bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying positive end-expiratory pressure before and during endotracheal tube removal versus extubation with concomitant aspiration: protocol for the randomised controlled multicentre EXSUPEEP trial
Authors: Sedillot Nicholas , Kallel Hela , Robine Adrien , Pineda Jose Arturo , Quenot Jean-Pierre , Servant Marion , Levrat Albrice , Damieux-Verdeau Clovis , Mezidi Mehdi , Thibert Nathalie , Bohé Julien , Ballesteros-Calzado Alvaro , Stevic Neven , Mahi Lena , Sigaud Florian , Maisonneuve Margaux , Thiery Guillaume , Prat Paul , Thille Arnaud W , Haouat Safia , Plantefeve Gaetan , Decullier Evelyne , Rabilloud Muriel , Bernon Pauline , Poncelin Yves , Bonnici Julie Catherine
Published: February 2025

Introduction

The optimal method for removing the endotracheal tube (ETT) during extubation in the intensive care unit (ICU) remains uncertain. Two methods are described for removing the ETT in ICU, namely the ‘Traditional technique’ with continuous aspiration during cuff deflation and ETT removal; and the ‘PEEP’ method, which consists in applying positive end-expiratory pressure (PEEP) before and during cuff deflation and ETT removal. Our hypothesis is that applying PEEP during extubation in the ICU would improve clinical outcome.

Methods and analysis

This is a prospective, multicentre, randomised, open-label, controlled, superiority trial, analysed by intention-to-treat, comparing ETT removal with concomitant suction vs application of PEEP before and during ETT removal. In total, 424 patients will be recruited and randomly assigned in a 1:1 ratio to one of two groups, according to the strategy of ETT removal. The primary outcome is the number of days free from any mechanical ventilation within 28 days following extubation. Secondary outcomes include the reintubation rate up to 7 days after ETT removal, the cumulative duration of non-invasive ventilation up to 7 days following extubation, the rate of acute respiratory failure, the rate of acquired pneumonia during the first 7 days following ETT removal, the length of stay in ICU and in hospital and all-cause mortality at 28 days following ETT removal.

Ethics and dissemination

The study was approved by the Ethics Committee ‘CPP Ile de France II’. Patients will be included after providing written informed consent. The results will be submitted for publication in peer-reviewed journals, and in national and international congresses.

Trial registration number

NCT05147636.
Incidence and determinants of households’ catastrophic payments for TB care: evidence from a multi-country trial (EXIT-TB project) implemented in East Africa
Authors: Ngadaya Francis Donard , Philbert Doreen , Wilfred Amani , Mshiu Johnson Jeremia , Binyaruka Peter , Mnyambwa Nicholaus P , Kimaro Godfather , Mori Amani Thomas , Wandinga Steve , Mmbaga Blandina T , Kirenga Bruce J , Yimer Getnet , Mfinanga Sayoki , Ngadaya Esther
Published: February 2025

Background

Despite free tuberculosis (TB) services in low-resource settings which are provided under countries’ respective National TB programmes, TB patients incur substantial costs when seeking care. These costs not only act as a barrier to access but also reduce adherence to TB treatment which further affects patients’ health outcomes and poses a financial burden to households. In the context of the EXIT-TB project implementation, we nested a patient cost study aiming at estimating the costs incurred by patients when seeking TB services. In addition, we also assessed the incidence and determinants of catastrophic health expenditure (CHE) among households affected by TB.

Methods

A cross-sectional analytical study was carried out in four East African Countries, namely; Tanzania, Kenya, Uganda and Ethiopia alongside EXIT-TB project implementation from 2019 to 2022. Direct and indirect costs incurred by drug-sensitive TB patients were collected after they had received TB services. Costs were considered catastrophic if they exceeded 20% of annual household income. Cost data were collected in each country’s national currency and converted to 2023 US dollars afterwards.

Results

The mean total cost incurred by patients when seeking TB care were US$130.85, US$97.90, US$84.63 and US$101.60 in Tanzania, Kenya, Uganda and Ethiopia, respectively. Overall, more than half (51.81%) of the TB-affected households experienced CHE due to TB. CHE was high among TB-affected households with poor socioeconomic status. TB patients residing in Ethiopia, households with >5 members, households with TB patients as household heads, unemployed and poor socioeconomic status were among the factors associated with a high incidence of CHE (p<0.05).

Conclusion

Despite the availability of free TB services in East Africa provided by the respective National TB programmes, more than half of TB-affected households experienced CHE due to TB. Our findings reinforce the need for cost mitigation policies among TB-affected households, particularly the worse offs so as to reduce the incidence of CHE and further impoverishment.
Relative importance and interactions of factors influencing low-value care provision: a factorial survey experiment among Swedish primary care physicians
Authors: Roczniewska Marta , Augustsson Hanna , Ingvarsson Sara , Hedberg Rundgren Emma , Szymański Kamil , von Thiele Schwarz Ulrica , Nilsen Per , Hasson Henna
Published: February 2025

Background

Low-value care (LVC) describes practices that persist in healthcare, despite being ineffective, inefficient or causing harm. Several determinants for the provision of LVC have been identified, but understanding how these factors influence professionals’ decisions, individually and jointly, is a necessary next step to guide deimplementation.

