bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized Trial of Self-Guided Parenting Intervention on Parent Competency and Child Behavior
Authors: Tanuri-Leeman Yehuda , Solomon Phyllis , Evans-Chase Michelle
Published: December 2024

Purpose: Given the increasing demand for mental health resources and challenges associated with engaging adolescents in therapy, it is crucial to evaluate alternative intervention modalities that empower parents to manage child behavior and enhance parental competency. This study evaluates the effectiveness of a parental guidance book on these outcomes. Method: A convenience sample of 128 Israeli parents were randomly assigned to experimental or control group. After pretest, treatment parents read a guidebook, and after 1 month, both groups were re-assessed. Multiple regression was used to test hypotheses. Results: Treatment parents reported significant improvements in parental competency and reductions in reported child behavior symptoms compared to controls. Frequency and number of strategies predicted an increase in parents’ sense of competency and control. Discussion: Substantial effect sizes indicate that structured, self-administered guidance can benefit parenting practices and outcomes. Findings support broader implementation of such interventions, particularly where traditional therapeutic resources are scarce or inaccessible.
A comparison of two law enforcement marksmanship assessments
Authors: Orr Robin Marc , Canetti Elisa Fontenelle Dumans , Schram Ben
Published: December 2024

Background:

Law enforcement officers (LEO) must be confident in their ability to employ their firearm and be accurate in its application in high stress, life threatening, situations. To assess officer firearm marksmanship and training needs, police officers are assessed annually on their firearm handling and shooting accuracy. The unknown is whether different marksmanship assessments may yield different results in officer qualification rates, and measures of officer firearm comfort, confidence, and safety.

Objective:

This study aimed to identify differences in officer firearm qualification rates and perceptions of comfort, confidence, and safety in the handling of their firearms between their current Traditional Pistol Assessment (TPA) and an Alternate Pistol Assessment (APA).

Methods:

Australian LEO (male n = 8; female n = 6) consented and participated in a cross sectional, within-subjects, randomised, repeated measures study. Subjective data (e.g. perceived confidence), objective data (e.g. heart rate and breathing rate), and marksmanship qualification results were collected for both assessments.

Results:

Four (29%) officers passed the TPA, while seven (50%) passed the APA. While more complex, officers had greater confidence in their sidearm handling and marksmanship ability following the APA. There were no significant differences in physiological demands between the two assessments.

Conclusions:

Officer firearm qualification rates are influenced by the nature of the marksmanship assessment undertaken as are their perceptions of firearm comfort, confidence, and safety when handling and firing their firearm. A firearms qualification assessment should include a variety of occupationally relevant situations (e.g. moving, shooting from behind cover, vocalisation, etc.), and consider impacts on officer firearms confidence.
Health threats to Polish firefighters during vehicle fires – analysis of fire and rescue operations in Poland in 2017–2022
Authors: Dudziński Łukasz , Bihałowicz Jan Stefan , Weiner Marcin , Kasperczyk Rafał , Kubiak Tomasz
Published: December 2024

Background

Firefighters while extinguishing fires, are exposed to air pollution resulting from combustion processes, especially dangerous when originating from the combustion of plastics. Air pollution during a fire results from the release of gases, vapors, smokes, and dusts of varying composition and toxicity levels into the atmosphere.

Objective

To analyse and estimate the health hazards to firefighters resulting from exposure to harmful chemical compounds generated during vehicle fires in Poland between 2017 and 2022.

Methods

Data from the Decision Support System of the State Fire Service (DSS-SFS), provided by the Operational Planning Office, were used. Events from the period 1st January 2017—31st December 2022 were analysed. Quantitative data were described using the mean (Mean) and standard deviation (SD). Correlations and differences at the significance level of p < 0.05 were considered statistically significant. The analysis is anonymous for both the victims and the officers involved in the described fire and rescue operations.

Results

According to the DSS-SFS system records, firefighters carried out n = 55,422 (min 8441, max 9847, mean 9237, SD 494.2) fire interventions (F), in the category of object: motor vehicles, during 2017–2022. The maximum firefighting operation times were observed for trucks, which may result from the purpose of these vehicles (carrying loads), the necessity of firefighting operations in the cargo space and the transported materials.

Conclusion

Attention should be paid to the various possibilities of exposure to fire substances, not only directly at the source of combustion but also in the fire engine, on protective clothing, firefighting equipment, which can cause secondary exposures long after the firefighting operation has ended, and the correct decontamination process..
Levator Veli Palatini Muscle Ratio Is a Clinically Significant Anatomic Predictor for Velopharyngeal Surgical Need
Authors: Mason Kazlin N. , Gampper Thomas , Black Jonathan
Published: December 2024

Objective

Velopharyngeal insufficiency (VPI) poses challenges for normal speech production, often necessitating surgical intervention. Determining optimal candidates for surgery remains complex and requires a nuanced understanding of underlying anatomic factors contributing to VPI. This study aimed to identify anatomic predictors that drive surgical recommendations for VPI.

