bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of clinical subgroups in anti-SRP positive immune-mediated necrotizing myopathy patients using cluster analysis
Authors: Cui Beibei , Liu Hongjiang , Liu Ruiting , Yin Geng , Xie Qibing
Published: January 2025

Background:

Anti-signal recognition particle immune-mediated necrotizing myopathy (anti-SRP IMNM) is a rare autoimmune disorder characterized by muscle weakness and necrosis. Identifying clinical subgroups within this patient population could facilitate the management of the disease.

Objectives:

To identify distinct clinical subgroups of anti-SRP IMNM patients.

Design:

A retrospective study was conducted on anti-SRP IMNM patients treated at West China Hospital of Sichuan University between January 2010 and October 2023.

Methods:

Clinical data were collected. Unsupervised cluster analysis was conducted to classify patients into distinct subgroups based on their clinical features. Statistical analyses were performed to compare the clinical characteristics and outcomes among the identified clusters.

Results:

A total of 116 patients were included in the study, and 3 distinct clinical subgroups were identified: Cluster 3 (acute), Cluster 2 (subacute), and Cluster 1 (poor prognosis). Patients in Cluster 3 exhibited a short disease course (median 3 months), severe muscle weakness (78.38% with Medical Research Council (MRC) score ⩽3), high muscle enzyme levels, and a good response to treatment. Cluster 2 patients were younger (mean age 45.83 years), had a longer disease course (median 6.5 months), milder muscle damage, and lower autoantibody titers. Cluster 1 patients were older (mean age 58.10 years), predominantly male (70.97%), and had higher incidences of interstitial lung disease (70.97%) and cardiac injury (45.16%). In Cluster 1, 16.13% of cases were refractory, and the relapse rate was 38.71%, which was significantly higher compared to the other two clusters.

Conclusion:

This study highlights the clinical heterogeneity among anti-SRP IMNM patients and identifies three distinct clinical subgroups with unique characteristics. These findings provide insights for personalized management.
Alterations in non-REM sleep and EEG spectra precede REM-sleep deficits in a model of synucleinopathy
Authors: Käufer Christopher , Stanojlović Miloš , Schidlitzki Alina , Bonsberger Jana , Storch Alexander , Richter Franziska
Published: January 2025

Background

Sleep disturbances often precede motor symptoms in neurodegenerative diseases like Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Neuroinflammation is implicated in PD pathophysiology and may contribute to non-motor symptoms such as sleep disturbances. The Thy1-αSyn mouse model, overexpressing human alpha-synuclein (αSyn), mimics key aspects of PD and DLB, making it valuable for studying related sleep disturbances and neuroinflammatory changes.

Objective

To investigate early-stage alterations in sleep architecture, electroencephalographic (EEG) patterns, and neuroinflammation in Thy1-αSyn mice.

Methods

We used telemetric EEG/electromyography (EMG) with video surveillance to compare sleep patterns and EEG spectral power between 2.5- and 4.5-month-old male Thy1-αSyn transgenic mice and wild-type littermates. Neuroinflammation was assessed by examining microglial (Iba1) and astrocytic (GFAP) activation in key sleep-regulating brain regions.

Results

Thy1-αSyn mice showed decreased resting wake time and increased non-REM sleep, with altered sleep bout frequency and length, indicating significant sleep architecture changes. Spectral analysis revealed a shift from higher to lower frequency bands, suggesting early neural circuitry disruptions due to αSyn overexpression. Significant microglial activation was observed at 3 months, with astrogliosis progressing by 5 months in key sleep-regulating regions, indicating that neuroinflammation may contribute to the observed sleep disturbances.

Conclusions

Early-stage Thy1-αSyn mice exhibit significant sleep architecture changes, EEG spectral shifts, and neuroinflammatory alterations. These findings suggest that neuroinflammation may play a role in the initial pathophysiological changes in PD and related synucleinopathies. Sleep, EEG, and neuroinflammatory changes could serve as early biomarkers for these diseases.
Environment, Climate, and Diabetes: An International Topic
Authors: Heinemann Lutz , Klonoff David C.
Published: January 2025

Every person with diabetes is affected by changes in the environment and climate. At the same time, the therapy of many people itself has a negative impact on these factors. One might assume that the relevant professional associations and health organizations, as well as health policymakers, have initiated appropriate activities. The manufacturers of antidiabetic drugs and medical devices used in diabetes therapy are aware of the problems at hand. To what extent they really implement changes in the production, storage, and transport of their products is not easy to assess. In summary, it should be said that the importance of environmental factors for people with diabetes and their therapy is probably still not sufficiently recognized.
Diversity in Medical School, Orthopaedic Surgery Residency, and ACGME-Accredited Foot and Ankle Orthopaedic Surgery Fellowship Training by Gender, Race, and Ethnicity
Authors: Silvestre Jason , George Kola , Nadeau Elizabeth K. , Scott Daniel J. , Gross Christopher E.
Published: January 2025

Introduction

Increasing diversity in the US health care workforce is a topic of increasing scrutiny and interest. This study analyzes the pipeline of demographic diversity for Accreditation Council for Graduate Medical Education (ACGME)-accredited foot and ankle orthopaedic surgery fellowship training.

