bluuebunny/crossref_metadata_2025 huggingface dataset:
Aerodynamic investigation of a three-stage transonic axial compressor
Authors: Wang Xiaochen , Ren Xiaodong , Li Xuesong , Gu Chunwei , Que Xiaobin , Zhou Guoyu
Published: January 2025

In high-loaded multistage axial compressors, shock waves are introduced into rotor designs to increase pressure ratio per stage, and shock structures should be organized differently to exploit inflow with varied Mach numbers. In this paper, aerodynamic performances under shock effects are investigated numerically in a three-stage axial compressor, and the compressor is tested to verify the numerical results. Compared with previous studies in transonic rotors, this paper focuses on the transonic flow in a multistage condition, and the analysis at design speed is achieved by combining through-flow and Computational Fluid Dynamics (CFD) calculations. Grid sensitivities and turbulence models in numerical methods are discussed, allowing accurate numerical predictions of the compressor with less than 1% errors in mass flow rate and efficiency. Flow problems are then identified based on comprehensive analysis of the meridional and three-dimensional flow fields. It is shown that most through-flow and CFD results agree well with each other and the test data, while a few problems still exist in flow details concerning about shock/boundary-layer interactions and off-design conditions. Two types of shock-induced separations on suction surfaces of transonic rotors are discovered at design speed, which leads to excessive loss correlated to different sources based on the strength comparison between passage shock and subsonic diffusion. Another problem is located in the stator of the third stage (S3), where the hub endwall flow presents evident failure tendency at near-choke and near-stall points of design speed. The analysis above lays solid fundamental for optimization design in future studies.
The mental health impact of climate change on Pacific Islanders: A systematic review focused on sea level rise and extreme weather events
Authors: Mengesha Netsanet Ayele , Sarnyai Zoltan
Published: January 2025

Objective

This systematic review investigates the impact of climate change on the mental health of Pacific Island Nations (PINs), with a focus on identifying culturally tailored interventions and appropriate research methodologies to address these impacts.

Method

A systematic review of peer-reviewed literature up to May 18, 2024, was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol and the Population, Interest Area, and Context (PICo) framework. Empirical studies on the impact of climate change on mental health in PINs were evaluated by using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

Results

Six studies from the Solomon Islands, Cook Islands, and Tuvalu were identified, indicating significant mental health impacts from sea level rise (SLR) and extreme weather events with compounding and mitigating effects across diverse groups. The Skills for Life Adjustment and Resilience (SOLAR) program was highlighted as a promising culturally adapted intervention.

Conclusion

Climate change significantly impacts mental health, particularly in PIN communities facing SLR and Extreme Weather Events (EWE). Culturally sensitive interventions, local knowledge, and further research are vital to mitigate these effects and support well-being.
Trademarks and Entrepreneurial Firm Success: Theory and Evidence from Venture Capital Investments in Private Firms
Authors: Bayar Onur , Chemmanur Thomas J. , Rajaiya Harshit , Tian Xuan , Yu Qianqian
Published: January 2025

We theoretically model an entrepreneur’s choice of his firm’s products to trademark, the relation between the number of trademarks and venture capital (VC) investment staging, long-run operating performance, and successful firm exit probability. We test model predictions using a large dataset of trademarks registered by VC-backed private US firms. We find that firms with a larger number of trademarks at first VC investment have a smaller number of VC financing rounds; have larger long-run sales and employment; and have greater probabilities of successful exit (initial public offering [IPO] or acquisition). Our instrumental variable analysis demonstrates that more trademarks causally enhance firm performance and reduce VC staging.

JEL code: G23, G24, L26, O34
Challenges in Breast Pathology: A Review of the Most Common Problems Encountered in a Subspecialty Consult Service Over 1 Year—Retrospective Review of 553 Specimens
Authors: Fnu Sonam , Downs Erinn , Rowe Jordi , Hoda Raza , McIntire Patrick , Booth Christine , Duckworth Ashley L. , Bhattarai Roshan , Komforti Miglena K.
Published: January 2025

Aims. To identify the most common reasons for consultation to a large specialty breast pathology service at a major institution. To provide insight into the overall challenges in practicing breast pathology. Methods. The anatomic pathology database at one institution was searched for all breast consultations received in 2021, excluding in-house patients and patients who were transferring care. Results. A total of 553 patients met the criteria ( n = 553) from a variety of academic and private practices. For each patient, the paperwork from the submitting institution was reviewed to identify the specific question, and subsequently classified into 14 categories. The reason for the consultation request was not provided for 78 (14%) patients, and a review of the outside diagnoses, where applicable, was performed. In summary, the top 5 reasons for consultation were: (1) assistance with classification of atypical intraductal epithelial proliferations (32%); (2) evaluation for the presence of (micro-)invasive carcinoma (14%); (3) evaluation of fibroepithelial (12%), (4) papillary (11%), and (5) spindle cell lesions (7%). Conclusion. We show an ongoing educational and practice gap for pathologists who most commonly struggle with classifying atypical precursor lesions, specifically when these are small and focal, or bordering on intraductal carcinoma (32%, 177/553). The second most common reason for consultation was classifying invasive carcinomas as microinvasive and subtypes (total of 20.4%, 113/553). As such, our data supports the continued need for rigid and clear criteria for diagnosing threshold lesions (namely atypical hyperplasias) and intraductal carcinoma of the breast.
Completion Rates of Smart Technology Ecological Momentary Assessment (EMA) in Populations With a Higher Likelihood of Cognitive Impairment: A Systematic Review and Meta-Analysis
Authors: Fifield Kate , Veerakanjana Kanyakorn , Hodsoll John , Kuntsi Jonna , Tye Charlotte , Simblett Sara
Published: January 2025