Design

Prospective observational cohort study.

Setting

Pediatric tertiary care hospital.

Methods

Magnetic resonance imaging data were acquired from 150 children (aged 4–17) to identify anatomic predictors of VPI and surgical need. Fourteen velopharyngeal variables were measured in the oblique coronal and midsagittal imaging planes. Calculations included differences in levator veli palatini (LVP) muscle angles of origin, mean extravelar length, differences between left and right extravelar segments, the VP Needs ratio, and a newly developed LVP ratio. Multivariate logistic regression models with k-fold cross validation were utilized to identify anatomic profiles predictive of VPI and receiving a surgical recommendation.

Results

The models demonstrated high accuracy, sensitivity, and specificity. Among anatomic variables, the LVP ratio emerged as the strongest determinant of surgical need (β = 11.256, p < .001). Notably, an increase in the LVP ratio of 0.10 is associated with a 3.08-fold increase in the likelihood of receiving a surgical recommendation. LVP ratios above 1.0 were significant for both VPI classification and surgical need.

Conclusions

The LVP ratio significantly differentiates individuals with VPI and is predictive of surgical need for VPI management. Inclusion of the LVP ratio into clinical evaluations may refine patient stratification, enabling more precise surgical decision-making tailored to individual anatomic variations.
Inpatient Care Experiences Differ for VA and Non-VA Hospitals, With Different Patterns by Health, Race, and Ethnicity
Authors: Elliott Marc N. , Beckett Megan K. , W. Cohea Christopher , Lehrman William G. , Goldstein Elizabeth , Schaefer James H. , Giordano Laura A. , Saliba Debra
Published: December 2024

This article estimates differences and difference-in-differences in patient experiences for Veterans Health Administration (VA) compared to non-VA patients in 2017, when there was concern about the health quality of VA hospitals, and in 2021, the second year of the COVID-19 pandemic, both overall, and for specific patient groups. We used data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In 2017, HCAHPS performance was somewhat better for non-VA than for VA hospitals, with Care Transition being the only measure for which VA hospitals performed better on average. By 2021, HCAHPS performance was better for VA than for non-VA hospitals for all but two measures (Quietness and Discharge Information), for which there were no differences from non-VA hospitals. In 2017, the VA provided worse experiences than non-VA hospitals for Black and poor-health patients; in 2021, VA hospitals outperformed non-VA hospitals for these, and all patient subgroups examined.
Conceptualizing Meaningful Experiences
Authors: Bastiaansen Marcel , Duerden Mat D.
Published: December 2024

Despite increased interest in experience and experience design in hospitality, tourism, and leisure, the field remains emergent. For experience design to mature in research and practice, clear consensus conceptualization of key constructs, like memorable, meaningful, and transformative experiences, is needed. While existing research identifies emotions as the key to memorable experiences, more conceptual work is needed to understand the unique impact and process behind meaningful experiences. This paper proposes an expanded conceptualization of the impact and process associated with meaningful experiences. We suggest that as individuals reflect on existing experiential (i.e., autobiographical) memories, they can extract insight from those memories. If any of the extracted insights connect with core sources of meaning, then the individuals perceive their experience as meaningful. Suggestions for potential strategies to design for meaningful experiences are also shared.
A Behavioral Microeconomics Model Of Tourist Destination Choice Under Loss Aversion
Authors: Boto-García David , Balado-Naves Roberto , Suárez-Fernández Sara
Published: December 2024

This paper offers a theoretical and empirical characterization of destination choice under risk perceptions with loss averse individuals. We develop a novel theoretical model that extends the traditional microeconomic theory of destination choice by incorporating reference-dependent preferences, particularly loss aversion. Within a random utility formulation, our model predicts that subjective threat perceptions diminish the likelihood of choosing destinations prone to terrorism, triggering spatial substitution effects across regions. To empirically validate our model, we leverage the occurrence of the Jihadist terrorist attacks in Barcelona in August 2017 as a natural experiment to estimate the elasticities of substitution between Spanish destinations. Using monthly microdata on domestic tourist destination choices between August 2016 and December 2018 by 69,440 individuals, we found that the probability of traveling to Catalonia decreased by 0.575 percentage points following the attack, which led to significant market reallocation effects towards the regions of Valencia and Andalusia.
Dynamics of phonetic-level language control in language switching with a letter-naming paradigm
Authors: Zhang Yong , Ji Feng , Li Ya , Yue Chang , Guo Huan , Damian Markus F.
Published: December 2024

Aims:

How bilinguals control multiple languages is the object of intense recent scientific debate. Empirical research on language control at various linguistic levels has remained scarce, with language control at the phonetic level particularly underexplored. The present study aimed to examine the dynamics of phonetic-level language control during speech production.

Design:

Chinese-English-German speakers named the letter of the alphabet in English (L2) or German (L3), either in single-language blocks or in alternate-language mixed blocks. Letters vary regarding how phonetically similar pronunciation is across the two languages, hence allowing to explore cross-language phonetic influences.