Methods

A factorial survey experiment was employed using vignettes that presented hypothetical medical scenarios among 593 Swedish primary care physicians. Each vignette varied systematically by factors such as patient age, patient request for the LVC, physician’s perception of this practice, practice cost to the primary care centre and time taken to deliver it. For each scenario, we measured the reported likelihood of providing the LVC. We collected information on the physician’s worry about missing a serious illness.

Results

Patient requests and physicians’ positive perceptions of the practice were the factors that increased the reported likelihood of providing LVC the most (by 14 and 13 percentage points (pp), respectively). When the LVC was low in cost or not time-consuming, patient requests further boosted the likelihood of provision by 29 and 18 pp. In contrast, credible evidence against the LVC reduced the role of patient requests by 11 pp. Physicians’ fear of missing a serious illness was linked with higher reported probability of providing LVC, and the credibility of the evidence against the LVC reduced the role of this concern.

Conclusions

The findings highlight that patient requests enhance the role of many determinants, while the credibility of evidence diminishes the impact of others. Overall, these findings point to the relevance of increased clinician knowledge about LVC, tools for patient communication and the use of decision support tools to reduce the uncertainty in decision-making.
Successful reperfusion accompanied by symptomatic intracranial hemorrhage (sICH) versus unsuccessful reperfusion without sICH after endovascular stroke thrombectomy: a post-hoc analysis of two randomized trials
Authors: Li Yanling , Fu Yusi , Feng Xinggang , Chen Lve , Luo Shiwei , Jiang Shunfu , Peng Huiyuan , Huang Xianjun , Zhang Wensheng , Huang Yihong , Zhang Min , Luo Genpei , Ge Fukui , Xu Jing , Huang Hanning , Guan Min , Chen Zhenze , Zi Wenjie , Yang Qingwu , Sang Hongfei , Qiu Zhongming , Li Mingchao , Nguyen Thanh N , Zhao Zhenqiang , Li Wei
Published: February 2025

Background

Functional outcomes in patients with acute ischemic stroke (AIS) with large vessel occlusion (LVO) undergoing endovascular treatment (EVT) with successful reperfusion (expanded Thrombolysis In Cerebral Infarction (eTICI) 2b-3) complicated by symptomatic intracranial hemorrhage (sICH) were compared with patients with unsuccessful reperfusion (eTICI 0–2a) without sICH.

Methods

Patients enrolled in this post hoc analysis were from two Chinese multicenter, randomized controlled trials: the DEVT and the RESCUE BT registries. Patients with AIS who underwent EVT were categorized into two groups according to the state of reperfusion: eTICI 2b-3 with sICH and eTICI 0–2a without sICH. The primary outcome was the modified Rankin Scale (mRS) scores at 90 days. The safety outcomes included early neurological deterioration and 90-day mortality.

Results

161 patients were included in this cohort analysis, among whom 71 experienced eTICI 2b-3 with sICH, and 90 had eTICI 0–2a without sICH. After adjusting for potential confounding factors, patients in the eTICI 2b-3 with sICH group had worse mRS at 90 days compared with those in the eTICI 0–2a without sICH group in the adjusted analysis (median 6 (IQR 4–6) vs median 4 (IQR 3–6); adjusted common OR 0.39, 95% CI 0.17 to 0.66). There were also higher rates of very poor outcome (mRS 5–6, 70.4% vs 42.2%; OR 2.90, 95% CI 1.38 to 6.11), mortality (66.2% vs 32.2%; OR 0.48, 95% CI 0.30 to 0.79), and early neurological deterioration (81.7% vs 40.0%; OR 0.16, 95% CI 0.07 to 0.35) in the eTICI 2b-3 with sICH group versus the eTICI 0–2a without sICH group.

Conclusions

Successful reperfusion complicated by sICH after EVT was associated with worse outcomes and higher mortality than unsuccessful reperfusion without sICH. These findings emphasize the need for additional efforts in assessing and managing post-EVT-associated sICH to optimize treatment strategies and improve outcomes.

Trial registration number

Direct Endovascular Treatment for Large Vessel Occlusion Stroke;https://www.chictr.org.cn; ChiCTR-IOR-17013568.

Intravenous Tirofiban Before Endovascular Thrombectomy for Acute Ischemic Stroke;https://www.chictr.org.cn; ChiCTR-INR-17014167.
Prediction of mortality risk in critically ill patients with systemic lupus erythematosus: a machine learning approach using the MIMIC-IV database
Authors: Chen Zhihan , Dai Yunfeng , Chen Yilin , Chen Han , Wu Huiping , Zhang Li
Published: February 2025

Objective

Early prediction of long-term outcomes in patients with systemic lupus erythematosus (SLE) remains a great challenge in clinical practice. Our study aims to develop and validate predictive models for the mortality risk.

Methods

This observational study identified patients with SLE requiring hospital admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database. We downloaded data from Fujian Provincial Hospital as an external validation set. Variable selection was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. Then, we constructed two predictive models: a traditional nomogram based on logistic regression and a machine learning model employing a stacking ensemble approach. The predictive ability of the models was evaluated by the areas under the receiver operating characteristic curve (AUC) and the calibration curve.