Ecological Momentary Assessment using smartphone technology (smart EMA) has grown substantially over the last decade. However, little is known about the factors associated with completion rates in populations who have a higher likelihood of cognitive impairment. A systematic review of Smart EMA studies in populations who have a higher likelihood of cognitive impairment was carried out (PROSPERO; ref no CRD42022375829). Smartphone EMA studies in neurological, neurodevelopmental and neurogenetic conditions were included. Six databases were searched, and bias was assessed using Egger’s test. Completion rates and moderators were analyzed using meta-regression. Fifty-five cohorts were included with 18 cohorts reporting confirmed cognitive impairment. In the overall cohort, the completion rate was 74.4% and EMA protocol characteristics moderated completion rates. Participants with cognitive impairment had significantly lower completion rates compared with those without ( p = .021). There were no significant moderators in the cognitive impairment group. Limitations included significant methodological issues in reporting of completion rates, sample characteristics, and associations with completion and dropout rates. These findings conclude that smart EMA is feasible for people with cognitive impairment. Future research should focus on the efficacy of using smart EMA within populations with cognitive impairment to develop an appropriate methodological evidence base.
Epidemiological Features of Sinonasal Adenocarcinoma and Prognostic Nomogram: A Study Based on the SEER Database
Authors: Yang Lu , Gu Yufeng , Yu Lei , Zhou Qiang , Liu Li , Mao Ying , Ma Ji , Li Yong , Li Na
Published: January 2025

Objective

Our study aimed to update demographic profiles of sinonasal adenocarcinoma (SNAC) between 2000 and 2020, identify independent prognostic risk factors, and devise a predictive nomogram for overall survival (OS).

Methods

Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, cases of SNAC from 2000 to 2020 were analyzed for incidence trends. Univariate and multivariate Cox regression models helped pinpoint factors impacting patient survival. A prognostic nomogram was then created based on these factors and assessed via concordance index, ROC analysis, and calibration curves.

Results

Analysis of 488 SNAC patients indicated a rising incidence, peaking among 60-69-year-olds, with a male predominance and the highest occurrence in White populations. Common sites of occurrence included the nasal cavity, and the maxillary and ethmoid sinuses. The nomogram, developed with 184 patients, highlighted older age (≥70), male sex, advanced T stages (T4b, T4a), distant metastasis, larger tumors (≥5 cm), and lack of surgery as poor prognostic indicators. Nomogram performance demonstrated strong predictive capabilities in both training and validation cohorts.

Conclusion

This investigation, leveraging the SEER database, elucidates the epidemiology of SNAC and pinpoints key adverse prognostic determinants: age ≥70, male gender, T stages T4b and T4a, presence of distant metastasis, tumor size exceeding 5 cm, and absence of surgical intervention. Moreover, it introduces a novel nomogram capable of accurately forecasting 1-, 3-, and 5-year OS for SNAC patients, thereby enhancing disease comprehension and facilitating the formulation of tailored therapeutic strategies by clinicians.
Preliminary efficacy and safety results of a new macular buckle model (NPB®) in myopic traction maculopathy
Authors: Viana Ana Rita , Ripa Matteo , Silva André , Matello Veronika , Parolini Barbara
Published: January 2025

Purpose

To describe the efficacy and safety outcomes of NPB® macular buckle (MB) in myopic traction maculopathy (MTM).

Methods

A monocentric, prospective cohort study of the naïve eyes who underwent MB surgery, alone or combined with pars plana vitrectomy (PPV) for MTM, using the new NPB® buckle, between December 2022 and June 2024. The anatomical results, postoperative complications, and MB ease of use were analyzed as the main outcomes. Secondary outcomes included changes in best-corrected visual acuity (BCVA), axial length (AL), and intraocular pressure (IOP).

Results

Forty eyes of 39 patients were included, 34 (85%) were female. MB implantation alone was performed in 32 eyes (80%) and combined surgery in 8 (20%). At the final visit, 22 eyes (56,4%) “resolved” and 17 (43,6%) “improved” their retinal status, and 26 eyes (66,7%) “resolved”, 8 (20,5%) “improved” and 5 (12,8%) “unchanged” their foveal status. Thirteen (32,5%) had repositioning surgery mainly due to MB decentration. Early complications (month 1) included diplopia in 3 eyes (7,5%) and elevation deficit without diplopia in 2 (5,0%). Late complications (month 6) involved mild buckle exposure in 3 cases (7,5%). No cases required MB removal or additional PPV. BCVA improved from 0,61 ± 0,35 to 0,49 ± 0,38 logMAR ( p = 0,013), AL changed from 31,5 ± 2,2 to 30,0 ± 2,2 mm ( p < 0,001), and IOP changed from 16,0 ± 2,7 to 14,5 ± 3,3 mmHg ( p = 0,013), between the baseline and the final visit.

