bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical Error Patterns of Students With Mathematics Difficulty: A Systematic Review
Authors: Lin Tzu-Hsing , Riccomini Paul J. , Liang Zhigao
Published: January 2025

This study reviews the literature on error patterns in mathematics among students with mathematics difficulty. We analyzed and synthesized the findings from 17 studies, focusing on the characteristics of error analysis studies, the mathematics topics examined, and the specific error patterns identified. The results revealed the following: (a) the criteria used to identify mathematics difficulties and the coding processes varied; (b) the mathematics topics investigated encompassed fractions (including fraction computation and representation), problem-solving, and general computation; and (c) a variety of common error types were identified across these mathematical domains. Implications for practitioners and researchers were discussed.
Prepubertal phthalate exposure can cause histopathological alterations, DNA methylation and histone acetylation changes in rat brain
Authors: Koc Seyda , Erdogmus Ekin , Bozdemir Ozlem , Ozkan-Vardar Deniz , Yaman Unzile , Erkekoglu Pınar , Zeybek Naciye Dilara , Kocer-Gumusel Belma
Published: January 2025

Di-2-(ethylhexyl)phthalate (DEHP) is a phthalate derivative used extensively in a wide range of materials, such as medical devices, toys, cosmetics, and personal care products. Many mechanisms, including epigenetics, may be involved in the effects of phthalates on brain development. In this study, Sprague-Dawley male rats were obtained 21–23 days after their birth (post-weaning) and were exposed to DEHP during the prepubertal period with low-dose DEHP (DEHP-L, 30 mg/kg/day) and high-dose DEHP (DEHP-H, 60 mg/kg/day, 37 days) until the end of adolescence (PND 60). The rats in the study groups were sacrificed during adulthood, and histopathological changes, epigenetic changes, and oxidative stress parameters were evaluated in brain tissues. Histopathological findings indicating the presence of deterioration in brain tissue morphology were obtained, more prominently in the DEHP-H group. Examining the hippocampus under the light microscope, pyramidal neuron loss was detected only in CA1 of the DEHP-L group, while in DEHP-H rats, pyramidal neuron losses were detected in the CA1, CA2, and CA3 regions. No significant change was observed in brain lipid peroxidation levels with DEHP compared to control. Significant increases in total glutathione (GSH) in both dose groups were considered to be an adaptive response to DEHP-induced oxidative stress. The decrease in DNA methylation in the brain, although not statistically significant, and the increase in histone modification showed that exposure to DEHP may cause epigenetic changes in the brain and these epigenetic changes may also take place as one of the mechanisms underlying the damage observed in the brain. The results suggest that DEHP exposure during early development may have a significant effect on brain development.
Sex Differences in Circadian Timing and Biological Night in Adolescents
Authors: Duston Armelle , Holtman Sydney , Bowen Anne E. , Cree Melanie G. , Nadeau Kristen , Wright Kenneth P. , Simon Stacey L. , Diniz Behn Cecilia G.
Published: January 2025

Circadian rhythms, intrinsic 24-h cycles that drive rhythmic changes in behavior and physiology, are important for normal physiology and health. Previous work in adults has identified sex differences in circadian rhythms of melatonin, temperature, and the intrinsic period of the human circadian timing system. However, less is known about sex differences in circadian rhythms at other developmental stages. To address this gap, we considered a secondary analysis of sleep and circadian data from two studies involving adolescent participants during the academic year: ( n = 32, 15 females). We collected 1 week of in-home actigraphy data to calculate sleep-wake parameters and in-laboratory salivary melatonin data collection in dim-light conditions was used to compute dim-light melatonin onset (DLMO) and offset (DLMOff) using a threshold of 4 pg/mL. We found that DLMO was an average of 96 min earlier, the time between DLMO and bedtime was an average of 56 min greater, and the biological night (time between DLMO and DLMOff) was 60 min longer in females compared to males, even though bedtimes and waketimes were not statistically different between the groups. In addition, after accounting for differences in bedtime, sex was still a significant predictor of DLMO. Conversely, no evidence was found indicating a difference in DLMOff or the phase angle between DLMOff and waketime by sex. These findings suggest that sex differences in circadian rhythms are present in adolescents and may have implications for circadian health during this important developmental period.
Estimating greenhouse gas emissions from the health sector in Canada: Mind the gap
Authors: Nowlan Jessica , Miller Fiona A.
Published: January 2025

Healthcare is a surprisingly large contributor to climate change, responsible for a significant quantity of global Greenhouse Gas (GHG) emissions. Global commitments to achieve “net zero” health systems, including by the federal government in Canada, suggest a growing need to understand and mobilize capacity for GHG emissions estimation across Canada’s health sector. Our analysis highlights efforts by public sector healthcare organizations in Canada to estimate an increasingly broad scope of GHG emissions, building on longstanding efforts to report or reduce energy-related emissions from facilities. It also identifies why such efforts will not be sufficient. Developing capacity for routine system-wide greenhouse gas emissions estimation can help Canada’s health systems to better understand their progress, including through international comparison. Yet emissions estimation is itself an investment, one that should not displace efforts to reduce the full scope of pollutants from the healthcare enterprise, and to build a truly sustainable health system.
Success Rate of Endoscopic Third Ventriculostomy in Children Younger Than 1 Year With Idiopathic Congenital Aqueductal Stenosis and Long-term Follow-up
Authors: Krejcí Tomáš , Kubina Lukáš , Krejcí Ondrej , Chlachula Martin , Lipina Radim
Published: January 2025

Introduction

The indication for endoscopic third ventriculostomy is often contested in children younger than 1 year. This study aims to establish the benefits of this modality in children with idiopathic congenital aqueductal stenosis.

