bluuebunny/crossref_metadata_2025 huggingface dataset:
An objective and accurate G1-conforming mixed Bézier FE-formulation for Kirchhoff–Love rods
Authors: Greco Leopoldo , Castello Domenico , Cuomo Massimo
Published: December 2023

We present a new invariant numerical formulation suitable for the analysis of Kirchhoff–Love rod model based on the smallest rotation map for which the two kinematic descriptors are the placement of the centroid curve and the rotation angle that describes the orientation of the cross-section. In order to guarantee objectivity with respect to a rigid body motion, the spherical linear interpolation ( slerp) for the rotations is introduced. A new hierarchical interpolation for the rotation angle of the cross-section is proposed, composed by the drilling rotation (with respect to the unit tangent of the centroid curve) contained in the geodetic interpolation of the ends’ rotations plus an additional polynomial correction term. This correction term is needed in order to enhance the accuracy of the proposed finite element (FE) formulation. The FE model implicitly guarantees the G1 continuity conditions, thanks to a change in the parametrization of the centroid curve that leads to a generalization of the one-dimensional (1D) Hermitian interpolation. A mixed formulation is used in order to avoid locking and improve the computational efficiency of the method. A symmetric tangent stiffness operator is obtained performing the second covariant derivative of the mixed functional for which the Levi-Civita connection of the configurations manifold of the rod is needed. The objectivity, the robustness, and accuracy of the G1-conforming formulation are confirmed by means of several numerical examples.
Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Teli Margareta , Thato Ratsiri , Hasan Faizul , Rias Yohanes Andy
Published: December 2023

Background: Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. Methods: From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. Results: A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = −.47; 95% Confidence Interval [CI]: −.64 to −.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. Conclusion: Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family’s involvement.
Reconsidering the Terminology: Study Participants as “Subjects” or Not?
Authors: Corpuz Jeff Clyde
Published: December 2023

The article highlights the importance of semantics in shaping our perception of this relationship and the ethical, psychological, and practical dimensions of conducting research on human beings. The term “subjects” implies passivity and contradicts the principles of informed consent and participant autonomy, whereas research physicians often maintain a similar patient-physician relationship with participants. The article suggests that adopting more appropriate terminology, such as “participants” or “volunteers,” can better acknowledge their active role and foster collaboration. The author emphasizes that language in scientific discourse plays a significant role in upholding ethical principles and preserving the unique physician-participant relationship in clinical research.
The role of compression in large scale data transfer and storage of typical biomedical signals at hospitals
Authors: Jacobsson Martin , Seoane Fernando , Abtahi Farhad
Published: December 2023

In modern hospitals, monitoring patients’ vital signs and other biomedical signals is standard practice. With the advent of data-driven healthcare, Internet of medical things, wearable technologies, and machine learning, we expect this to accelerate and to be used in new and promising ways, including early warning systems and precision diagnostics. Hence, we see an ever-increasing need for retrieving, storing, and managing the large amount of biomedical signal data generated. The popularity of standards, such as HL7 FHIR for interoperability and data transfer, have also resulted in their use as a data storage model, which is inefficient. This article raises concern about the inefficiency of using FHIR for storage of biomedical signals and instead highlights the possibility of a sustainable storage based on data compression. Most reported efforts have focused on ECG signals; however, many other typical biomedical signals are understudied. In this article, we are considering arterial blood pressure, photoplethysmography, and respiration. We focus on simple lossless compression with low implementation complexity, low compression delay, and good compression ratios suitable for wide adoption. Our results show that it is easy to obtain a compression ratio of 2.7:1 for arterial blood pressure, 2.9:1 for photoplethysmography, and 4.1:1 for respiration.
Corporate strategy on climate risk in the courtroom: Not worth powder in shot
Authors: Gibbs-Kneller David
Published: December 2023

In ClientEarth v Shell Plc, ClientEarth brought ‘ground-breaking’ derivative litigation against the board of directors of Royal Dutch Shell Plc by alleging their corporate strategy on climate risk was determined in breaches of duties under the Companies Act 2006, ss. 172 and 174. This analysis of ClientEarth demonstrates the importance of the decision for climate litigation. First, it confirms that corporate strategy on climate risk is a matter for the directors and is not actionable because there is no accepted methodology on managing climate risk that can evidence the strategy is unreasonable. Second, it confirms that even if corporate strategy on climate risk is determined in breach of duty, it is still not worth powder in shot to pursue derivatively. The decision means climate risk is left to the private ordering of the company. That should send a message to Parliament because the directors’ determination of what is best for the company is not frictionless with environmental law goals. Without effective public ordering, the friction risks the UK failing to meet its international climate obligations.
Research on cord-laying angle and mechanical balance of rolling lobe air springs
Authors: Junjie Chen , Yueling Tan , Xinfeng Liu
Published: December 2023

