bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a predictive model for the need for early surgery in patients with adhesive small-bowel obstruction
Authors: Sun Yanhao , Hu Yilong , Sun Yuanfang
Published: December 2024

Objective

To develop a predictor of early surgical intervention in patients with adhesive small-bowel obstruction (ASBO), to optimise treatment strategies and improve patient outcomes.

Methods

A retrospective analysis was conducted of patients with ASBO between August 2019 and June 2024. Clinical, laboratory and imaging data were analysed. A scoring system was developed using C-reactive protein (CRP) concentration, white blood cell (WBC) count, body mass index (BMI), and imaging findings.

Results

The developed ASBO surgical score predicted the need for early surgery with a sensitivity of 89.6%, a specificity of 87.3%, and an area under the curve of 0.88. Patients with a score of 5 to 7 were significantly more likely to require surgical management: 75% of these patients underwent surgery, versus 4.2% in the Conservative treatment group. Key predictors of the need for surgery were high CRP concentration (>54.3 nmol/L), high WBC count (>11.0 × 109/L), BMI <22 kg/m2, maximum small intestinal diameter on computed tomography images >3.85 cm, and free fluid in the abdominal cavity.

Conclusions

The ASBO surgical score is a practical tool that should aid in the timely identification of patients requiring surgical intervention, and may reduce the risk of complications and improve the outcomes of patients.
Probabilistic Analysis of Airborne Collision Risk by Data Driven Approach
Authors: Wu Jingshu , Bati Firdu , Pistryakov Ilya , McNeill Donald B.
Published: December 2024

Aviation safety relies on maintaining adequate spacing between aircraft. While uncertainties are common, this study employs approaches that account for small uncertainties and deviations in aircraft positions. The objective is to assess the likelihood of airborne collision risks using data from the Aviation Risk Identification and Assessment (ARIA) developed by MITRE. To achieve this, we utilize a model that integrates probability density functions (PDFs), convolution integrals, and engineering dynamics. The study validates results from the convolution approach using a logit model for binary outcome data, where 1 indicates a collision event if the spacing is less than or equal to [Formula: see text], and 0 otherwise. Predictions from both the convolution and logit models show similarities in the horizontal dimension, with parameters derived exclusively from data-driven methods. Total collision risks are calculated by multiplying probabilities across horizontal, vertical, and time intervention dimensions. Notably, vertical spacing data exhibit considerable volatility, leading to a wider probability range and discussions on threshold crossings. Reliability theory is also applied to analyze the impact of timely interventions. This study highlights the correlation between collision probabilities and ARIA scores, while Bayesian Monte Carlo simulations reveal underlying data patterns. Additionally, the research addresses the strengths and limitations of the analytical models. For instance, navigation system errors and deviations in paired aircraft positions are often dynamic and unknown, and ARIA data may not fully capture the complexities of potential collisions. These factors underscore the need for further data-driven efforts to obtain more accurate estimates of uncertainties and overlap probabilities.
Pyrolysis of Dutch mixed plastic waste: Lifecycle GHG emissions and carbon recovery efficiency assessment
Authors: Petrík Juraj , Genuino Homer C. , Kramer Gert Jan , Shen Li
Published: December 2024

Plastic production and consumption contribute to climate change and the depletion of non-renewable fossil resources, necessitating a shift towards a circular economy. This study explored the potential of pyrolysis as a novel approach to managing plastic waste and achieving plastic circularity in the Netherlands. Specifically, we focused on the pyrolysis of DKR-350, a low-quality mixed-plastic sorting residue. Using the life cycle assessment framework, we analysed DKR-350 pyrolysis, based on empirical data from pilot-scale trials, from two perspectives depending on the system’s primary function: waste management or naphtha production. We also considered the impacts of pyrolysis feedstock pre-treatment, including washing. Our findings demonstrated that pyrolysis of DKR-350, with lifecycle greenhouse gas (GHG) emissions of 876 kg CO2 eq. per 1000 kg pyrolysed unwashed DKR-350, can offer significant environmental benefits compared to incineration, resulting in a 28%–31% reduction in lifecycle GHG emissions. Sensitivity analysis showed the potential for achieving a 39%–65% reduction in GHG emissions by 2030, with lifecycle GHG emissions representing a mere 470 kg CO2 eq. per 1000 kg pyrolysed unwashed DKR-350 for the best sensitivity case. Lastly, we analysed the carbon recovery efficiency – a potential circularity indicator based on substance flow – resulting in 38%–55% of recovered carbon in pyrolysis oil, the system’s main product from a lifecycle perspective.
Simultaneous remediation of As(V), Cd(II) and Pb(II) in aqueous solution and soil using Fe/Ca-modified biochar
Authors: Zhou Yan , Liu Wenhui , Chen Dandan , Liu Bangwei , Lu Ping , Zhang Yiwei
Published: December 2024