Methods

Retrospective analysis was performed on patients <1 year old with idiopathic congenital aqueductal stenosis undergoing endoscopic third ventriculostomy between 2004 and 2020. Preoperative cerebral imaging was performed in all cases. Endoscopic third ventriculostomy efficacy and overall patient outcome were evaluated over the entirety of the monitoring period averaging 146 months (range, 34-218 months). Outcome was assessed by modified Rankin Scale score. Treatment success was assessed in relation to the Endoscopic Third Ventriculostomy Success Score (ETVSS), patient age, and perioperative findings of membranes in the interpeduncular cistern.

Results

The study comprised 14 children aged from 6 to 280 days, mean age 16 weeks, with 11 patients aged <6 months. The characteristic presentation was progressive macrocephaly, with the setting sun sign in 2 cases. The overall Endoscopic Third Ventriculostomy Success Score was 52.1%, whereas endoscopic third ventriculostomy was successful in 12 patients (85.7%) in the first year postoperation and in 11 cases (78.6%) in the long term. Endoscopic third ventriculostomy failure was not related to patient age ( P > .99) or perioperative findings of interpeduncular cistern membranes ( P = .51). Patient outcome averaged modified Rankin Scale score 1. Most children were without or with minimal disability.

Conclusions

We consider endoscopic third ventriculostomy a safe and effective modality for the initial treatment of patients aged <1 year presenting with congenital aqueductal stenosis–based hydrocephalus.
Platens from the Past: Yugonostalgia and the UNIS-tbm Typewriter
Authors: Ghodsee Kristen R.
Published: January 2025

This article explores the lost history of the Olympia Traveller and Traveller de Luxe typewriters. Designed in Germany but manufactured in a once multiethnic town called Bugojno in the Republic of Bosnia and Herzegovina as part of a thriving Yugoslav typewriter industry, these machines were once exported to all corners of the globe with more than ninety different keyboards. Sold throughout Yugoslavia under the brand name UNIS-tbm and UNIS-tbm de Luxe, these typewriters were also common objects in many former Yugoslav homes and have recently become ubiquitous props in a thriving culture of “Yugonostalgia.” Using Roland Barthes’s key 1957 insight about the “mythologies” that inhere in quotidian objects, this article views the typewriters as a concrete embodiment of the memory of Yugoslavia as an imagined community of “brotherhood and unity.” Using historical accounts in the Yugoslav, Bosnian, and international press, as well as expert interviews with journalists, curators, and historians, this article pieces together the backstory of a fascinating piece of Yugoslav material culture and its legacies and meanings in an ethnically homogeneous but corrupt and disappointing neoliberal present.
A Food Pantry Nutrition Education Program RCT: Food Choices and Diet-Quality
Authors: Katare Bhagyashree , Echols Brittni , Plakias Zoe , Nayaga Rodolfo M. , Hodge Krystal L.
Published: January 2025

Purpose

Food pantries have provided nutrition education to promote healthy food choices with mixed outcomes. This study assessed the impact of Guided Stars food quality rating system to promote healthy food choices among food pantry clients.

Design

Randomized parallel-group study with balanced randomization.

Setting

A client-choice food pantry in a midwestern city.

Subjects

613 food pantry clients.

Intervention

Clients were randomly assigned to a one-time treatment group (n = 330) where they received a nutrition information sheet with pantry foods ranked using the Guided Starts rating system, or a control group (n = 299) that did not receive this information.

Measure(s)

Healthy food selection; food selection quality measured by a Healthy Index.

Analysis

Multiple linear regression models to estimate the effect of the intervention on the food choices of the food pantry client, accounting for potential confounders.

Results

Results showed a decrease (−.021, P < .05) in the selection of lower nutrition-rated food items, particularly among men.