Data and analysis:

Three-way repeated-measures analysis of variance (ANOVA) with trial type (non-switch vs. single-language for mixing costs; non-switch vs. switch for switch costs), response language (English/L2 vs. German/L3), and phonetic similarity (similar vs. neutral vs. different) as variables were conducted on 52 subjects’ response times and accuracy for mixing costs and switch costs, respectively.

Findings:

Results showed substantial mixing and switch costs, as well as a “reversed language dominance” effect, suggesting inhibitory control in response to cross-language phonetic interference. Cross-language facilitation was observed for phonetically similar letters, and mixing/switch costs were modulated by phonetic similarity in a complex pattern.

Originality:

The findings show a complex interplay of suppression (e.g., as indexed by switch costs) and facilitation (i.e., the effect of phonetic similarity between letter translation equivalents).

Significance:

The evidence for cross-language phonetic interference as well as facilitation effects at local and global levels of control implies a dynamic interaction between the two phonetic systems.
Sociomaterial production of parents’ positions in the ECEC institution
Authors: Järventausta Eeva , Paananen Maiju , Karila Kirsti , Tammelin Mia
Published: December 2024

Much of the discussion about parents’ positions in the early childhood education and care (ECEC) institution relates to the discussion of ECEC quality, in which parental involvement is a key factor. This article suggests that focusing on the sociomaterial nature of the reality, including quality, will help to furnish a more nuanced view of how parents’ positions within the ECEC institution are shaped. The concept of assemblage is used as a tool to examine how parents’ positions are produced in interaction between situational social, symbolic, and material elements related to local ways of organizing ECEC and families’ situations. The research material consists of interviews with parents of four-year-old (n=51) children. The analysis focused on the parents’ varying positions and how they are produced in sociomaterial assemblages. Four case families, each of which illuminates how a certain position within the ECEC institution is produced, were chosen to demonstrate the usefulness of the concept of assemblage in understanding the productive force of the interlinkage between families’ varying life circumstances and local ways of organizing ECEC. As a result, the opportunities for families to be part of the decision-making related to the organization of ECEC can vary greatly.
Visible activities, invisible children: Preschool digital communication in Sweden
Authors: Wahlgren Catarina
Published: December 2024

Digitalisation has changed communications dramatically over the last 20 years. This has entailed that preschool documentation of children and their activities, previously communicated with enrolled families, have become part of a mass distribution of social images. Thereby photographs, which initially aimed to involve the families in their children's education, are made visible to larger groups in society. This article examines digitally circulated photographs from three preschools in Sweden and, using critical image analyses, relates them to visibility, transparency and participation. The results show that digitally circulated photographs mediate a normative image of a universal preschool child, where the extended visibility of the preschool does not seem to make children's different interests, characteristics and standpoints visible. In fact, the children themselves are, in order to protect them, almost made invisible in the photographs. The discussion of this article concerns the ethics of a mass distribution of images where children are portrayed as a uniform group, and raises the fact that children become dependent on adults to interact with the photographs. Aims of marketing seem to become superior to aims of involvement, and preschools are able to tailor their communications to reach certain audiences. Thereby digital communication seems to contribute to increasing rather than decreasing inequalities among children.
The threat within: Power dynamics impeding cross-border journalism practice–perspectives from African investigators
Authors: Meyer Ruona
Published: December 2024

This paper reveals incidents of episodic and systemic power that threaten fully virtual, remote collaboration between African investigative journalists (AJs) and their colleagues in Global North countries. Safety is conceptualized as journalists’ ability to surmount threats sparked by occupational power structures unique to cross-border journalism. The workplace is the digitally mediated, often temporal space where socialized media enables journalists co-produce and distribute investigative reports. Interviews with 25 journalists across west and southern Africa showed that tension within virtual teams causes: disagreements over media cultures and wages; downplaying of risks; de-prioritization of cultural norms and disparities in access to funding. The resulting consequences affected journalists’ psychological, financial, and physical safety during, and beyond collaboration. Respondents coped by Compliance or Avoidance, exiting their teams or leaving investigative journalism in general. Awareness of technology-based inequity, cultural norms concerning mental health, and agile appraisal of threats are recommendations for journalists and donors. By adapting organisational Sources of Power theory to virtual workplaces, this study specifies the work routines and conditions that cause colleague-based threats during cross-border journalism work. The creation of a new power category for assessing breaches of cultural norms is a modest contribution towards understanding power asymmetries within transnational investigations mainly funded by and consumed in non-African countries.
Slowing the Churn: What’s Really Behind Superintendent Turnover in Ellington City School District?
Authors: Joseph Shawn , Scott Stacy L.
Published: December 2024