A novel Fe/Ca-modified biochar (BC) derived from corn stalk was prepared in this study for the simultaneous adsorption and immobilization of arsenic, cadmium and lead in aqueous solution and soil, respectively. The adsorption experiment in aqueous solution indicated that 1Ca-Fe@BC exhibited excellent removal efficiency ( R, %) towards arsenic (46.3%), cadmium (76.3%) and lead (93.6%). The presence of cadmium and lead could enhance the adsorption efficiency of arsenic by facilitating the formation of ternary complexes with it. Moreover, both cooperative and competitive effects occurred between cadmium and lead adsorption. When the distribution coefficient of cadmium and lead was equimolar, cooperative adsorption prevailed. However, when the distribution coefficient deviated from this balance, competitive adsorption dominated with a higher affinity for lead. The soil culture experiment demonstrated that the utilization of 1Ca-Fe@BC could enhance the stability of arsenic, cadmium and lead in soil by enhancing soil cation exchange capacity and pH while reducing dissolved organic carbon. The competitive and cooperative effects of arsenic, cadmium and lead in soil were consistent with those found in aqueous solution. The results showed that 1Ca-Fe@BC exhibited an excellent remediation efficiency for both arsenic, cadmium and lead-contaminated aqueous solution and soil.
Exploring the Impact of Public Service Motivation on Public Employee’s Coping Strategy With Clients: Nuanced Insights From Varied Contexts
Authors: Tao Lei , Liu Ning , Wen Bo
Published: December 2024

This study analyzes the impacts of public service motivation (PSM) on the front-line public employees’ coping strategy, considering the moderating roles of two contextual factors: organizational performance pressure and clients’ help deservingness. Two vignette-based survey experiments were conducted separately in regulation and service settings (financial regulators and healthcare workers) in China. The findings indicate agreement across different settings on the positive effects of PSM on public employees’ intention to move against clients. However, the evidence regarding the moderating roles of organizational performance pressure and clients’ help deservingness points to more complexity, with the results varying in the regulation and service settings. In the regulation setting, organizational performance pressure crowds out financial regulators’ PSM, leading to declining intentions of moving against clients. However, in the service setting, clients’ help deservingness serves as a significant contextual factor, moderating the relationship between healthcare workers’ PSM and intentions on moving against clients.
Using the Life History Calendar to Examine Victimization, Mental Health, and Seeking and Attaining Help Among Transgender Women: An Example of a Culturally Relevant Adaptation
Authors: Hereth Jane E. , Kennedy Angie C. , Garthe Rachel C. , Durand Brenna , Morein Lane , Lunger Lexy , De Smet Lucas E. , Thornton Lukas E. , Blackburn Allyson M. , Saba Jessica
Published: December 2024

Transgender women are at increased risk for interpersonal violence victimization, including physical and sexual child abuse and mistreatment, intimate partner violence and sexual assault, and transgender-related community violence. Experiencing multiple forms of interpersonal victimization is associated with a range of adverse mental health outcomes. Life course approaches such as the life history calendar (LHC) are useful for examining trajectories of victimization and associated mental health outcomes, yet to date this method has not been used to examine transgender women’s victimization trajectories. In this paper, we describe adapting the LHC to examine transgender women’s experiences of victimization, adverse mental health, help-seeking, and help-attainment ( N = 103), and we share participants’ feedback on the acceptability of the LHC. First, we engaged in an iterative and collaborative process to adapt existing LHCs used in studies on victimization among cisgender women to ensure relevancy for our sample and then we conducted one-on-one interviews with participants using the adapted LHC. At the end of the interview, participants were asked for feedback about their experience. Responses were transcribed verbatim and coded using open and thematic coding methods. Overwhelmingly participants (97.8%) found the experience to be “positive” (73.0%) or “neutral” (39.3%). Just two participants’ responses were coded as only “challenging.” Other themes included enjoying the process of using the calendar to reflect on their life events and feeling good about using their stories to help others. The adaptation and findings from our study demonstrate that despite high levels of victimization and trauma and potential difficulty discussing these topics in a research context, transgender women who participated in this study found the LHC interview to be acceptable and, in many cases, positive. Findings can inform future LHC adaptations and research as well as the development of culturally relevant and effective mental health interventions for transgender women.
SedaDNA shows that transhumance of domestic herbivores has enhanced plant diversity over the Holocene in the Eastern European Alps
Authors: Zetter Scarlett , Garcés-Pastor Sandra , Lammers Youri , Brown Antony G , Walsh Kevin , Goslar Tomasz , Lavergne Sébastien , Coissac Eric , Consortium PhyloAlps , Tribsch Andreas , Heintzman Peter D , Greve Alsos Inger
Published: December 2024

The Eastern European Alps boasts highly biodiverse ecosystems and a rich archaeological history. However, there is limited research on the enduring impacts of historical climate change and human activities on plant biodiversity in this region. Using sedimentary ancient DNA, we reconstructed plant and animal dynamics from 8500 years before present (ka BP) around Großer Winterleitensee (Zirbitzkogel, Austria). Variable intensities of human activities since the Middle Bronze Age (~3.5 ka BP) facilitated the persistence of biodiverse Alpine meadow communities and lowered timberlines below their natural limit. Since the end of the Bronze Age (~2.8 ka BP), human activities, particularly pasturing, and increasing temperatures, emerged as significant drivers of plant community dynamics. The introduction of sheep ( Ovis aries) did not reduce wild mammal presence, including red deer ( Cervus elaphus), hare ( Lepus), European mole ( Talpa europaea), bank vole ( Myodes glareolus), and short-tailed field vole ( Microtus agrestis). During the High & Late Mediaeval Period, (~1150–450 BP), cattle ( Bos taurus) and horses ( Equus caballus) became the dominant domesticates, while all wild mammals except the short-tailed field vole and Eurasian water shrew ( Neomys fodiens) declined or even disappeared. These changes are also accompanied by a significant transformation of plant community structure. The ability to determine both plant responses and animal drivers from the same palaeolimnological sequence vastly improves our ability to partition causes of vegetation change over the Holocene. Here, we reveal that plant biodiversity is maintained or increased by moderate cattle grazing. Therefore, non-intensive domesticated stock grazing is essential for maintaining diverse Alpine meadows.
Multiproxy analysis of indigenous maize (Zea mays) use, lower Saginaw River, Great Lakes, USA
Authors: Lovis William A. , Egan-Bruhy Kathryn C.
Published: December 2024

