bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Care Management of Acute Pulmonary Embolism
Authors: Yuriditsky Eugene , Lyhne Mads Dam , Horowitz James M. , Dudzinski David M.
Published: January 2025

The unprimed right ventricle is exquisitely sensitive to acute elevations in afterload. High pulmonary vascular tone incurred with acute pulmonary embolism has the potential to induce obstructive shock and circulatory collapse. While emergent pulmonary reperfusion is essential in severe circumstances, an important subset of pulmonary embolism patients may exhibit a less extreme presentation posing a management dilemma. As intensive care therapies have the potential to both salvage and harm the failing right ventricle, a keen understanding of the pathophysiology is requisite in the care of the contemporary patient with hemodynamically significant pulmonary embolism. Here, we review right ventricular pathophysiology, an approach to risk stratification, and offer guidance on the medical and mechanical supportive and therapeutic strategies for the critically ill patient with acute pulmonary embolism.
Artificial neural network-based predictive models for analyzing the flexural and compressive strength of PLA/carbon parts fabricated via material extrusion-based 3D printing
Authors: Mishra Vishal , Veeman Dhinakaran
Published: January 2025

This study focuses on material extrusion-based (MEX) 3D printing of PLA reinforced with milled carbon fiber composite using the fused deposition modeling technique, structured through an L16 orthogonal array design. The effects of key 3D printing input parameters (print temperature, layer thickness, infill pattern, and print speed) on flexural and compressive properties were recorded, including flexural force and stress and compressive force and stress. Levenberg-Marquardt (LM) and Scaled Conjugate Gradient (SCG) algorithm was developed to predict and evaluate the accuracy of the experiment. Regression analysis showed strong correlation between predicted and actual values, with LM recoding R-squared values of 0.99,983, 0.9809, and 0.98,968 for training, validation, and testing, respectively and 0.99,446, 0.98,119, and 0.98,876 for the SCG model. Both models effectively captured the relationships between input parameters and fracture toughness, with overall R-squared values of 0.99,506 for LM and 0.98,863 for SCG, indicating robust predictive performance across all datasets.
A novel numerical approach to elucidate experimental scatter in portal pressure measurement using ultrasound contrast agent
Authors: Palani Senthil Kumar , Rangarajan Srinivasan Echchur , Thittai Arun K. , Ramarathnam Krishna Kumar
Published: January 2025

The use of ultrasound contrast agents (UCAs) for estimating portal pressure has recently gained attention due to its clinical promise, yet variability in acoustic amplitude poses challenges. UCAs contain microbubbles (1–10 µm in diameter), and understanding their acoustic response is essential to address this variability. However, systematic exploration of factors influencing microbubble behavior remains limited in current literature. This paper introduces a novel finite element analysis-based framework for portal pressure estimation, bridging key gaps. Developed in two stages, the model first captures the subharmonic response of a single bubble to an acoustic excitation of 50 kPa at 4 MHz, highlighting the influence of bubble size on resonance frequency. In the second stage, single-bubble responses are extended to analyze how microbubble population, size, and spatial distribution affect portal pressure estimation. For the first time, this study elucidates the experimental scatter in pressure measurements through a comprehensive consideration of these variables, offering new directions for UCA-based clinical pressure estimation in applications such as portal and cardiac pressure assessment.
“Timing” Transitions or “Times” in Transition? Revisiting the Value of Time Suspension for Young People in Italy After the COVID-19 Pandemic
Authors: Cuzzocrea Valentina
Published: January 2025

Much has been written to address the increasing complexity of youth temporalities, especially through a focus on when adulthood is reached, an approach that informs the tradition of youth studies called “youth transitions.” This article discusses some of the shortcomings of this approach that were revealed during the global pandemic, through the social distancing measures that were put in place in response to it and how young people reacted to new imposed rhythms. The pandemic has predominantly been seen as a “suspension,” with implications in particular on two different temporal dimensions: on the one hand, young people have experienced profound changes in their everyday lives due to lockdown restrictions; and, on the other hand, at the biographical level, a search for alternative lifestyles has emerged, impacting on mid-term perspectives. These changes urge us to reconsider various phenomena of time suspension associated with youth, such as moratorium and waithood, paying attention to the value that young people attribute them. Borrowing from Flaherty’s work on time work, this article discusses various nuances of time suspensions that allow us to examine agency transformations during the pandemic. It does so by looking at a case study of young people in Italy, and how a disregard for the temporalities that are typical of value to youth appears to have taken place, based on documentary sources and qualitative material analyzed for a project called IANG. By reflecting on the changes in the ways of looking at young people during the pandemic, and zooming in on some rituals that were reworked due to lockdown restrictions such as the final school exam, I conclude that we should shift attention from “timing transitions,” to “times” in transition, and look more attentively at the meanings attributed to various forms of time suspension that make up youth through specific youth temporalities.
Impact of Tacrolimus, Sirolimus, Age, and Body Mass Index on the Occurrence of Skin Cancer and Islet Dysfunction After Transplantation
Authors: Orr Christopher , Stratton Jeannette , El-Shahawy Mohamed , Forouhar Elena , Peng Alice , Singh Gagandeep , Omori Keiko , Qi Meirigeng , Kandeel Fouad
Published: January 2025