Conclusion

Food-labeling nutrition education strategies could help promote healthy food choices at food pantries, especially among future-biased clients. However, an information-based intervention alone may not be enough to alter food choices in low-income populations.
Job Choice Under Crisis Conditions: Differences in Motivational Systems and Job-Attribute Preferences of Young Adults
Authors: Peter Alexander , Muehlfeld Katrin
Published: January 2025

The COVID-19 pandemic delivered a fundamental shock that significantly impacted individual working conditions and increased job insecurity across numerous occupations and industries. Against this background, this study analyzes how two basic motivational systems, the behavioral activation system (BAS) and behavioral inhibition system (BIS), which shape human responses to (perceived) threats, influence the formation of job-attribute preferences. BIS and BAS have been shown to impact human decision-making and behavior in many different domains pervasively. However, despite their fundamental nature, they have remained understudied as possible deep-level influences on the formation of occupational preferences of young people about to choose a job to embark on. We address this research gap by applying an adaptive choice-based conjoint experiment based on a sample of 1,005 young adults. Results show that the perceived relative importance of significant job attributes in a crisis-ridden environment is related to the sensitivity of specific BIS and BAS subscales.
Advancing lung cancer diagnosis: Combining 3D auto-encoders and attention mechanisms for CT scan analysis
Authors: Wang Meng , Yang Zi , Zhao Ruifeng
Published: January 2025

Objective

The goal of this study is to assess the effectiveness of a hybrid deep learning model that combines 3D Auto-encoders with attention mechanisms to detect lung cancer early from CT scan images. The study aims to improve diagnostic accuracy, sensitivity, and specificity by focusing on key features in the scans.

Materials and methods

A hybrid model was developed that combines feature extraction using 3D Auto-encoder networks with attention mechanisms. First, the 3D Auto-encoder model was tested without attention, using feature selection techniques such as RFE, LASSO, and ANOVA. This was followed by evaluation using several classifiers: SVM, RF, GBM, MLP, LightGBM, XGBoost, Stacking, and Voting. The model's performance was evaluated based on accuracy, sensitivity, F1-Score, and AUC-ROC. After that, attention mechanisms were added to help the model focus on important areas in the CT scans, and the performance was re-assessed.

Results

The 3D Auto-encoder model without attention achieved an accuracy of 93% and sensitivity of 89%. When attention mechanisms were added, the performance improved across all metrics. For example, the accuracy of SVM increased to 94%, sensitivity to 91%, and AUC-ROC to 0.96. Random Forest (RF) also showed improvements, with accuracy rising to 94% and AUC-ROC to 0.93. The final model with attention improved the overall accuracy to 93.4%, sensitivity to 90.2%, and AUC-ROC to 94.1%. These results highlight the important role of attention in identifying the most relevant features for accurate classification.

Conclusions

The proposed hybrid deep learning model, especially with the addition of attention mechanisms, significantly improves the early detection of lung cancer. By focusing on key features in the CT scans, the attention mechanism helps reduce false negatives and boosts overall diagnostic accuracy. This approach has great potential for use in clinical applications, particularly in the early-stage detection of lung cancer.
Moral Socialism and Liberal Citizenship
Authors: Stevenson Nick
Published: January 2025

The current crisis of liberal democracy has led to a reconsideration of the idea of socialism. This article seeks to critically compare three different approaches to socialism, all of which draw on specifically moral criteria. The first is a form of liberal socialism that has a long history in critical theory and has most recently been re-imagined by Axel Honneth through a theory of recognition. The second is a conservative version of socialism, which encourages citizens to return to native traditions that can restrain the destructive individualism of liberalism. Finally, I look at a more materialist version of socialism that can be associated with the writing of Marx. In the concluding section, I argue that the return to a materialist vision of moral socialism is long overdue; this is especially the case in the context of the impoverished cultural life of neoliberal capitalism, and the ongoing ecological crisis.
The leadership expectations statement: A simple tool for enhancing leadership in healthcare organizations
Authors: Fortenberry John L.
Published: January 2025

Healthcare organizations are reliant on cadres of managers to oversee operations, ensuring the delivery of excellent patient care and accomplishment of institutional missions. These managers obviously must be well versed in the principles of management, but they also must be proficient in leadership. As leadership can take many different forms, healthcare organizations must take care in their associated leadership development efforts to ensure that they have a firm grasp on the precise leadership qualities needed within their given organizations. Achieving this knowledge can be greatly facilitated by developing leadership expectations statements. This article profiles leadership expectations statements, presents a recent statement developed by Willis Knighton Health, and outlines the steps required for assembling and using them in any healthcare institution.
Phthalonitrile resins based on biomass vanillin with high storage modulus and good processing window
Authors: Yan Wenhui , Sang Xiaoming , Chen Xinggang , Jiang Qian , Peng Caizhen , Guo Tianfei
Published: January 2025

Bio-based phthalonitrile resins were synthesized using a two-step process. Initially, vanillin underwent a nucleophilic reaction with nitro and potassium carbonate to form intermediates, which were then dissolved in N, N-dimethylformamide. The intermediate was divided into two portions, with 4,4’-oxydianiline and 4,4’-methylenedianiline added to each portion, respectively, to produce two different vanillin-based phthalonitrile monomers: OVA monomer and DVA monomer. The successful synthesis of these two bio-based phthalonitrile monomers was confirmed using Fourier transform infrared spectroscopy and proton nuclear magnetic resonance spectroscopy. Differential scanning calorimetry was employed to study the processability of the monomers, revealing that OVA monomer and DVA monomer had a wide processing window of 110°C and 69°C, respectively, which were advantageous for resin processing. Dynamic mechanical analysis showed that the storage modulus of the OVA and DVA resins reached 4818 MPa and 3526 MPa, respectively, with a 24-h water absorption rate of only 1.03% and 0.90%. This study presents a viable method for synthesizing bio-based phthalonitrile resins, which can be widely utilized as functional and structural materials in daily life due to their renewability, degradability, and minimal environmental impact.
Characterization of time-frequency response in the two-stage herringbone gear transmission system based on crack-pitting coupling time-varying mesh stiffness
Authors: Dong Hao , Zhao Dai-Ning , Bi Yue , Liu Sheng-Sheng , Yan Wen , Hou Xiang-Ying , Jin Guang-Hu , Wang Chang-Jiang
Published: January 2025