Conclusions

The new MB model is an effective and safe technique for MTM treatment as a first-line strategy, alone or in combination with PPV.
Contradictions and change: The dynamics of international collaboration in music education between India and Norway
Authors: Brøske Brit Ågot , Eri Thomas
Published: January 2025

This study explores contradictions in an international music education partnership project involving Norway and India. The study aims to contribute knowledge about systemic contradictions that might occur in international partnership projects in music education and to briefly discuss how such contradictions might energize international collaboration. Recordings from six project group meetings between the involved partners, recordings from a group conversation session, and the first author’s research diary constitute the empirical data in this study. The analysis is informed by cultural–historical activity theory, in which contradictions are viewed as both barriers to and energizers for development. The identified contradictions are categorized into three topics: the role of the music teacher, the role and type of music/music education, and the need for structure. The findings suggest that the identified contradictions can be attributed to three culturally and historically constituted discursive practices: the Indian educational system, the Norwegian school music tradition, and the guru-shishya tradition. Although it is a common perception that societal and systemic contradictions cannot be resolved within the boundaries of small-scale projects, such projects can create a third space in which the multivoicedness of discursive practices found in international collaboration can become a transformative force for new practice models. This could create opportunities to recognize motivational similarities despite perceived differing discursive practices.
Crackwave R-convolutional neural network: A discrete wavelet transform and deep learning fusion model for underwater dam crack detection
Authors: Guo Bo , Li Xu , Li Dezhi
Published: January 2025

Crack detection is an essential part of structural health monitoring (SHM) for underwater dams, which is crucial for preventing potential structural failures and ensuring the long-term stability. Deep learning-based image processing algorithms have become a research hotspot in the field of crack detection. However, the complex underwater environment has posed challenges to underwater dam crack detection. To address these issues, we propose CrackWave R-convolutional neural network (CW R-CNN), a novel underwater dam crack detection model that fuses discrete wavelet transform (DWT) and deep learning. The proposed model introduces a novel backbone network, DwtResNet, which incorporates DWT to comprehensively extract frequency-domain features from underwater crack images. To overcome the limitations of Intersection over Union (IoU), particularly when predicted and ground truth bounding boxes do not overlap, we employ the generalized IoU (GIoU) function. Furthermore, we apply the soft nonmaximum suppression (NMS) algorithm to reduce the risk of missing fine cracks. In addition, we utilized a self-developed underwater dam image acquisition robot to capture a large number of underwater dam crack images, forming the self-acquired dataset. Evaluating the proposed model on this dataset showed that its MAP_0.5 outperformed SSD, YOLOv5, and the conventional Faster R-CNN. The proposed model proved more effective than other models, especially in detecting fine cracks and handling complex backgrounds. These experimental results not only demonstrate the effectiveness of CW R-CNN in underwater dam crack detection but also highlight its potential application in SHM. It provides essential technical support for the safe monitoring of underwater dam structures.
Morality as experienced: A scoping review of moral matters encountered by adults living with rare diseases
Authors: Quintal Ariane , Hotte Élissa , Racine Eric
Published: January 2025

Most rare diseases are poorly understood, affected individuals struggle tobe timely diagnosed and to access tailored, appropriate, and affordablecare. Following pragmatist theory, individuals living with rare diseasesmay experience these obstacles as morally problematic situations, wherethey struggle with actualizing their cherished values amid their lifecircumstances. These embedded and contextualized lived episodes aredistinct from moral challenges and moral issues, which are more abstract,decontextualized, and speculative moral matters. We sought to uncoverthe moral matters of adults living with rare diseases in the qualitativeliterature while elucidating the moral dimensions of morally problematicsituations. Moral matters were extracted from 25 qualitative studies andsubjected to thematic and interpretive analyses. The uncovered moralissues addressed abstract considerations relating to accessibility, limitedknowledge, and unpredictability of illness manifestations. Moralchallenges and morally problematic situations spanned across the fourphases of the medical trajectory: the diagnostic odyssey, the diagnosis,clinical care and treatment, and medical follow-up. Moral challengesnamely pertained to poor communication of diagnoses, lack of shareddecision-making, and lack of holistic support. Morally problematicsituations featured moral dimensions, namely (1) internal tensions (e.g.,being misunderstood), (2) constraints to agency (e.g., powerlessness anddisempowerment), in addition to (3) empowerment and selfadvocacystrategies (e.g., being assertive and demanding), notably in episodeswhere support from clinicians lacked. This study highlights the usefulnessof distinguishing these three types of moral matters in ethical analysis. Italso shows how moral dimensions of morally problematic situations carryexistential importance for affected individuals.
Public Enemy #1: How Many More?
Authors: Rosario Carrie
Published: January 2025