The inflation of the rubber bellow leads to flexion and deformation during the operational process. The cord, serving as the primary load-bearing element of the rubber bellow in air springs, undergoes continuous changes in angle due to bending, torsion, and internal stress and moment within the bellow. This alteration causes the resultant force on the cord to deviate from its original direction, disrupting the force balance of the bellow and subsequently diminishing its fatigue life. To identify an optimal cord-laying angle that minimizes deviation from the cord's direction under the resulting force during operation, a theoretical model is established for the rubber bellow in rolling lobe air springs. This model is based on thin shell momentless theory and a force analysis of bellow micro-elements. The mapping relationship between the inflated cord angle and the uninflated cord-laying angle is examined. Furthermore, the dynamic variation of the cord angle along the longitudinal direction after the inflation of the rubber bellow is explored in this article. Additionally, a novel indirect measurement method for determining the outer diameter of the bellow is proposed to acquire the cord angle. This method is employed to verify the validity of the optimal cord-laying angle and the finite element model. The results indicate that the optimal setting interval Y for the cord-laying angle of sample A is [45°, 47°]. This finding not only offers theoretical support for the forming process of rubber bellows in rolling lobe air springs and the optimization of bellow characteristics but also introduces a new approach for measuring cord angle variations.
The ghosts of “internal colonisation”: Anthropogenic impacts of Russian imperial ambitions in Ukraine
Authors: Bogachenko Tetiana , Oleinikova Olga
Published: December 2023

The Anthropocene denotes an era of accelerated human impact on the environment. Although discourses of the Anthropocene are often criticized for representing colonial and specifically capitalist interests of economic growth, this paper examines, in the case of Ukraine, how these discourses can be applied to uncover and address social (post)colonial impacts of non-capitalist regimes (those also not classified as “Global North”). In particular, the analysis focuses on the aftermath of the 1986 Chernobyl nuclear plant accident on local communities in Ukraine. As academics of Ukrainian background, authors share their first-hand experiences of such impact on their lives and wellbeing of their families, communities, and land. The narrative research framework is used to engage with the modern Ukrainian community and discuss the implications of geopolitical and cultural proximity of the coloniser, with a particular focus on displacement and forced migration. This is especially relevant as it is reflected in the current refugee crisis and tactics of nuclear terrorism used by the Russian government in the war against Ukraine. This paper is a valuable resource for promoting and giving a voice to the Ukrainian people and potentially other peoples in post-Soviet space to unveil their colonial legacy and utilise the discourses of the Anthropocene to aid more effective decolonisation processes in the future of the region.
Research on the localization of pipe burst based on transient flow in a water supply network
Authors: Zheng Guolei , Tian Yimei , Li Zhengxuan , Cheng Jing , Liang Jianwen , Peng Sen
Published: December 2023

Methods for determining pipe burst (PB) locations based on supervisory control and data acquisition systems (SCADAs) have been widely studied. Existing location methods either only detect PB areas or are only applied to relatively simple pipe networks. Thus, it is necessary to develop a PB localization method that can both accurately locate the PB and be used for complex pipe networks. Accordingly, in this study, a complex experimental pipe network with a high-frequency SCADA was built, and PB events were constructed under different conditions. After they were analyzed, the water pressure and flow anomalous features of the PBs were summarized. According to the propagation laws and damping theories of transient flow (TF), a PB localization method, that is, the TF simulation (TFS) method, was first proposed and developed after a TF model of the experimental pipe network was established. Using this method, two PB events were recognized, the burst pipes were identified, and the PBs were accurately located. Compared with the negative pressure wave method, the TFS method exhibits a higher location accuracy and a wider applicability to pipe networks. Through error analyses, it is shown that the TFS method has small errors. To reduce cost, the sampling frequency was decreased to 50 Hz, that is, the minimum required sampling frequency for this study, and under this condition, PB localization was successfully realized. An additional three PB localizations illustrate that they have acceptable errors and that the TFS method has good repeatability.
Who is To Blame? Partisans’ Use of Blame Spreading in Reaction to Unfair or Dishonest Behavior
Authors: Meli Amy D.
Published: December 2023