Results

A total of 395 patients and 100 patients were enrolled respectively from MIMIC-IV database and the validation cohort. The LASSO regression identified 18 significant variables. Both models demonstrated good discrimination, with AUCs above 0.8. The machine learning model outperformed the nomogram in terms of precision and specificity, highlighting its potential superiority in risk prediction. The SHapley additive explanations analysis further elucidated the contribution of each variable to the model’s predictions, emphasising the importance of factors such as urine output, age, weight and alanine aminotransferase.

Conclusions

The machine learning model provides a superior tool for predicting mortality risk in patients with SLE, offering a basis for clinical decision-making and potential improvements in patient outcomes.
UAV Group Distribution Route Optimization Under Time‐Varying Weather Network
Authors: Jie Wanchen , Pei Cheng , Yan Hong , Lin Weitong
Published: February 2025

The rapid advancement in unmanned aerial vehicle (UAV) technology has marked a transformative shift in various industries, with logistics distribution service being one of the prime sectors reaping the benefits. UAVs offer substantial benefits in speed, cost, and reach, promising to revolutionize logistics, especially in remote areas. On the one hand, they are poised to meet demands for quick and versatile delivery options. On the other hand, their deployment comes with challenges. Weather variabilities such as rainfall, wind speed, and the need for safe take‐off intervals can compromise UAV safety and operation. Conventional route optimization often overlooks these dynamic factors, resulting in inefficient or unworkable delivery routes. The repeated time‐consuming calculations are caused by repeated trials when making UAV group distribution plans. Recognizing these gaps, this study proposes a data representation to effectively transform the flight flyable area of UAVs into a time‐varying network that maintains spatiotemporal connectivity and establishes a mathematical model that represents the complexities of UAV group distribution. Then, a multistage dynamic optimization algorithm specifically tailored for large‐scale time‐varying network distribution route search is designed to obtain the stable and optimal solution. Subsequent experimental validations on actual case datasets have confirmed the correctness, effectiveness, and adaptability of the algorithm. Benchmarking against traditional CPLEX methods demonstrated that the algorithm not only rivals the best solutions but does so with a 38.8 times increase in computational speed. When pitted against the shortest path Dijkstra and A∗ algorithms, the method consistently outperformed, delivering solutions up to 3.5 times faster in large‐scale applications. Moreover, the parameter sensitivity analysis is performed on the algorithm by adjusting the safe flight thresholds of rainfall and wind speed parameters and revealed that the performance of the algorithm has a strong positive correlation with the size of the time‐varying network.
Digital Mapping and Memory
Authors: Hay Duncan , Vaughan Laura , Lichtenstein Rachel
Published: February 2025

This paper presents two digital public history resources—online maps—that are concerned with the everyday lives and reminiscences of Jewish people in two cities in the United Kingdom: London and Manchester. Using techniques derived from Geographic Information Systems (GIS), and the spatial humanities more broadly, these resources take the form of interactive maps which compile recordings of oral history interviews with background research, documentary photographs, and historical maps. Drawing on the work of Raphael Samuel and Pierre Nora, and the insights derived from space syntax urban research and what we have termed ‘memory mapping,’ we discuss the tensions between memory, which in Nora’s sense refers to the past as it is recalled informally and colloquially, and history, the academic study of the past. Digital mapping technologies, we argue, shape new opportunities for exploring the relationship between these two modes of historical thinking. Through a consideration of specific examples taken from the two maps, we discuss how bringing these materials into dialogue with cartographic maps opens new avenues for spatially and historically situated research into memory.
Precedence of Praxis: Humanizing Pedagogy in a Standards-Dominated System
Authors: Thurston Emily , Nguyen JoeAnn , Butler Tequila , Compitello Pete
Published: February 2025

This qualitative case study examines the implementation of humanizing pedagogies in 18 English language arts classrooms. Using semi-structured interviews and observations, we investigated how ELA teachers navigated policy mandates and a compliance culture while enacting reflexive, responsive, and student-centered instruction. As a problem of practice, our findings highlight neoliberal and new managerial barriers to humanizing pedagogy, underscoring the significance of a whole-child approach at all levels of the education system, particularly in contexts where standardized assessments dominate concepts of educational equity and excellence.
Careering through Comedy: Liminal Boundaries in Freelance Creative Work
Authors: Stoyanova Russell Dimitrinka , Butler Nick
Published: February 2025

Comedians are well-known for pushing the boundaries of taste, decency, and social mores in their acts, often to hilarious effect. But professional comedians must also navigate a range of visible and invisible boundaries as their careers unfold. One of the pivotal shifts occurs with the transition from the live circuit to television. While these two domains are often seen as closely connected, live work and TV work are in fact characterized by very different rules of entry and progression. Drawing on 82 interviews with comedians and other industry players, this paper explores the risks and rewards involved in making the transition from one institutional context to another. In particular, we develop the concept of ‘liminal career boundary’ to explain how and why boundaries emerge in fluid, informal organisational contexts such as freelance creative work. This concept extends our understanding of organisational liminality as a state of disorientating in-betweenness, one that is partly objective (insofar as it is determined by key industry gatekeepers) and partly subjective (insofar as it is perceived by professionals who are attempting to cross a career boundary).
High-grade astrocytoma in a sheep: clinical, pathology, and genetic investigations
Authors: Mignacca Sebastian A. , Konold Timm , Gallisai Elena , Maestrale Caterina , Gomez-Vitores Ana , Nunez Alejandro
Published: February 2025