Public Enemy #1: How many more? explores historical and contemporary manifestations of the tobacco industry on public health, and specifically Black lives, in the United States. This is reinforced with bold text that serves as a mini poem within the poem, emphasizing tobacco’s impact on mortality. By juxtaposing messaging from the industry with Black American music (e.g., Hip Hop, R&B lyrics), TV culture references, and movements for racial justice, the poem provides an opportunity for critical analysis of the intersections between commercial tobacco, systemic racism, and capitalism. It counters narratives focused on personal responsibility and instead offers a complex, nuanced understanding of how systems of power intersect to harm communities. The title, a hip-hop reference to the group Public Enemy, whose songs include political messages to raise cultural consciousness, is a call to reflect on who is really the most dangerous threat in our society. I intentionally use italics for emphasis and references from Black culture to elevate our lives, voices, contributions, and legacies, which are in no way expendable. Any loss is a societal loss. Birthed from the pains of my own series of tobacco-related familial losses, this poem is a testament that the fight is one of reclamation that must be ongoing and provides an opportunity for reckoning and truth-telling. Like the Public Enemy song it references, Public Enemy #1: How many more? is a battle cry to take system-level action on these intricately woven epidemics to rectify, rather than perpetuate injustice, and advance racial and health equity. To view the original version of this poem, see the supplemental material section of this article online.
Using Anti-Blackness and Historical Inquiry to Ground Nursing and Research Practice in Black Populations
Authors: Vogel Octavia , Salzinger Meredith , Daniel Gaea , Smith Kylie
Published: January 2025

Since the “Black Lives Matter” reckoning of 2020, professional health organizations have made public statements and apologized for not recognizing the role of racism in the creation of health disparities. For the American Nurses Association, this has taken the form of the National Commission to Address Racism in Nursing . One result of that work has been the Report on the History of Racism in Nursing, which details the constant maligning of the competence of Black nurses and their systematic exclusion from institutions within the profession. In this article, we want to take these ideas further and argue that the issue for nursing is not so much a generic kind of racism that a professional reorganization can address, but rather a deep and abiding “anti-blackness” that is intrinsic to the heart and soul of medical and health knowledge itself. Anti-blackness as an idea comes from a collection of theoretical interventions developed by Black philosophers, literary theorists, sociologists, and historians who continue to grapple with the question posed by W.E.B. DuBois: “How does it feel to be a problem?” Anti-blackness is the “relegation of Black people to inhumanity and non-being” and “is a global phenomenon that takes on distinct forms of expression in each sociocultural context.” Given the call to understand the role of historical, social, political, environmental, and economic factors via the social determinants of health, a more expansive approach is needed to articulate the Black lived experience. Anti-blackness is one tool available to nurses interested in a deeper level of analysis.
Aircraft detection from satellite imagery using synthetic data
Authors: Everman Robert , Wagner Torrey , Ranly Neil , Cox Bruce
Published: January 2025

This paper explores the advancement of object detection models within the domain of satellite imagery analysis, focusing on the innovative application of synthetically generated datasets to enhance model performance. Motivated by the inherent challenges of manual dataset annotation, such as errors, limited variability, and geographical biases, this study employs synthetic data generation techniques to create a diverse dataset by overlaying 3D models of 31 different aircraft types onto satellite imagery, creating a dataset of 5000 images containing 27,375 aircraft. This dataset includes a variety of environmental conditions and image transforms aimed at training a more robust and generalizable object detection model. Using a pre-trained model based on the YOLO v8x architecture, an extensive comparison of fine-tuned models trained separately on traditional manually annotated datasets was compared with a fine-tuned model trained on the synthetic dataset. The results show the model trained with synthetic data achieves a performance within 2% of the other models, detecting actual aircraft in diverse circumstances, despite only being trained on synthetic data derived from 3D models. By providing a scalable, efficient, and accurate method for training object detection models, this research demonstrates the possibility of detecting previously unseen objects based only on a 3D model.
NRXN2 Homozygous Variant Identified in a Family with Global Developmental Delay, Severe Intellectual Disability, EEG Abnormalities and Speech Delay: A new Syndrome?
Authors: Karaer Derya , Özçelik Ayşe Aysima , Karaer Kadri
Published: January 2025

Background. This study aims to characterize the clinical phenotype of a family with two siblings exhibiting neurological manifestations, utilizing whole exome sequencing (WES) to identify potential pathogenic variants within the NRXN2 gene. Methods. A consanguineous family with two affected siblings displaying developmental delay, severe intellectual disability, epilepsy, and speech delay was examined. WES was performed on DNA samples from affected and unaffected family members, followed by a comprehensive bioinformatics analysis. In-silico tools were employed for variant interpretation and structural modeling of the NRXN2 protein. Clinical and genetic data were integrated to elucidate the potential impact of the identified variant. Results. WES revealed a novel homozygous missense variant (c.1475T>G, p.Leu492Arg) in the NRXN2 gene in both affected siblings. This variant was absent in healthy family members and public databases. In-silico analysis predicted a detrimental effect on protein function. Parental segregation confirmed heterozygous carrier status. The variant was classified as ‘Likely Pathogenic’ based on ACMG/AMP criteria. Conclusion. This study identifies a novel homozygous missense variant in NRXN2 associated with global developmental delay, severe intellectual disability, speech delay and epilepsy. The findings underscore the critical role of NRXN2 in neurodevelopment and highlight the potential implications of genetic variations within this gene in neurodevelopmental disorders. Further research and functional validation are warranted to deepen our understanding of NRXN2-related disorders and explore potential therapeutic interventions.
Exploring the Etymology of YouXi: A Chinese Perspective on the Concept of Game
Authors: Feng Zihan
Published: January 2025