Herein, we characterized the percentage of tacrolimus to the combined sirolimus and tacrolimus trough levels (tacrolimus %) observed during islet transplant-associated immune suppression therapy with post-transplant skin cancer. Although trough levels of tacrolimus and sirolimus were not different ( P = 0.79, 0.73, respectively), high tacrolimus % resulted in a 1.32-fold increase in skin cancer odds when adjusting for age, sex, body mass index (BMI), and use of mycopheonlate mofetil (MMF; p = 0.039). Skin cancer patients were likely to have been older but not differ significantly (mean difference 12 years, P = 0.056), but age was significantly associated with a 1.22-fold increase in adjusted skin cancer odds ( P = 0.046). BMI was inversely associated with skin cancer, with an adjusted odds ratio (OR) of 0.40 ( P = 0.022). High tacrolimus % (>35) resulted in a 4.6-fold increase in skin cancer frequency, whereas sirolimus above 75% of the combined therapy led to a 5.2-fold increase in islet graft dysfunction (IGD) events/year. By calculating the maximum safe exposure (MSE) to tacrolimus % according to patient age and BMI, we found that cumulative months spent above MSE was predictive of skin cancer (1.20-fold increase, P = 0.003). Individuals exceeding the MSE for 1 year were 9.2 times more likely to develop skin cancer ( P = 0.008). Results suggest that strategies targeting immunosuppression ratios based on age and BMI may minimize cancer risk while improving graft survival and function.
New Polysaccharides from Hygrophorus olivaceoalbus (HO-P) and Agrocybe aegerita  (AA-P) and their Biological Activities
Authors: Yang Tong , Zhao Hui , Ding Xiang , Hou Yiling
Published: January 2025

Background

Fungal polysaccharides are an essential active polymer compound in human cells. A clear understanding of the structure of polysaccharides is the foundation for conducting research and utilization of polysaccharides.

Purpose

To explore the structure and immunomodulatory activities of polysaccharides from Hygrophorus olivaceoalbus and Agrocybe aegerita.

Methods

High-performance liquid chromatography, high-performance gel-permeation chromatography, nuclear magnetic resonance, and gas chromatography–mass spectrometry analysis were utilized to analyze the structure of Hygrophorus olivaceoalbus polysaccharide (HO-P) and Agrocybe aegerita polysaccharide (AA-P). The immunomodulatory activities of these polysaccharides were also studied.

Results

The HO-P consisted of (1↓6)-Galp, (1↓4)-Glup, (↓1)-Glup, and (1↓4,6)-D-Manp with the ratio of mannose, galactose, and glucose being 1:1:2. The AA-P was consisted of (1↓4,6)-Glup, (1↓4)-Arap, and (1↓6)-Galp with the ratio of galactose, glucose, and arabinose being 3:2:1. AA-P and HO-P could both mainly by reducing G0/G1 phase, which leads to the significant proliferation of B cells and RAW264.7 cells, respectively. At the same time, AA-P and HO-P could significantly stimulate the necrosis factor-α secretion of T cells, IgA, IgD, IgE, IgG, and IgM secretion of B cells and tumor necrosis factor-α secretion of RAW264.7 cells, but neither of them could stimulate interleukin-1↓ secretion of RAW264.7 cells.

Conclusion

Due to its better branching degree, AA-P is more conducive to forming a triple-helix, three-dimensional configuration, as well as better solubility and smaller molecular weight, thus exhibiting higher biological immune activity against immune cells than HO-P.
Do Racial Differences Exist for Vocational Rehabilitation Applicants with Schizophrenia? A Propensity Score Matched Case-Control Study
Authors: Chan Fong , Iwanaga Kanako , Kaya Cahit , Rumrill Phillip , Bezyak Jill , Wu Jia Rung , Chen Xiangli , Zapata Patricia
Published: January 2025

Background

The COVID-19 pandemic and the Black Lives Matter movement revealed American society's unconscious bias and systemic discrimination against Black/African Americans and other minority groups, including people with disabilities. These disparities are particularly pronounced for individuals with intersecting identities, such as race, gender, disability, and poverty, leading to racism and ableism.

Method

This case-control study investigated racial disparities in acceptance rates for state vocational rehabilitation (VR) services among applicants with schizophrenia. Utilizing the U.S. Department of Education Rehabilitation Services Administration (RSA-911) dataset for the program year 2018, we compared acceptance rates between Black/African American and White American VR applicants with schizophrenia. Propensity score matching (PSM) was performed to create a White applicant with schizophrenia (control, n = 2,971) group and a black applicant with schizophrenia (treatment, n = 2,971) group with similar demographic characteristics to control selection bias.

Results

Our findings indicated no significant difference in VR acceptance rates between the two groups: 73.7% for Black/African Americans with schizophrenia and 72.4% for White Americans with schizophrenia.