Blame attribution research suggests partisans acknowledge evidence that portrays copartisans negatively but blame externalities for negative events. This study identifies another blame attribution pattern. When people observe unfair/dishonest behavior by a copartisan, instead of shifting blame entirely to others, they engage in blame-spreading. I conduct two tests: a survey of undergraduate students who watched part of a 2020 Presidential debate and a survey experiment of a random sample of adults that randomizes the party affiliation of the debate participant engaging in unfair/dishonest behavior. When the unfair actor is a copartisan, people blame both participants equally. When the unfair actor is in the out-party, people blame the out-party actor. These findings suggest individuals acknowledge undesirable behavior among copartisans, but seek to justify it by identifying blame-worthy behavior by others, thus providing an additional mechanism in motivated reasoning whereby individuals acknowledge events while finding a way to justify such behavior.
A Shadow’s Influence? How the Shadow Docket Influences Public Opinion
Authors: Smart EmiLee
Published: December 2023

Does increased use of the shadow docket influence public opinion of the Supreme Court? In recent years, the shadow docket of the Supreme Court has been used with increased frequency to make important decisions. The little research done previously on this docket has led to speculation that the shadow docket creates potential problems with perceptions of legitimacy for the Court. I theorize that procedures matter in changing public opinion of an institution when the procedures are nontransparent, stray from expected norms, and are thus perceived as politically unfair. I administered a survey experiment and find evidence to suggest that use of the shadow docket procedure does lead to less support for decisions as well as an increased support for measures of broad court curbing. The results have important implications for approval of the Court as well as the role of the Court in a transparent democracy.
Carrying an unintended pregnancy to term and long-term maternal psychological distress: Findings from the Dutch prospective Amsterdam Born Children and their Development study
Authors: Beumer Wieke Y , Roseboom Tessa J , Koot Marjette H , Vrijkotte Tanja , van Ditzhuijzen Jenneke
Published: December 2023

Background:

Given the estimated high rate of unintended pregnancies, it is important to investigate long-term effects on psychological distress in women carrying an unintended pregnancy to term. However, research into associations between unintended pregnancies carried to term and psychological distress postpartum is mixed, and especially, evidence on long-term associations is scarce.

Objective:

To examine whether carrying an unintended pregnancy to term is associated with maternal psychological distress later in life, up to 12 years postpartum.

Design:

This study is based on the population-based birth cohort study ‘Amsterdam Born Children and their Development’ study, which included pregnant people in 2003 ( n = 7784) and followed them up until 12 years postpartum.

Methods:

Unintended pregnancy was measured as a multidimensional construct, based on self-reported data around 16 weeks gestation on pregnancy mistiming, unwantedness and unhappiness. Symptoms of maternal psychological distress were assessed around 3 months, 5 years and 12 years postpartum using multiple questionnaires measuring symptoms of depression, anxiety and stress. Multiple structural equation modelling models were analysed, examining the associations between dimensions of unintended pregnancy and maternal psychological distress per time point, while controlling for important co-occurring risks.

Results:

Pregnancy mistiming and unhappiness were significant predictors of more maternal psychological distress around 3 months postpartum. Around 5 years postpartum, only pregnancy mistiming was positively associated with maternal psychological distress. Dimensions of unintended pregnancy were no longer associated with maternal psychological distress around 12 years postpartum. Strikingly, antenatal psychological distress was a much stronger predictor of maternal psychological distress than pregnancy intention dimensions.

Conclusion:

Those who carried a more unintended pregnancy to term reported more symptoms of psychological distress at 3 months and 5 years postpartum. People carrying an unintended pregnancy to term may benefit from extra support, not because of the pregnancy intentions per se, but because they may be related to antenatal psychological distress.
Non-pharmacological interventions for the treatment of post-stroke fatigue: A systematic review
Authors: Komber Ahmad , Chu Shuk Han , Zhao Xu , Komber Hend , Halbesma Nynke , Mead Gillian
Published: December 2023

Background:

Post-stroke fatigue (PSF) affects 50% of stroke survivors. Current guidance on management of this condition is limited.

Aims:

This systematic review and meta-analysis aimed to identify and analyze all randomized clinical trials (RCTs) of non-pharmacological interventions for the treatment of PSF.

Summary of review:

Six electronic databases were searched from inception to January 2023 for English-language RCTs investigating the efficacy of non-pharmacological interventions versus passive controls in patients with PSF. The primary outcome was fatigue severity at the end of the intervention. The Cochrane risk-of-bias (ROB)2 tool was used to assess evidence quality. A total of 7990 records were retrieved, 333 studies were scrutinized, and 13 completed RCTs (484 participants) were included. Interventions included psychological therapies, physical therapies, and brain stimulation. Nine studies provided sufficient data for meta-analysis, of which seven also had follow-up data. Fatigue severity was lower in the intervention groups at the end of the intervention compared with control (participants = 310, standardized mean difference (SMD) = −0.57, 95% confidence intervals (CIs) (−0.87 to −0.28)) and at follow-up (participants = 112, SMD = −0.36, 95% CIs (−0.83 to 0.10)). Certainty in the effect estimate was downgraded to low for a serious ROB and imprecision. Subgroup analysis revealed significant benefits with physical therapy and brain stimulation but not psychological therapies, though sample sizes were low.

