bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-earthquake running reliability assessment method of high-speed railway simply supported beam bridge-track system based on probability density evolution method
Authors: Zhu Zhihui , Li Xia , Gong Wei , Zhou Gaoyang , Tang Yongjiu , Zheng Weiqi
Published: February 2025

In view of the problems that the current post-earthquake running safety assessment of trains mostly relies on the deterministic analysis under a single earthquake, lacks the consideration of seismic randomness. And it’s difficult to provide the driving reliability evaluation results and speed reduction recommendations after the earthquake. This paper proposes a post-earthquake running reliability assessment method of high-speed railway simply-supported beam bridge-track system based on probability density evolution method. Random non-stationary ground motion simulation under different PGA is realized by using the number theoretical method and spectrum method, considering the randomness of ground motion spectrum characteristics. Through incremental dynamic analysis of the track-bridge system, to construct a database of post-earthquake track residual deformation, and further establish key index of post-earthquake track residual deformation. Moreover, the OpenSees-TRBF co-simulation method is used to carry out post-earthquake running safety speed threshold analysis, and then the mapping model between different track damage grades and running safety speed thresholds is established. Finally, the probability density evolution method (PDEM) is used to solve the probability distribution of track residual deformation under different PGAs, which is combined with the mapping model to obtain the post-earthquake running reliability corresponding to each grade of driving speed. Additionally, a five-span railway simply supported beam bridge is used as an example to verify the method proposed in this paper, and the recommended speed with 95% running reliability under each PGA is given. The method realizes a more accurate and comprehensive post-earthquake running safety assessment of high-speed railway bridges, and can provide guidance suggestions for deceleration operation with high assurance rate, so as to guarantee the post- earthquake resilience of high-speed railroad network.
Hepatic Expression of Fibroblast Growth Factor 19 Significantly Correlates With Serum Bile Acids in Neonatal Cholestasis
Authors: Fouad Ola A. , Zaghlol Doaa F. , Sweed Dina M. , Saber Magdy A. , Sira Mostafa M.
Published: February 2025

Background:

Bile acids in the ileum act as a feedback regulator of their own synthesis by inducing the release of ileal fibroblast growth factor 19 (FGF19), which inhibits the cholesterol-7-alpha hydroxylase enzyme. In cholestasis, this feedback mechanism is dysregulated. FGF19 is not expressed in the healthy liver. We aimed to assess the hepatic expression of FGF19 in neonatal cholestasis (NC) and its relation to serum bile acids.

Methods:

The study included 41 patients with NC. FGF19 immunohistochemical staining in liver tissue (hepatocytes, endothelial cells, bile ducts, and bile canaliculi) was evaluated as negative, weak, moderate, and strong staining. FGF19 staining in 6 liver samples from explants of children with Crigler-Najjar syndrome type-1 served as controls.

Results:

Hepatocyte, endothelial, and canalicular FGF19 expression was significantly higher in cholestasis group compared to controls ( P = .039, .006, and .028 respectively). Serum bile acids had significant correlation with hepatocyte FGF19, endothelial, and bile duct FGF19 expressions ( P = .002, .003, and .01, respectively) but not with canalicular FGF19 expression. Hepatocyte FGF19 expression significantly associated with cholestasis severity in terms of serum total bilirubin, direct bilirubin, and aspartate transaminase levels ( P = .01, .02, and .02, respectively).

Conclusion:

Hepatic FGF19 expression significantly upregulated in NC and correlated with cholestasis severity.
Study protocol for paradigm shift in vascular access creation: The VAC study
Authors: Guocun Hou , Lanhua Mi , Fan Bian , Dongping Chen , Guangqi Chang , Jilin Chen , Xiaojuan Cheng , Jian Feng , Xueqiang Fan , Jianqiang He , Qiang He , Jian Huang , Hua Jiang , Bin Liu , Dan Liao , Chuan Li , Zongyang Liu , Mingxi Lu , Xiuyong Li , Chenquan Tang , Siwen Wang , Pei Wang , Liyun Xu , Kang Xun , Xiaowen Ye , Fei Yin , Liang Yuan , Zhiming Ye , Lihong Zhang , Lingfeng Zhao , Shen Zhan , Yaling Zhang , Yaxue Shi
Published: February 2025

Background:

The radial artery deviation and reimplantation (RADAR) technique uses an artery-to-vein (end-to-side) configuration. We have developed a modified RADAR (M-RADAR) technique. This new technique enables a side-to-side anastomosis between the vessels, and furthermore, the distal cephalic vein is ligated. The VAC Study (Paradigm Shift in Vascular Access Creation) is a multicenter randomized controlled trial comparing the clinical outcomes of radiocephalic fistula created using the conventional technique (CT group) versus the modified RADAR method (M-RADAR group).