Conclusions

This outcome contrasts with previous studies that suggest racial bias still exist in state VR services. Our findings may indicate that, when selection bias is controlled, acceptance rates for VR services between White Americans and Black/African Americans with disabilities may be comparable. This study contributes to the ongoing dialogue on racial equity in disability services, and it presents an alternative research method for conducting racial difference studies in VR.
Adapting Individual Placement and Support for Unemployed Adults with Autism Spectrum Disorder
Authors: Florence Ana Carolina , Elwyn Glyn , Mueser Kim T. , McGurk Susan R. , Liebmann Edward P. , McLaren Jennifer L. , Drake Robert E.
Published: January 2025

Background

Employment benefits adults with autism spectrum disorder (ASD) in many ways, yet unemployment remains high. Existing interventions use predominantly “train-place” methods, emphasizing pre-employment training before competitive employment. As an alternative, Individual Placement and Support is a “place-train” model, originally developed for people with serious mental illness, that is rapidly spreading to new populations, including adults with ASD. Adaptations to evidence-based interventions for new groups should receive scientific validation.

Objective

This article outlines the scientific steps to adapt Individual Placement and Support to serve the needs of adults with ASD.

Methods

The authors describe a scientific approach to developing, implementing, studying, and disseminating Individual Placement and Support to adults with ASD.

Results

A five-step approach to adapting Individual Placement and Support to adults with ASD includes 1) Involving stakeholders; 2) Examining available data from different perspectives; 3) Conducting a pilot study to establish acceptance, feasibility, proximal and distal outcomes, and adaptations; 4) Conducting comparative effectiveness research; 5) Translating research to policy.

Conclusions

Evidence-based interventions can transfer usefully to new populations and settings, but the process should follow scientific methods. As an example, this article describes a scientific process for adapting Individual Placement and Support to adults with ASD.
Perspectives on the Lingering Effects of COVID-19 on the Employment and Quality of Life of People with Spinal Cord Injuries: Results of an Inclusive Community Conversation
Authors: LoBianco Anthony , Adams Chithra , Fitzpatrick Calisa
Published: January 2025

Background

Earlier research has focused on the immediate impacts of the COVID-19 pandemic on persons with Spinal Cord Injury (SCI).

Objective

The present study revisits lessons learned from the previous study and assesses the longer-term effects of the pandemic.

Methods

We used a community conversation method to inform our analysis. The themes examined include adapting to a “new normal” way of interacting with the world, employment, social isolation, and physical and mental health.

Results

We found that a person's ability to adapt to changing circumstances is a major predictor of how one will respond to the aftermath of a pandemic, and that this adaptability is heightened for persons with SCI.

Conclusion

Service providers, healthcare professionals, employers, and persons with SCI should be attuned to the impact of an individual's adaptation skills when dealing with long term societal social upheavals. This is particularly relevant for the SCI community, and continued inclusive research is necessary to understand these effects.
Sensitized-points acupuncture versus routine integrative acupuncture for chronic low back pain: A randomized-controlled feasibility study
Authors: Tan Huijuan , Tumilty Steve , Chapple Cathy , Huang Guangyi , Baxter G David
Published: January 2025

Background

Chronic low back pain (cLBP) is a global health complaint. Acupuncture is an effective therapy for cLBP; however, evidence for an optimal acupuncture practice scheme is limited.

Objective

This study aimed to determine the feasibility of conducting a randomized controlled trial (RCT) to assess the effectiveness of two acupuncture regimes (sensitized-points acupuncture and routine integrative acupuncture package) for cLBP.

Methods

This was a two-arm, assessor-blind, randomized-controlled feasibility study. Thirty adult participants with cLBP were randomly assigned into two groups. Each group received 8 sessions of either sensitized-points acupuncture or routine integrative acupuncture package, respectively. Treatments were conducted twice per week. Outcomes were assessed at baseline (week 0), on a weekly basis for four weeks (week 1, 2, 3, 4), and follow-up (week 12). Student's t-tests, Mann-Whitney U tests, Fisher's exact tests, descriptive analyses, and power analyses were used for statistics.

Results

Participants were recruited over 10 weeks with a recruitment rate of 12 participants per month. The treatment plan in both groups was well accepted and tolerated. Besides, the study was characterized by low adverse event rates (8.0% in Group A, 11.7% in Group B), high completion of the outcome measures (97.8% in Group A, 94.3% in Group B), and high participant retention rate (100% in Group A, 93.8% in Group B). Furthermore, preliminary analyses showed that both regimes of acupuncture were potentially efficacious and safe.

Conclusions

Conducting a fully powered RCT to evaluate efficacy and safety of two acupuncture regimes in the management of cLBP is feasible.
Clarifying the characteristics of interprofessional rehabilitation programs for adults with chronic low back pain: A scoping review
Authors: Wami Sintayehu Daba , Chala Mulugeta Bayisa , Wolde Sara Yirgalem , Donnelly Catherine , Gelaye Kassahun Alemu , Pullatayil Abdul , Adefris Esayas , Miller Jordan
Published: January 2025

Background

Interprofessional rehabilitation programs are recommended by practice guidelines based on their effectiveness in improving health-related quality of life, pain, and function for people with chronic low back pain (CLBP). However, the most appropriate program characteristics are poorly described in the literature.

Objective

This scoping review aimed to synthesize the characteristics of interprofessional rehabilitation programs for people living with CLBP.