Methods

This was a cross-sectional study of medical students, orthopaedic surgery residents, and orthopaedic foot and ankle fellows at US-accredited training programs from 2013 to 2022. Self-reported demographic data were available for trainees and compared with the 2020 US Census according to federal guidelines. Participation-to-prevalence ratios (PPRs) were calculated and analyzed to classify representation of demographic groups in orthopaedic foot and ankle surgery training as overrepresented (PPR > 1.2), equivalent (PPR = 0.8-1.2), and underrepresented (PPR < 0.8).

Results

Disparities existed in demographic representation among medical students, orthopaedic surgery residents, and ACGME-accredited orthopaedic foot and ankle fellows among women (48.4% vs 16.1% vs 20.1, P < .001), black (6.9% vs 4.6% vs 4.5%, P < .001), Asian (23.9% vs 14.1% vs 23.9%, P < .001), and Hispanic (6.1% vs 4.6% vs 3.0%, P < .001) trainees. There were no self-reported American Indian/Alaska Native and Native Hawaiian/Pacific Islander trainees in orthopaedic foot and ankle fellowship training (PPR = 0). Women (PPR = 0.40), black (PPR = 0.36), and Hispanic (PPR = 0.16) trainees were underrepresented in orthopaedic foot and ankle training relative to the US population. In contrast, Asian (PPR = 3.45), men (PPR = 1.61), and white (PPR = 1.21) trainees were overrepresented in orthopaedic foot and ankle relative to the US population.

Discussion

There is a lack of gender, racial, and ethnic diversity in orthopaedic foot and ankle training relative to the US patient population and earlier stages of medical training. Increased efforts to recruit underrepresented groups may promote diversity and inclusion in the emerging orthopaedic foot and ankle surgery workforce.

Levels of Evidence:

III
Determination of Pathogens in Surgical Site Infections in Ankle Fractures and Implications for Empirical Antibiotic Treatment
Authors: Plasmeijer Hannah , Tausendfreund Jasper , Hoogewerf Martine , Penning Diederick , Joosse Pieter , Schepers Tim , Tanis Erik
Published: January 2025

Surgical site infections (SSIs) are the most common complication after surgery for ankle fractures. This retrospective study aimed to determine the pathogens cultured in SSI and their antimicrobial susceptibility patterns to provide a recommendation for empirical therapy. Patients who underwent surgical treatment for an ankle fracture were included. Cases were screened for the occurrence of SSI and divided into superficial (short course [total of <2 weeks] of oral antibiotics) and deep SSI (surgical debridement and long course [total of >2 weeks] antibiotics). Culture results, antimicrobial susceptibility patterns, empirical antibiotic regimen, type and timing of culture collection, and treatment strategies were collected from electronic health records. In total, 81 (9%) out of 931 patients developed an SSI (39 (48%) superficial SSI and 42 (52%) deep SSI). The most common pathogens in 16 superficial SSI and 37 deep SSI with positive cultures were Staphylococcus aureus, cultured in 11 (69%) superficial SSI and 23 (62%) deep SSI, and Enterobacter cloacae species, cultured in 5 (31%) superficial SSI and 12 (32%) deep SSI. Higher frequencies of gram-negative bacteria and polymicrobial infections were found in deep SSI. It is recommended to aim for empirical treatment at gram-positive and gram-negative microorganisms in the case of both superficial and deep SSI.

Level of Evidence: Prognostic, Level 2: Retrospective.
Computerized Tomography for Diagnosing Traumatic Arthrotomies of the Ankle
Authors: Cho Elizabeth , LeDuc Ryan , Castillo Hector , Pinzur Michael S. , Hamid Kamran S. , Schiff Adam P.
Published: January 2025

Background

Owing to the risk for septic arthritis, traumatic arthrotomies are an urgent surgical problem for the treating orthopaedic surgeon. Traditionally, diagnosis is with the saline load test (SLT), although in the awake patient is an invasive and potentially painful procedure. While computerized tomography (CT) has been shown to be a reliable diagnostic tool for traumatic arthrotomies of other joints, its role has only recently been investigated in the setting of ankle arthrotomy.

Methods

Eight fresh-frozen mid-tibia ankle cadaveric specimens were included for study. Baseline CT scans were performed to confirm intact ankle joint capsules with absence of intra-articular air. Ankle arthrotomies were performed under fluoroscopic guidance with vertical 1 cm incisions made at the anteromedial or anterolateral portals. After arthrotomy, all ankles underwent a second CT scan, and images were evaluated for the presence of intra-articular air. Finally, SLT was performed and the volume of saline required for extravasation was recorded.

Results

Of 8 ankles, 100% (n = 8) demonstrated intra-articular air on CT scan following arthrotomy. Computerized tomography scan and SLT both demonstrated 100% sensitivity and specificity for diagnosing ankle arthrotomies. Average saline volume necessary for extravasation (and positive SLT) was 4 mL (range: 2-7 mL) and did not differ by foot position.