While there has been extensive academic discussion on the definition of games, very few studies have explored how similar concepts are expressed in languages other than English. In this paper, I investigate the etymology of the Chinese term YouXi, a Chinese term regarded as the equivalent of “game.” Firstly, I discuss the possible origins, evolution, usages, and inherent aesthetics and values of YouXi. Secondly, I contrast YouXi with “game” and reveal that YouXi reflects a unified understanding of game and play. In addition, I argue that in terms of ontological differences, “game” highlights rule-based interaction and player competition, whereas YouXi emphasizes the sense of immersion and safety. Finally, I integrate these findings with existing game studies to propose a definition of YouXi as the experimental exploration of alternative life experiences and further suggest interpreting game and play through this perspective.
The relation between estimated pulse wave velocity and peripheral arterial disease: A study based on NHANES
Authors: Ning Meiling , Jiang Xuehe , Jia Shuang , Cui Na , Yu Limei
Published: January 2025

Background

As a type of atherosclerotic lesion affecting the peripheral vascular system, peripheral arterial disease (PAD) has an elevated disability rate and seriously affects patients’ quality of life. Estimated pulse wave velocity (ePWV) is an alternative indicator of pulse wave velocity and is closely linked with atherosclerosis. However, the link between ePWV and PAD is unelucidated.

Objectives

This research was undertaken to dissect the linkage between ePWV and PAD.

Methods

This project enrolled 6250 participants in the NHANES between 1999 and 2004. The linkage between ePWV and PAD and its possible influencing factors were explored by constructing a weighted logistics regression model and subgroup analysis. In addition, the threshold effect analysis and restricted cubic spline (RCS) model were utilized to evaluate the non-linear link.

Results

The weighted logistic regression model demonstrated a great positive linkage between ePWV and PAD risk in the fully adjusted model (OR = 1.29, 95% CI: 1.18–1.42, p < .001). There was a significant nonlinear link between ePWV and PAD. When ePWV was higher than 9.297, the risk of PAD increased significantly (OR = 1.03, 95% CI: 1.02–1.04, p < .001). No significant linkage was detected when the value was below this threshold. Additionally, the subgroup analysis further demonstrated that ePWV had a stronger positive link with PAD in the elderly population (age ≥60 years) and in people with BMI ≤30.

Conclusion

ePWV is an effective predictor of PAD risk especially in the elderly and non-obese population.
Arthrodesis or arthroplasty, complete or partial: where are we at in the 21st century?
Authors: Jump Chris , Trail Ian A. , Talwalkar Sumedh
Published: January 2025

Osteoarthritis of the wrist presents complex surgical challenges. A wide variety of surgical options are available when conservative management fails to provide adequate pain relief. Despite advancements in management, such as modifications of partial wrist arthrodesis techniques and increasing use of total wrist replacements, in most scenarios there is no single preferred option. The surgeon’s role is crucial in assessing the patient and creating a bespoke treatment strategy that will provide an optimal outcome. This article presents an approach to management of the degenerate wrist based on current evidence.
Effect of Seating Location on Undergraduates’ Performance Based on Classroom Size and Quadrant Surveying: A Chinese empirical analysis
Authors: Yu Siyu , Zhang Xiaoyue , Tao Rong , Huang Wanyu , Chen Jiangsheng , Xiao Xieyu
Published: January 2025

This study explores the relationship between seating quadrants and student performance, including the role of classroom type in the quadrant effect. Data collected from 131 classes taught at 17 colleges of Northwest A&F University in China were analyzed using the ordinary least squares method. The results revealed that where a student sat in a classroom always had a significant effect on their performance. Classroom type also played an important role in students’ academic performance, specifically, the longer the depth of the classroom, the more obvious the quadrant effect. Additionally, different classroom utilization schemes resulted in different student densities in the classrooms, further affecting students’ academic performance. The higher the student density, the better the academic performance. We thus propose that the classroom utilization schemes should be in line with the matching relationship between student density and the classroom and that students be taught in small classrooms as much as possible.
How Can Non-Hospital Surgical Centres Improve Their Environmental Footprint (and Reduce Costs)?
Authors: Bajwa Barinder , Zhang Zach , Tuen Young Ji , Courtemanche Rebecca , S. Arneja Jugpal
Published: January 2025

Introduction

Every industry has greenhouse gas emissions, with healthcare a significant contributor. In Canada, the healthcare sector is directly and indirectly responsible for 4.6% of the country's greenhouse gas emissions. Operating rooms (ORs) are major contributors to hospital waste, making the OR low hanging fruit for analyzing environmental practices. The OR can adopt a green mindset to reduce its carbon footprint, yet barriers to going green exist. Herein we study non-hospital surgical centres in British Columbia to assess current green practices, attitudes towards environmental sustainability, and barriers to implementation.