Methods

The scoping review was guided by the framework developed by Arksey and O'Malley, which has been further enhanced by the Joanna Briggs Institute (JBI). Electronic databases, including Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, SCOPUS, PubMed, Web of Science, and Cochrane Library, were searched to identify relevant published studies.

Results

Out of 13370 articles identified through our search, seventy-nine studies fulfilled our eligibility criteria. In the majority of the studies (n = 75), interprofessional rehabilitation programs for people with CLBP consisted of two or more of the following interventions: physical activity and exercise (n = 68), education (n = 61), psychotherapy (n = 52), and vocational support/advice (n = 31). In a few studies describing the underlying theories, the biopsychosocial model, which emphasizes the need to address social, psychological, and physical components in the management of CLBP, was the most often cited theoretical framework.

Conclusion

There is substantial variation in how interprofessional rehabilitation programs for people with CLBP are conceptualized and evaluated. A detailed description of the intervention evaluated, and the underlying theoretical frameworks was also lacking in most studies. We recommend the use of a consistent term and components aligned with practice guidelines.
The effect of neuromuscular electrical stimulation superimposed on quadriceps training on gait dynamics after anterior cruciate ligament reconstruction
Authors: Li Shihao , Lu Bin , Zhang Yuanyuan , Liu Jun , Xu Weiguo , Li Qi
Published: January 2025

Background

Abnormal gait dynamics are an important risk factor responsible for the high incidence of traumatic knee osteoarthritis in patients undergoing anterior cruciate ligament (ACL) reconstruction.

Objective

To evaluate the effect of neuromuscular electrical stimulation (NMES) superimposed quadriceps training on gait dynamics.

Methods

A total of 32 postoperative patients were randomly allocated to the NMES and conventional training (CT) groups, with 16 patients per group. Patients in the CT group received the standardized conventional training for 60 min per day, 3 days per week for 6 weeks, while those in the NMES group received the same conventional training, but with NMES superimposed on the conventional open chain training of the quadriceps. The amount of time for training was equal between the two groups. Patients were evaluated at 8 and 14 weeks after surgery. The outcome measurements were maximum voluntary isometric contraction (MVIC) of the quadriceps used to assess the quadriceps strength, Lysholm score used to assess knee function and peak vertical ground reaction force (PvGRF), heel medial (HM) peak pressure and heel lateral (HL) peak pressure used to assess gait dynamics.

Results

Compared to the CT group, the NMES group had greater improvements in quadriceps strength (p<0.001, effect size = 2.93), knee function (p = 0.049, effect size = 2.06), and gait loading (including HL peak pressure (P = 0.007, effect size = 0.89) and PvGRF (P = 0.019, effect size = 0.62)). After the intervention, participants in both groups had a significantly lower rearfoot impulse and significantly higher forefoot impulse.

Conclusions

The NMES superimposed on conventional quadriceps open chain training has shown additional improvements in gait loading in patients after ACL reconstruction, which suggests it may contribute to delaying the onset of early postoperative traumatic knee osteoarthritis. In addition, changes in foot impulse may suggest a progressive trend in quadriceps avoidance gait in the early postoperative period.
Patients six months after arthroscopic rotator cuff repair exhibit increased thoracic kyphosis compared to healthy individuals despite standard rehabilitation protocol
Authors: Yazgan Dagli Beyza , Yilmaz Ayse Neriman , Dagli Ali Cihan , Ozturan Kutay Engin
Published: January 2025

Background

Shoulder pain is often accompanied by disturbances in spinal posture, such as increased thoracic kyphosis. Moreover, a high prevalence of scapular dyskinesis has been observed in the majority of shoulder pain patients. However, these alterations seen in individuals with shoulder pain have not been thoroughly examined after arthroscopic rotator cuff repair (RCr).

Objective

To investigate alterations in spinal alignment and mobility, shoulder range of motion, and scapular dyskinesis (SD), to determine whether differences exist between patients with RCr and healthy individuals.

Methods

The study included 26 participants who had undergone RCr (the RCr group) and 29 healthy individuals (the healthy group). The Spinal Mouse device (IDIAG-M360) was utilized to measure spinal alignment (thoracic kyphosis, lumbar lordosis, sacral-hip angles, and pelvic inclination), and spinal mobility. The study also evaluated the presence of scapular dyskinesia (SD), and shoulder range of motion (ROM) using the observational SD test and a universal goniometer, respectively. All variables were compared between the groups.

Results

The RCr group had an increased mean thoracic kyphosis compared to the healthy group (p = 0.033). However, no significant differences in spinal mobility were observed between the groups (p > 0.05). The results from the scapular dyskinesia analysis revealed considerable variations between the groups (p = 0.001). Among shoulder ROM variables, only external rotation was reduced in the RCr group (p = 0.003). Further subgroup analysis based on trauma status revealed that individuals with non-traumatic rotator cuff tear exhibited an increased thoracic kyphosis angle (p = 0.037).