Primary neoplastic diseases of the CNS in livestock are rare compared to companion animals. Here we describe the clinical, pathologic, and genetic findings in an adult sheep with a high-grade cerebral astrocytoma. Clinically, apathy, ataxia, bilateral amaurosis, and horizontal resting nystagmus were observed. The signs were suggestive of a space-occupying lesion affecting the vestibular and ascending reticular activating systems. The CSF had high total protein, hypercellularity, and pleocytosis. Macroscopically, a friable, gray-pink, ovoid mass (6 × 3 × 4 cm) was observed within most of the right parietal, occipital, and temporal cerebral subcortical areas, extended into the thalamus, hippocampus, and the cerebral peduncles, and reached the ipsilateral choroid plexus and the lateral ventricles. Histologically, the well-delimited, unencapsulated lesion consisted of proliferating neoplastic spindloid-to-polygonal cells mainly arranged in streams and bundles supported by minimal fibrous stroma, and random areas of coagulative necrosis and hemorrhages without pseudopalisading in the center of the mass. Immunohistochemistry revealed strong immunolabeling of spindle cells for S100, vimentin, and glial fibrillary acidic protein. Immunolabeling for neuron-specific enolase was restricted to trapped neurons; oligodendrocyte transcription factor 2 (OLIG2), pan-cytokeratins, and SOX10 were immunonegative. TP53 gene sequencing of the neoplasm did not demonstrate any point mutations involving exons 2–11.
“The Only Way to be Moved to Think is to Lose One’s Way”: Bewilderment(ing) Reading Practices
Authors: Kuby Candace R.
Published: February 2025

This paper engages with concepts from Nathan Snaza’s book Animate Literacies: Literature, Affect, and the Politics of Humanism in relation to reading practices as an academic, both as a scholar and as a teacher. This paper thinks with Snaza’s writing on bewilderment to (re)think academic reading practices. I focus on reading for pleasure, reading outside one’s disciplinary field, and reading difficult texts. The title of this article is a quote from Snaza’s (2019) book where they discuss bewilderment and literacy. Bewilderment is an affective condition of disorientation when disciplined attention fails and thus, one might not know one’s way as a reader. Therefore, I question, similarly to Snaza, what if literacy is a both/and—both meaning-making and something else, something more? Is it possible for literacy to not be about conscious meaning-making events or representational constructions? In the literacy community we think of literacy as symbolic representations of thought and readers must crack the phonetic code of symbols to make meaning. However, Snaza’s writing prompts us to think differently about reading. Thus, reading creates spaces for us to be otherwise if we conceptualize reading as otherwise, not solely as an act of meaning-making and comprehension but also about how and what it a/effectually produces.
Bringing theory to life: integrating case-based learning in applied physiology for undergraduate physiotherapy education
Authors: Elgheit Rehab E. Abo , Nashat Nagwa
Published: February 2025

Background

Case-based learning (CBL) is considered an effective teaching approach that provides medical students with a learning environment simulating future actual practice. So we aimed to implement CBL, as an additional component to traditional teaching methods (TTMs) in applied physiology for undergraduate physiotherapy students (UPS) and to evaluate its impact on students’ perception and academic performance compared to TTMs alone.

Methods

CBL was implemented during the teaching of applied physiology throughout the neuroscience course in the 4th semester for UPS. Nine cases related to the topics taught were selected. The academic achievement was evaluated through the students’ grades, and the students’ perception and facilitators’ feedback were explored through a structured, web-based perception questionnaire.

Results

Of the 244 UPS students, 238 completed the survey following the CBL approach. A total of 97.5% reported a higher perception of the combined CBL with TTMs compared to the traditional approach, with a median overall perception score of 99.0. 93.3% of the enrolled students ensured that combined CBL with TTMs was better in all features in applied physiology education. Integrating CBL with TTMs was associated with improved academic performance. While the maximum grade remained consistent at 10 for both traditional physiology labs and combined CBL with TTMs, the minimum grade improved significantly from 2.0 in traditional lab teaching to 7.5 in combined CBL and TTMs. Median grades also increased from 8.5 to 10.0 when CBL was combined with TTMs, with better performance observed at both the 25th and 75th percentiles under the hybrid CBL and TTMs approach (10.0 vs. 7.0 and 10.0 vs. 9.5, respectively).

Conclusion

Incorporating CBL alongside TTMs provided a more engaging learning experience, with increased students’ perception, and promoted their academic achievement. An enhanced teaching framework with the integration of CBL can be broadly implemented as a more interactive teaching tool not only in applied physiology but also in other health sciences to overcome the limitations of the TTMs and ensure better outcomes.
Thematic assignments making vocational concepts visible during students’ work placements in Norwegian vocational education
Authors: Øgård Monika , Hillen Stefanie A. , Wuttke Eveline
Published: February 2025