Methods:

Prospective, multicenter, randomized study starting in December 2024. Participant recruitment has commenced. All data are collected via paper-based Case Report Forms (CRFs). The primary clinical endpoints include the 1-year primary patency rate of AVF and the incidence of venous juxta-anastomotic stenosis. Secondary endpoints include the 1-year access-assisted primary patency, access cumulative patency, hospitalization rates, mortality, and an analysis of the economic costs associated with maintaining vascular access. An estimated 408 participants will be recruited from approximately 29 dialysis units across China.

Discussion:

A high-quality, adequately powered multicenter randomized controlled trial (RCT) is still needed to provide clear guidance for clinicians on selecting optimal treatment strategies for the cephalic vein during AVF surgery.

Trial registration:

Registration number: ChiCTR2400093537, Registered on 2024–12–06.
Climate change and multiple sclerosis: Clinical challenges and strategies
Authors: Balshi Alexandra
Published: February 2025

Climate change poses significant challenges for people with multiple sclerosis (PwMS), exacerbating symptoms such as heat sensitivity. Increasing levels of air pollution contribute to neuroinflammation and has been associated with symptom flares, and mobility impairments complicate resource access for PwMS during climate-related weather emergencies. This paper explores the broad implications of climate change on multiple sclerosis (MS) and offers strategies for clinicians to address these emerging challenges, as understanding the broad impacts of climate change on MS is crucial to provide effective care in a changing world.
Experiences of women with familial breast cancer history: A constructivist grounded theory study
Authors: Sobhani Reyhaneh , Semmar Yassir , Rezaei Sajjad , Shakiba Mina
Published: February 2025

This study aimed to evaluate the experiences of women with familial breast cancer history (FBCH) to understand their emotions and reactions. A qualitative approach was used relying on the constructivist grounded theory (CGT) methodology. Data were collected through in-depth semi-structured interviews with 20 women attending a Medical Imaging Center with FBCH and a high risk (over 25%) according to the Tyrer-Cuzick breast cancer risk assessment model. Theoretical concept derived from the subset of the seven main research questions resulted in 30 subcategories with 10 categories, which were categorized into two core concepts, “adaptive responses” and “maladaptive responses.” Based on the findings, in screening target women, physicians and other healthcare professionals should consider referrals not only to genetic and medical imaging services but also to psychological services as supportive measures to preserve the quality of life of these individuals.
State-dependent functional network connectivity alterations in post-stroke dementia with subcortical lesions
Authors: Cai Huaying , Zhang Nan , Jiang Yun , Wu Qianwen , Ni Linhui , Han Guocan , Liaocheng Jiaao , Wu Dan , Zhao Zhiyong
Published: February 2025

Background

Recent studies have revealed disrupted dynamic functional network connectivity (dFNC) in stroke or dementia brains. However, it remains unclear how the dFNC was altered in post-stroke dementia (PSD).

Objective

This study aimed to explore PSD-specific alterations in the dFNC and their association with clinical assessments.

Methods

We included 19 normal controls (NC), 16 PSD, and 20 post-stroke non-dementia (PSND) patients who underwent resting-state functional magnetic resonance imaging scan. Independent component analysis, combined with a sliding-window approach, was employed to calculate dFNC. The cognitive performance was assessed by both Mini-Mental State Examination and MiniCog assessments, which were subsequently used for multiple regression analysis to investigate the relationships with dFNC.

Results

We identified 13 meaningful resting-state networks, and the dFNC among them derived four states exhibiting different connection patterns. In state III with strong connections within high-order networks, PSD and PSND both showed increased connectivity between visual network (VN) and high-order networks relative to NC; in state I with weak connections among all networks, PSD showed weaker connectivity between default mode network (DMN) and executive control network and between VN and DMN compared to PSND. Moreover, the dFNC measures showed significant correlations with cognitive assessments of patients.