Conclusions

RCr patients exhibited an increased thoracic kyphosis angle and an increased presence of SD, despite showing similar spinal mobility when compared to healthy individuals. These findings may necessitate further research investigating the effectiveness of thoracic mobilization techniques and targeted strengthening exercises aimed at mitigating the increased thoracic kyphosis angle and SD observed in patients undergoing rehabilitation following RCr.
Prenatal Diagnosis of Nonsyndromic Craniosynostosis: A Scoping Review
Authors: Daly Gwendolyn E. , Stefanko Alexa , Henning Catherine , Crupi Lisa , Howell Lori K. , Wolfswinkel Erik M.
Published: January 2025

Craniosynostosis is rarely diagnosed in utero. Prenatal diagnosis has the potential to improve patient outcomes and streamline care, however, and is becoming more feasible as technology improves. The objective of this study is to examine existing literature on prenatal diagnosis of nonsyndromic craniosynostosis.

In accordance with PRISMA guidelines, Embase, Cochrane, and PubMed were searched for articles discussing prenatal diagnosis of nonsyndromic craniosynostosis via imaging studies. Studies that exclusively examined syndromic craniosynostosis were excluded.

Diagnostic criteria for prenatal diagnosis of craniosynostosis.

The search identified 2129 articles. And 12 articles met inclusion criteria and were included in the final analysis. Ten of 12 included studies (83.3%) utilized biometric data (biparietal and occipitofrontal diameter, cranial index) to analyze fetal head shape. Two of 12 studies (16.7%) utilized specific ultrasonic markers to identify craniosynostosis including a “brain shadowing sign.” One study (8.3%) created a systematic quantitative screening methodology with formal shape analysis for identification of sagittal synostosis. In all included studies, identification of craniosynostosis was possible in the second or third trimesters.

Prenatal diagnosis of craniosynostosis is feasible and has the potential to improve patient outcomes. Creation of screening protocols and standardized metrics for sonographic diagnosis are important next steps in craniosynostosis care.
Unveiling Oral Health Differences: Gingival Health and Hygiene in Children With and Without Cleft Lip and Palate
Authors: Genovez Guida Paola , Costa Matheus Souza de Campos , de Azevedo-Silva Lucas José , Dalben Gisele da Silva , Garib Daniela Gamba , Pompéia Fraga de Almeida Ana Lúcia
Published: January 2025

Objective

To compare the oral hygiene and gingival health of children with and without cleft lip and palate.

Design

Cross-sectional comparative study.

Setting

Institutional tertiary referral hospital.

Patients/Participants

This study was conducted on 108 children aged 6 to 12 years, divided into 3 groups: Group 1 = children with cleft lip and alveolus with or without cleft palate, unilateral or bilateral ( n = 36, 22 boys and 14 girls, aged 8, 39 ± 1.61 years), Group 2 = children with isolated cleft palate ( n = 36, 8 boys and 28 girls, 8.11 ± 1.88 years); and Group 3 = children without clefts ( n = 36, 18 boys and 18 girls, 8.53 ± 1.33 years).

Main Outcome Measures

The clinical parameters evaluated were Gingival Index (GI) and Patient Hygiene Performance (PHP) Index. analysis of variance and Kruskal–Wallis tests were used to evaluate intergroup differences. Correlations between the variables age, PHP Index and GI were assessed by the Spearman correlation ( P < .05).

Results

The results demonstrated no statistically significant difference between the three groups for the PHP index ( P = .126). There was also no intergroup difference for GI ( P = .418).

Conclusions

No difference for the gingival status was observed between children with cleft lip and palate and with isolated cleft palate. Children with oral clefts present adequate gingival status compared to noncleft children.
Design, Development, and Evaluation of a 3D-Printed Buccal Myomucosal Flap Simulator
Authors: Cin Mitchell D. , Nourmohammadi Zahra , Hamdan Usama , Zopf David A.
Published: January 2025

Objective

Buccal myomucosal flap procedures have become a critical tool in the armamentarium of the cleft surgeon. Mastering this technique is complex and providing sufficient training opportunities presents significant challenges. Our study details the design, development, and evaluation of a low-cost, high-fidelity buccal myomucosal flap surgical simulator. Our goal is to establish a reliable teaching tool for early learners, validated through craniofacial surgeon assessment.

Design

The simulator comprises of an anatomical model and a stand created using computer-aided design software. Hard tissues were 3D-printed, while soft tissues were cast in silicone. The model underwent review by craniofacial surgeons utilizing a 1 to 5 Likert scale across six evaluation domains.

Setting

In-person simulated dissection session.

Patients/Participants

Sixteen craniofacial surgery providers from various subspecialties.

Interventions

None.

Main Outcome Measure

Anonymized survey responses.

Results

The simulator received fair to high scores across all evaluation domains, notably 4.31 as a training tool, 3.77 as a competency evaluation tool, 3.92 as a rehearsal tool, and 3.93 in relevance to practice.

Conclusions

The validated buccal myomucosal flap simulator theoretically enables the acquisition of surgical skills in a zero-risk simulated environment. Plans involve integration into a structured curriculum with diverse participants. Continued iteration and adoption hold the promise of significantly enhancing access to training for competency of cleft and craniofacial procedures.
Evaluation of the Effect of Unilateral Cleft Palate on Piriform Aperture Dimensions
Authors: Aytuğar Emre , Kalabalık Fahrettin , Haylaz Emre , Şamil Özkan Muhammed , Akan Burçin
Published: January 2025

Objective

The aim of the present research was to assess and compare the piriform aperture dimensions of subjects with a unilateral cleft lip and palate (UCLP) and those of a control group using cone-beam computed tomography (CBCT).