Many students in vocational education and training (VET) programmes in Norway fail to see the connection with the school-based curriculum content they explore and learn and the tasks they perform during work placements. Consequently, the relevance of various vocational concepts remains invisible when conducting tasks at work, hence student motivation for learning may decrease and students’ understanding accordingly. This study examines how thematic assignments, designed by a team of experienced vocational teachers in Norway, who teach the subject vocational specialization, foster students’ boundary learning and contribute to students’ knowledge development of vocational concepts. The research focuses on the thematic assignments, the boundary objects, helping students to navigate between the school and the workplace. The thematic assignments serve as shared references that bridge these two learning contexts. Semi-structured observations were made of students, teachers, and supervisors in the workplace, and interviews were conducted with teachers and supervisors to gain insight into practices and personal perspectives. The findings indicate that the teachers’ joint design and their individual student adjusted use of the thematic assignments, helped students to ‘see’ the vocational concepts in practice and to stress their importance and necessity to learn. An additional result is that the assignments worked as an anchor for improved communication and collaboration among all parties involved.
Spontaneous renal hematoma as a rare vascular manifestation of Behçet’s disease: a case report
Authors: Boustani Salma , Idrissi Elhoucine El , Elkaddouri Oumaima , Elkourchi Mehdi , Wakrim Soukaina , Bouissar Wassila
Published: February 2025

Behçet’s disease (BD) is a rare systemic vasculitis with multi-organ involvement, including infrequent arterial complications. We report a case of a 20-year-old male who presented with a renal spontaneous hematoma, leading to the diagnosis of BD. This rare manifestation underscores the importance of considering BD in young patients with unexplained vascular issues. Early diagnosis and appropriate management are crucial for better outcomes.
Evacuating Patients With Pediatric Cancer From Ukraine: Impact on Medical Care Capacity in Poland
Authors: Oszer Aleksandra , Kliuchkivska Khrystyna , Kołodrubiec Julia , Sopilnyak Andriy , Salek Marta , Włodarski Marcin W. , Dutkiewicz Małgorzata , Nowicka Zuzanna , Krawczuk-Rybak Maryna , Styczyński Jan , Machnik Katarzyna , Irga-Jaworska Ninela , Mizia-Malarz Agnieszka , Karolczyk Grażyna , Skoczeń Szymon , Balwierz Walentyna , Drabko Katarzyna , Mycko Katarzyna , Derwich Katarzyna , Chaber Radosław , Ociepa Tomasz , Peregud-Pogorzelski Jarosław , Dembowska-Bagińska Bożenna , Łaguna Paweł , Kałwak Krzysztof , Szczepański Tomasz , Raciborska Anna , Czauderna Piotr , Agulnik Asya , Młynarski Wojciech ,   on behalf of the Polish Society of Pediatric Oncology and Hematology and the SAFER Ukraine Collaborative
Published: February 2025

PURPOSE

Soon after the Russian invasion of Ukraine in February 2022, an initiative was organized to evacuate Ukrainian children with cancer, most initially to Poland. This study assessed the impact of this rapid increase in clinical need on the Polish system of pediatric cancer care.

METHODS

This multicenter longitudinal approach was performed among all 19 Polish Pediatric Oncology Centers (PPOCs). We compared PPOC capacity before the invasion with that during the first 11 weeks after the invasion, using three ratios: patients to physicians (PtP), patients to nurses (PtN), and patients to beds (PtB). In addition, we used national data from an ongoing leukemia clinical trial to assess differences between the two study periods in the time required to comply with protocol-indicated medical procedures requiring general anesthesia.

RESULTS

During the study period, 237 Ukrainian refugee children with cancer were treated in PPOCs; 60% of them arrived during the first 21 days of the war. The relative increase in patients varied significantly among the PPOCs, ranging from 42% to 460%. The average PtP, PtN, and PtB ratios increased significantly by 85%, 131%, and 105%, respectively. The portion of patients experiencing a delay in obtaining medical procedures requiring general anesthesia increased from 15% before the war to 18.2% (
P
= .043).

CONCLUSION

Because of the large number of Ukrainian children with cancer were evacuated to Poland, capacity of PPOCs was reduced, affecting cancer care for all patients. Maintaining standards of pediatric oncology care in Poland would not be possible without further patient referral to medical facilities around the world by international humanitarian collaborative action.
“The Evolving Role of PTH Signaling in Osteocytes”
Authors: Kiryaman Gokce , Enabulele Irobosa , Banville Myra , Divieti Pajevic Paola
Published: February 2025

Over the past decade, advancements in cell line development and genetic tools have led to a wealth of new insights into the effects of parathyroid hormone (PTH), particularly on osteocytes—cells deeply embedded within the bone's mineral matrix. These cells were once believed to be inactive bystanders, with little, if any, role in skeletal and mineral homeostasis. This concept of passive osteocytes has been challenged in recent years and osteocytes are now recognized for their crucial functions in skeletal mechanotransduction, bone modeling and remodeling, mineral ion regulation, and hematopoiesis. Moreover, osteocytes are key targets of PTH and studies utilizing genetically modified mice, in which the PTH receptor is either deleted or overexpressed, have shed light on the hormone's complex effects on these cells. Several signaling molecules, including salt kinase inhibitors and histone deacetylases, have been identified as part of PTH's intracellular signaling cascade. In addition to its effects on bone metabolism, PTH has also been implicated in regulating bone energy metabolism, skeletal aging, and hematopoiesis. This review summarizes both classical and emerging effects of PTH on osteocytes, highlights the limitations of current research, and offers perspectives for future investigations in the field.
Getting Infrastructure Built: The Law and Economics of Permitting
Authors: Liscow Zachary
Published: February 2025