Due to factors such as eccentric load and error, the gear will produce cracks and pitting corrosion and other failure modes, resulting in the change of the dynamic characteristics of the two-stage herringbone gear transmission system (TSHBGTS), which will have a serious impact on the stability of the operation of the high-torque engine. To investigate the impact of crack-pitting coupling on the vibration characteristics of the TVMS, a dynamic model with 48 degrees of freedom was developed. This model considers various factors such as errors, time-varying meshing stiffness (TVMS), torsional stiffness, support stiffness, tooth friction, and repulsion slot variations. The potential energy method is employed to calculate the TVMS for each herringbone gear pair in the system, accounting for the effects of crack-pitting coupling and changes in the retractor slot parameter. The dynamic model is solved using the Runge–Kutta numerical integration method, enabling the analysis of the system’s time-domain and frequency-domain responses under varying degrees of crack-pitting coupling. The vibration testing explores how different degrees of crack-pitting coupling affect the system’s time-frequency response characteristics. The results reveal that the system’s stiffness decreases with an increasing degree of crack-pitting coupling, initially dominated by pitting and eventually by crack influence. The time-domain response characteristics exhibit shock behavior that varies with the meshing cycle, becoming more pronounced with increased crack-pitting coupling. Additionally, the frequency-domain response is characterized by side frequency signals near the octave frequency, indicative of crack-pitting coupling effects. This behavior exacerbates as the crack-pitting coupling intensifies, leading to deteriorating vibration stability. Comparative analysis of test and theoretical data demonstrates consistency in trends, affirming the model’s accuracy. The research results are of great significance for the dynamic stability and quality evaluation of TVMS.
Design and analysis of the road energy harvester with an elastic element
Authors: Jang Seon-Jun , Kim Byeong-Ryong , Lee Donghun , Lee Seung-Ryeol
Published: January 2025

This study introduces the integration of an elastic component into a speed bump-type energy harvester designed to generate power from the pressure exerted by passing vehicles. The research begins by presenting a passively actuated speed bump design, which serves as the input mechanism for the harvester and fully lowers when vehicles travel below a specific speed. Subsequently, a design equation integrating the elastic element into the energy harvester is formulated. Numerical simulations and experimental testing were conducted to evaluate the effects of the elastic element on the harvester’s performance. The results demonstrate that the elastic component can extend the duration of power generation, although it may reduce the peak power output. Additionally, the elastic element was found to reduce stress on the harvester’s transmission components, thereby improving its durability. These enhancements suggest that the elastic element could increase the viability of speed bump energy harvesters, particularly those employing electromagnetic induction, for practical road applications.
Multi-objective optimization of wire cutting process parameters for Ti-6Al-4V alloy is performed using NSGA-II and EWM-TOPSIS optimized artificial neural network
Authors: Sun Lunye , Chen Biao , Zhou Qinghong , Zhao Dewang
Published: January 2025

Due to its exceptional mechanical properties, the Ti-6Al-4V alloy is increasingly being utilized in various aerospace applications. Among the numerous processing methods available, wire electrical discharge machining (WEDM) stands out as one of the most efficient techniques for working with Ti-6Al-4V alloy. However, due to the presence of numerous processing parameters and complex influencing patterns, improper selection of processing parameters can significantly impact both the surface quality and machining efficiency. To address this challenge, a four-factor, three-level full factorial cutting experiment was conducted in this study. The influence trends of parameters such as pulse-on time ( Ton), pulse-off time ( Toff), peak current ( IP), and open voltage ( OV) on surface roughness, material removal rate, and kerf width were analyzed based on the experimental results. Artificial neural networks were employed to establish data-driven models, and their accuracy was subsequently validated. Additionally, the NSGA-II was employed for multi-objective optimization of computational results. Moreover, the EWM-TOPSIS method was utilized to effectively rank the solutions obtained from multi-objective optimization. The optimal parameters for the WEDM process were determined as follows: Ton of 8.44 μs, Toff of 5.12 μs, IP of 13.9 A, and OV of 209.44 V. The proposed method offers a more convenient and applicable approach for the selection of appropriate processing parameters.
Effect of ply structure on thermal residual stress in 3D needle-punched C/SiC composites
Authors: Li Longbiao
Published: January 2025