Conclusion

In this small cadaveric study, CT scan and SLT were both able to detect 100% (n = 8) of traumatic ankle arthrotomies with 100% sensitivity and specificity. Further comparative study of CT scan and SLT for detection of traumatic ankle arthrotomy in a clinical setting is warranted.

Levels of Evidence:

Level IV
Efficacy and safety of anti-CD38 monoclonal antibodies-based therapy versus standard therapy in newly diagnosed multiple myeloma patients: a systematic review and meta-analysis
Authors: Osama Muhammad , Khan Muhammad Haris , Khan Safeena , Hussain Amna , Tahir Ammara , Ullah Mehran , Afridi Abdullah , Ullah Ubaid , Rehman Wajeeh Ur
Published: January 2025

Background:

Anti-CD38 monoclonal antibodies (mAbs) have significantly changed the multiple myeloma treatment landscape. This meta-analysis compared the efficacy and safety of anti-CD38 mAb-based therapy versus standard therapy in newly diagnosed multiple myeloma (NDMM) patients.

Methods:

We performed a comprehensive literature search on PubMed, the Cochrane Database, and ClinicalTrials.gov. The primary outcomes were progression-free survival (PFS) and minimal residual disease (MRD) status. Dichotomous outcomes were pooled using risk ratio (RR) along with the 95% confidence interval (CI) in RevMan 5.4. Subgroup analysis and meta-regression analysis were performed. The RoB 2.0 tool was used to assess the risk of bias.

Results:

Our meta-analysis included 11 randomized controlled trials. There were 5270 patients; 3040 TEs and 2230 TIEs. Anti-CD38 mAbs significantly improved MRD negativity (RR 1.94, 95% CI: 1.59–2.37; p < 0.00001) and PFS (RR 0.51, 95% CI: 0.45–0.58; p < 0.00001). Subgroup analyses revealed better outcomes for both the TE (MRD: RR 1.52, 95% CI: 1.37–1.68; PFS: RR 0.43, 95% CI: 0.34–0.54) and TIE (MRD: RR 3.49, 95% CI: 2.65–4.61; PFS: RR 0.55, 95% CI: 0.47–0.64) populations. Meta-regression revealed that Eastern Cooperative Oncology Group (ECOG) score 0 significantly influenced MRD status (β = −0.015, p < 0.05), whereas ECOG scores 1 and 2 lacked statistical significance. Subgroup analysis revealed that PFS was significantly different between standard (RR 0.47) and high (RR 0.81) cytogenetic risk groups.

Conclusion:

In NDMM patients, anti-CD38 mAb-based therapy significantly improved MRD status, and PFS compared with standard therapy alone, in both TE and TIE patients, suggesting a favorable benefit–risk profile.
Construction of functional tissue-engineered microvasculatures using circulating fibrocytes as mural cells
Authors: Wang Xiaolin , Tan Hong , Gunawardena Harsha P , Cao Jin , Dang Lu , Deng Hongbing , Li Xueyong , Wang Hongjun , Li Jinqing , Cui Caibin , Gerber David A
Published: January 2025

Mural cells are essential for maintaining the proper functions of microvasculatures. However, a key challenge of microvascular tissue engineering is identifying a cellular source for mural cells. We showed that in vitro, circulating fibrocytes (CFs) can (1) shear and stabilize the microvasculatures formed by vascular endothelial cells (VECs) in a collagen gel, (2) form gap junctions with VECs and (3) induce basement membrane formation. CFs transplanted into nude mice along with VECs in either collagen gel or Matrigel exhibited activities similar to those mentioned above, that is, sheathing microvasculatures formed by VECs, inducing basement membrane formation and facilitating the connection of the engineered microvasculatures with the host circulation. Interestingly, the behaviour of CFs also differs from that of human brain vascular pericytes (HBVPs) in vitro, which often infiltrate the lumen of capillary-like structures in a mosaic pattern, actively proliferate and exhibit lower endocytosis and migration capacities. We concluded that CFs are a suitable cellular source for mural cells in the construction of tissue-engineered microvasculatures.
From necrolocution to meaningful dialogues
Authors: Moyo Inocent
Published: January 2025

Lydia Gibson’s article ‘Ant Logic and Necrolocutors’ challenges geographers and other scholars in cognate disciplines working on environmental research or on Indigenous communities to transcend the ant logic and gaze by recognising power, knowledge, and death as important immaterial actors. If this is not done, there is a danger of engaging in research and analysis that reproduces colonialism and coloniality in terms of recommendations which confer on people conditions in which they are the living dead. In researching marginalised communities such as the racialised, gendered, and black bodies on whom death is wrought, inter alia, it is important to pay attention not only to what they say but also its meaning. It is through grasping the meaning of what subaltern communities say and mean that it can be claimed that our analysis of the social realities and worlds of people is relevant.
Integrating AI·IoT-OAHPs with existing elderly care systems
Authors: Wu Yanyi
Published: January 2025