Evidence for the presence and pre-European use of maize on the lower Saginaw River drainage, southern Michigan, Great Lakes, USA, is presented and evaluated. An integrated multiproxy approach is employed, including macro-botanical data from feature contexts and micro-botanical data from adhered carbonized residues, δ13C isotope information derived from carbonized food residues, and dental disease data from a local mid-eighteenth-century indigenous burial population. Results of absolute dating and ceramic stylistic analysis reveal an early micro-botanical presence of maize ca. 1900 BP, with macro-botanical evidence lagging until 1000 years later. Absolute dates, both direct and associated, reveal macro-botanical evidence through the 18th century, when local populations display dental pathologies consistent with a high maize consumption diet. Of interest is the presence of an inverse spatial and altitude relationship between micro-botanical evidence of maize from carbonized food residues on ceramic vessels, and the presence of macro-botanical remains, suggesting a behavioral partitioning of maize-related activities.
‘I Want to Break Free’: Breaking Gender Stereotypes and Reconstructing Gender Identities by Women Entrepreneurs in India
Authors: Kulshrestha Reeti , Sahay Arunaditya
Published: December 2024

In India, though women form a significant part of the population, gender stereotypes prevent women from engaging in entrepreneurship because they gain identities that are counterproductive. It is therefore important to study how Indian women entrepreneurs break the gender stereotype, reconstructing new gender identities. A longitudinal study with unstructured interviews capturing narratives of the entrepreneur and her team members was conducted adopting a qualitative, multi-method approach including focus groups and secondary data. Employing the Gioia method for analysis, our study makes three important contributions. First, it identifies enablers, obstacles, blockages and accelerators that help Indian women entrepreneurs reconstruct gender identity. Second, our study shows the intersectionality of concurrent identities and gender stereotyping at workplace, societal and personal levels. Third, our study brings out identity evolution drivers that helped in breaking the gender stereotype. The research advances knowledge on gender identity and gender stereotypes in entrepreneurship literature, particularly in the context of women entrepreneurs.
Design and experiment study on a novel magnetorheological impact damper coupled with multiple parallel relief orifices for reducing higher impact peaks
Authors: Wang Huixing , Li Dong , Cai Fangxu , Li Yancheng , Wang Jiong , Zheng Jiajia
Published: December 2024

Conventional magnetorheological (MR) dampers exhibit the drawbacks of excessively large and non-adjustable peak force/acceleration during the initial impact in the context of high-impact loads, limiting their applicability in the field of impact resistance. This paper introduces an innovative MR damper (MRD), which, coupled with multiple parallel relief orifices, is capable of effectively mitigating the initial impact peak and enhancing the plateau effect during the mid and late stages of impact. Firstly, the configuration and principle of the novel MRD with multiple orifices (MRDWO) are illustrated and its nonlinear model, based on Bingham-Plastic model and accounting for minor loss, is established. Secondly, the structural design and fabrication of MRDWO were conducted. Simultaneously, for comparative purposes, a traditional MRD with an identical structure to MRDWO, except for the absence of relief orifices, was also fabricated. Then, experimental investigations were conducted separately on MRDWO and MRD without relief orifices (MRDWOO) under various impact velocities and control currents to study their damping forces, accelerations, and displacement responses. Finally, the experimental results of MRDWO were utilized to validate the reliability of the aforementioned nonlinear model. Additionally, a comparative analysis was conducted between MRDWO and MRDWOO under various operating conditions in terms of impact forces, accelerations, and displacements. The results indicate that the novel MRDWO significantly reduces the impact force/acceleration peak during the initial impact and enhances the plateau effect of force/acceleration in mid to later stages, thereby reducing the required displacement for absorbing. This is crucial for mitigating the initial impact damage and improving the damping efficiency of the MR damper.
Nursing Use of Function-Focused Care with Hospitalized Patients Living with Dementia
Authors: Resnick Barbara , Boltz Marie , Galik Elizabeth , McPherson Rachel , Kuzmik Ashley , Wells Chris , Zhu Shijun
Published: December 2024