Conclusion:

Non-pharmacological interventions improved fatigue but the quality of evidence was low. Further RCTs are needed for PSF management.
Depression screening within 3 months of primary shoulder arthroplasty decreases medical complications, implant complications, and costs of care in patients with diagnosed depressive disorder
Authors: Gordon Adam M , Elali Faisal R , Miller Chaim , Schwartz Jake M , Choueka Jack
Published: December 2023

Background

It is unknown if nonpharmacologic interventions are protective of adverse outcomes in depression patients. We studied whether depression screenings/psychotherapy visits were associated with lower: (a) medical complications, (b) readmission rates, (c) implant-related complications, and (d) healthcare expenditures.

Methods

A nationwide claims database was queried for primary shoulder arthroplasty from 2010 to 2020. Depression patients included those who had (n  =  3566) and did not have (n  =  17,769) a pre-operative depression screen/psychotherapy visit within 3 months of shoulder arthroplasty. A 90-day period was utilized for complications and readmissions. Implant complications were assessed over 2 years. Costs were surgeon reimbursements. Logistic regression models computed odds ratios (OR) of complications and readmissions. P-values less than 0.005 were significant.

Results

Depression patients who did not undergo screening had threefold higher odds of 90-day medical complications (28.08 vs. 7.26%; OR: 3.33, p < 0.0001). Readmissions (3.97 vs. 3.48%; p  =  0.719) were similar between non-screened vs. screened patients. Implant complications were higher among non-screened vs. screened patients (15.89 vs. 8.02%; OR: 1.93, p < 0.0001), including prosthetic joint infections (2.05 vs. 0.93%; OR: 2.04, p < 0.0001). Costs were significantly higher in patients without screening ($10,916 vs $8703; p < 0.0001).

Discussion

Shoulder arthroplasty surgeons may consider counseling their depression patients about the importance of having a recent screening by their physician. Level of Evidence: III
The perspectives of health sciences students the new way of learning: Mixed methods design
Authors: Berenshtein Yisca , Tesler Riki , Hochwald Inbal Halevi , Green Gizell
Published: December 2023

Objectives

The study aimed to determine the following four differences between students in the fields of nursing and health systems management: (a) attitudes towards web-based learning, (b) online course anxiety, (c) online course self-efficacy, and (d) intentional use of technology for learning and find factors that influence students’ intentional learning with technology.

Methods

The study utilized an explanatory sequential mixed methods design. The study was performed according to the checklist for assessment and reporting of document analysis for mixed methods design and research in health professions education. We included students from the School of Health Sciences, including those studying nursing and health systems management. There were 304 students included in our study.

Results

Students from health systems management had more positive attitudes toward web-based learning than nursing students. Health science students’ years of study, online course self-efficacy, and web-based learning influence intentional learning with technology among students. The qualitative finding corresponds only with the qualitative result demonstrated that online course self-efficacy predicts the intentional use of technology for learning.

Conclusions

It is needed to consider factors for designing effective online learning experiences in health science, enabling educators to enhance intentional technology-based learning for nursing and health systems management students through web-based learning optimization.
Top Company Officers and Auditor School-ties on Audit Fee: Evidence From Indonesia
Authors: Nasih Mohammad , Soeprajitno Raden Roro Widya Ningtyas , Harymawan Iman , Nowland John
Published: December 2023

The purpose of this study is to examine the relationship between top management school-ties represented by the CEO (Chief Executive Officer), CFO (Chief Financial Officer), and the Auditor with the Audit Fee. This study uses 627 observations from companies listed on the Indonesia Stock Exchange from 2010 to 2018 and uses the Ordinary Least Square Regression analysis model. This study finds that the combination of school-ties between CFO and Auditor showed a positive relationship with Audit Fee, while the combination of school-ties between CEO and Auditor did not. This study contributes to literature related to the relationship between school-ties and audit fees of public companies in Indonesia. It is also hoped that it can contribute to the implementation of company policies, management, external parties, named regulators, and investors. This study chose school-ties as a part of social-ties to represent the condition of Top company officers and Auditors ties.