This case describes the atypically high churn rate of superintendents in Ellington City School District from 2011 to 2022. The case explores the tenures and controversies of four superintendents: Norris, Larkin, Martinez, and Hall (all pseudonyms). Detailing allegations of employee mistreatment, racism, sexism, and school board secrecy, this case raises several questions: How does a superintendent or school board address racial tension in a school district? What factors hinder superintendents from leading effectively? What is the role of the school board, and how are board members held accountable for their actions?
Does school leadership affect teacher work engagement in Turkish schools? Investigating the mediating effect of teacher job satisfaction: A multilevel structural equation modelling analysis
Authors: Ersan Albayrak Elanur , Dinç Berrenur , Hacımustafaoğlu Demet , Özdemir Murat
Published: December 2024

Emerging research highlights the central role of leadership in the effectiveness of Turkish schools, particularly in influencing teacher engagement, a key factor in achieving better school outcomes. This study investigated how and under what conditions school leadership is beneficial for teachers’ work engagement using data collected from 368 public secondary school teachers in Turkey. A model was developed to explore the direct and indirect relationships among school leadership, teacher job satisfaction, and work engagement, and it was tested at both the teacher and school levels. A multilevel structural equation model analysis was used to test the developed model. The results indicated that school leadership has a significant impact on teachers’ job engagement, regardless of the school where they work. Furthermore, job satisfaction played a mediating role in the relationship between school leadership and work engagement at both levels. The effect of school leadership on teachers’ work engagement at both levels occurs on the condition that job satisfaction acts as a mediator. This result makes a valuable contribution to the existing literature. Based on the results of the study, we also offer some suggestions for policy makers and school leaders to increase teacher work engagement by emphasising teacher job satisfaction.
Do Green Spaces Mitigate Mental Health Disorders in Tehran? Evidence from 358 Neighborhoods
Authors: Shahabi Shahmiri Mojtaba , Boujari Pouria , Sadat Fazeli Dehkordi Zeynab , Khatami Seyed Mahdi
Published: December 2024

Background

With a prevalence of mental disorders affecting 18 out of every 100 Iranians and a rising urban population, it is crucial to examine the impact of built environments on people's well-being.

Objective

While some studies have conducted individual-level surveys in Iran, this research aims to investigate the potential impact of green spaces on mental health at the neighborhood level in Tehran.

Method

Using secondary data from 358 neighborhoods in Tehran in 2011, a linear regression analysis was conducted to investigate the correlation between four green space indicators and three mental health metrics.

Results

The results indicate that green space indicators have the potential to mitigate mental disorders in Tehran, with accessibility to green spaces emerging as the most impactful factor among those studied on mental disorders and anxiety. However, no significant association was found with depression when considering intervening variables. The study also found that other green space indicators, such as the ratio of green space in neighborhoods and satisfaction with green spaces, did not show significant effects, underscoring the importance of accessibility over size or quantity of green spaces per person. Additionally, our findings suggest that higher levels of unemployment in neighborhoods have a more pronounced impact on mental disorders among sociodemographic factors.

Conclusion

Urban planners and designers should prioritize equitable access to green spaces within neighborhoods, rather than focusing solely on size or per capita availability. Additionally, policymakers should recognize that addressing both environmental and socioeconomic factors—rather than just one–can effectively alleviate residents’ mental health issues.
Diagnostic challenges in pediatric arthritis: A case of systemic juvenile idiopathic arthritis misdiagnosed as septic arthritis in a 3-year-old boy
Authors: Alesaeidi Sogol , Jari Mohsen
Published: December 2024

Arthritis in children has several causes, including infectious, inflammatory, and infiltration of malignant cells, and it is important to differentiate them as soon as possible. We present the case of a 3-year-old boy who was initially diagnosed with septic arthritis secondary to joint pain, swelling, and high fever. Despite appropriate antibiotic therapy, the patient’s symptoms persisted, leading to an eventual diagnosis of systemic juvenile idiopathic arthritis (sJIA). This case highlights the importance of distinguishing between septic arthritis and sJIA because early misdiagnosis can lead to delayed treatment and potential complications.
User-centered design and development of a web-based tool to support healthy feeding practices by parents of urban minority youth at risk for childhood obesity
Authors: Mateo Katrina F , Vilme Helene , Verdaguer Sandra , Fuqua Abigail , Hoyt Kris , Davis Jacquelyn , Leung May May
Published: December 2024

Objectives

Technology, mobile health (mHealth), and “eHealth” are broadly used in childhood overweight and obesity interventions. However, the impact of technology-based interventions where parents or caregivers are involved is unclear. Thus, the objective of this manuscript is to provide valuable insights about the development of a parent–child web-based tool to promote healthy eating among preadolescents.

Methods

The tool development was an iterative process and comprised of two phases. In Phase 1, formative research (focus groups and interviews) were conducted with parents of children around the topics of dietary behaviors, technology use, and proposed intervention components. In Phase 2, a brief survey, focus groups, interviews, and user-centered approaches were used to confirm/finalize content, assess the website wireframe, and conduct usability testing.