Three-dimensional needle-punched (3DNP) carbon fiber-reinforced silicon carbide (C/SiC) composites possess better mechanical properties and lower cost than two-dimensional plain-woven (2DPW) or three-dimensional braided (3DB) C/SiC composites. For 3DNP C/SiC composite, the composite’s internal thermal residual stress (TRS) affects the mechanical properties and damage mechanisms, for example, initial matrix cracking, fiber/matrix (F/M) interface debonding, fibers fracture and pullout under the mechanical loading. In this paper, the effect of ply structure on the TRS of 3DNP C/SiC composites with different ply structures was investigated. Cyclic loading/unloading tensile tests at different tensile peak stresses were conducted to obtain the mechanical hysteresis loops. The composite’s thermal residual strain, peak strain, and tangent modulus with increasing peak stresses were calculated through the hysteresis loops and used to derive the thermal residual stress and strain using the common intersection point (CIP) method. Relationships between the composite’s ply structures, mechanical hysteresis loops, thermal residual stress/strain, and internal damage state were established. The analysis can better help the engineering designers reduce the thermal residual stress by adjusting the composite’s ply structures.
The Extended Mind in Young Children: Cost-Dependent Trade-Off Between External and Internal Memory
Authors: Liang Yibiao , Blaser Erik , Yi Jia Ying , Sai Liyang , Kaldy Zsuzsa
Published: January 2025

Most work on working memory development has children remember a set of items as well as they can. However, this approach sidesteps the extended mind, the integration of external information with memory. Indeed, adults prefer to use external resources (e.g., lists, models) but will remember more as the cost to access them increases. Here, in our shopping game, we investigated this trade-off in 5- to 8-year-olds. Using a touchscreen, children shopped in a virtual store. Their shopping list and the store were not visible simultaneously but could be toggled. We manipulated access cost by varying a delay (0–4 s) before the list’s reappearance. Across three preregistered experiments at two sites (the United States and China, N = 141), a pattern emerged: When it was costlier to do so, children revisited the list less often, studied it longer, and selected more correct items. Also, children recognized the costs, identifying the no-delay condition as easier. Young children showed a cost-dependent trade-off of external-resource use versus working memory.
Holocene paleoenvironmental reconstructions in western Brittany (Bay of Brest): Part II – A 7 kyr human-environment story with a focus on the Neolithic-Bronze Age transition
Authors: Valero Clara , Penaud Aurélie , Lambert Clément , Vidal Muriel , Pailler Yvan , Nicolas Clément , Poncin Olivier , Stéphan Pierre , Ehrhold Axel
Published: January 2025

The Bay of Brest (BB, NW France) is a semi-enclosed basin of 180 km² subject to macro-tidal dynamics and to the fluvial influences of the rivers Aulne and Elorn, which combined drain watersheds of 2600 km². This coastal environment is subject to natural climate oscillations overlaid on the long-term landscape transformations inherited from the post-glacial sea level rise and increasing anthropogenic forcing since the Neolithic (6.9 ka BP), and especially from the Bronze Age (4.2 ka BP) onwards. The BB therefore appears suitable for the reconstruction of the interactions between climate, environment and human dynamics across the Holocene. In this study, a palynological stack was created based on five cores (including two new cores PALM-KS05 and PALM-KS06 from the Brest harbour), allowing us to discuss vegetation dynamics over the last 7 kyrs. Since the Neolithic period, the forest cover has decreased in favour of open and agro-pastoral landscapes. This trend is not uniform, however: forest cover first declined slowly around 4 ka BP, then strongly decreased at the end of the Iron Age, before experiencing a revival of about five centuries at the end of the Roman period (1.7–1.2 ka BP). Finally, a drastic fall of tree pollen taxa is recorded at the start of the Middle Ages. This study is the first on long-term Holocene trends that allows discussion of both climatic and anthropogenic forcing at an unprecedent average study resolution of 35 years. We also place this local evolution in a wider context to detail interactions between natural and anthropic forcings over the last 7 kyrs BP at a regional-scale and we discuss paleoenvironments and human dynamics thanks to the incorporation of an up-to-date corpus of archaeological data.
New insights into the long-term adverse effects of antimalarials in patients with systemic lupus erythematosus
Authors: Araújo Olga , Espinosa Gerard , Hernández-Rodríguez José , Hernández-Negrín Halbert , Adán Alfredo , Pelegrín Laura , Cervera Ricard
Published: January 2025

Background

Hydroxychloroquine is recommended for all patients with systemic lupus erythematosus (SLE) because of its efficacy and safety. Previous studies of antimalarial toxicity under non-experimental conditions have often grouped hydroxychloroquine and chloroquine. This study focuses on the long-term toxicity of antimalarial drugs in SLE patients at a single reference centre. The research seeks to identify trends in antimalarial toxicity and determine risk factors contributing to long-term adverse effects.

Materials and Methods

Retrospective data were collected from electronic medical records of consecutively diagnosed SLE patients, followed for at least 5 years, from 1998 to 2017. The outcome variable “antimalarial long-term adverse effect” was considered if the adverse effect occurred after at least 5 years of continuous antimalarial treatment. Hazard regression analysis was used to identify independent factors associated with long-term antimalarial adverse effects.