JEL Classification: H83, M42, G32, G34
Lexical Bundles in Reading Comprehension Passages of Chinese National Matriculation Entrance Test: A Corpus-Based Contrastive Analysis
Authors: Wang Feng , Jia Xingxing , Lin Zhong
Published: December 2023

The construct of reading is presented in language assessment. Previous studies have focused on reading issues encountered by English learners, most of which are manifested by certain linguistic features: lexical bundles (LBs). Addressing this, the study aims to analyze LBs in reading comprehension passages in the Chinese National Matriculation Entrance Test (NMET) and contrast them with those in the International English Language Testing System (IELTS), by focusing on the form, function, and frequency of three-word formulaic units. Data collected from self-built corpora based on the two tests were analyzed using Biber et al.’s structural and functional taxonomies. Results suggested that NMET includes a substantially lower frequency of bundles and a notably limited range of bundle patterns than IELTS. Results also indicated that the structural forms of LBs in NMET are clausal and that the dominant function is referential. This study has pedagogical implications for test designers and English reading educators.
Supply Chain Finance and Industrial Efficiency: Evidence From ICT Industry
Authors: Meng Jiajia , Wang Xuedong , Yang Jialu
Published: December 2023

This study explores the impact of supply chain finance on industrial efficiency and the internal mechanism. The super-efficiency model and quantitative analysis method were used based on the time series data of the ICT industry in Shenzhen from 2005 to 2020. In order to better investigate the impact of supply chain finance on industrial efficiency, this study categorized industrial efficiency into operational efficiency and innovation efficiency to reflect the durability and virtuousness of the industry development. Results indicate that supply chain finance has an inverted U-shaped nonlinear effect on industrial efficiency. Even though the long-term effect on operational efficiency is positive, the effect on innovation efficiency reveals an inverted U-shape, mainly due to the mediating effect of industrial concentration. Theoretically, this study sheds light on the intricate effects of supply chain finance at the industrial level, and also provides valuable insights into the potential inhibition mechanism, which enriches and deepens the related research on the supply chain finance from the nonlinear perspective, make the research findings more consistent with the fact of industrial development and avoid the linear stereotypes of the existing theory consensus. Practically, it is conductive to an objective understanding for managers and policymakers, so that supply chain finance can facilitate both operational and innovation efficiencies and realize the effective integration of supply chain finance and industrial development.
E-learning Acceptance in Face-to-Face Universities due to COVID-19
Authors: Estriegana Rosa , Medina-Merodio Jose-Amelio , Robina-Ramírez Rafael , Barchino Roberto , De-Pablos-Heredero Carmen
Published: December 2023

The COVID-19 pandemic has led to unprecedented shifts in higher education worldwide. These sudden educational changes have the potential to accelerate the acceptance of online learning, or, conversely, to increase its rejection. The purpose of this experimental study is to examine students’ acceptance of and intentions toward the continued use of online learning, which was abruptly introduced by face-to-face universities due to the COVID-19 pandemic. To this end, responses to an online questionnaire from students at three face-to-face universities ( N = 194) were analyzed using structural equation modeling. The study was based on the technology acceptance model (TAM), we also included other relevant factors, such as emotional aspects, feelings of uncertainty, security of the e-learning system, and satisfaction with educational technology. The results indicate that the uncertainty associated with COVID-19, emotional factors, and security did not significantly affect the students’ intention to use e-learning systems; however, these factors had a significant impact on students’ perception of satisfaction, which is a decisive factor that positively influences the process of adoption of e-learning systems. This study discusses noteworthy theoretical and practical implications for education that will help teachers and universities in decision making regarding the digital transformation process.
Expectations and Effectiveness of Preschool Teacher Training Program: A Case Study of Teacher Training Course for the Holistic Music Educational Approach for Young Children
Authors: Lee Liza
Published: December 2023

This study examines the expectations and effectiveness of a teacher training program for early childhood music education, specifically focusing on the Holistic Music Educational Approach for Young Children (HMEAYC) and its integration with local cultural frameworks. Participants ( n = 30) from a private university’s Department of Early Childhood Development and Education, aged between 22 and 25 years old, were about to obtain their early childhood education teaching qualification. The 36-week training, consisting of 3 hr per week, employed collaborative teaching methods and collective reflection to gather pre- and post-training data. The results indicate a 90.91% pass rate for participants who successfully obtained the HMEAYC teacher qualification. While overall expectations regarding course identity, musical skills, and pedagogical competence did not exhibit significant changes, participants with better training outcomes experienced significant positive changes in psychological cognition of musical skills and curriculum identity, with no significant difference in pedagogical competence cognition. Furthermore, Spearman’s correlation coefficient analysis revealed positive correlations between cognitive changes in musical skills, course identity, and pedagogical competence after training. Conversely, negative correlations were observed between cognitive changes in musical skills and both course identity and pedagogical competence before training, suggesting a strong association between changes in music skills and other variables.
Postoperative Time Course of Avulsion-Type Herniation Focused on the Development of New Modic Changes and Their Effect on Short-Term Residual Low Back Pain
Authors: Kawaguchi Kenichi , Saiwai Hirokazu , Iida Keiichiro , Kobayakawa Kazu , Matsumoto Yoshihiro , Harimaya Katsumi , Kato Go , Nakashima Yasuharu
Published: December 2023

Study Design

Retrospective study.