Results

From the Phase 1 formative research, parents preferred reading/looking up health-related information on larger laptop/tablet screens, but preferred smartphones when reading “on-the-go.” Suggestions for an online health tool included quick/easy/low-cost recipes, tips for healthy feeding and involving their children around healthy dietary-related behaviors, clear tool navigation, and using pictures/visuals. In Phase 2, when finalizing the tool wireframe and content, parents preferred a variety of motivational healthy feeding tips, local family-oriented community events, and a simple layout with minimal clicking to access links. During usability testing, parents responded positively to the content (healthy feeding tips, recipes, coupons, and free community events) and the clean layout.

Conclusions

Formative research and user-centered approaches with parents of preadolescents resulted in a web-based, mobile-friendly health promotion tool.
Decreasing Incidence of Youth Wrestling Injuries: A 10-Year Analysis of National Injury Data
Authors: Snyder Eli M. , Obana Kyle K. , Abdelaziz Abed , Parisien Robert L. , Ahmad Christopher S. , Popkin Charles A. , Trofa David P.
Published: December 2024

Background:

Wrestling is among the most common youth sports in the United States, with about 260,000 high school participants annually. There is a lack of literature investigating wrestling injury profiles and mechanisms of injuries. In the past 15 years, urgent care utilization has increased, and National Federation of State High School Associations (NFHS) concussion protocols have been developed and implemented.

Purpose/Hypothesis:

The purpose of this study was to analyze causes, diagnoses, body parts, and trends associated with wrestling injuries presenting to US emergency departments. It was hypothesized that there would be (1) decreased overall injuries presenting to emergency departments because of increased urgent care utilization and (2) decreased concussions because of the NFHS rule implementation and revision.

Study Design:

Descriptive epidemiology study; Level of evidence, 3.

Methods:

Youth wrestling injuries presenting to US emergency departments between January 1, 2013, and December 31, 2022, were queried from the National Electronic Injury Surveillance System database. The data included date of presentation, age, sex, race, body part, injury diagnosis, disposition, and a brief injury narrative. National estimates (NE) were calculated using the associated statistical weight of the reporting hospital. Linear regressions were performed to investigate the relationship between year and NE for overall injuries, diagnoses, body parts, mechanisms of injury, and other subanalyses. Statistical significance was set at P < .05.

Results:

A total of 8628 (NE = 296,502) wrestling injuries met the inclusion criteria for this study. The mean age at presentation was 14.3 ± 2.6 years (range, 3 to 18 years). The shoulder (NE = 43,207 [14.6%]), head (NE = 40,875 [13.8%]), and knee (NE = 30,218 [10.2%]) were the most injured body parts. The most common diagnoses were strain/sprain (NE = 91,924 [31%]), other/not stated (NE = 53,736 [18.1%]), and fracture (NE = 52,261 [17.6%]). Common mechanisms of injury included not specified (NE = 148,169 [50%]), impact with mat (NE = 61,557 [20.8%]), and abnormal rotation/strain (NE = 37,449 [12.6%]). Overall injuries ( P = .01) (coefficient: –1763 [95% CI, –2963 to −563]) and concussions ( P = .01) (coefficient: –178 [95% CI, –302 to −55]) statistically significantly decreased.

Conclusions:

Our study showed a trend in the decrease in overall injuries and concussions in high school wrestlers. Strains/sprains were the most common diagnoses with the shoulder being the most common site. Youth wrestlers would benefit from future research analyzing risks associated with these injuries as well as advances in protective gear.
Patient Engagement in Evidence-Based Practice Frameworks
Authors: Dusin Jarrod , Peltzer Jill
Published: December 2024

Evidence-based practice (EBP) is the cornerstone of contemporary healthcare, promoting the integration of scientific evidence, clinical expertise, and patient values to inform clinical decision-making and enhance patient outcomes. While patient engagement is recognized as a critical component of EBP, the extent to which it is incorporated in various EBP frameworks is unclear. This study is a secondary analysis of a scoping review which evaluated EBP frameworks used in healthcare settings. In the current study, our objective was to assess the level of patient engagement within those frameworks. To achieve this, we employed a patient engagement framework which characterizes engagement as a continuum, spanning consultation to involvement to shared leadership/partnership, across 3 healthcare domains: direct care, organizational design and governance, and policymaking. Our analysis revealed a gap in integrating patient values and preferences within EBP frameworks. Only 3 of the assessed frameworks showed a high degree of engagement across all domains. Future research should focus on developing strategies for implementing and evaluating meaningful engagement in EBP.
A semiautomatic multi criteria method for mineral resources classification
Authors: Hernández Heber
Published: December 2024