Results

Three hundred 22 patients followed for a median of 15 years were analysed. The mean age at SLE diagnosis was 33.4 years, and 91.3% were women. Antimalarial drugs were started in 314 (97.5%) patients. Adverse effects were observed in 55 (17.5%) patients, mainly macular toxicity (11.5%). The incidence of all types of toxicity was higher in the long-term users than in the short-term users (12.1% vs 5.4%; p < .001). Previous use of chloroquine (HR 3; 95%CI 1-9), anti-ß2-glycoprotein antibody positivity (HR 2; 95%CI 1-4) and hydroxychloroquine doses higher than 5 mg/kg/day (HR 2.6; 95%CI 1-7) were identified as independent factors associated with long-term antimalarial toxicity.

Conclusions

In our experience over the past 20 years, almost all SLE patients were treated with antimalarials. Macular toxicity was the most common long-term adverse effect. Patients with previous use of chloroquine, higher than recommended doses of hydroxychloroquine, and positive anti-ß2-glycoprotein antibodies were more likely to develop long-term antimalarial toxicity.
Cryopreserved Umbilical Cord Mesenchymal Stem Cells Show Comparable Effects to Un-Cryopreserved Cells in Treating Osteoarthritis
Authors: Yan Bo , Chen Huixin , Yan Li , Yuan Qiang , Guo Le
Published: January 2025

Non-cryo and hypothermic preservations are two available options for short-term storage of living cells. For long-term cell storage, cryopreservation is an essential procedure as it prolongs the storage time, allowing for the transport and testing of cells, as well as the establishment of cell banks. But it is unclear whether cryopreservation reduces the therapeutic effects of human umbilical cord mesenchymal stem cells (hucMSCs) on osteoarthritis (OA). To investigate this, we compared the basic biological characteristics and the anti-OA efficacy of un-cryopreserved hucMSCs (UC-MSCs) and cryopreserved hucMSCs (C-MSCs). A mono-iodoacetate-induced rat OA model was established to evaluate the anti-OA properties of UC-MSCs and C-MSCs. And the conditioned medium of UC-MSCs (UC-CM) and cell freezing medium of C-MSCs (C-CFM) were collected for the mechanism study. No significant differences were found between UC-MSCs and C-MSCs in cell viability, immunophenotype, and trilineage differentiation capacity. In vivo, UC-MSCs and C-MSCs exhibited similar cartilage-repairing effects by attenuating pain and alleviating pathological changes in OA rat joints. In vitro, C-CFM and UC-CM promoted the proliferation of chondrocytes, improved the expression of anabolism-related molecules ( Col2, COL2, and SOX9), and decreased the expression of catabolism-related molecules ( Adamts5, Mmp13, Il6, COL10, and MMP13). These results indicated that UC-MSCs and C-MSCs had comparable anti-OA effects, and cryopreservation did not alter the anti-OA capability of hucMSCs, which provides further support for clinical use of C-MSCs in treating OA.
Perspectives and Limitations of Mesenchymal Stem Cell–Based Therapy for Corneal Injuries and Retinal Diseases
Authors: Hermankova Barbora , Javorkova Eliska , Palacka Katerina , Holan Vladimir
Published: January 2025

The eye represents a highly specialized organ, with its main function being to convert light signals into electrical impulses. Any damage or disease of the eye induces a local inflammatory reaction that could be harmful for the specialized ocular cells. Therefore, the eye developed several immunoregulatory mechanisms which protect the ocular structures against deleterious immune reactions. This protection is ensured by the production of a variety of immunosuppressive molecules, which create the immune privilege of the eye. In addition, ocular cells are potent producers of numerous growth and trophic factors which support the survival and regeneration of diseased and damaged cells. If the immune privilege of the eye is interrupted and the regulatory mechanisms are not sufficiently effective, the eye disease can progress and result in worsening of vision or even blindness. In such cases, external immunotherapeutic interventions are needed. One perspective possibility of treatment is represented by mesenchymal stromal/stem cell (MSC) therapy. MSCs, which can be administered intraocularly or locally into diseased site, are potent producers of various immunoregulatory and regenerative molecules. The main advantages of MSC therapy include the safety of the treatment, the possibility to use autologous (patient’s own) cells, and observations that the therapeutic properties of MSCs can be intentionally regulated by external factors during their preparation. In this review, we provide a survey of the immunoregulatory and regenerative mechanisms in the eye and describe the therapeutic potential of MSC application for corneal damages and retinal diseases.
Impact of frailty and comorbidity on initial response to lung cancer screening invitation and low-dose CT screening uptake: Findings from the Yorkshire Lung Screening Trial
Authors: Almatrafi Anas , Gabe Rhian , Beeken Rebecca J , Neal Richard D , Clegg Andrew , Best Kate E , Relton Samuel , Brown Martel , Tam Hui Zhen , Hancock Neil , Crosbie Philip A.J. , Callister Matthew E.J.
Published: January 2025

Background

Low-dose computed tomography screening reduces lung cancer-specific mortality in high-risk individuals. Lung cancer risk factors overlap with comorbid diseases, highlighting the significance of frailty and comorbidities for lung cancer screening (LCS). Here, we describe the prevalence of frailty and comorbidity in those invited for LCS and evaluate their associations with response to telephone risk assessment invitation and subsequent uptake of LCS.