Methods

All accredited non-hospital surgical centres in BC were invited to complete a survey on current practices and plans to reduce their environmental impact.

Results

Of 56 non-hospital surgical centres contacted, 18 responded, with 89% willing to adapt their practice to promote environmental sustainability, yet lacked current knowledge (56%) and formal plans (0%). The wide use of anesthetic gases with high global warming potential (64%) and disposable drapes/ gowns (78%/ 67%) were noted. Barriers to adopting green practices included: cost (44%), infrastructure (44%), regulatory guidelines (39%), knowledge (39%), and safety (28%).

Conclusions

Transitioning to more environmentally sustainable practices in ORs can enhance healthcare value by reducing both costs and greenhouse gas emissions. The greatest effect can be achieved through prudent choice of anesthetic gas agent, followed by reusable linens and drapes. Education and regulatory leadership were identified as crucial for overcoming these barriers. This study underscores the need for education, guidelines, and economically viable options to transition from awareness to action.
Optimizing time in harness
Authors: Bavan Luckshman , Bradley Catharine S. , Verma Yashvi , Kelley Simon P.
Published: January 2025

Aims

The primary aims of this study were to determine the time to sonographic correction of decentred hips during treatment with Pavlik harness for developmental dysplasia of the hip (DDH) and investigate potential risk factors for a delayed response to treatment.

Methods

This was a retrospective cohort study of infants with decentred hips who underwent a comprehensive management protocol with Pavlik harness between 2012 and 2016. Ultrasound assessments were performed at standardized intervals and time to correction from centring of the femoral head was quantified. Hips with < 40% femoral head coverage (FHC) were considered decentred, and hips with > 50% FHC and α angles > 60° were considered corrected. Survival analyses using log-rank tests and Cox regression were performed to investigate potential risk factors for delayed time to correction.

Results

A total of 108 infants (158 hips) successfully completed the bracing protocol and were included in the study. Mean age at treatment initiation was 6.9 weeks (SD 3.8). All included hips centred within two weeks of treatment initiation. At two, five, eight, and 12 weeks following centring of the femoral head, 13% (95% CI 8 to 19), 67% (95% CI 60 to 74), 98% (95% CI 95 to 99), and 99% (95% CI 98 to 100) of hips had cumulatively achieved sonographic correction, respectively. Low α angles at presentation were found to be a risk factor for delayed time to correction (hazard ratio per 1° decrease in α angle 1.04 (95% CI 1.01 to 1.06); p = 0.006).

Conclusion

The majority of decentred hips undergoing Pavlik treatment achieved sonographic correction within eight weeks of centring and radiological severity at presentation was a predictor for slower recovery. These findings provide valuable insights into hip development during Pavlik treatment and will inform the design of future prospective studies investigating the optimal time required in harness.

Cite this article: Bone Joint J 2025;107-B(1):118–123.
Current concepts of fourth-generation minimally invasive and open hallux valgus surgery
Authors: Lewis Thomas L. , Barakat Ahmed , Mangwani Jitendra , Ramasamy Arul , Ray Robbie
Published: January 2025

Hallux valgus (HV) presents as a common forefoot deformity that causes problems with pain, mobility, footwear, and quality of life. The most common open correction used in the UK is the Scarf and Akin osteotomy, which has good clinical and radiological outcomes and high levels of patient satisfaction when used to treat a varying degrees of deformity. However, there are concerns regarding recurrence rates and long-term outcomes. Minimally invasive or percutaneous surgery (MIS) has gained popularity, offering the potential for similar clinical and radiological outcomes with reduced postoperative pain and smaller scars. Despite this, MIS techniques vary widely, hindering comparison and standardization. This review evaluates the evidence for both open Scarf and Akin osteotomy and newer-generation MIS techniques. Fourth-generation MIS emphasizes multiplanar rotational deformity correction through stable fixation. While MIS techniques show promise, their evidence mainly comprises single-surgeon case series. Comparative studies between open and MIS techniques suggest similar clinical and radiological outcomes, although MIS may offer advantages in scar length and less early postoperative pain. MIS may afford superior correction in severe deformity and lower recurrence rates due to correcting the bony deformity rather than soft-tissue correction. Recurrence remains a challenge in HV surgery, necessitating long-term follow-up and standardized outcome measures for assessment. Any comparison between the techniques requires comparative studies. Surgeons must weigh the advantages and risks of both open and MIS approaches in collaboration with patients to determine the most suitable treatment.

Cite this article: Bone Joint J 2025;107-B(1):10–18.
The risk of dislocation in dual-mobility versus 36 mm heads in primary total hip arthroplasty for osteoarthritis
Authors: Hussein Yousef , Iljazi Afrim , Sørensen Michala S. , Overgaard Søren , Petersen Michael M.
Published: January 2025

Aims

Dislocation is a major concern following total hip arthroplasty (THA) for osteoarthritis (OA). Both dual-mobility components and standard acetabular components with large femoral heads are used to reduce the risk of dislocation. We investigated whether dual-mobility components are superior to standard components in reducing the two-year dislocation and revision risk in a propensity-matched sample from the Danish Hip Arthroplasty Register (DHR).