Objective

To investigate the characteristics of newly developing Modic changes following discectomy and their impact on residual low back pain (LBP) in the early postoperative stage of lumbar disc herniation.

Methods

We included 96 patients who underwent microscopic discectomy. Through MRI, we assessed new developments of Modic changes and the progression of disc degeneration at the surgical level. The presence of cartilaginous endplates was evaluated using resected specimens, and the main outcome was assessed using the visual analog scale (VAS). Further, the prevalence and time course of Modic changes, and their effects on clinical outcomes in the early postoperative period were examined.

Results

A new development of Modic changes was detected in 28% of cartilaginous herniations at 6 months. Modic changes were observed more frequently in patients with cartilaginous herniation than in those without cartilaginous herniation postoperatively ( P < .001). The VAS scores for LBP up to 6 months were greater in patients with Modic changes ( P < .001) than those without; however, no significant differences were identified in the presence or absence of Modic changes over the year follow-up. The development of Modic changes was closely associated with residual LBP at 6 months (β:0.511, P < .001).

Conclusions

Modic changes develop predominantly in patients with avulsion-type herniation than in those with annular rupture at an earlier phase after discectomy. Furthermore, disc herniation with cartilaginous endplates may be associated with a slower decrease in LBP for up to 6 months, supporting the notion that newly developing endplate changes may cause residual LBP.
Exploring criteria for university mathematics teachers’ selection of calculus textbooks
Authors: Viramontes-Miranda Juan de Dios , Sánchez Aguilar Mario
Published: December 2023

This study delves into the nuanced process of calculus textbook selection by university mathematics lecturers. Drawing from a conceptual framework that encompasses various selection criteria, including culture-driven, student-driven, resource-driven, teacher-driven, mathematics-driven, and constraints-driven factors, the research examines the predominant criteria guiding lecturers’ choices. Data from participating lecturers reveal a multifaceted decision-making process. “Culture-driven selection” emerges as a significant criterion, indicating the influence of curriculum committees. Additionally, educators prioritize “student-driven selection,” valuing accessibility and contextualization, while also favoring textbooks with abundant resources and problems. The study underscores the complexity of textbook selection, shedding light on how instructors navigate educational, commercial, and student-centered considerations. These findings offer insights beneficial for textbook authors and publishers, useful for the creation of resources aligned with educators’ preferences.
Findings from a decade of ground motion simulation validation research and a path forward
Authors: Rezaeian Sanaz , Stewart Jonathan P , Luco Nicolas , Goulet Christine A
Published: December 2023

Simulated ground motions have the potential to advance seismic hazard assessments and structural response analyses, particularly for conditions with limited recorded ground motions such as large magnitude earthquakes at short source-to-site distances. However, rigorous validation of simulated ground motions is needed for hazard analysts, practicing engineers, or regulatory bodies to be confident in their use. A decade ago, validation exercises were mainly limited to comparisons of simulated-to-observed waveforms and median values of spectral accelerations for selected earthquakes. The Southern California Earthquake Center (SCEC) Ground Motion Simulation Validation (GMSV) group was formed to increase coordination between simulation modelers and research engineers with the aim of devising and applying more effective methods for simulation validation. Here, we summarize what has been learned in over a decade of GMSV activities, principally reflecting the views of the SCEC research community but also extending our findings and suggestions for a path forward to broader United States and worldwide simulation validation efforts. We categorize different validation methods according to their approach and the metrics considered. Two general approaches are to compare validation metrics from simulations to those from historical records or to those from semi-empirical models. Validation metrics are categorized into ground motion characteristics and structural responses. We discuss example validation studies that have been impactful in the past decade and suggest future research directions. Key lessons learned are that validation is application-specific, our outreach and dissemination need improvement, and much validation-related research remains unexplored.
How to classify risk based on clinical and molecular modeling: integrating molecular markers in the risk assessment of myelodysplastic syndrome
Authors: Xian Rena R.
Published: December 2023