Older adults living with dementia engage in little physical activity when hospitalized. This has negative implications including functional decline, infections, and longer lengths of stay, and reflects a lower quality of care. One of the approaches used to help overcome challenges to engaging patients in physical activity and optimizing the quality of care provided is referred to as function-focused care. Function-focused care is a philosophy of care in which patients are helped to engage in physical activity, including mobility and self-care, at their highest level during all care interactions. The focus of this study was to describe the function-focused care provided by nurses at 2 and 6 months after exposure to the implementation of Function-Focused Care for Acute Care Using the Evidence Integration Triangle (FFC-AC-EIT). It was hypothesized that in treatment sites there would be an increase in the percentage of routine activities in which nurses provided function-focused care to patients between 2 and 6 months. This was a descriptive study of nurse–patient interactions. At 2 months, 54 nurse–patient observations were done, and at 6 months, 69 nurse–patient observations were done. Out of 19 possible activities in which the nurse could provide function-focused care, the mean number of function-focused care activities performed by nurses at 2 months was 3.2 ( SD = 2.0), or 83% of the observed activities. At 6 months, 2.6 ( SD = 2.6) function-focused care activities were performed and this increased to 86% of the activities observed. There was a mean of 0.5 ( SD = 1.1) or 16% of the observed function-focused care activities not performed at 2 months and .3 ( SD = 0.8) or 11% of observed activities not performed at 6 months. Although there was a limited engagement of patients in physical activity during routine care overall, more function-focused care was provided to patients following the implementation of FFC-AC-EIT, the longer the staff were exposed to the intervention.
Understanding Available Data Sources to Estimate the Size and Distribution of Community Health Workers in the United States
Authors: Lombardi Brianna M. , Lombardi Brooke , Galloway Evan , Zerden Lisa de Saxe
Published: December 2024

This study used three national data sources to estimate the size and distribution of Community health workers (CHWS) in the United States. CHWs were identified in the National Plan and Provider Enumeration System (NPPES; 2022), Bureau of Labor Statistics (BLS) data (2021), and American Community Survey (ACS; 2020). The rate of CHWs per 100,000 people was calculated and compared across states. Then, the study assessed if the rate of CHWS per the population varied in states with or without CHW certification or reimbursement in a series of one-way analyses of variance (ANOVAs). Nationally, the rate of CHWs per 100,000 people in NPPES is 7.44, 18.37 in the BLS, and 35.44 in the ACS. No significant differences in the mean number of CHWs per 100,0000 people in states with or without certification and/or reimbursement was found. Further exploration of available data sources is needed to provide new insights and potential solutions to employ, fund, and sustain the CHW workforce.
Emerging Uses of Artificial Intelligence in Chronic Dermatologic Disease: A Scoping Review
Authors: Hollman Dylan , Doktorchik Chelsea , Mukovozov Ilya
Published: December 2024

Background:

Recent years have seen a surge in the use of artificial intelligence (AI) in healthcare, including dermatology. This scoping review aimed to assess the emerging applications of AI use in the context of chronic, non-neoplastic dermatologic diseases.

Methods:

MEDLINE, Embase, PubMed and SCOPUS were searched on August 11, 2023 using variations of the search concepts “dermatology,” “artificial intelligence,” and 12 common chronic dermatologic conditions. Article screening and data extraction were completed, and each study was categorized into themes and conditions.

Results:

A total of 224 unique studies were included. The most prevalent conditions that were studied in the context of AI included psoriasis (n = 67), atopic dermatitis/eczema (n = 41) and acne (n = 36). The majority of AI applications involved clinical evaluation (n = 176), images (analysis, generation or segmentation) (n = 163) and data analysis (n = 46). Clinical evaluation was further divided into 2 subthemes: diagnosis (n = 104) and disease assessment (n = 67). Diagnostic and analytic applications of AI are limited by the training datasets available (quantity of training data, image quality) and insufficient diagnostic information provided (eg, the patient’s reported history of their lesion, disease/symptom onset and risk factors).

Conclusions:

Common applications of AI are predominantly as an automated diagnostic tool for evaluating disease severity/characteristics, while niche and novel applications were explored further. However, recognizing the limitations of technology is critical prior to the widespread application of AI in dermatological practice. The insights from the current study can inform clinical adoption of AI in dermatology, and highlight research gaps to guide future academic initiatives.
Pain Self-Management Strategies for Hidradenitis Suppurativa Patients: An In-Person Survey Study
Authors: Huang Christina , Keller Matthew , Yang Sherry
Published: December 2024

Background:

Pain is an undermanaged symptom of hidradenitis suppurativa (HS). Relatively few studies have investigated at-home pain management measures HS patients use, the efficacy of these measures, and how they may correlate with disease severity.

Objectives:

The objective of this study is to survey pain management strategies used by HS patients and evaluate their efficacy.

Methods:

We conducted a survey study on patients with HS from April 2023 to April 2024 at the Hidradenitis Suppurativa Clinic at Thomas Jefferson University Hospital (Philadelphia, PA). We measured the usage of certain pain management options in the past year for HS patients and asked patients to rank their pain relief from each measure on a Likert scale. We also recorded the clinically determined Hurley stage for HS severity to study correlations between the Hurley stage and pain management methods used/efficacy.

Results:

Surveyed patients (n = 63) indicated a preference for over-the-counter (OTC) and topical pain management measures. For higher Hurley stages, rates of cannabis or prescription pain management usage were higher. Patients with Hurley stage III reported significantly greater relief from prescription opioid and non-opioid medications when compared to oral OTC medications; however, the degree of relief was considerably less than that obtained by patients with milder disease.