Methods

This population-based cohort study analyzed data from the DHR and the Danish National Patient Register. We included all patients undergoing primary THA for OA from January 2010 to December 2019 with either dual-mobility or standard acetabular components with metal-on-polyethylene or ceramic-on-polyethylene articulations with a 36 mm femoral head. The samples were propensity score-matched on patient and implant characteristics. The primary outcome was the difference in the absolute risk of dislocation within two years, with a secondary outcome of the difference in the absolute risk of revision surgery of any cause within the same timeframe. The cumulative incidence of dislocation was calculated using the Aalen-Johansen estimator, while the difference in absolute risk was estimated using absolute risk regression (ARR).

Results

We included 4,499 patients with dual-mobility components and 4,499 patients with standard components after propensity score-matching. Both groups had a mean age of 75 years (SD 8.5), included approximately 60% females, and had a two-year survival of 95.3% (95% CI 94.6 to 95.9). The dual-mobility group was 80% less likely to dislocate within two years (ARR 0.20 (95% CI 0.14 to 0.28); p < 0.001), with no significant difference in the risk of revision compared to standard components (ARR 1.15 (95% CI 0.89 to 1.48); p = 0.293).

Conclusion

Dual-mobility components are associated with a reduced risk of dislocation and with no significant difference in the risk of revision for any cause within two years of THA when compared to standard acetabular components with 36 mm femoral heads.

Cite this article: Bone Joint J 2025;107-B(1):50–57.
Comparing cup placement, leg length, and offset discrepancy after total hip arthroplasty between CT-based robotic arm-assisted and navigation systems
Authors: Shimizu Akira , Murakami Satoshi , Tamai Takayuki , Haga Yuuki , Kutsuna Tatsuhiko , Kinoshita Tomofumi , Takao Masaki
Published: January 2025

Aims

Excellent outcomes have been reported following CT-based robotic arm-assisted total hip arthroplasty (rTHA) compared with manual THA; however, its superiority over CT-based navigation THA (nTHA) remains unclear. This study aimed to determine whether a CT-based robotic arm-assisted system helps surgeons perform accurate cup placement, minimizes leg length, and offsets discrepancies more than a CT-based navigation system.

Methods

We studied 60 hips from 54 patients who underwent rTHA between April 2021 and August 2023, and 45 hips from 44 patients who underwent nTHA between January 2020 and March 2021 with the same target cup orientation at the Department of Orthopedic Surgery at Ozu Memorial Hospital, Japan. After propensity score matching, each group had 37 hips. Postoperative acetabular component position and orientation were measured using the planning module of the CT-based navigation system. Postoperative leg length and offset discrepancies were evaluated using postoperative CT in patients who have unilateral hip osteoarthritis.

Results

The absolute differences in radiological inclination (RI) and radiological anteversion (RA) from the target were significantly smaller in rTHA (RI 1.2° (SD 1.2°), RA 1.4° (SD 1.2°)) than in nTHA (RI 2.7° (SD 1.9°), RA 3.0° (SD 2.6°)) (p = 0.005 for RI, p = 0.002 for RA). The absolute distance of the target’s postoperative centre of rotation was significantly smaller in the mediolateral (ML) and superoinferior (SI) directions in rTHA (ML 1.1 mm (SD 0.8), SI 1.3 mm (SD 0.5)) than in nTHA (ML 1.9 mm (SD 0.9), SI 1.6 mm (SD 0.9)) (p = 0.002 for ML, p = 0.042 for SI). Absolute leg length and absolute discrepancies in the acetabular, femoral, and global offsets were significantly lower in the rTHA group than in the nTHA group (p = 0.042, p = 0.004, p = 0.003, and p = 0.010, respectively). In addition, the percentage of hips significantly differed with an absolute global offset discrepancy of ≤ 5 mm (p < 0.001).

Conclusion

rTHA is more accurate in cup orientation and position than nTHA, effectively reducing postoperative leg length and offset discrepancy.

Cite this article: Bone Jt Open 2024;6(1):3–11.
Portuguese Reactions to the Housing Crisis: Is It Possible to Move from the Residualisation to Post-neoliberalisation of Housing Policies?
Authors: Marques Pereira Sandra
Published: January 2025

For decades, the analysis of housing policies in Portugal has focused on its distinct trajectory compared to those of other countries in western and northern Europe. However, the rise of the housing affordability crisis and the civic, media and political prominence that the housing issue has acquired in recent years have highlighted important similarities (despite some key specifics) with the dynamics that have been occurring internationally. This article discusses Portuguese political reactions to the affordability crisis. It presents a critical discussion of the ambitious multi-measure policy package ‘Mais Habitação’ (More Housing), including its content, the political conditions of its introduction, and its public reception - in the light of the recent international debates on the paths, possibilities, and obstacles to the post-neoliberalisation of housing policies.
240  Gbps SI-FMF/FSO communication system based on LP modes and PV code with the impact of foggy weather in Alexandria and Setif
Authors: Abd El-Mottaleb Somia A. , Bencheikh Abdelhalim , Singh Mehtab
Published: January 2025