Conclusions

Our findings suggest that PSD-specific functional network connectivity (FNC) alterations are state-dependent, and dFNC reveals a coexistence mechanism of functional impairment and compensation in large-scale brain networks, which is not observed in static FNC. This offers a new perspective to understand the neural mechanisms of PSD.
Role of chaplains in end-of-life care: Case studies on healing
Authors: Vaughn Julie LaMay
Published: February 2025

Within hospital settings, chaplains offer emotional support, spiritual counseling, and healing services to patients and simultaneously address ethical considerations by upholding confidentiality and impartiality. This study examines the impact of chaplains in hospital settings on patients, families, and healthcare teams by analyzing diverse case studies and personal anecdotes. Further, it highlights the significant spiritual and pastoral roles of chaplains, which potentially contribute to ethical decision-making in end-of-life situations. Results reveal that chaplains play a crucial and dynamic role in providing ethical support to patients, families, and healthcare personnel. Additionally, the traits possessed by chaplains can help ensure the continuous provision of care and adherence to best practices. This study further examines the various ethical conflicts of interest that may occur when chaplains participate in and discuss effective conflict management strategies. Finally, it contributes to the ongoing academic discussion on chaplains’ role in and impact on patient-centered care and ethical decision-making within healthcare organizations.
Better schools and breakfast cereals: School choice as consumer choice
Authors: Warnick Bryan R. , Fitz Julie
Published: February 2025

Universal school choice programs are rapidly expanding in the United States. One argument in support of school choice is that it unleashes the power of competitive markets to improve schools and satisfy customers. This article reexamines the idea that school choice is a consumer choice. It does so, first, by comparing school choice with other forms of consumer choice, like the choice of a breakfast cereal, along eight dimensions. The comparison shows that school choice functions very differently than it does with other types of consumer goods or services. Second, using the work of German sociologist Georg Simmel, the article looks at how competitive markets have been said to advance human relationships and create communities. The article then seeks to find a way to reconcile the potential upsides of consumer choice with the benefits of public deliberation, advocating for a renewed attention to choice programs within public schools, formulated in certain ways.
Correlates of Well-Being and Academic Outcomes Among Student Parents in College During the COVID-19 Pandemic
Authors: Garcia Aileen S. , Wang Dan , Williams Michael Steven , Payton Jessica , Hyun Sunah , Tuliao Minerva
Published: February 2025

The present study examines the impact of the coronavirus disease-2019 (COVID-19) pandemic on the well-being and academic outcomes of student parents, a group that often faces significant challenges balancing parenthood with education. Using data from a national survey of 60,719 undergraduate students aged 18–24, including 795 student parents, statistical analyses compared student parents to nonparents, examining perceived stress and support, well-being, and academic success. Findings revealed that student parents reported higher levels of COVID-related and financial stress, less faculty support, and poorer health, mental health, and academic outcomes. Generalized linear models revealed student parents’ gender, perceived COVID-related stress, faculty and campus support, and academic stress to be key predictors of their well-being and academic performance. This study underscores the need for targeted support from institutions, faculty, and policymakers to address the unique challenges faced by student parents, especially during chronic stressful periods, to ensure a more equitable higher education environment.
Goal Satisfaction, Not Attainment, Predicted Occupational Performance Improvement During Behavioral Activation/Problem-Solving Rehabilitation After Breast Cancer
Authors: Wechsler Stephen , Singh Sheel , Azuero Andres , Khalidi Sarah , Stevens Courtney J. , Hegel Mark , Muse Colleen , Newman Robin , dos Anjos Sarah , Morency Jamme , Ejem Deborah , Bakitas Marie , Lyons Kathleen
Published: February 2025

Occupational performance challenges are common among breast cancer survivors (BCS). In a recent randomized controlled trial (RCT), our rehabilitation intervention catalyzed significantly greater improvements in occupational performance compared to an education-based control condition. To describe BCS’ activity priorities and examine what short-term goal characteristics (i.e., focus) and outcomes (i.e., attainment, satisfaction) predicted long-term occupational performance improvement. Post hoc analysis of intervention session data from an RCT. Content analysis was used to summarize participants’ short-term and long-term goals. Linear regressions were conducted to examine associations between weekly goal characteristics and outcomes and occupational performance improvement. Among 138 BCS, 119 (86.2%) set long-term goals focused on exercise. Self-reported satisfaction with weekly goal outcomes was the strongest predictor of occupational performance improvement (ηp2 = 0.14–0.17, p < .001). Satisfaction with short-term goal outcomes, regardless of goal focus or attainment, predicts long-term occupational performance improvement in the year following breast cancer treatment.
Assessment of school leadership and quality of inclusive practices in early childhood education in the United Arab Emirates
Authors: Alnuaimi Aysha , Opoku Maxwell Peprah , Nketsia William
Published: February 2025