Methods

Analysis was based on the intervention arm of the Yorkshire Lung Screening Trial, where ever-smoked individuals aged 55–80 were invited to telephone risk assessment followed by community-based LCS if at higher risk. The electronic frailty index (eFI) was used to compute individual frailty scores (categorised as fit, mild, moderate and severe) and derive comorbidity data.

Results

Of 27,761 individuals invited, 24.1% ( n = 6702), 8.5% ( n = 2353) and 1.7% ( n = 459) had mild, moderate and severe frailty, respectively. Over half responded to the invitation to telephone risk assessment ( n = 14,523, 52.5%) with frailty associated with a higher response rate compared to fit individuals: adjusted odds ratio (ORadj) 1.34, 95% confidence interval (CI) 1.26–1.42 for mild frailty; ORadj 1.28, 95%CI 1.16–1.40 for moderate frailty; and ORadj 1.32, 95%CI 1.08–1.61 for severe frailty. Similar patterns were seen with comorbidity counts. After assessment, moderate (ORadj 0.75, 95%CI 0.59–0.96) and severe (ORadj 0.67, 95%CI 0.43–1.04) frailty were associated with reduced screening uptake.

Conclusion

The presence of frailty was associated with increased response to LCS invitation. Given the strong association between frailty and reduced life expectancy, these results suggest that people with potentially more life years to be gained from LCS may be less inclined to take part. Further research is needed to explore the interactions between frailty and LCS decision-making to inform future invitation strategies.
Seeds of Change: Nurturing Entrepreneurial Ecosystems for Sustainable Enterprises in Lebanon and Jordan
Authors: Shatila Khodor , Nigam Nirjhar , Mbarek Sondes
Published: January 2025

This study investigates how entrepreneurial inputs and regulatory environments affect the evolution of Lebanese and Jordanian entrepreneurial ecosystems (EE). We attempted to understand how these ecosystems work by focusing on the input configurations that trigger entrepreneurship and how these regulatory environments have been formed. The researchers tested the theoretical model using structural equation modelling (SEM) to investigate EE as a relative construct and the interrelationship between the different factors that impact such systems. This data collection method built a base for a comparative study based on 300 respondents from each country, using Google Forms. These results indicated a strong positive relationship among finance, networks, economic policy stability, innovation, and EE in Lebanon and Jordan. This can give entrepreneurs financial support, social networks, and economic stability to help them thrive and innovate. For further research, a comparative analysis with other regions could underscore the importance of EE in both countries and offer a more comprehensive global perspective for interpreting these ecosystems. This study adds to the literature on Lebanese and Jordanian entrepreneurship by potentially influencing the future development of EE in these countries.
Navigating Uncertainty: Challenges Faced by Bangladeshi Female Entrepreneurs in East London, UK
Authors: George Richard , Dhaliwal Spinder
Published: January 2025

Asian businesses have played a significant role in the UK economy, with research often examining the success factors of Asian entrepreneurs who rose from humble beginnings. However, there is a paucity of research on Asian women in business who are playing an increasingly important role within this entrepreneurial minority. This study aims to rectify this by shedding light on the challenges and experiences of eight Bangladeshi female entrepreneurs in the Brick Lane area of London. The last few years has seen the UK economy face several challenges as a result of the COVID-19 pandemic as well as a downturn in the economy caused by a number of macroenvironmental factors (ONS. [2023]. GDP in history: How the COVID-19 pandemic shocked the UK economy). The Brick Lane area of London, located in the East End, has undergone much change and transformation and is dominated by male-led businesses. This poses a challenge for female-led enterprises. The women in the study sample of qualitative, semi-structured telephone interviews explored the challenges they faced in starting up and developing their businesses within a patriarchal community and, in particular, how the turbulence of the COVID-19 pandemic impacted them. This research contributes to several neglected issues within this important field of Asian entrepreneurship in the UK and, as a result, a clearer picture will emerge of the roles, responsibilities and relationships of the relatively marginal Bangladeshi women entrepreneurs. This study aims to fill a research gap and to add to the growing body of academic literature on female entrepreneurs and ethnic minority entrepreneurs and on understanding the business and societal issues they face. It provides valuable insights for policymakers and business support professionals regarding this potentially influential and growing subgroup.
Information Disclosure of Electronic Commerce in Vietnam: Expectancy and Social Contract Theory Perspectives
Authors: Tran-Pham Trang Minh , Ton Han Nu Ngoc , Lan Dang Hoang , Chau Huynh Thi Minh
Published: January 2025