This letter addresses the integration of artificial intelligence and the Internet of Things-based older adult healthcare programs with existing community and institutional elderly care systems. It highlights the current disconnect leading to service duplication and resource inefficiencies, proposes multifaceted integration approaches, and underscores the importance of supportive policies. International examples are referenced to demonstrate successful models, emphasizing the need for coordinated care to enhance service delivery and optimize resource use.
Technology for Good? Tencent’s Corporate Social Responsibility, Institutional Chameleon, and the Future of Platform Economies
Authors: Li Luzhou , Zhang Zhian
Published: January 2025

There have been global regulatory debates and efforts aimed at holding digital platforms accountable for the public interest. Utilizing mixed methods of documentary research and expert interviews, this article examines how the Chinese digital giant Tencent leverages its adaptive capabilities for corporate social responsibility (CSR) initiatives in response to increasingly stringent regulation in China. Specifically, it explores Tencent’s organizational restructuring, including the establishment of the sustainable social value (SSV) division, as well as the accompanying corporate practices and discursive strategies aimed at enhancing its legitimacy. As an exemplar of the “institutional chameleon,” Tencent has deftly navigated regulatory waters through organizational metamorphosis. However, while Tencent’s enhanced CSR initiatives have certainly yielded some social benefits, the SSV initiatives are increasingly emerging as a new business frontier for the company, leveraging its vast infrastructural capacities to capitalize on the very social fabric it purports to support. This underscores the complexities and contradictions inherent in its CSR practices and the significance of the intrinsic logic of digital platforms as a modern business.
The governance principles and value dissemination of science and technology ethics in science and technology communication*
Authors: Liu Xuan , Ma Jianquan , Li Zhengfeng
Published: January 2025

Value dissemination in science and technology (S&T) communication is not only a crucial component of the overall S&T ethics governance system but also a significant means to effectively convey the connotation of S&T ethical values. This study examines the significance and inherent characteristics of the dissemination of S&T ethical values in S&T communication, analyses the key values that need to be disseminated while considering its unique process, and discusses the prominent issues and challenges faced by contemporary S&T communication in achieving value dissemination. Finally, it proposes governance principles for S&T communication to realize the dissemination of S&T ethical values.
Unpacking Chinese Medical Students’ Well-being and Its Relationship with Grit and Resilience
Authors: Fu Jia , Wang Ying
Published: January 2025

Enlightened by the tenets of positive psychology (PP), well-being is regarded as a critical construct in the educational situation. The other factor is resilience documented as a precarious value among medical students that will allow them to deal with the challenges faced in both their educations and future professions. Furthermore, grit is another considerable point in the learning process that has been at the center of researchers’ attention in recent years due to its long-run importance; however, what remains ambiguous is the role of grit and resilience in mitigating learners’ well-being among medical students. To this end, 1,088 Chinese medical students (359 males and 729 females) took part in this study. They completed three questionnaires including the resilience scale, grit scale questionnaire, and general well-being scale. Multiple regressions were run and it was revealed that grit and resilience could predict 64.5% of the variance in well-being which was significant. Finally, some implications and recommendations have been presented for language teaching stakeholders in scholastic contexts.
Navigating Migration: Role of Body Image and Cultural Intelligence in Racial Minority Adaptation
Authors: Sharma Namrata , Hussain Dilwar
Published: January 2025

This study investigated the interrelations of body image and cultural intelligence in the acculturation process and outcomes for an internal migrant group belonging to the northeastern states of India ( N = 246). Outside the Northeast India region, the sample formed a racial minority that often faced discrimination. Experiencing race and appearance-induced discrimination evidently influenced the body image, well-being and adjustment of the sample. Responses to self-reported questionnaires indicated that body image positively correlated to cultural intelligence and the integration acculturation strategy, both of which promoted adaptation. Body image also negatively related to the least adaptive marginalisation acculturation strategy. Furthermore, path analysis indicated that body image predicted life satisfaction ( β = 0.22, p < .05), and cultural intelligence positively moderated ( β = 0.21, p < .05) effects of body image on life satisfaction. It is suggested that cultural intelligence may promote viable outcomes of body image through its influence on self-esteem and facilitating adaptive outcomes of acculturation strategies among racial minorities in contexts characterised by prejudice.
Shopping Tourism: Its Positive Impact on Mixed-Use Shopping Mall Communities (MUSMC)
Authors: Pang Caryn , Sanders Eulanda A.
Published: January 2025

In this case study, the authors seek to deliver a point of view whereby the relationship between shopping tourism and mixed-use shopping mall communities (MUSMCs) positively impacts the local economy. MUSMCs are mixed-use commercial properties that combine community building, shared values, and experiences. Shopping tourism has become an important segment of the tourism value chain where tourists seek to travel to a destination to shop. From the perspective of MUSMC management, delivering an exciting place to visit and creating memorable experiences through strategies such as placemaking and dining experiences is a win for both the MUSMCs and the local economy. This case study is suited for undergraduate, graduate, and executive education students enrolled in hospitality, tourism, and retailing courses. Depending on the level of coursework, this case study can be analyzed and discussed from different angles such as social, cultural, and economic impact and output.
Anterior Lumbar Interbody Fusion (ALIF) Versus Full-Endoscopic/Percutaneous TLIF With a Large-Footprint Interbody Cage: A Comparative Observational Study
Authors: Morgenstern Christian , Nogueras Francisco , Delbos Geoffrey , Morgenstern Rudolf
Published: January 2025

Study Design

Exploratory prospective observational case-control study.