Discussions at the World Early Childhood Conference in 2022 suggested that children from vulnerable backgrounds are excluded from accessing early childhood education. In the United Arab Emirates (UAE) context, although leadership is pivotal in this discourse in extending early childhood education to all children, there is a lack of empirical studies on the perspectives of school leaders regarding the implementation of inclusive education for all children. In view of this, the current study explored the relationship between heuristic leadership and the quality of inclusive practices. This study was guided by two conceptual models, namely the heuristic inclusive education framework and Bronfenbrenner's ecological systems model. One hundred and fifty-one public school leaders, recruited across the UAE, completed a survey employing the Quality Scale of Inclusive School Development and the Heuristic Inclusive Education Leadership Scale. The data were subjected to correlation, hierarchical and moderation analysis. The results showed ambivalence among the participants regarding both heuristic leadership and inclusive practices; however, a positive relationship was found between them. The study recommends that policymakers reflect on heuristic leadership and inclusive system development in early childhood education reform in the UAE.
Absolute and relative reliability of Pressure Pain Threshold (PPT) assessment in patients with nonspecific shoulder pain
Authors: Pavlou Kyriakos , Constantinou Antonis , Savva Christos , Pamboris George M. , Kyriakou Panagiotis , Ploutarchou George , Karagiannis Christos , Korakakis Vasileios
Published: February 2025

This study investigates the intra- and interrater reliability of Pressure Pain Threshold assessments in patients with nonspecific shoulder pain, focusing on chronic and subacute stages. A sample of 26 adults was evaluated using a mechanical algometer across six anatomical points. Intrarater and interrater reliability were calculated using the intraclass correlation coefficient (ICC), standard error of measurement, and minimal detectable change (MDC). Results demonstrated almost perfect reliability for both intrarater (ICC range: 0.96–0.99) and interrater (ICC range: 0.92–0.99) assessments. Standard error of measurement and MDC values for intrarater reliability showed clinically acceptable error, except for the upper trapezius and mid-deltoid, where MDC value exceeded 25% of the grand mean, suggesting reduced precision between nonspecific shoulder pain stages. For interrater reliability, the adductor pollicis brevis, upper trapezius, and infraspinatus also showed less precision, with MDC values exceeding 25% of the grand mean, particularly in chronic patients. Despite these findings, no significant differences were observed between the subacute and chronic groups. While relative reliability was high, the findings highlight the need for caution in interpreting absolute reliability, especially for inter-rater assessments at specific muscle sites.
Exceptional response to TROP2 inhibition with sacituzumab govitecan in a patient with small cell carcinoma of the breast: a case report
Authors: Fitzsimmons Kasey C. , Fajardo Michelle A. , Noor Zorawar
Published: February 2025

We present a case report of a patient with metastatic small cell neuroendocrine carcinoma of the breast (SCNCB), a high-grade neuroendocrine triple-negative breast cancer, who achieved a complete response after two cycles of sacituzumab govitecan-hziy (SG) (Trodelvy) as third-line systemic therapy. She originally presented with estrogen receptor-positive disease, and we were able to clearly demonstrate transformation into triple-negative SCNCB via serial tissue biopsies. This is the first reported case of SG for SCNCB, and it shows an outstanding response in a patient who had undergone prior systemic therapies. Clinical trials are needed to address the potential role of TROP2 inhibition and the use of SG as a therapy for SCNCB.
Fictions of the market: The shelter component of the consumer price index in theory and practice
Authors: Rogan K James
Published: February 2025

The consumer price index (CPI), calculated in the United States by the Bureau of Labor Statistics, is a gauge of commodity prices’ fluctuations month-over-month as they are experienced by consumer households. The CPI has wide-ranging influence on economic expectations, especially in inflationary periods. The influence of the so-called “shelter component” of the CPI, which purports to measure fluctuations in housing prices nationally, is considerable. Despite its primacy, the shelter component is deeply flawed and has only limited use when it comes to providing an actual picture of fluctuations in housing and rental prices. In the CPI, housing is not treated as a produced commodity but as a tap from which something called ‘housing services’ flows, to be consumed by households. The failures of the shelter component, I find, are the failures of orthodox economics, also springing from a steadfast refusal to center production. I argue that the reigning economic treatments of housing are based on untenable theoretical assumptions that severely constrain their usefulness; as such, the shelter component of the CPI should be rejected entirely. But first, it is necessary to understand it fully.
Neck cellulitis complicating spectacle frames’ contact dermatitis: A case report
Authors: Hamdan Rémy , Chea Cyrielle , Brisson Maxime , Coeur Jules , Cortes Espejo Carmen , Leleu Camille
Published: February 2025