Given the benefits to economic growth and economic mobility, and the need to transition to green energy, getting infrastructure built is an urgent issue. I first review the evidence on the costs and benefits of the current regime of government approvals for such building: in the United States, permitting is slow, infrastructure is expensive, and environmental outcomes are not particularly good. I propose a framework for reform with two dimensions: the power of the executive branch to decide and its capacity to plan. After considering reform possibilities, I propose that reforming both dimensions could lead to a possible “green bargain” that benefits efficiency, the environment, and democracy.
A Practical Guide to Shift-Share Instruments
Authors: Borusyak Kirill , Hull Peter , Jaravel Xavier
Published: February 2025

A recent econometric literature shows two distinct paths for identification with shift-share instruments, leveraging either many exogenous shifts or exogenous shares. We present the core logic of both paths and practical takeaways via simple checklists. A variety of empirical settings illustrate key points.
Philipp Strack, 2024 Clark Medalist
Authors: Fudenberg Drew
Published: February 2025

The 2024 John Bates Clark Medal of the American Economic Association was awarded to Philipp Strack, Professor of Economics at Yale University, for his pathbreaking contributions to the study of individual decision making, which have introduced new techniques, improved our understanding of important economic phenomena, and helped spark a new wave of research on the economics of information while building bridges between modern economic theory and a wide range of adjacent disciplines. This article summarizes some of Philipp’s papers, and explains how they build on and improve previous work.
Chlorophyll-a determinations in mesocosms under varying nutrient and temperature treatments: in-situ fluorescence sensors versus in-vitro measurements
Authors: Levi Eti Ester , Jeppesen Erik , Nejstgaard Jens C. , Davidson Thomas Alexander
Published: February 2025

Harmful algal blooms (HABs) are a significant threat to freshwater ecosystems, and monitoring for changes in biomass is therefore important. Fluorescence in-situ sensors enable rapid and high frequency real-time data collection and have been widely used to determine chlorophyll-a (Chla) concentrations that are used as an indicator of the total algal biomass. However, conversion of fluorescence to equivalent-Chla concentrations is often complicated due to biofouling, phytoplankton composition and the type of equipment used. Here, we validated measurements from 24 Chla and 12 phycocyanin (cyanobacteria indicator) fluorescence in-situ sensors (Cyclops-7F, Turner Designs) against spectrophotometrically (in-vitro) determined Chla and tested a data-cleaning procedure for eliminating data errors and impacts of non-photochemical quenching (i.e. light-induced decrease in fluorescence intensity). The test was done across a range of freshwater plankton communities in 24 mesocosms (i.e. experimental tanks) with a 2x3 (high and low nutrient x ambient, IPCC-A2 and IPCC-A2+50% temperature scenarios) factorial design. For most mesocosms (tanks), we found accurate (r2 ≥ 0.7) calibration of in-situ Chla fluorescence data using simple linear regression. An exception was tanks with high in-situ phycocyanin fluorescence, for which multiple regressions were employed, which increased the explained variance by >10%. Another exception was the low Chla concentration tanks (r2 < 0.5). Our results also show that the high frequency in-situ fluorescence data recorded the timing of sudden Chla variations, while less frequent in-vitro sampling sometimes missed these or, when recorded, the duration of changes was inaccurately determined. Fluorescence in-situ sensors are particularly useful to detect and quantify sudden phytoplankton biomass variations through high frequency measurements, especially when using appropriate data-cleaning methods and accounting for factors that can impact the fluorescence readings. Nevertheless, corroborating these data with in-vitro Chla assessments would provide additional validation for the early warnings provided by sensor data.
Optical system for quantum key distribution over an atmospheric communication channel
Authors: Shiryaev Daniil S. , Razzhivina Karina R. , Kundius Andrei A. , Belyakov Nikita A. , Polukhin Ivan S. , Kolodeznyi Evgenii S.
Published: February 2025

Subject of study. An optical system, composed of transmitting and receiving telescopes, was designed for quantum key distribution, based on the subcarrier wave modulation method, over an atmospheric channel. Aim of study. The aim of the study was to develop an optical system that allowed the use of single-mode fibers as the input and output of the system, ensured the transmission of an ultralow-power optical signal without introducing additional distortion, and implemented a protocol for distributing a quantum key over an atmospheric optical communication channel at a distance of up to 25 m. Method. An experimental setup with an atmospheric quantum communication channel was developed, which showed stable quantum key distribution without interruptions throughout the measurement process. Radiation propagation simulations were also performed to estimate the insertion loss of the optical signal. Main results. Simulations revealed that the optical losses in the quantum key distribution system amounted to approximately 17 dB. The atmospheric communication channel was studied at distances of 5, 10, and 25 m. Considering all optical elements of the system, including the ferrules of the output and input fibers of the quantum key distribution modules, the attenuation of the optical signal was approximately 8, 13, and 18 dB, respectively. Based on the atmospheric optical losses, the quantum key generation rates were of the order of 500, 350, and 190 bits/s with increasing distance and insertion losses. The probability of a quantum error was in the range of 3% to 5%, which was lower than the threshold of 6%, ensuring the legitimacy of the generated key and excluding the possibility of an attack on the communication channel. Practical significance. The compatibility of the developed optical system with single-mode optical fibers allows its integration into the existing infrastructure of data transmission lines without the need for additional optical radiation converters. Owing to the analyzed characteristics of the optical system for distributing a quantum key over an atmospheric communication channel, it can be applied in communication systems based on the Internet of Things, unmanned vehicles, and other moving objects.
VSS-SpatioNet: A Multi-scale Feature Fusion Network for Multimodal Image Integrations
Authors: Xiang Zeyu
Published: February 2025