Objectives

Aim of this study was to compare clinical and radiologic outcome, as well as peri-operative complications, of anterior lumbar interbody fusion (ALIF) and full-endoscopic/percutaneous trans-Kambin transforaminal lumbar interbody fusion (pTLIF) with a large-footprint interbody cage.

Methods

Patients that underwent elective ALIF and pTLIF with a large-footprint interbody cage were prospectively evaluated. Clinical follow-up was measured pre- and post-operatively with Visual Analogic Scale and Oswestry Disability Index scores. Radiologic outcome was assessed with a computed tomography scan and standing films at 12 months.

Results

44 patients underwent ALIF and 43 pTLIF surgery (total 87 cases). Clinical pre- and post-operative scores were comparable between both groups with 33.4 months mean follow-up. Median surgical time was significantly lower for pTLIF (28 minutes) compared to ALIF (72 minutes). Radiologic outcome was favorable for ALIF with a significantly higher increase in segmental lordosis compared to pTLIF. Fusion rates did not significantly differ between both groups. ALIF showed significantly less cage subsidence than pTLIF. Complications included 9 (21%) cases with transitory post-operative radiculitis for ALIF and 12 (28%) for pTLIF; post-operative partial muscle weakness 3(6%) cases for ALIF and 4 (9%) for pTLIF. Two (4%) cases required revision surgery for pTLIF.

Conclusions

ALIF and trans-Kambin pTLIF obtained comparable clinical outcome and fusion rates, while segmental lordosis restoration was favorable for ALIF. pTLIF required less surgery time and presented less intra-operative complications, while ALIF reported lower rates of post-operative subsidence, revision surgery and complications during follow-up.
When should a runner on third base advance? Analyzing factors that influence the success of sacrifice flies in US Major League Baseball games
Authors: Kato Mamiko , Yanai Toshimasa
Published: January 2025

This study aims to identify factors influencing the success of sacrifice flies in US Major League Baseball. From baseball-tracking outputs of official games during 2023–2024, 3439 flyouts reaching >50 m from home plate when a runner was on third base with <2 outs were analyzed. A multiclass classification model was developed to predict results of runners at third base (i.e., stayed at third base, tagged out at home plate, or scored on a sacrifice fly) from batted ball kinematics, runner's sprint speed (SS), the fielder's arm strength (AS), and ballpark. Average probability scores were compared by systematically altering these inputs. The results show that (i) the model accurately predicted the runner staying at third and sacrifice flies (F-score ≥ 0.842) but could not predict tag outs (0.057), (ii) nearly all flyouts reaching <70 m from home plate would result in the runner staying on third base, whereas the runner usually would score when the flyouts reach ≥85 m, and (iii) the shortest flight distance required for a sacrifice fly could be expressed by a simplified linear function: distance = 87.2–3.1SS + 0.7AS. This function will help set targets for better decision-making and greater success of sacrifice flies.
Mid-Career Maternity Breaks—A Model of Role Transitions in the Process of Opting Out and In
Authors: Mukherjee Payal
Published: January 2025

In this article, a model of role transition for mid-career women taking maternity and childcare breaks is presented. Three distinct phases of a break in mid-career—opting out, staying home and opting in—are identified and at every stage, women face multifaceted challenges in navigating role transitions. Using transcendental phenomenology, various themes are identified in the lived experiences by interviewing 26 mid-career women who had opted out and opted back in after a minimum of two years. The findings indicate that participants experience both macro and micro transitions during the stages of opting out and opting in, resulting in a range of positive and negative emotions. The resulting model incorporates the environmental factors that affect this process, and results elucidate the nuanced aspects in navigating this complex transition. Emphasising a departure from traditional linear career paths, I recommend adopting the three pillars of the Kaleidoscope Career Path model—authenticity, balance and challenge—as strategies to cope with the uncertainties and challenges of mid-career women’s professional lives.
Complement-Mediated Hemolytic Uremic Syndrome Due to MCP/CD46 Mutation: A Case Report
Authors: Abdeen Abdul Muhsen , Al-Nusair Jowan , Samardali Malik , Alshal Mohamed , Al-Astal Amro , Khitan Zeid
Published: January 2025

Thrombotic microangiopathy (TMA) is a severe condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage, often involving the kidneys. Complement-mediated hemolytic uremic syndrome (cHUS), a rare form of TMA, arises from dysregulated alternative complement pathway activation, frequently due to genetic mutations. We report the case of a 23-year-old male presenting with TMA secondary to a heterozygous mutation in the membrane cofactor protein (MCP/CD46) gene. The patient exhibited severe renal and cardiovascular complications, including acute kidney injury requiring hemodialysis, uremic pericarditis, and persistent anemia. Diagnostic evaluation confirmed complement dysregulation, and management with eculizumab, plasmapheresis, and hemodialysis was initiated. Renal biopsy revealed classic TMA features, and genetic testing identified the MCP mutation, underscoring the importance of genetic predispositions in guiding diagnosis and therapy. This case emphasizes the critical role of genetic testing in TMA evaluation and highlights the potential for improved outcomes through targeted complement inhibition and individualized care strategies.
Improving Complaint Handling: The Rhetorical Turn in Defensive and Accommodative Strategies
Authors: van Mulken Margot , Heslenfled Liza
Published: January 2025