Design

CBCT data of 40 subjects with a complete UCLP (28 males and 12 females, with a mean age of 17.21 ± 5.75 years) and 40 CBCT images of age- and sex-matched subjects with no cleft, serving as the control group (28 males, 12 females; mean age, 17.25 ± 5.74 years) were included in the study. The maximal height and width of the piriform aperture as well as nasal bone height were measured and statistically compared between the groups.

Results

There were no significant differences in the age and sex distributions between the groups. The mean piriform aperture height was significantly lower in the UCLP group than in the control group, while the mean piriform aperture width was significantly higher in the UCLP group compared to the control group ( P < .01). Furthermore, the mean bony nasal height was found to be significantly lower in the UCLP group than in the control group ( P < .01).

Conclusions

According to the present findings, UCLP is associated with changes in the piriform aperture dimensions due to lower height and higher width values. These structural alterations may contribute to the functional and aesthetic nasal challenges in patients with UCLP.
Study on mechanical properties and strength criterion of mudstone under loading and unloading considering pre-peak damage
Authors: Qin Hui , Tang Hua , Yin Xiaotao , Cheng Xu , Tang Shengping
Published: January 2025

In the highway construction of the southwestern Transverse Mountain area of China, mass mudstone engineering disasters have occurred, primarily attributed to engineering disturbances and water-rock interaction. Engineering disturbances commonly lead to varying degrees of pre-peak damage. To elucidate the evolutionary laws of strength in pre-peak damaged mudstone, we first defined the pre-peak damage variable ( Da) for mudstone, and through triaxial loading and unloading tests, obtained the mechanical characteristics of pre-peak damaged mudstone, analyzing its brittle properties from an energy perspective. Subsequently, through scanning electron microscopy tests, we analyzed the microstructural features to reveal the failure mechanism. Finally, the damage ratio strength theory (DR) was introduced to characterize the strength of the mudstone and validate the suitability of the DR. The results demonstrate that: (1) Mudstone with pre-peak damage exhibits a significant weakening effect due to water-rock interaction, with a maximum reduction in peak strength of approximately 28%. Compared to the loading stress path (LSP), the overall strength of the mudstone is lower under the unloading stress path (ULSP), and the deformation modulus decreases more significantly with Da under the ULSP. (2) Both the Daand confining pressure contribute to a decrease in the brittleness index of the mudstone. Under the ULSP, the mudstone is more prone to brittle failure. (3) The development of micro-cracks in pre-peak damaged mudstone makes it more susceptible to water infiltration, exacerbating the deteriorating effect of water-rock interaction, thus affecting its mechanical properties. (4) The DR can effectively characterize the strength of pre-peak damaged mudstone. The Damage Ratio (ν D,c) of mudstone under the LSP is in the range of 1.07∼1.50, and under the ULSP is in the range of 1.11∼1.52. The ν D,c under the LSP is smaller than under the ULSP, decreases with the Da, and exhibits plastic deformation, indicating that the DR can simultaneously characterize the strength and brittleness of the mudstone. The research results can provide guidance for the design parameters and disaster prevention of disturbed mudstone engineering.
Doxycycline Versus Vancomycin for the Treatment of Methicillin-Resistant Staphylococcus Aureus-Associated Acute Pulmonary Exacerbations in People With Cystic Fibrosis
Authors: Brickel Kendall H. , Kelley Denise , Jaso Theresa , Tran Hai Quyen , Fullmer Jason , Beachler Danielle , Wulfe Steven
Published: January 2025

Background:

Among people with cystic fibrosis (PwCF), methicillin-resistant Staphylococcus aureus (MRSA)-associated acute pulmonary exacerbations (APEs) have been increasing in prevalence and can cause rapid declines in lung function and increased mortality. Fortunately, since 2019, incidence has started to decline.

Objective:

The purpose of this study was to evaluate if doxycycline has comparable efficacy to vancomycin for the treatment of APEs in PwCF. Given the potential toxicities and intolerances associated with vancomycin, evaluating alternative therapies such as doxycycline is warranted.

Methods:

A multicenter retrospective cohort study was conducted in adult and pediatric PwCF who received greater than 48 hours of either vancomycin or doxycycline to treat MRSA-associated APEs between May 1, 2014, and August 31, 2021. The primary outcome was the number of PwCF with a return to ≥90% of baseline forced expiratory volume in the first second (FEV1).

Results:

There were 229 PwCF encounters screened, of which 89 met inclusion criteria (n = 26, vancomycin; n = 63, doxycycline). There were no differences between vancomycin and doxycycline for the primary outcome: 18/26 (69.2%) in the vancomycin group vs 51/63 (81.0%) in the doxycycline group ( P = 0.23). Secondary outcomes were similar between groups, including no difference in incidence of acute kidney injury (AKI), although a significantly higher incidence of adverse events occurred in the vancomycin arm.