Conclusion:

Pain management can be challenging for HS patients, especially among those with higher disease severity. Of note, altered pain pathways in HS could contribute to the reduced effect of pain relief methods in more severe stages.
Measurement of crack width from the two-dimensional sonar images of the moss-covered surface of underwater concrete components based on K-means clustering
Authors: Shen Sheng , Cao Zheng , Chen Jianteng , Zhang Jianzhong , Zheng Zhidong , Zheng Haofeng , Zhou Changcun
Published: December 2024

Imaging sonar can precisely measure the sizes of some large defects on the surface of underwater concrete components (UCCs). However, it is challenging for image sonar to measure the widths of small cracks on UCCs. Another difficulty is the coverage of aquatic organisms, such as moss. The moss coverage divided into four stages changes the hardness and roughness of UCCs to cause wrong signal intensity of echo, crack image generation, and crack width measurement. This article first illustrates the imaging principles of surficial cracks in UCCs using a two-dimensional imaging sonar and derives a theoretical equation of crack width measurement. Then, the appropriate settings of two main factors in actual inspection, scanning distance l and pitch angle α, are determined by experimentally obtaining the measurement error distribution of concrete cracks with various stages of moss coverage. It also summarizes the correction equation of crack width measurement at different stages of moss coverage. For the case of unknown stages of moss coverage, the peak gray P and the mean value M of fitting the Gaussian curve of the gray-level histogram of the sonar images are experimentally proved to be effective in distinguishing the different stages of moss coverage by a K-means clustering process. Experimental results indicate that 0.75 m ≤  l ≤ 2.0 m and 15° ≤  α ≤ 30° is the appropriate ranges of l and α in the practical measurement. The boundary line equation to separate Stage I and Stages II & III of moss coverage is 60 ≤  P +  M ≤ 80. The boundary line equation to separate Stages II & III and Stage IV is 75 ≤  P +  M ≤ 110.
Beyond Arm Capacity in Chronic Stroke: Evaluating Paretic Arm Non-Use Through Arm Efficiency—A Cross-Sectional Study
Authors: Le Perf Gaël , Faity Germain , Mottet Denis , Muthalib Makii , Laffont Isabelle , Bakhti Karima
Published: December 2024

Background

After a stroke, the use of the paretic arm is determined by its capacity (what it can or cannot do). When both arms have capacity to perform a task, the choice of which arm to use must be based on another criterion, probably by comparing the efficiency of each arm. Two numerical models account for this: the capacity model (the paretic arm is chosen in preference) and the efficiency model (the most efficient arm is chosen).

Objective

To numerically determine whether capacity or efficiency best predict the use of the paretic arm in activities of daily living.

Methods

We performed numerical simulations to predict paretic arm use with either the capacity model or the efficiency model. We used the Bayesian Information Criterion (BIC) to compare the adequacy of the 2 models in predicting clinical and accelerometric data collected from 30 patients with chronic stroke.

Results

The efficiency model predicted arm use in activities of daily living better than the capacity model (BIC = −66.95 vs −5.89; root mean square error = 0.26 vs 0.72).

Conclusions

The study highlights the importance of considering efficiency when assessing paretic arm non-use. Assessing individuals’ arm efficiency should help personalize rehabilitation strategies after stroke.
Design and Early Progress of the Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) Trial
Authors: Hoh Brian , Martin Renee , Yeatts Sharon D , Turan Tanya , Boyette Renee , McLaren Stephanie , Butler Lesley , Peters Keith , Smith Jessica , Cavallari Larisa , Wabnitz Ashley , Sabagha Noor , Unger Chris , Frasure Jamey , Broderick Joseph , Chimowitz Marc I
Published: December 2024

Background: The usual treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) consists of dual antithrombotic treatment with clopidogrel and aspirin for 90 days followed by aspirin alone but the risk of recurrent stroke remains high up to 12 months. The Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial was designed to determine whether other combinations of dual antithrombotic therapy are superior to clopidogrel and aspirin. Methods: CAPTIVA is an ongoing, prospective, double-blinded, 3-arm clinical trial at over 100 sites in the USA and Canada that will randomize 1683 high-risk subjects with a symptomatic infarct attributed to 70-99% stenosis of a major intracranial artery to 12 months of treatment with 1) ticagrelor (180 mg loading dose, then 90mg twice daily), 2) low dose rivaroxaban (2.5mg twice daily), or 3) clopidogrel (600mg loading dose, then 75 mg daily). All subjects receive aspirin (81mg daily), intensive risk factor management, and will undergo blinded CYP2C19 genotype analysis. The primary goal of the trial is to determine whether rivaroxaban or ticagrelor or both are superior to clopidogrel for lowering the primary endpoint (ischemic stroke, intracerebral hemorrhage (ICH), or vascular death) within 12 months. A prespecified interim safety analysis will be conducted when the first 450 randomized subjects have been followed for 12 months to evaluate the risk of major hemorrhage in the rivaroxaban and ticagrelor arms. Results: Enrollment began in August 2022 and, as of June 26, 2024, the 450th subject was randomized into the study. Conclusion: CAPTIVA is evaluating two alternative dual antithrombotic therapies to clopidogrel and aspirin to maximize the chance of establishing more effective antithrombotic therapy for symptomatic ICAS, one of the most common and high-risk cerebrovascular diseases worldwide.
Extreme Events and Inter-state Migration in India: An Empirical Analysis
Authors: Richa  , Noy Ilan , Sen Subir
Published: December 2024