This article examines how Aristotelian rhetorical principles— ethos, pathos, and logos—can help manage social media outrage in complaint handling by translating them into defensive and accommodative response strategies commonly used in service recovery. Two online experiments evaluated four strategies for their effects on complainants’ moods: (a) blame-shifting; (b) promising action; (c) apologizing; and (d) a combination of empathy, apology, and promise. The results showed that accommodative strategies were more effective than defensive ones, with the combination of empathy, apology, and promise as the most effective. The findings suggest incorporating rhetorical training in business communication to enhance response efficacy.
A Crossroad Between Reformulating the Power-sharing System and Federalism for Lebanon
Authors: Cortés Francisco Salvador Barroso , Hachem Father Talal
Published: January 2025

Lebanon is suffering from multiple crises, and the lack of reaction on behalf of the authorities demands a serious reflection on whether Lebanon, as a state entity, can or cannot be saved. It is facing the end of the Second Republic or witnessing the birth of a new political order alien to the former. Although the Lebanese speak the same language and share many cultural and social traditions, the weakening of the central government, its inability to resolve many crises, and deep differences over Lebanon’s regional positioning favor the withdrawal of communities and create fertile ground for the resurgence of the federalist debate. The article argues that the most suitable option to overcome the current stalemate relies not on federalism or partition but on modifying the power-sharing system. The persistent issues arising from implementing semi-consociationalism are highlighted to argue that restoring a fully developed consociational system would enable Lebanon to regain its political stability and order, better equipping it to confront future challenges.
Gendered Experiences of Intravenous Iron Infusion Reactions: A Patient Perspective
Authors: Pebdani Roxanna Nasseri
Published: January 2025

Hypophosphatemia following iron infusion is thought to be a relatively rare complication of intravenous iron infusion, though research is beginning to demonstrate that it occurs more often than previously assumed. Still, healthcare professionals are often unaware of this potential complication. This, coupled with the medical bias women can receive in health settings—plus the over-representation of women receiving intravenous iron—means that symptoms of hypophosphatemia may be misinterpreted or worse, misdiagnosed. This article presents an account of a patient experience of hypophosphatemia following intravenous iron. Key points include: healthcare providers should be aware of this potential complication, healthcare providers must be prepared to listen, assess, address, and treat potential hypophosphatemia that occurs after receiving an iron infusion, and physicians should monitor phosphate, particularly in patients who develop fatigue, nausea, bone pain, and other symptoms of hypophosphatemia after receiving an iron infusion. Further research on the prevalence, impact, and duration of hypophosphatemia following iron infusion is needed.
The Lived Experience of Suffering by Nigerian Female Breast Cancer Survivors: A Phenomenological Perspective
Authors: Nwozichi Chinomso Ugochukwu , Ojewale Margaret Olutosin , Salako Omolabake , Brotobor Deliverance , Olaogun Elizabeth
Published: January 2025

Breast cancer is a significant public health concern globally, and its impact extends beyond physical survival. Survivors often grapple with a myriad of challenges, including psychological distress, social isolation, and financial hardship. These challenges are often exacerbated in low-resource settings like Nigeria, where limited access to quality healthcare, socioeconomic disparities, and cultural stigma surrounding cancer can significantly impact the quality of life for survivors. This study aims to explore the suffering perceived by long-term breast cancer survivors in Nigeria, focusing on their lived experiences during and after treatment. Using a phenomenological approach, in-depth interviews were conducted with 22 women who have survived breast cancer for over 5 years. Data were analyzed using thematic analysis to capture the essence of their suffering, allowing for a deep understanding of their lived experiences. Five main domains emerged: (1) Physical Suffering, (2) Emotional Distress, (3) Social Suffering, (4) Financial Strain, and (5) Spiritual and Resilient Coping. Participants described their suffering as a multifaceted journey marked by physical pain, emotional turmoil, social stigma, financial challenges, and resilience fostered through spirituality and support systems. The phenomenological analysis revealed that the participants’ suffering extended beyond the physical, touching every aspect of their lives and reshaping their identities and perceptions of self. The findings highlight the complex nature of suffering among breast cancer survivors in Nigeria, underscoring the need for comprehensive survivorship care that addresses physical, psychosocial, and spiritual dimensions. By understanding the essence of their suffering, healthcare providers can develop more compassionate, context-specific care strategies that validate and support the holistic needs of survivors.
A Unique Simulation Methodology for Practicing Clinical Decision Making
Authors: Amar Shimon , Bitan Yuval
Published: January 2025

BACKGROUND

While bedside teaching offers invaluable clinical experience, its availability is limited. Challenges such as a shortage of clinical placements and qualified teaching physicians, coupled with increasing medical student numbers, exacerbate this issue. Simulation-based learning encompasses varied educational values and has the potential to serve as an important tool in medical students’ education.