Myelodysplastic syndrome (MDS), also known as “myelodysplastic neoplasm,” is a heterogeneous group of clonal myeloid neoplasms that typically affects older adults. The clinical phenotype, symptoms, and complications relate to the depth of cytopenia and progression to acute myeloid leukemia (AML). The diagnosis of MDS relies on morphologic criteria, such as evidence of dysplasia, disordered maturation, and increasing blast counts, which separate the disease into histologic subtypes with different probabilities for progression to AML. The treatment of MDS is often risk-adapted depending on the prognostic profile of each patient's disease. There has been a coevolution of diagnostic and prognostic systems for MDS developed over the past 40 years, both of which have now incorporated molecular markers. The new International Prognostic Scoring System-Molecular (IPSS-M) improves partitioning of patients compared to prior versions with resultant upgrading of 34% of patients into higher-risk groups due to the presence of mutations. The new IPSS-M also more accurately distinguishes intermediate-risk patients separating them into two tiers. The two new diagnostic classifications include MDS defined by mutations in SF3B1 and TP53, though there are differences in diagnostic criteria. Future efforts to refine MDS prognostication could investigate the interface between MDS and clonal cytopenia of undetermined significance, expand access to genomic testing, obtain results in a less invasive manner, and develop treatment-response predictors and dynamic risk models.
The approach of HMA plus VEN with or without BMT for all patients with AML
Authors: Male Heather J. , Lin Tara L.
Published: December 2023

Treatment options for acute myeloid leukemia (AML) have expanded over the last 5 years. New regimens are increasing the options for patients who previously may not have been offered any antineoplastic therapy. The use of the hypomethylating agent (HMA) decitabine or azacitidine combined with the BCL2 inhibitor venetoclax (HMA-VEN) has improved overall survival in an older and unfit population compared to HMA therapy alone. Delivering these regimens outside academic centers allows more patients with AML to be treated, though support and collaboration with allogeneic stem cell transplant (SCT) centers should still be considered to determine eligibility and promptly initiate a donor search for potential transplant candidates. Expanding the use of HMA-VEN to younger and fit patients who are also candidates for intensive chemotherapy (IC) is being studied prospectively and is not recommended at this time outside of a clinical trial. Retrospective studies suggest populations that may benefit from HMA-VEN over IC, but this is not yet confirmed prospectively. Utilizing HMA-VEN prior to allogeneic SCT is also under investigation, and some retrospective data show feasibility and the ability to achieve measurable residual disease negativity pretransplant. Upcoming prospective randomized clinical trials aim to answer the comparability or superiority of HMA-VEN vs IC in fit populations and its potential use as a standard pretransplant induction regimen.
Multiple myeloma: a paradigm for blending community and academic care
Authors: Berdeja Jesús G.
Published: December 2023

The care of the multiple myeloma (MM) patient is complex, with most patients requiring multiple lines of therapy over a span of many years to decades. Since the days when autologous stem cell transplantation became the standard of care for a large subset of patients, it was imperative that community practices and specialized academic centers work together to optimize the initial care of patients. Now, with the unprecedented number of treatment options and the introduction of chimeric antigen receptor T-cell therapies and bispecific T-cell engagers, that collaboration has become even more important and stretches from the upfront treatment to the relapsed and refractory disease setting. I will discuss the unique safety profile and logistical aspects that pose challenges and opportunities for the safe and successful delivery of these therapies. Close interaction, communication, and established partnerships between the primary oncologist, the myeloma specialist, and the transplant or immune effector cell provider will be required to provide the optimal care longitudinally for each patient. This multidisciplinary approach to treating MM can serve as a paradigm for blending community and academic care.
Clinical research in the community
Authors: Birhiray Ruemu Ejedafeta , Birhiray Maya Nicole
Published: December 2023

Most patients with high-risk hematologic malignancies are treated in community oncology practices near their residence. This is partly due to patients' ardent desire to be closer to home and trust in local caregivers. Treatments are increasingly complex, even as initial therapy, and more so upon relapse. Improved outcomes in the past decade are largely available through clinical trials primarily offered through academic medical centers. Limited availability of clinical trials at community oncology practices is a major contributor to outcome disparities among minorities, rural, and elderly patients, all of whom are underrepresented in clinical trials. Between 2003 and 2023, the National Cancer Institute (NCI) established programs to address these challenges: the Community Clinical Oncology Program, Minority- Based Community Clinical Oncology Program, NCI Community Cancer Centers Program, and NCI Community Oncology Research Program. However, disparities have persisted, particularly for pharmaceutical-directed clinical research. Lack of representation in clinical research results in data absenteeism, data chauvinism and hallucination, and a delay in treatment availability for high-risk hematologic malignancies in community practice. To address this, the US Congress enacted the Food and Drug Administration Omnibus Act in 2022 to help establish diversity plans that would broaden clinical trial patient enrollment in the United States. We recommend using these initiatives in community oncology practices, including the adoption of the DRIVE strategy in collaboration with pharmaceutical companies, as well as using the NCI-established programs to promote clinical trial availability for patients with high-risk malignancies treated in community oncology practices.
Current use of bispecific antibodies to treat multiple myeloma
Authors: Lee Holly , Neri Paola , Bahlis Nizar J.
Published: December 2023