Extreme events-induced migration is a growing concern for low- and middle-income countries due to the increased variability in the weather and the rise in the number of disasters associated with climate change. The objective of this article is to examine the interlinkages between weather, disasters, and migration, in India. To examine the bi-directional flow of migrants across Indian states, we estimate gravity models with Poisson Pseudo Maximum Likelihood (PPML) method following previous studies’ methodology. We find that agriculture-dependent states and states with low levels of human development are more likely to face out-migration driven by weather variations and disasters. Internal migration is seasonal, temporary and often short distance in nature. We provide statistical evidence that repeated exposure of the vulnerable population to extreme weather and disasters may ultimately lead to more permanent migration. This raises urgent questions concerning the efficacy of disaster risk management and climate change adaptation policies at the sub-national level.
Unveiling the Impact of Nature-Based Tourism Marketing: A Phenomenological Analysis of Experiences and Emotional Engagement on Tourist Behaviour in the United Arab Emirates
Authors: Vij Mohit , Vij Anu , Kabiraj Sajal , Medina-López Ana
Published: December 2024

This study explores the impact of nature-based tourism marketing on traveller behaviour in the United Arab Emirates (UAE), a region primarily known for its man-made attractions. Identified through bibliometric analysis, there is a significant gap in understanding how these marketing strategies influence tourists. Grounded on the Travel Career Pattern (TCP) theory and using a qualitative phenomenological methodology approach, data were gathered through semi-structured, in-depth interviews with international tourists. Thematic analysis-based findings reveal that the success of nature-based tourism marketing, in terms of attracting tourists, increased expenditure on accommodations, guided tours or local products, hinges on the authenticity and emotional appeal of the marketing content. Furthermore, maintaining the long-term appeal and environmental integrity of nature-based destinations depends on responsible tourism practices. Despite challenges like over-tourism and environmental degradation, participants supported sustainable management practices to address these issues. The TCP model effectively explains how these factors resonate differently with tourists at various stages of their travel careers. This research illustrates the effectiveness of nature-based tourism marketing in enhancing tourist experiences and contributing to the economic and environmental sustainability of destinations.
World Christianity 2025: Regional Perspectives
Authors: Zurlo Gina A. , Johnson Todd M. , Crossing Peter F.
Published: December 2024

This article marks the 41st year of including statistical information on World Christianity and mission in the IBMR. This year’s focus is geographical, covering major religious trends in Africa, Asia, Europe, Latin America, Northern America, and Oceania over the last 125 years. This year’s article includes the Middle East, which is formed by countries in Northern Africa and Western Asia. In 2025, the Global South is home to 69% of all Christians in the world, projected to reach 78% by 2050. Africa became the continent with the most Christians in 2018, passing Latin America (which passed Europe in 2014).
Creating Space for Students with Profound Intellectual and Multiple Disabilities to Construct Meaning in Adaptive Music Classrooms
Authors: Siegal Cameron R.
Published: December 2024

Of individuals with an intellectual disability, 1% are recognized as having a profound intellectual disability and commonly present at a mental age of roughly three years or below. While inclusive music education models and therapeutic models have received considerable attention, there is a scarcity of literature on music education for students with profound intellectual and/or multiple disabilities (PIMD) in adaptive, substantially separate music classes that provide access to music curricula, pedagogies, and supports specifically designed for students with PIMD. This article includes a philosophical discussion of adaptive music education for students with PIMD—particularly nonspeaking students—and provides suggestions and pedagogies for working with these individuals. Implementing these strategies will position music educators to provide equitable access to music education and more effectively serve this vulnerable population of individuals.
Framework to Action: Developing and Implementing a Statewide Network to Expand Opioid Treatment Access Using SHIFT-Evidence in Texas
Authors: Deem Bolton Carma , Finley Erin P. , Karns-Wright Tara , Potter Jennifer S.
Published: December 2024

Background:

In Texas, the expansion of access to effective treatments for opioid use disorder remains a significant public health challenge. This study aimed to demonstrate the application of the Successful Healthcare Improvement from Translating Evidence in Complex Systems (SHIFT-Evidence) framework in developing and implementing a statewide network for office-based opioid treatment (OBOT) to underserved populations.

Methods:

We identified systemic gaps in access to medications for opioid use disorder (MOUD) across Texas, using a targeted needs assessment of barriers and facilitators to buprenorphine prescribing. Findings were integrated into a planning template based on SHIFT-Evidence, which guided the identification of additional barriers across the health care system and iterative selection of strategies to address implementation barriers at multiple health care system levels, drawing on the Expert Recommendations for Implementing Change taxonomy. Strategies were prioritized based on feasibility and impact. To evaluate the program’s effectiveness in expanding access to MOUD, we conducted a descriptive analysis of data from the Texas Department of State Health Services’ Clinical Management for Behavioral Health Services data system to assess geographic reach and clients served within the program.