OBJECTIVES

In this study, we evaluate a new Clinical Decision Making Integrated Digital Simulation (CDMIDS) method that was developed in order to enhance the clinical decision-making competency and self-confidence of medical students early in their clinical training through practicing fundamental core skills.

METHODS

The study compares 108 4th-year medical students’ questionnaire responses pre-/postself-assessments following practice of a new clinical decision-making simulation methodology.

RESULTS

Results indicate a positive participant experience, with the simulation perceived as a valuable platform for practicing integrated bedside decision making. Notably, participants demonstrated a statistically significant increase in willingness to make clinical decisions. The simulation contributed to enhanced knowledge, professional skills, and self-confidence in clinical decision making.

CONCLUSION

The use of a CDMIDS method integrates clinical decision making as part of early medical school curriculum. Moreover, the method boosts learners’ professional confidence, self-directed learning, and additional experiences. The method is flexible and can be applied in any medical school, especially those with limited resources, by making specific, localized modifications.
Time will tell: Working from home and job satisfaction over time
Authors: Sundermeyer Stefanie
Published: January 2025

This article examines the short- and long-term impact of working from home on satisfaction with flexibility, feelings of loneliness, and job satisfaction and contributes towards the understanding of circumstances that determine whether working from home has positive or negative effects on job satisfaction. Theoretically, this study argues in the context of the job demands-resources model that working from home increases job satisfaction in the short-term due to increased flexibility. In the long-term, however, the positive effect of working from home on job satisfaction is expected to decrease because loneliness countervails the positive effect of flexibility. The predictions are tested using data from 16 waves of the Household, Income and Labour Dynamics in Australia Survey. Event-study regressions reveal that working from home permanently boosts satisfaction with flexibility but increases loneliness in the long run. In line with the argumentation, the results indicate that the positive effect of working from home on job satisfaction diminishes the longer employees are working from home.
Analytical and numerical study of wire-coating process using viscoelastic fluid
Authors: Zaman Saquib Ul , Aslam Muhammad Nauman , Sarwar Lubna
Published: January 2025

This paper demonstrates the theoretical study of heat transfer over the wire coating process for the Carreau fluid. The process of coating wire or cables enhances the mechanical and electrical strength of the wire. The aim is to improve the understanding and control of the wire-coating process when using viscoelastic fluids, to optimize coating quality, uniformity, and efficiency, as well as to identify the most effective process parameters. First, we modeled the problem for cylindrical coordinates, and then the Flow governing equation are simplified using normalized variables and parameters. After making changes, we used the perturbation method to solve the final equation and obtain the analytical expression for the velocity distribution as well as the pertinent engineering quantities. Afterward, we used the Runge-Kutta fourth-order approach to solve it numerically. The velocity of molten polymer increases with increasing the values of We. The temperature profile increases with increasing the values of the pressure gradient parameter ( A), (δ) and Brinkman number ( Br). The effects of the [Formula: see text] and pressure gradient are discussed with the help of various graphs. Hybrid nanofluids are versatile and have a wide range of potential applications due to their enhanced thermal, mechanical, and fluidic properties.
Infra-red remote sensing inversion technology for hidden fire sources in mine fire areas – joint GSO and PSO algorithms
Authors: Feng Qiyong , Xue Yanping
Published: January 2025

Mine fires have always been a serious challenge to mining safety, and the existence of hidden fire sources in mine fire areas is one of the key factors causing coal seam spontaneous combustion. Hidden fire source refers to the potential fire source that cannot be easily detected by traditional detection means in the mine. They gradually accumulate heat in the complex environment of the mine. If not detected and dealt with in time, it can lead to a serious mine fire. However, traditional fire detection methods are difficult to detect hidden fire sources in the early stages, and in severe cases, can lead to catastrophic mine fires. Therefore, this study proposes a combined firefly optimisation algorithm and particle swarm optimisation algorithm for infra-red remote sensing inversion of hidden fire sources in mine fire areas, and verifies it. The results indicated that the inversion model could accurately obtain the location and intensity information of hidden fire sources. The joint algorithm exhibited higher accuracy and faster convergence speed during the training process, with an accuracy of 97.64% and an average temperature error of only 0.73°C. The average accuracy of the inversion model optimised by the joint algorithm improved to 99.48%, the average calculation time reduced to 7.25 seconds, and the efficiency has been improved by 51.92%. This study innovatively combines infra-red remote sensing inversion technology with intelligent algorithms to improve the efficiency and accuracy of detecting hidden fire sources in mine fire areas, which helps to reduce safety risks and economic losses caused by mine fires.
Case Report and Analysis of an Intriguing Phenomenon in Schizophrenia: Incubus Syndrome
Authors: Gogoi Porineeta , Ghosh Soumitra
Published: January 2025