Mineral resources are classified as measured, indicated, or inferred based on the geological confidence derived from estimation results and the quality and quantity of available data. In the mining industry, there are numerous accepted criteria for this classification. The selection and combination of these criteria, determined through arbitrary decision rules, depend on the characteristics of each project and are the responsibility of a qualified person. The problem with the current methodology is that the same data, using the same criteria, can yield different results depending on the person analyzing them. This contradicts the need for objectivity in the classification process, creates uncertainty in decision-making, and diminishes investor confidence. This article presents an innovative methodology for mineral resource classification using machine learning, which complements the work of the qualified person, reduces time costs, decreases subjectivity, and simplifies the reproducibility and auditability of the process, aligning with the fundamental principles of classification. The proposed methodology consists of three stages: first, classification criteria are selected, recording variables block by block. Then, blocks are grouped by similarity using the k-prototypes algorithm. Finally, the blocks are smoothed using a multilayer neural network to correct the "spotted dog" effect. This methodology is applied in two cases: a porphyry copper model and a high-sulfidation gold deposit in southern Peru. The results obtained reflect the fundamental principles of classification: transparency, objectivity, reproducibility, and auditability based on quantifiable principles. Additionally, the methodology ensures results consistent with the utilized characteristics, imposes no restriction on the acceptability of any type of input information, reduces time costs, and limits human intervention.
Geological and Structural Controls on Marble Quarrying and Aesthetic Patterns: Espírito Santo State (Brazil)
Authors: Hartwig M.E. , Pinheiro V.S. , Fardim B.R. , Lemos R.B. , Santos J.C. , Grou J.V.
Published: December 2024

The purpose of this study was the geological characterization of Pit 9 quarry, located in the district of Itaoca, State of Espírito Santo (Brazil). The methodology integrates petrographic, mineralogical, and structural studies. Different types of brittle and ductile structures were surveyed. Structural data were collected at one-meter intervals at the base of the rock slopes, serving as the basis for developing conceptual 3D geological models. Three varieties of marble were identified: calcite, dolomite, and banded. The metamorphic banding is heterogeneous and discontinuous, varying from centimeters to meters in thickness. Its mineralogy consists of carbonates, tremolite, and diopside. The metamorphic banding may also contain disintegrable schistose lenses rich in phlogopite, with a modal attitude of 122/52. Two folding phases were identified, consistent with those described regionally. The marbles are cut by granite and metamafic dikes. These bodies exhibit thin halos of contact metamorphism. Thick felsic dikes cause fracturing of the surrounding rock. At the investigated mining level, the rock mass is poorly fractured and fissures, and non-persistent, tight joints predominate. It can be concluded that the varieties of marble are controlled by the folding pattern, and the intrusive igneous rocks generally degrade rock quality by compromising block physical integrity.
Azacytidine Plus PD-1 Therapy in Relapsed or Refractory Hodgkin Lymphoma
Authors: Qian Liren , Zhu Haiyan , Liu Yu , Ding Mingshuang , Bumbea Horia , Tomuleasa Ciprian
Published: December 2024

Background: The treatment of relapsed or refractory (R/R) Hodgkin lymphoma (HL) remains challenging. Azacitidine has been demonstrated enhancing PD-1 expression in vivo. The aim of this study is to evaluate the safety and efficacy of azacitidine when given together with PD-1 therapy(AP) in treating patients with relapsed/refractory classic Hodgkin lymphoma.

Methods: Adult patients with R/R HL who had progressed after at least 1 prior line of therapy were enrolled to receive Azacytidine(75 mg/m2 qd on days 1-7) plus PD-1 therapy(200mg qd on day 8). Treatment continued until disease progression or unacceptable toxicity occurred post CR. Patients discontinue treatment after 2 years of sustained CR (NCT06190067).

Results: 2 patients with R/R HL were enrolled. Patient 1 received complete remission after two cycles of ABVD, but relapsed after six cycles of ABVD. Patient 1 then received complete remission again after four cycles of DP（Decitabine pus PD-1 therapy）, but relapsed again after six cycles of DP. Then, the patient received complete remission the third time after 3 cycles of AP and received AP maintenance therapy. The patient is still in complete remission until now (8 months). Patient 2 received partial remission after two cycles of ABVD，but progressed after four cycles of ABVD. Patient 2 received complete remission after 3 cycles of AP and received AP maintenance therapy. The patient is still in complete remission until now (9 months).

Conclusion: This study found that the AP regimen was effective and safe in patients with R/R HL after multiline therapy. Surprisingly, in the patient who relapsed after demethylated drug decitabine plus PD-1 therapy, AP regimen also showed a better response. More R/R HL patients need to be enrolled and further prospective studies were warranted.
Enhancing Quality of Life in Myeloproliferative Neoplasms: Insights from Janus Kinase Inhibitors-a Comprehensive Review and Meta-Analysis
Authors: Shahzad Moazzam , Noor Jawad , Dave Prashil , Khalid Muhammad Fareed , Zaidi Maheen , Goyal Shriya , Naeem Ammad , Mir Waleed Ahmed , Anwar Iqra , Amin Muhammad Kashif , Jaglal Michael V. , Ammad Ud Din Mohammad , Mohammad Turab , Faisal Muhammad Salman
Published: December 2024

Background

Patients with myeloproliferative neoplasms (MPN) are known to have a high symptomatic burden, impairing quality of life. While JAK inhibitors (JAKi) have been the therapeutic backbone for the treatment of MPN, only a few studies have focused on quality of life (QoL) aspects. This meta-analysis aims to explore the effects of JAKi on QOL in MPN.