Conclusion and Relevance:

The findings of this study suggest doxycycline may be a reasonable alternative to vancomycin for MRSA-associated APEs, particularly in PwCF who may not tolerate vancomycin or who require concomitant nephrotoxins such as intravenous (IV) aminoglycosides.
The Bittersweet Journey of Anticipatory Grief: Clinical Implications for Nurturing Caregivers of Aging Parents
Authors: Rodriguez Josephine Laquis , Wright Galaxina G. , Leopold Patrice J. , Petion Ashlei R.
Published: January 2025

The demographic shift toward an aging population, as highlighted by the Pew Research Center, underscores the need for understanding the complex emotional and psychological processes faced by families caring for elderly parents. This article explores anticipatory grief, a phenomenon characterized by the preemptive mourning and emotional turmoil experienced as loved ones age and their health declines. The authors delve into the phases of anticipatory grief, its impact on caregivers, and the importance of providing both physical and emotional support. Further, it examines the role of attachment theory in shaping responses to grief and the application of relational cultural theory in therapeutic settings. Through a case study and suggestions for future research, this article aims to provide a comprehensive framework for clinicians and families navigating the challenging but rewarding journey of caring for aging parents.
Measurement Invariance of the First Years Inventory (FYIv3.1) Across Age and Sex for Early Detection of Autism in a Community Sample of Infants
Authors: Chen Yun-Ju , Sideris John , Watson Linda R. , Crais Elizabeth R. , Baranek Grace T.
Published: January 2025

The use of parent-report screeners for early detection of autism is time- and cost-efficient in clinical settings but their utility may vary by respondent characteristics. This study aimed to examine the degree to which infants’ age and sex impacted parental reports of early behavioral signs of autism captured by the First Years Inventory Version 3.1 (FYIv3.1). The current sample included 6,454 caregivers of infants aged 6 to 16 months recruited through the North Carolina vital records. Using moderated nonlinear factor analysis for each of the seven FYIv3.1, we identified differential item functioning in small to medium effect sizes across 18 out of 69 items, with the majority of biases associated with infants’ age (e.g., object mouthing, walking, pretend, and imitation), while sex-related biases were minimal. This indicates that differential scoring algorithms by infants’ age and more closely spaced monitoring may be needed for these constructs for more accurate identification of autism in infancy.
Age-Based Trends in Suicidal Ideation Among Child Welfare System-Involved Youth
Authors: Hassler Gabriel W. , Ayer Lynsay , Sheftall Arielle H. , Griffin Beth Ann , Ohana Elie
Published: January 2025

Youth involved with the child welfare system (CWS) exhibit elevated rates of suicidal ideation. This study explores age-, sex-, and race-specific trends of suicidal ideation among 7–18-year-olds within the CWS. Utilizing data from all three versions of the National Survey for Child and Adolescent Well-Being ( N = 5783), which included nationally representative samples of CWS-involved youth, we stratified the sample by age, sex, race, and ethnicity to observe subpopulation-specific trends. Our analysis estimated rates of self-reported suicidal ideation in each demographic stratum. Notably, we discovered that 7–10-year-old males and females reported higher rates of suicidal ideation (∼26%) than any other demographic group except 15–16-year-old females (∼27%). This trend was consistent across all racial and ethnic subgroups. Additional investigations are required to identify the causes of these elevated rates in younger children and to determine if this trend extends to children outside the CWS.
Adolescent Football Players’ Attitudes in Cyprus Toward Gender Stereotypes, Masculinity, and Gender-Based Violence
Authors: Shiakou Monica , Alexopoulos Antonis , Vasou Celia , Nicolaou Pantelitsa , Epaminonda Maria , Neofitides Spyros
Published: January 2025

This study examined how toxic masculinity, gender-based violence, and sports engagement intersect among adolescent football players in Cyprus. Focus groups with 34 participants (average age 15.3 years, M = 28, F = 6) explored three key areas: (1) perceptions of gender stereotypes and traditional masculinity in sports; (2) attitudes toward gender-based violence and their behavioral impacts; and (3) how sports involvement influences traditional gender norms. Findings showed that male players held sexist views, saw men as protectors and women as vulnerable, and frequently encountered gender-based violence, though they struggled to define and address it. The study supports prior research linking sports to traditional masculinity and gender-based violence and suggests ways of engaging men and boys in ending gender-based violence.
When Social Hierarchy, Power, and Collective Autonomy Motivate Social Movement and Counter-Movement Mobilization Among Disadvantaged and Advantaged Groups
Authors: Rivera-Rodriguez Adrian , Mercado Evelyn , Tropp Linda R. , Dasgupta Nilanjana
Published: January 2025

What happens when disadvantaged group members try to gain power in an attempt to protect their collective autonomy? The present integrative review outlines dynamic social processes and conditions under which efforts to restrict a group’s collective autonomy motivate social movement mobilization among disadvantaged groups to challenge social hierarchies that limit their power. This, in turn, threatens advantaged groups’ perceptions of their access to power and, by extension, their sense of collective autonomy, motivating them to reaffirm the existing social hierarchy by mobilizing counter-movements. We propose a theoretical model, called the Movement Mobilization Model of Collective Autonomy, to articulate these dynamic processes by integrating sociological, psychological, and organizational science literatures. The model specifies the conditions under which social movements and counter-movements are activated, psychological processes that drive action, how they play off each other, and offer directions for future research.