This case report examines Incubus syndrome, blending medieval folklore and psychiatric phenomenology, using a rare case from Northeast India to highlight the limited literature. It focuses on the case of a 45-year-old woman with schizophrenia, post-separation from her spouse, who experienced auditory hallucinations of a benevolent male figure, sensations of being touched, and rhythmic movements of a phallus. The concept has shifted from a folkloric view to that of a recognised psychopathological condition, linked to various disorders like schizophrenia and sleep-related disorders.
Understanding ESG prioritization in companies from tropical emerging markets and Australia
Authors: Andrade Christian Mascarenhas , Santos Lucas josé Machado dos , Areias Caio Alexandrino Costa
Published: January 2025

This study investigates the dynamic interplay between Environmental, Social, and Governance (ESG) practices and the life cycles of tropical emerging markets, explicitly focusing on companies from China, India, Brazil, Mexico, South Africa, and Australia. Utilizing a quantitative approach with panel data, we examine whether ESG maturity influences the cash flow dynamics of these companies. The hypotheses were confirmed: H1 reveals that companies in immature cycle phases prioritize decisions centered around the "G" dimension of ESG. H2 suggests that companies in mature life cycle phases emphasize decisions related to the "E" and "S" dimensions of ESG. H3 indicates that companies in mature life cycle phases prioritize the "S" dimension over the "E" dimension within their ESG strategies. The results unveil distinct prioritization patterns of ESG dimensions across different lifecycle stages, shedding light on the evolving strategy of companies and providing valuable insights for academia and business.
No direction home: Without theory, we are lost
Authors: Imbroscio David
Published: January 2025

This commentary offers a response to Robert Lake's ‘On resisting the seduction of theory’. Professor Lake is correct that theory seduces, distracts, and is, at times, perhaps even most often, misused and misguided – and much too detached from practice. I argue that theorization is nonetheless essential. It and it alone provides the necessary understanding of our unjust world that allows us the possibility of making it less so.
Who theorizes?
Authors: Derickson Kate
Published: January 2025

In ongoing struggles for collective liberation, what use is theory? In this short commentary I respond to Bob Lake's provocative argument that theory is of little use to the people about whom it is usually made. While I share and admire Lake's sense of urgency and scepticism, I come to different conclusions about the uses and value of theory making, particularly when done by those understand themselves as part of the processes they study.
Mental Health of Black Canadians: A Scoping Review
Authors: Olanlesi-Aliu Adedoyin , Giwa Aisha , Salami Bukola
Published: January 2025

Black Canadians frequently experience significant challenges when attempting to access mental health care, resulting in discrepancies in mental health outcomes. This article describes a scoping review that aimed to understand the range and nature of research conducted on the mental health of black Canadians and to identify the gaps in this literature. An established methodological framework guided the scoping review process. We searched research databases (CINAHL, Embase, Global Health, MEDLINE, PsycINFO, Scopus, Sociological Abstracts, and Web of Science) and grey literature sources for peer-reviewed articles and grey reports on the health of black Canadians. Of the 14 121 articles screened, 43 were included in the review. Our review found spiritual support, resilience, collective culture, and culturally congruent support as facilitators of positive mental health of black people in Canada, while stigmatization, misconceptions, low uptake of mental services, and difficulties accessing mental health services were the most significant barriers. Strategies for improving the mental health of black people in Canada center on social, emotional, and community support. Our findings indicate the need for black stakeholder involvement in awareness creation and knowledge improvement, which will help to dispel the myths and misconceptions about mental health in black populations.
Weakly Supervised Temporal Action Localization With Contrastive Learning-Based Action Salience Network
Authors: Jingtao Sun , Weipeng Shi , Shaoyang Hao , Jialin Wang
Published: January 2025

In recent years, the wide application of weakly supervised temporal action localization (WTAL) technology has accelerated the efficiency of video analysis. However, this domain continues to confront numerous challenges, especially due to the lack of precise temporal annotations. Consequently, this technique becomes highly susceptible to contextual background noise and overly reliant on prominent action segments, leading to less-than-ideal action localization. To alleviate this problem, we propose the contrastive learning-based action salience network (CLASNet), comprising two pivotal modules: feature contrast separation module (FCSM) and boundary refinement module (BRM). FCSM utilizes a contrastive learning approach to effectively separate action features from background features, thereby enhancing the discriminability of features. Concurrently, BRM introduces boundary refinement loss to rectify the temporal boundaries of actions, thereby further elevating the precision of temporal localization. The collaborative functioning of these two key modules effectively resolves the ambiguity issues in temporal action localization under weak supervision, markedly enhancing localization accuracy. Furthermore, CLASNet is versatile and can be integrated into different WTAL frameworks, achieving enhanced localization performance while preserving the original end-to-end training manner. Utilizing three large-scale benchmark action localization datasets, THUMOS14, ActivityNet v1.2, and ActivityNet v1.3, we embed CLASNet into various cutting-edge weakly supervised temporal action localization methods, such as CO2-Net, DELU, and ACRNet, for empirical substantiation. The experimental outcomes reveal that CLASNet significantly enhances the efficacy of these methods in action localization, offering novel perspectives for the advancement of temporal action localization technology.