Targeted immunotherapy has significantly improved the outcome of patients with hematological malignancies by leveraging the power of the immune system to eliminate tumor cells. In multiple myeloma (MM), bispecific T-cell engagers (BsAb) targeting B-cell maturation antigen (BCMA), G protein–coupled receptor, class C, group 5, member D (GPRC5D), and Fc receptor-like 5 (FcRL5) have already demonstrated remarkable clinical activity in triple-class refractory patients. However, responses to BsAb are not universal, and resistance often emerges while on therapy. Mechanisms mediating resistance are tumor intrinsic or immune dependent. Reported tumor intrinsic factors include antigenic loss (biallelic or functional) through deletions or mutations of target genes, increased soluble BCMA (for BCMA targeting BsAb), high tumor burden, and extramedullary disease. Immune-mediated resistance are largely dependent on T-cell fitness and tolerant immune environment. Understanding these mechanisms will allow the design of optimized BsAb therapy and an informed approach to sequencing and combining these molecules with other anti-MM agents and immune therapies.
Langerhans cell histiocytosis: promises and caveats of targeted therapies in high-risk and CNS disease
Authors: Abla Oussama
Published: December 2023

Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm driven by activating mutations in the MAPK pathway, most commonly BRAF-V600E and MAP2K1. It affects children and adults, with a wide spectrum of clinical presentations ranging from self-limited to multisystem (MS) life-threatening forms. LCH is defined by the accumulation of CD1a+/CD207+ cells in different organs, and patients with liver, spleen, or hematopoietic system involvement have a higher risk of mortality. Patients with neurodegeneration (ND) have devastating outcomes and are resistant to systemic therapies. MS-LCH is treated with risk-adapted therapy, but many patients require multiple salvage regimens that are myelosuppressive and expensive. MAPK inhibitors are increasingly being used, but most patients relapse upon discontinuation of therapy. Here, we review the management of central nervous system disease and how novel cerebrospinal fluid biomarkers might predict patients at high risk of ND who could benefit from early MAPK inhibition. Further, we discuss treatment strategies for refractory/relapsed (R/R) LCH, with a focus on MAPK inhibitors' efficacy and challenges (ie, the unknown): long-term toxicity in children, optimal duration, if they are curative, whether it is safe to combine them with chemotherapy, and their high price tag. Lastly, emerging strategies, such as the new panRAF inhibitor (Day 101) in patients with R/R LCH, ERK1/2 or CSF1R inhibition in patients with MEK1/2 inhibitor resistance, and targeting the microenvironment (checkpoint plus MEK inhibition) or senescent cells (mTOR or BCL-XL inhibitors) in R/R patients, are also examined.
Richter transformation—is there light at the end of this tunnel?
Authors: Eyre Toby A.
Published: December 2023

Richter transformation (RT) represents an uncommon (2% to 10%) but feared complication of chronic lymphocytic leukemia (CLL). The disease is characterized by rapid disease kinetics, a high-risk genetic mutational profile, chemoimmunotherapy resistance, and consequent poor survival. The typical overall survival (OS) from the pre-Bruton tyrosine kinase (BTK)/B-cell lymphoma 2 (BCL2) inhibitor CLL era is 6–12 months, and recent series of RT complicating progression on a BTK or BCL2 inhibitor in heavily pretreated relapsed CLL patients suggests an OS of only 3–4 months. Despite these sobering survival statistics, novel agents have the potential to impact the natural RT disease course. This article reviews recent therapeutic developments, focusing on inhibitors of BTK, BCL2, the PD1-PDL1 axis, and T-cell–activating/engaging therapies. Herein, I discuss the importance of randomized clinical trials in a disease where small single-arm studies dominate; industry engagement, including the role of registrational studies; and the need to integrate prospectively planned correlative biological studies embedded within future clinical trials to help discover which patient benefits most from each class or combination of novel targets.
The role of emicizumab in acquired hemophilia A
Authors: Poston Jacqueline , Kruse-Jarres Rebecca
Published: December 2023

Acquired hemophilia is a rare bleeding disorder that predominantly affects older people with potential underlying comorbidities, including cardiovascular and thrombotic risk factors. The current standard therapies with hemostatic agents for acute bleeding and immunosuppression often require inpatient management, are not approved for routine bleeding prophylaxis, and contribute to the high mortality in this population. Emicizumab is a factor VIII (FVIII) mimetic approved for bleeding prophylaxis in congenital hemophilia A with and without FVIII inhibitors. Given subcutaneously, it may allow easier outpatient bleeding prophylaxis and reduce intensity of immunosuppression. This article summarizes the currently available data on the efficacy and safety of emicizumab in acquired hemophilia A.