Results:

Applying SHIFT-Evidence provided a structured process for identifying key barriers occurring at multiple levels (patient, prescriber, and prescriber organization) and selecting tailored strategies to address each. This approach supported the successful development and expansion of an OBOT provider network, increasing access to treatment services from 6 provider organizations (10 locations) serving 52 clients in fiscal year 2019 to 23 provider organizations (48 locations) serving 1311 clients in fiscal year 2023.

Conclusions:

The comprehensive, multilevel approach supported by the application of SHIFT-Evidence effectively facilitated prioritization and planning to address systemic gaps across multiple health care system levels. The successful enhancement of treatment access highlights the framework’s utility in supporting improvements within complex health care systems.
Clinical and ultrasound characteristics in patients with sars-cov-2 pneumonia, associated with hospitalization prognosis. e-covid project
Authors: Ramon Noemí Fàbrega , Bravo Marta Ortega , Cortada Gerard Torres , Culleré Joaquim Sol , Cabús Mònica Solanes , Peruga Jose María Palacín
Published: December 2024

Background

During the COVID-19 pandemia, the imaging test of choice to diagnose COVID-19 pneumonia as chest computed tomography (CT). However, access was limited in the hospital setting and patients treated in Primary Care (PC) could only access the chest x-ray as an imaging test. Several scientific articles that demonstrated the sensitivity of lung ultrasound, being superior to chest x-ray [Cleverley J et al., BMJ 370, 202013] and comparable to CT scan [Tung-Chen Y et al., Ultrasound Med Biol 46:2918-2926, 2020], promoted the incorporation of this technique in the assessment of COVID-19 patients in PC. [Pérez J et al., Arch. Bronconeumol 56:27-30, 2020; Gargani L et al., Eur Heart J Cardiovasc Imaging 21:941-8, 2020, Soldati G et al., J Ultrasound Med 39:1459, 2020] A prior study in our territory (Lleida, Spain) was designed to predict complications (hospital admission) of COVID-19 pneumonia in PC patients, being different patterns of Lung ultrasounds (LUS) risk factors for hospital admission. [Martínez Redondo J et al., Int J Environ Res Public Health 18:3481, 2021] The rationale for conducting this study lies in the urgent need to understand the determinants of severity and prognosis in COVID-19 patients with interstitial pneumonia, according to its lung ultrasound patterns. This research is crucial to provide a deeper understanding of how these pre-existing ultrasound patterns related to disease progression influence the medical treatment.

Methods

The objective of the study is to generate predictive models of lung ultrasound patterns for the prediction of lung areas characteristics associated with hospitalizations and admissions to the Intensive Care Unit (ICU) associated with COVID-19 disease, using ultrasound, sociodemographic and medical data obtained through the computerized medical history.

Results

A single relevant variable has been found for the prediction of hospitalization (number of total regions with potentially pathological presence of B lines) and one for the prediction of ICU admission (number of regions of the right lung with potentially pathological presence of B lines). In both cases it has been determined that the optimal point for classification was 2 or more lung affected areas. Those areas under the curve have been obtained with good predictive capacity and consistency in both cohorts.

Conclusions

The results of this study will contribute to the determination of the ultrasound prognostic value based on the number of lung areas affected, the presence of pulmonary condensation or the irregularity of pleural effusion patterns in COVID-19 patients, being able to be extended to other lung viral infections with similar patterns.
Comparison of models to predict incident chronic liver disease: a systematic review and external validation in Chinese adults
Authors: Cong Xue , Song Shuyao , Li Yingtao , Song Kaiyang , MacLeod Cameron , Cheng Yujie , Lv Jun , Yu Canqing , Sun Dianjianyi , Pei Pei , Yang Ling , Chen Yiping , Millwood Iona , Wu Shukuan , Yang Xiaoming , Stevens Rebecca , Chen Junshi , Chen Zhengming , Li Liming , Kartsonaki Christiana , Pang Yuanjie ,   on behalf of the China Kadoorie Biobank Collaborative Group
Published: December 2024

Background

Risk prediction models can identify individuals at high risk of chronic liver disease (CLD), but there is limited evidence on the performance of various models in diverse populations. We aimed to systematically review CLD prediction models, meta-analyze their performance, and externally validate them in 0.5 million Chinese adults in the China Kadoorie Biobank (CKB).

Methods

Models were identified through a systematic review and categorized by the target population and outcomes (hepatocellular carcinoma [HCC] and CLD). The performance of models to predict 10-year risk of CLD was assessed by discrimination (C-index) and calibration (observed vs predicted probabilies).

Results

The systematic review identified 57 articles and 114 models (28.4% undergone external validation), including 13 eligible for validation in CKB. Models with high discrimination (C-index ≥ 0.70) in CKB were as follows: (1) general population: Li-2018 and Wen 1–2012 for HCC, CLivD score (non-lab and lab) and dAAR for CLD; (2) hepatitis B virus (HBV) infected individuals: Cao-2021 for HCC and CAP-B for CLD. In CKB, all models tended to overestimate the risk (O:E ratio 0.55–0.94). In meta-analysis, we further identified models with high discrimination: (1) general population (C-index ≥ 0.70): Sinn-2020, Wen 2–2012, and Wen 3–2012 for HCC, and FIB-4 and Forns for CLD; (2) HBV infected individuals (C-index ≥ 0.80): RWS-HCC and REACH-B IIa for HCC and GAG-HCC for HCC and CLD.