Public Abstract

What happens when disadvantaged groups feel that their freedom to define and practice their collective identity (i.e., collective autonomy) is restricted? The present theoretical review outlines the conditions under which social inequality activates the feelings of collective autonomy restriction among disadvantaged group members and motivates the mobilization of social movements seeking social equality. As these social movements gain traction, advantaged group members may feel that their privileged position and collective autonomy are threatened. These feelings of threat and collective autonomy restriction among advantaged groups in turn motivate them to mobilize counter-movements that seek to protect social hierarchy and their privileged position within it. The process outlined in this case is relevant to individuals from both marginalized and privileged backgrounds, as it illustrates the different ways in which real-world power structures shape the way they experience and navigate social movements and counter-movements as they unfold in real time.
Data Visualization Expert Lessons Learned: Implications for Program Evaluators
Authors: Douville Sarah , Grandjean Targos Piper T. , Jones Natalie D. , Knight Ciara , Azzam Tarek
Published: January 2025

This qualitative study explores the lessons learned from experts who use data visualization in evaluation. Findings suggest that collaborative communication with stakeholders—such as identifying needs, managing expectations, and determining the story to tell—is important before initiating the visualization process. Additionally, evaluators are advised to consider audience culture(s), varying levels of visual literacy (visualcy), and accessibility requirements. Experts emphasized the importance of mastering core principles of data visualization over mastery of specific software and argued that no software tool is best for every visualization. Experts also noted that data visualization can facilitate stakeholder understanding by distilling complex information and telling a data-driven story about programs and policies. By applying these lessons, evaluators can enhance their ability to create data visualizations that are technically sound and tailored to audience needs and ability, ultimately improving communication and supporting informed decision-making.
Polarization-insensitive, negative indexed inverted U-shaped flexible metamaterial absorber based on microstructure resonator for multi-band energy harvesting
Authors: Sakib Shihabun , Hoque Ahasanul , Islam Mohammad Tariqul , Islam Md. Shabiul , Soliman Mohamed S. , Alsaif Haitham
Published: January 2025

This article presents a polarization-insensitive, negative indexed inverted U-shaped flexible metamaterial absorber based on a microstructure resonator for multi-band energy harvester application. The vertical inverted U-shaped joint and central split ring resonator together create significant resonance covering three consecutive L-, S-, and C-band absorption peaks for four resonance frequencies: 1.975 GHz with 99.99% absorption, 2.85 GHz with 99.28% absorption, 5.265 GHz with 96.79% absorption, and 5.5 GHz with 89.12% absorption. The design has a rare double negative metamaterial feature at 5.265 GHz, while a balanced geometrical appearance that is polarization insensitive for θ and φ improved the structure’s durability and tunability. Finite computer simulation technology was used to simulate and examine the mechanisms involved in absorption at 1— 6 GHz. Based on Rogers RO4350 B and copper, the structural design showed excellent absorption for 15° and 30° bends and 2 × 4, 4 × 8 arrays with an efficiency of 96.38% at an incidence angle of 30° in transverse magnetic mode, a 3x 3 array was developed for energy harvesting. For energy harvesting applications using array structure, the efficiency parameter is unnoted in most of the reported articles. Moreover, the array demonstrated polarization insensitivity for both transverse electric and transverse magnetic modes at angles of 0°, 30°, and 60°. The proposed quad-band absorber shows significant potential for energy harvesting applications.
A Review on Biohazards Removal in Ethiopia: Efficacy of Existing Treatment Systems and Challenges
Authors: Yenew Chalachew , Yenesew Muluken Azage , Ambelu Argaw , Bayeh Gashaw Melkie , Yeshiwas Almaw Genet
Published: January 2025

Background:

Wastewater treatment is crucial to protecting public health and the environment by removing Biohazards. In Ethiopia, however, significant research gaps limit progress, especially regarding the efficiency of Biohazard removal in existing treatment facilities. This review evaluates the effectiveness of current treatment methods for Biohazard removal, highlights key challenges, and offers recommendations.

Methods:

This scoping review followed PRISMA guidelines, systematically searching databases like NLM. Science Direct, HINARI and Scopus for Biohazard removal studies in Ethiopia, with independent reviewers screening and analyzing relevant data to identify key challenges.

Results:

Out of 1218 studies initially recorded by title and abstract, only 11 articles were selected for analysis. The Activated Sludge Process emerged as a highly effective system, achieving 85% to 95% removal of antimicrobial resistance (AMR) and total coliforms. Other methods, such as the Conventional Activated Sludge, and Anaerobic-Aerobic Reactors, demonstrated promising results but were found only in select locations. However, the widely adopted Oxidation Ponds, Ethiopia’s most common wastewater treatment system, showed the lowest AMR removal efficiency, at just 30% to 50%. Significant challenges, including inadequate infrastructure, high operational costs, and weak regulatory enforcement.

Conclusions and recommendations:

The review underscores the need for affordable wastewater treatment in Ethiopia, highlighting challenges such as inadequate infrastructure and high costs. To enhance effectiveness and reduce public health risks from Biohazards like AMR, recommendations include adopting cost-effective treatment technologies, strengthening regulatory frameworks, increasing public awareness, promoting corporate responsibility, and investing in infrastructure for sustainable wastewater management.