This study investigates the sequential relationships among motivations for online information disclosure, willingness to disclose and purchase behaviours on e-commerce platforms. The expectancy theory of motivation and social contract theory provide the theoretical basis, interpreting how anticipated disclosure outcomes and perceived fairness in the exchange process impact willingness to disclose and subsequent purchase decisions. This study employed a quantitative research approach with three sampling methods (e.g., purposive sampling, quota sampling and snowball sampling). The mass survey was distributed to students from five universities located in Ho Chi Minh city and Ha Noi capital, the two largest e-commerce markets in Vietnam. There were 695 valid cases used for theoretical estimation by using partial least squares structural equation modelling. Three driven forces of information disclosure were identified (e.g., flow experience, perceived information relevance and trust in platform), while the perceived Internet competency negatively impacts willingness to disclose. In turn, willingness to disclose had a significantly positive impact on online purchase behaviour. The study suggests that the behavioural and contextual factors causing online disclosure should be interpreted to design effective disclosure regulations and norms. It’s crucial for business providers to promote a sense of fairness and build strong customer relationships to enhance user decision-making.
A Comprehensive Review of Psychosocial, Academic, and Psychological Issues Faced by University Students in India
Authors: Gull Mubashir , Kaur Navneet , Abuhasan Wael M. F. , Kandi Suneetha , Nair Sidharth Murali
Published: January 2025

Background

University students confront a wide range of issues during their pursuit of education. Understanding these issues is essential for developing effective treatments and support systems.

Purpose

This study aims to delineate the landscape of scholarly literature pertaining to psychosocial, academic, and psychological issues among university students. It further identifies key journals and publishing trends within the fields, thereby significantly contributing to this domain. Additionally, this study outlines the scientific field networks that offer theoretical and conceptual foundations for exploring the psychosocial, academic, and psychological challenges faced by university students. Furthermore, it also intends to systematically categorise various types of problems encountered by university students in India.

Methods

To systematically gather and investigate the problems encountered by students in higher education, this study utilises bibliometric analysis, highlighting topics related to mental health. Data were extracted from Scopus and Web of Sciences databases.

Results

The analysis of the literature yielded 12 overarching categories related to challenges faced by university students: stress, academic stress, depression, anxiety, internet/ smartphone addiction/ gaming disorder, low self-esteem, loneliness, insomnia, suicidal ideations, eating disorders, drug addiction, adjustment issues.

Conclusion

Academic institutions should prioritise student mental health, as it affects academic performance and can lead to psychological disorders. Universities need Guidance and Counselling Cells staffed with professionals to help students manage psychosocial, academic, and psychological challenges.
Prevalence of Comorbidities and Racial Disparities in Anterior Uveitis Risk Among Ankylosing Spondylitis Patients
Authors: Alfatlawi Halah , Alharbi Abdulmajeed , Kwak Eun Seo , Sheikh Rawnag El , Altorok Nezam
Published: January 2025

Introduction:

Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the axial spine, commonly associated with extra-articular manifestations such as anterior uveitis (AU). Racial disparities have been observed in the prevalence of AU among AS patients, with African American individuals often experiencing higher frequencies compared to their white counterparts. Moreover, AS is linked with various comorbidities, contributing to increased morbidity and mortality. This study aims to investigate the prevalence of AU and associated comorbidities among AS patients, with a focus on racial differences.

Methods:

This retrospective study utilised data from the 2020 National Inpatient Sample (NIS) database, identifying adult patients with AS admitted to hospitals in the United States. Descriptive statistics were employed to analyse demographic characteristics and comorbidity prevalence. Multivariate analysis assessed the association between AU, race, comorbidities, and inpatient outcomes.

Results:

Our analysis revealed significant racial disparities in the prevalence of AU among AS patients. Patients with AU tended to be younger, with a mean age of 48 years versus a mean age of 60 in patients with AS without AU. Among patients with AS without AU, 82% were Caucasians and African Americans represented 6%. Among patients with AS with AU, Caucasians represented 71% and African Americans represented 18%. In terms of outcomes, patients with a history of AU exhibited similar inpatient mortality rates (less than 1%) compared to those without (3%). Acute kidney injury (AKI) was more prevalent among patients with AU (24%) versus those without (16%) but was not statistically significant. The comorbidities commonly associated with AS include hypertension, both complicated (23%) and uncomplicated (40%), along with diabetes presenting with and without chronic complications at rates of 17% and 11%, respectively.

Conclusion:

Our study underscores the need for further research to elucidate the relationships between AS, AU, and comorbidities, particularly in the context of racial disparities. Improved risk assessment and early detection strategies tailored to the African American population are crucial for facilitating timely diagnosis and targeted treatment interventions for AS. Addressing these disparities and advocating for proactive management approaches can help mitigate healthcare inequities and enhance overall health outcomes for African American AS patients.
Peri-anal Hyperpigmentation in a Patient with Rectal Cavernous Haemangioma
Authors: Ghonge Nitin P. , Kumar Karunesh
Published: January 2025

Introduction:

Cavernous hemangioma of rectum is a slow-flow vascular malformation characterized by multiple dilated intramural blood vessels which shows T2 hyperintense signal, mainly on fat-suppressed sequences and may cause bleeding.

Case Details:

The report describes a case of a 16 Years boy who presented with recurrent episodes of rectal bleeding with hyperpigmentation in peri-anal region. MRI study suggested the diagnosis of rectal cavernous hemangioma.

Conclusion:

The illustrated case images highlight the role of clinical examination and MRI in diagnosis of rectal cavernous hemangioma. Peri-anal hyperpigmentation in a young patient with rectal bleeding should raise suspicion of rectal hemangioma.