Methods

Following PRISMA guidelines, PubMed, Cochrane Register of Controlled Trials, and Clinicaltrials.gov were searched using MeSH terms and keywords for “Myeloproliferative Disorder”, “Quality of Life”, and “Janus Kinase Inhibitors” from the date of inception to January 31, 2024. 17 out of 129 articles reporting QoL with the use of JAKi in MPN patients were included. The inter-study variance was calculated using the Der Simonian-Laird Estimator. Proportions along with a 95% confidence interval (CI) were extracted to compute pooled analysis using the “meta” package by Schwarzer et al. in the R programming language (version 4.16-2).

Results

A total of 2136 patients were included for analysis. The median age was 64.9 (26-90) years and 57.2% (1175-2055) were male. The median follow-up time was 6.5 (6-67) months. Most patients had MF 70.6%, followed by PV 17.6% (3/17), while ruxolitinib was the most commonly used JAKi 41.2%, followed by Momelotinib 23.5%, Pacritinib 11.7%, Fedratinib 17.6%, and Gandotinib 6%. The most commonly used questionnaire to assess for QoL was EORTC QLQ-C30, 41.2%. The mean percentage change in baseline score for fatigue, insomnia, and appetite loss was -8.2,-12.1, and -5.7, respectively. MPNSAF TSS was the most commonly used questionnaire to assess symptom score 88.2%. The pooled ≥50% symptoms improvement was 40.3% (95% CI 0.32-0.49, I2=85%, p< 0.01 n=960), while the pooled spleen response, defined as at least a 35% reduction in spleen volume, was 29.1% (95% CI 0.21-0.38, I2=92%,p< 0.01 n=1664). Anemia 31%, diarrhea 29.5%, thrombocytopenia 21.6%, and nausea 13.7% were the most commonly reported side effects, with a mortality rate of 10.7%.

Conclusions

This analysis shows symptomatic improvement as well as better QoL with JAKi in MPN patients. However, further randomized studies are needed to better delineate these findings and establish guidelines.
Fluconazole Prophylaxis Significantly Reduce High Risk Invasive Fungal Infection in Immunocompromised Patients Stratified By a Risk Prediction Model
Authors: Ma Jiexian , Ma Xinyuan , Zuo Xinyu , Shen Shuhong
Published: December 2024

Abstract:

Background: Patients on immunosuppressive drugs or those who are critically ill are at high risk for invasive fungal infections (IFIs). The assessment of IFI risk and the initiation of prophylaxis in these patients remain unclear.

Methods: A Nomogram model was developed to evaluate humoral and cellular immune indicators in relation to IFI risk. High-risk patients, as identified by the model, were selected for a prospective, randomized study to assess the efficacy and safety of fluconazole prophylaxis. Patients deemed high risk received either fluconazole prophylaxis or a placebo until IFI occurrence or risk downgrade for up to 90 days. We compared the incidence of IFI and mortality during treatment between the two groups.

Results: The Nomogram, created from a training cohort (n=384), included age, IgG level, and CD4+ cells count as predictive indicators of IFI, was validated in a separate cohort (n=281) with an area under the curve of 0.723. A total of 266 patients were recruited for the prospective study, with 158 high-risk patients randomly assigned to receive either fluconazole (n=78) or a placebo (n=80). Proven or probable IFI was reported in 8 patients in the fluconazole group and 39 patients in the placebo group (p=0.00). High risk IFI could be reduced to the low risk level with fluconazole prophylaxis. There was no significant difference in survival between the fluconazole and placebo groups (P=0.34). Adverse events potentially related to treatment were reported by 4 patients (4.9%) in the fluconazole group.

Conclusions: This nomogram model effectively and reliably predicts the risk of IFI in immunocompromised patients. Fluconazole prophylaxis significantly reduces the incidence of IFI, particularly yeast infections, and may help to prevent fungal colonization. (ChiCTR2400079810.)
The Burden of Cardiovascular-Related Mortality in Early-Onset Acute Myeloid Leukemia
Authors: Akpan Inemesit , Oluwadeyi Esther Yemisi , Sanni Abdulsabur , Igbenabor Christiana Aina , Gold-Olufadi Shakirat , Ilerhunmwuwa Nosakhare Paul
Published: December 2024

Introduction

Acute myeloid leukemia (AML) is an aggressive hematological malignancy that is rare in individuals under 50 years old (early-onset AML) even though it constitutes approximately one-third of leukemia cases in adults. Cardiovascular-related death (CVD) remains a prevalent cause of mortality in the older population with AML. The epidemiology of CVD in individuals with early-onset AML is not well understood. This study examines the trends of CVD in early-onset AML compared to older individuals with the disease.