Infrared and visible image (vis-ir) fusion is vital for enhancing clarity and enriching information, with significant applications in medical and biological imaging. Existing models, relying on convolutional neural networks (CNNs) or Transformers, often face challenges in balancing computational efficiency and capturing long-range dependencies. This paper introduces VSS-SpatioNet, a novel lightweight fusion network leveraging a Visual State Space (VSS) module instead of Transformers. Its asymmetric encoder-decoder structure integrates multi-scale features through a VSS-Spatial (VS) fusion strategy, combining CNN and VSS branches to capture fine details and long-range information. Extensive experiments demonstrate VSS-SpatioNet's superior performance, highlighting its potential in advanced imaging applications.
ILR-Net: Low-light image enhancement network based on the combination of iterative learning mechanism and Retinex theory
Authors: Yin Mohan , Yang Jianbai
Published: February 2025

Images captured in nighttime or low-light environments are often affected by external factors such as noise and lighting. Aiming at the existing image enhancement algorithms tend to overly focus on increasing brightness, while neglecting the enhancement of color and detailed features. This paper proposes a low-light image enhancement network based on a combination of iterative learning mechanisms and Retinex theory (defined as ILR-Net) to enhance both detail and color features simultaneously. Specifically, the network continuously learns local and global features of low-light images across different dimensions and receptive fields to achieve a clear and convergent illumination estimation. Meanwhile, the denoising process is applied to the reflection component after Retinex decomposition to enhance the image’s rich color features. Finally, the enhanced image is obtained by concatenating the features along the channel dimension. In the adaptive learning sub-network, a dilated convolution module, U-Net feature extraction module, and adaptive iterative learning module are designed. These modules respectively expand the network’s receptive field to capture multi-dimensional features, extract the overall and edge details of the image, and adaptively enhance features at different stages of convergence. The Retinex decomposition sub-network focuses on denoising the reflection component before and after decomposition to obtain a low-noise, clear reflection component. Additionally, an efficient feature extraction module—global feature attention is designed to address the problem of feature loss. Experiments were conducted on six common datasets and in real-world environments. The proposed method achieved PSNR and SSIM values of 23.7624dB and 0.8653 on the LOL dataset, and 26.8252dB and 0.7784 on the LOLv2-Real dataset, demonstrating significant advantages over other algorithms.
Sickness absenteeism among nurses after the COVID-19 pandemic: A study protocol
Authors: Ismail Halim , Huam Zhe Shen , Yew Sheng Qian , Ahmad Hanis , David Chan Chee Hoong , Baharudin Mohd Hafiz , Muhd Aris Nor Azila
Published: February 2025

Introduction

Sickness absenteeism among the nurses in Malaysia is not fully understood. Complicated with the increase in workload and mental stress during the COVID-19 pandemic and the manifestation of long COVID-19 symptoms, there is a need for an updated insight on the prevalence and the risk factors of sickness absenteeism among nurses in Malaysia. As such, we designed a study protocol that assess the prevalence and risk factors of sickness absenteeism among nurses in Malaysia in the post-COVID-19 pandemic era.

Materials and methods

This is a correlational cross-sectional study. The sociodemographic and clinical questionnaire, sickness absenteeism questionnaire, job characteristics questionnaire, Demand-Control-Support Questionnaire (DCSQ), Work-Related Strain Inventory (WRSI), Work and Family Conflict Scale (WAFCS), the COVID-19-related workplace worries questionnaire, as well as the Depression, Anxiety, and Stress (DASS-21) questionnaire will be randomly distributed to 166 nurses from October 2024 to May 2025.

Discussion

While physical illnesses, psychological disorders, job-related factors, and sociodemographic factors have been identified as risk factors to sickness absenteeism among healthcare professionals in general, the role of these risk factors in causing sickness absenteeism among the nurses remains unclear. Additionally, the increased stress and workload faced by nurses during the COVID-19 pandemic, as well as post-acute COVID-19 syndrome, may have further impacted sickness absenteeism.