Conclusions

Several models showed good discrimination and calibration in external validation, indicating their potential feasibility for risk stratification in population-based screening programs for CLD in Chinese adults.
Si-Wu-Tang improves liver fibrosis by restoring liver sinusoidal endothelial cell functionality and reducing communication with hepatic stellate cells
Authors: Wang Le , Qu Jiaorong , Li Jianan , Xue Xiaoyong , Qin Lingling , Li Yufei , Dou Yuanfeng , Mu Xiaohong , Li Xiaojiaoyang
Published: December 2024

Background

Liver fibrosis is a complex reparative process in response to chronic liver injuries, with limited effective therapeutic options available in clinical practice. During liver fibrosis, liver sinusoidal endothelial cells (LSECs) undergo phenotypic changes and also play a role in modulating cellular communications. Si-Wu-Tang (SWT), a traditional Chinese herbal remedy, has been extensively studied for its effectiveness in treating hematological, gynecological and hepatic diseases.

Materials and methods

The component of SWT were identified by ultra-high-performance liquid chromatography (UHPLC). After establishing bile duct ligation (BDL)-induced liver fibrosis mice model and VEGFA-stimulated LSEC model, we invested the mechanism of SWT through RNA sequencing combined with molecular biology techniques.

Results

SWT significantly improved the sinusoidal permeability and liver fibrosis induced by BDL and effectively regulated pathological processes in LSECs, such as angiogenesis, cell adhesion, basement membrane formation and defenestration. The anti-fibrosis effects of SWT were attributed to the inhibition on LSEC adhesion via COL8A1, on LSEC angiogenesis via IL-1β and the induction of LSEC defenestration by OLR1. Additionally, SWT disrupted the intercellular crosstalk between LSECs and hepatic stellate cells (HSCs) driven by IL-1β, thus alleviating liver fibrosis.

Conclusion

SWT collectively ameliorated liver fibrosis by inhibiting the COL8A1/IL-1β/OLR1 pathways associated with LSEC angiogenesis, adhesion and defenestration, as well as suppressing LSEC secretion of IL-1β to reduce HSC activation.
GRK6 palmitoylation dictates triple-negative breast cancer metastasis via recruiting the β-Arrestin 2/MAPKs/NF-κB signaling axis
Authors: Wang Wen-Ke , Lin Hui-Yu , Lin Che-Hsuan , Lee Hsun-Hua , Chen Yen-Lin , Lin Yu-Hsien Kent , Chiu Hui-Wen , Sheen-Chen Shry-Ming , Lin Yuan-Feng
Published: December 2024

Background

Triple negative breast cancer (TNBC) belongs to the worst prognosis of breast cancer subtype probably because of distant metastasis to other organs, e.g. lungs. However, the mechanism underlying TNBC metastasis remains largely unknown.

Methods

Bioinformatics analysis was conducted to evaluate the mRNA/protein expression and prognostic significance of G protein–coupled receptor kinase 6 (GRK6) in BC subtypes. RT-PCR assays were used to test the GRK6 expression in human BC tissues and cell lines. The in vitro cellular migration and in vivo lung colony-forming assays were established to estimate the metastatic potentials of TNBC cells. Western blotting was employed to examine protein phosphorylation, translocation and expression in the designed experiments.

Results

Here we show that GRK6 upregulation is extensively detected in TNBC compared to normal mammary tissues and other BC subtypes and correlates with an increased risk for distant metastasis in TNBC patients. GRK6 knockdown suppressed but overexpression potentiated the cellular migration and lung colony-forming abilities of TNBC cells. Moreover, our data demonstrated that the posttranslational palmitoylation of GRK6 is extremely critical for activating β-Arrestin 2/mitogen-activated protein kinases (MAPKs)/NF-κB signaling axis and fostering the metastatic potentials of TNBC cells. Accordingly, the pharmaceutical inhibition of GRK6 kinase activity dramatically suppressed the activation of β-Arrestin 2, MAPKs and NF-κB and the cellular migration ability of highly metastatic MDA-MB231 cells. Sequentially blocking the β-Arrestin 2/MAPKs/NF-κB axis with their inhibitors predominantly mitigated the GRK6-promoted migration ability of poorly metastatic HCC1937 cells.

Conclusion

Our results not only provide a novel mechanism for TNBC metastasis but also offer a new therapeutic strategy to combat metastatic TNBC via targeting GRK6 activity.
Research advances in the construction of stem cell-derived ovarian organoids
Authors: Zhang Tianyue , Zhang Mengtong , Zhang Sichen , Wang Shaowei
Published: December 2024

Ovarian organoids are essential in female reproductive medicine, enhancing our understanding of ovarian diseases and improving treatments, which benefits women’s health. Constructing ovarian organoids involves two main processes: differentiating induced pluripotent stem cells (iPSCs) into germ and ovarian somatic cells to restore ovarian function and using extracellular matrix (ECM) to create a suitable ovarian microenvironment and scaffold. Although the technology is still in its early stages, future advancements will likely involve integrating high-throughput analysis, 3D-printed scaffolds, and efficient iPSC induction, driving progress in reproductive and regenerative medicine.