Method

Cases of AML diagnosed in individuals aged 15 years and older between 2000 and 2020 were extracted from the Surveillance, Epidemiology, and End Results (SEER) Research Plus Data 17 Registries. Descriptive statistics of sex and race were compared between early-onset AML (15-49 years) and adult-onset AML (diagnosed at age 50 years and older). Standardized mortality ratio (SMR), age-standardized incidence-based mortality rates (ASMR), and annual percentage change (APC) were used to compare mortality trends.

Results

A total of 70,824 patients with AML were diagnosed between 2000 and 2020. Early-onset AML accounted for 13,096 cases (18.5%). Among these, 1,966 patients (3.5%) died from cardiovascular diseases, with 129 deaths occurring in those with early-onset AML (6.6% vs. 93.4% in adult-onset AML). Among those with early-onset AML who died from CVD, the racial distribution was as follows: White individuals accounted for 72 deaths (55.8% vs. 75.2% in adult-onset AML), Black individuals - 25 deaths (19.4% vs. 8.1% in adult-onset AML), Hispanic individuals - 21 deaths (16.3% vs. 8.98% in adult-onset AML), Asian individuals - 10 deaths (7.75% vs. 7.13% in adult-onset AML), and Native Americans accounted for 1 death (0.775% vs. 0.44% in adult-onset AML).

The SMR for early-onset AML was higher compared to adult-onset AML (3.00 [2.47-3.63] vs. 2.71 [2.56-2.87]).

From 2000 to 2020, the overall ASMR in early-onset AML increased more significantly compared to adult-onset AML (APC, 4.60% [0.99 to 9.41] vs. 2.40% [1.42 to 3.54]). The increase in ASMR among early-onset AML was more pronounced in males compared to females (APC, 2.71% [1.18 to 4.26] vs. 2.07% [0.66 to 3.49]), and higher in non-Hispanic Blacks compared to non-Hispanic Whites (APC, 3.76% [1.28 to 6.30] vs. 2.85% [1.70 to 4.01]). There was no significant change among other racial groups.

Conclusion

Although AML is uncommon in individuals under 50 years old, the rate of CVD mortality is rising faster in younger AML patients compared to older individuals with the disease, who are traditionally more predisposed to cardiovascular conditions. High surveillance for the onset of cardiovascular disease should be maintained in young people with AML to address this rising issue.
Single-Cell Multi-Omics Analysis Reveals Autologous Stem Cell Chemo-Mobilization with Etoposide +Cytarabine Plus G-CSF in Multiple Myeloma
Authors: Zhu Zhijuan , Zhu Jiali , Li Xiaofan , Zhu Ming , Dai Jinxian , Huang Jialiang , Li Nainong
Published: December 2024

Introductions: We previously reported that autologous stem cell chem-mobilization with Etoposide +Cytarabine (EA) plus G-CSF was highly effective and safe for patients with multiple myeloma (MM). However, the state of mobilized CD34+ peripheral blood stem cells (PBSCs) and molecular mechanisms underlying its high-efficiency mobilization remain unknown.

Methods: Here, we employed matched single-cell transcriptome and chromatin accessibility sequencing to profile CD34+PBSCs of patients with MM(n=12) mobilized with EA+ G-CSF (n = 9), plerixafor + G-CSF (n = 3), along with healthy allo-donors (n = 5) mobilized with G-CSF. In addition, we integrated single-cell transcriptomic data with public CXCR4 inhibitors or G-CSF mobilized PBSC transcriptomic data to obtain a comprehensive map of seven mobilization strategies.

Results: The integrated map showed the alterations in the transcriptional landscape of mobilized PBSCs among mobilization strategies, revealing that EA plus G-CSF mobilized a higher fraction of hematopoietic stem cells (HSCs) and promoted a bias towards lymphoid differentiation compared to CXCR4 inhibitor and G-CSF. Meanwhile, CD34+ hematopoietic stem progenitor cells (HSPCs) mobilized by EA+G-CSF exhibited a higher proliferation capacity. We also explored the cellular and molecular basis of the high mobilization efficiency of CD34+ HSPCs by EA plus G-CSF in MM. Interestingly, we found that EA plus G-CSF mobilized CD34+ HSPCs exhibited significantly higher potential for cytarabine resistance, along with increased activity in the G-CSF signaling pathway and inflammatory response. The positive correlation between these three pathways suggested that chemotherapeutic agents may induce the endogenous G-CSF signaling pathway. Additionally, the JAK-STAT signaling pathway, which acts as a cross-talk mechanism between the G-CSF signaling pathway and the inflammatory response, also showed enhanced activity. Finally, we proposed the hypothesis of EA+G-CSF mobilization, suggesting that chemotherapeutic drug-induced changes in gene expression can either enhance (via the G-CSF pathway, RAC2, and ITGA4) or complement (via EGR1) the G-CSF mobilization process.

Conclusion: EA plus G-CSF mobilized a significantly higher fraction of CD34+ HSPCs favoring the lymphoid as well as proliferative capacity. EA-induced transcriptional changes might promote or complement G-CSF mobilization process to enhance PBSC mobilization efficacy in MM.