure practices related to green loans.
Unlocking Trading Insights: A Comprehensive Analysis of RSI and MA Indicators
Authors: Singh Kewal , Priyanka
Published: February 2025

In the evolving landscape of financial markets, technical analysis remains a cornerstone for traders seeking to gain an edge. This article presents a comprehensive analysis of two pivotal technical indicators: the Relative Strength Index (RSI) and Moving Averages (MA). Through meticulous research, we dissect the intricacies of these indicators, evaluating their predictive power and effectiveness in various market conditions. Our study employs a robust methodological framework, incorporating historical data analysis, algorithmic testing, and behavioural finance perspectives to assess the utility of RSI and MA in unlocking trading insights. We reveal how the RSI’s overbought and oversold signals, when combined with MA’s trend-following properties, can be harmonized to refine entry and exit strategies. The article also explores the adaptability of these indicators in the face of market volatility and the potential for enhanced performance through algorithmic integration. Our findings suggest that while RSI and MA are potent tools individually, their combined application can significantly bolster trading strategies. This research not only enriches the existing body of knowledge but also provides practical frameworks for traders aiming to optimize their technical analysis toolkit.
A Prospective Observational Study of the Short-term Benefits of Pulmonary Rehabilitation in Connective Tissue Disease-related Interstitial Lung Diseases
Authors: Gedert Rosemary , Huang Suiyuan , Sabbagh Maya , McInroy Melissa , Huang Steven , Khanna Dinesh , Nagaraja Vivek
Published: February 2025

Background and Objectives:

Interstitial lung disease (ILD) is a common manifestation of connective tissue disease (CTD). (a) Pulmonary rehabilitation (PR) can be utilised to improve dyspnoea and quality of life in patients with chronic lung conditions, including both obstructive and restrictive lung diseases. (b) This study aims to determine if PR can be a useful therapy to improve functional capacity and self-reported measures of dyspnoea in patients with CTD-ILD.

Methods:

Patients with a diagnosis of CTD-ILD at a tertiary centre were prospectively enrolled to receive PR in this study. The primary outcome was a change in the 6-minute walk test (6MWT) between baseline and 8 weeks after PR. The secondary outcome measures included pulmonary function tests (PFTs) and Patient-Reported Outcomes Measurement Information System (PROMIS→) Dyspnoea, St George’s Respiratory Questionnaire (SGRQ), and Leicester Cough Questionnaire (LCQ), which were collected before and at 8 weeks after PR. P < .05 was considered statistically significant.

Results:

Twenty-one patients were included in the data analysis. The baseline characteristics are shown in Table 1 . Following PR, there was a statistically significant improvement in the 6MWT ( Figure 1 ). Improvement in scores was observed in LCQ and the symptom domain of the SGRQ. Trends towards improvement were noted in PROMIS→ Dyspnoea scores.

Conclusion:

In CTD-ILD patients, an 8-week course of PR led to improvements in functional capacity (6MWT) and certain quality of life domains (LCQ and symptom domain of SGRQ). Future studies are required to determine the longer-term benefit of PR in CTD-ILD patients and if these improvements are sustained.
Theoretical Considerations for Engaging Black Youth and Families in Child-Serving Systems: Strengths-Based Approaches, Intersectionality, and Culturally Responsive Trauma-Informed Care
Authors: Williams-Butler Abigail , Ludeke Rachel , Ghanem Nuha , Matthews Miracle , Kawaii-Bogue Babe
Published: February 2025

This article is temporarily under embargo.