This paper presents a novel, to the best of our knowledge, high-speed
optical communication system
achieving a 240 Gbps transmission capacity by integrating
step-index few-mode fiber (SI-MMF) and free space optics (FSO).
Knowing that Hermite-Gaussian modes (HGMs) are eigenmodes of a free
space medium and the linearly polarized modes (LPMs) are eigenmodes of
step-index few-mode fiber (SI-FMF), and by considering the similarity
between HGM ( and ) and LPM ( and ), respectively, the system employs
dual-polarization (DP) and linearly polarized (LP) modes (, , and ), combined with optical code division
multiple access (OCDMA) using permutation vector (PV) codes. Each
polarization state carries data from three LP modes, with each mode
supporting four OCDMA channels, each assigned a unique PV code. The
system’s performance is evaluated under varying fog conditions using
key metrics such as quality-factor (Q-factor), bit error rate (BER),
and eye diagrams, which provide a comprehensive assessment of signal
strength and quality. Real-world applicability is assessed using
meteorological data from two African cities, Alexandria, Egypt, and
Setif, Algeria. System performance is characterized using the
Q-factor, bit error rate (BER), and eye diagrams. The results show
that, in Alexandria, successful transmission is achieved over
1.41 km. In Setif, the transmission distance is reduced to
1.31 km due to slightly higher atmospheric attenuation. These
ranges are observed at a BER below HG00 and a Q-factor exceeding 3.10.
Consequently, these findings confirm the viability of the proposed
system for high-capacity optical communication in challenging weather
conditions, making it suitable for future 6G networks.
Feasibility using a compact fiber optic Sagnac interferometer for non-contact soft tissue surface mechanical wave speed detection
Authors: Chen Gui , Xia Jinjun
Published: January 2025

The Sagnac interferometer offers distinct advantages in vibrational wave detection. In this study, an air-coupled transducer and a compact fiber-optic Sagnac interferometer were developed for non-contact elasticity characterization in biological tissues. Given the challenge of limited light collection by a compact fiber optic Sagnac interferometer in biological tissues, this study aims to explore the potential of using a compact Sagnac interferometer to measure vibrational waves in biological tissues. The speeds of the generated vibrational surface waves in tissue-mimic phantoms were measured. Measurement errors caused by cross-correlation wave tracking were analyzed, and the performance of the integrated system was characterized. The results demonstrated the effectiveness of the integrated system and the cross-correlation algorithm in tracing the speed of vibrational surface waves in tissue-mimicking phantoms. They suggested potential applications for the non-invasive, contactless characterization of the mechanical properties in soft biological tissues.
Biomathematical enzyme kinetics model of prebiotic autocatalytic RNA networks: degenerating parasite-specific hyperparasite catalysts confer parasite resistance and herald the birth of molecular immunity
Authors: Pirovino Magnus , Iseli Christian , Curran Joseph A. , Conrad Bernard
Published: January 2025

Catalysis and specifically autocatalysis are the quintessential building blocks of life. Yet, although autocatalytic networks are necessary, they are not sufficient for the emergence of life-like properties, such as replication and adaptation. The ultimate and potentially fatal threat faced by molecular replicators is parasitism; if the polymerase error rate exceeds a critical threshold, even the fittest molecular species will disappear. Here we have developed an autocatalytic RNA early life mathematical network model based on enzyme kinetics, specifically the steady-state approximation. We confirm previous models showing that these second-order autocatalytic cycles are sustainable, provided there is a sufficient nucleotide pool. However, molecular parasites become untenable unless they sequentially degenerate to hyperparasites (i.e. parasites of parasites). Parasite resistance–a parasite-specific host response decreasing parasite fitness–is acquired gradually, and eventually involves an increased binding affinity of hyperparasites for parasites. Our model is supported at three levels; firstly, ribozyme polymerases display Michaelis-Menten saturation kinetics and comply with the steady-state approximation. Secondly, ribozyme polymerases are capable of sustainable auto-amplification and of surmounting the fatal error threshold. Thirdly, with growing sequence divergence of host and parasite catalysts, the probability of self-binding is expected to increase and the trend towards cross-reactivity to diminish. Our model predicts that primordial host-RNA populations evolved via an arms race towards a host-parasite-hyperparasite catalyst trio that conferred parasite resistance within an RNA replicator niche. While molecular parasites have traditionally been viewed as a nuisance, our model argues for their integration into the host habitat rather than their separation. It adds another mechanism–with biochemical precision–by which parasitism can be tamed and offers an attractive explanation for the universal coexistence of catalyst trios within prokaryotes and the virosphere, heralding the birth of a primitive molecular immunity.
Making Tracey: An interview with Shu Kei
Authors: Bettinson Gary
Published: January 2025

This interview with writer–producer Shu Kei provides an oral history of Hong Kong drama Tracey (2018), the directorial debut of rising talent Jun Li. An integral player in every aspect of Tracey’s production, Shu Kei recounts the film’s inception, preparatory phase, shooting, editing, release and reception. He chronicles the vicissitudes of working with a new generation of actors and a first-time director. His account of Tracey’s production sheds light on Hong Kong filmmaking practice in general, revealing how methods of script construction and shot design operate in contemporary Hong Kong cinema.