Conclusion

By examining the various risk factors of sickness absenteeism, especially in the post-COVID-19 pandemic era, this research will inform future targeted interventions to reduce sickness absenteeism among Malaysian nurses and its associated consequences.
Passive acoustic monitoring of baleen whale seasonal presence across the New York Bight
Authors: Estabrook Bobbi J. , Bonacci-Sullivan Lisa A. , Harris Danielle V. , Hodge Kristin B. , Rahaman Ashakur , Rickard Meghan E. , Salisbury Daniel P. , Schlesinger Matthew D. , Zeh Julia M. , Parks Susan E. , Rice Aaron N.
Published: February 2025

The New York Bight is an ecologically and economically important marine region along the U.S. Atlantic Coast. Extensive assessments have characterized the habitats and biota in this ecosystem; however, most have focused on fishes, benthic habitats, and human impacts. To investigate the spatial and temporal occurrence of whales in this region, we conducted a three-year passive acoustic monitoring survey that documented the acoustic presence of five baleen whale species that occur within the New York Bight and are of conservation concern: North Atlantic right whales (Eubalaena glacialis), humpback whales (Megaptera novaeangliae), fin whales (Balaenoptera physalus), sei whales (Balaenoptera borealis), and blue whales (Balaenoptera musculus). Data were recorded with 14 bottom-mounted acoustic sensors across the continental shelf between 2017 and 2020. Right whales were detected across all seasons, with most detections in autumn closer to New York Harbor and spring detections at sites closer to the continental shelf edge. Humpbacks were detected during all months of the year with varying distribution of detections across the shelf. The year-round presence of right and humpback whales challenges previous hypotheses that this region is primarily a stopover location along their migration paths. Fin whales were detected at all sites on most days. Sei whales were detected primarily during the spring at offshore sites. Blue whales were detected in the winter at sites closer to the continental shelf edge, but were rare. These data improve our understanding of baleen whale seasonal occurrences in the New York Bight and can inform monitoring and mitigation efforts associated with the management and conservation of these species.
Prevalence and chemotherapy of Staphylococcus aureus mastitis in dairy cattle
Authors: Shah Asjad Umair , Ali Khan Jawaria , Avais Muhammad , Zaman Syed Haider , Munir Zubir , Abbas Safdar , Tariq Mahnoor , Rahman Muneeb ur , Tariq Fiza , Nawaz Saqib , Fouad Dalia , Anjum Aftab Ahmad , Ahmed Qazi Israr
Published: February 2025

This study aimed to isolate and characterize Staphylococcus aureus (S. aureus) from samples of mastitis milk taken from dairy cattle in Punjab’s Narowal District. 200 milk samples were collected aseptically from different dairy herds in the district, including clinical mastitis (CM) and sub-clinical mastitis (SCM) cows. Blood agar and mannitol salt agar were used for S. aureus isolation and identification. Selective media were then used for additional purification. Observations of morphological and biochemical traits verified the existence of S. aureus. Through questionnaire-based surveys, the prevalence of S. aureus mastitis was identified, and risk variables linked to its incidence were evaluated. The findings showed that S. aureus mastitis was prevalent in 42.5% of cases, with sub-clinical cases having a greater incidence (45.8%) than clinical cases (37.5%). Risk factors such as distance from dung pile to stall(m), source of water, dung removal per day, lactation period (weeks), parity, effect of milk yield (L), traumatic injury of udder, housing type, floor type, teat dipping, and bedding type was identified and their relationship to the occurrence of S. aureus mastitis was studied. Tests for antibiotic sensitivity revealed that S. aureus isolates were responsive to gentamycin, ceftiofur, tetracycline, enrofloxacin, and ciprofloxacin but extremely resistant to penicillin and amoxicillin. Additionally, the Somatic Cell Count (SCC) and California Mastitis Test (CMT) were used at different intervals to assess the effectiveness of the medication. Furthermore, compared to other treatment groups, a larger percentage of cure rates was seen in the groups receiving ceftiofur and enrofloxacin. Overall, this study contributes to the development of more effective management methods for S. aureus mastitis in dairy calves by offering insightful information about the condition’s prevalence, risk factors, antibiotic sensitivity, and effectiveness of treatment.
Differential impact of divalent metals on native elongating transcript sequencing (NET-seq) protocols for RNA polymerases I and II
Authors: Huffines Abigail K. , Schneider David A.
Published: February 2025

Throughout all domains of life, RNA polymerases (Pols) synthesize RNA from DNA templates, a process called transcription. During transcription, Pols require divalent metal cations for nucleotide addition and cleavage of the nascent RNA after misincorporation or polymerase stalling. Recently, several next-generation sequencing techniques have emerged to study transcription at single-nucleotide resolution in vivo. One such technique, native elongating transcript sequencing (NET-seq), allows for isolation of transcription elongation complexes associated with a specific Pol, defining polymerase occupancy on the DNA template. Originally developed to study RNA polymerase II (Pol II), NET-seq has been adapted for RNA polymerase I (Pol I) and bacterial RNA polymerase. We recently optimized Pol I NET-seq in Saccharomyces cerevisiae, however, we omitted nucleases and their metal cofactors, which are commonly used in Pol II NET-seq. Here, we investigated the effect of CaCl2 ± MNase and MnCl2 ± DNase I on Pol I occupancy. We found that exposure of Pol I to CaCl2 and MnCl2 during NET-seq caused a significant reduction in immunoprecipitation of nascent rRNA compared to the untreated control samples, with a more severe effect when incubated with MnCl2 vs. CaCl2. Surprisingly, in contrast to the Pol I results, we found that metal treatment during Pol II NET-seq did not have a significant effect on nascent transcript capture. Taken together, these observations reinforce the conclusion that transcription elongation complexes formed by Pols I and II have unique characteristics and emphasize the need to carefully consider experimental conditions deployed in all stages of nucleic acid library generation.