Neck cellulitis occurs as a result of dental, pharyngeal or ear infections or following trauma, but rarely via a cutaneous entry point. A 34-year-old female patient consulted with a left-sided, painful cervical swelling with limited head rotation and trismus, accompanied by a painful, oozing, retroauricular contact dermatitis (CD). Clinical examination confirmed the left cervical cellulitis with superinfected retroauricular CD. A computed tomography scan of the neck revealed no abscess. Systemic antibiotic therapy against streptococci and staphylococci for 8 days, combined with hygiene care for the CD lesions and the avoidance of glasses with metal frames, resulted in complete recovery without recurrence. Patch tests revealed sensitization to several metals, particularly nickel. Eyeglasses may cause allergic CD, an inflammatory skin disease caused by a delayed-type hypersensitivity reaction. Metal spectacle frames are particularly prone to causing CD, mainly due to the presence of nickel. Because of the skin breakdown it entails, spectacle frames’ CD may lead to skin infections and neck cellulitis. Spectacle frame CD should be investigated in patients presenting with retroauricular eczema. To our knowledge, the case of neck cellulitis induced by spectacle frame-allergic CD has never been reported.
Impact of Music Expression-Related Parameters on Pianists’ Kinematics and Muscle Activity: A Systematic Review
Authors: Mailly Robin , Turner Craig , Goubault Etienne , Dal Maso Fabien , Verdugo Felipe
Published: February 2025

Bodily gestures are essential in piano performance. They allow sound production and, at the same time, facilitate the communication of the expressive content of music. From pianists’ perspective, music expression-related parameters include not only single performance parameters (timing, sound intensity, articulation, etc.), but also more complex parameters (named hereafter abstract parameters), such as music structure features (e.g., phrasing) and extra-musical ideas (e.g., emotions, narratives, etc.). This systematic review aimed to investigate the impact of both performance and abstract parameters related to music expression on kinematics and muscle activity of expert pianists. As complementary objectives, we documented ontological and methodological differences between the studies included, and we addressed how music expression-related parameters affect pianists’ exposure to risk factors of injuries. The search strategy consisted of using concepts and keywords in Medline, Embase, SPORTDiscus, and Web of Science databases, and we followed the PRISMA guidelines. Sixteen studies were included. Eleven studies focused on performance parameters, four studies focused on abstract parameters, and one study addressed both performance and abstract parameters. Performance and abstract music expression-related parameters impacted pianists’ kinematics and muscle activity in a variety of ways. The specific effects were dependent on the type of task and the gestural variable investigated by studies. Important differences in ontological (performance or abstract parameters studied, gestural variable investigated) and methodological choices (experimental task and instrument used, data acquisition and processing procedures) prevent the establishment of a thorough dialogue between music research studies and biomechanics and motor control studies. A set of performance parameters (playing loud, playing fast, staccato articulation, large handspan chords) were identified as potential risk factors of injuries. Further interdisciplinary research mixing methods from empirical music research and biomechanics would help enhance knowledge on the impact of music expression on pianists’ gestures for both performance and injury prevention purposes.
Exploring Syntactic Complexity and Text Readability in an ELT Textbook Series for Chinese English Majors
Authors: Li Chili , Wang Xue , Qian Long
Published: February 2025

The effectiveness of English Language Teaching (ELT) materials significantly influences the learning outcomes of English as a Foreign Language (EFL) learners, positioning these resources as cardinal in the acquisition process. Despite this widely acknowledged significance, there remains a notable gap in research concerning the evaluation of key factors, such as syntactic complexity and text readability, which determine text difficulty. To address this gap, the present study evaluated the syntactic complexity and readability of a series of Intensive Reading textbooks widely used by English majors in China by adopting data mining technologies, including the L2 syntactic complexity analyzer (L2SCA) and six readability indicators. It also aimed to explore the impact of syntactic complexity as a predictor variable on text readability using multiple regression analysis. The results revealed that the selected series of textbooks demonstrated an increasing pattern of syntactic complexity and a decreasing pattern of text readability, indicating the appropriateness of the text difficulty level for this series. It was also found that clause per T-unit (C/T), clause per sentence (C/S), and dependent clauses per clause (DC/C) were the most significant predictors of readability among the 14 indicators of syntactic complexity. The analytical approach, which leverages data-mining technologies for ELT material evaluation, sets a precedent for future research. The insights gained from this study offer valuable implications for the development of ELT materials in China and other similar EFL contexts, helping to optimize learning by providing appropriately challenging content.
Working Overtime and Turnover Intention Among Chinese Social Workers: Roles of Organizational Identity and Individual Income
Authors: Huo Weidong , Shi Bolin
Published: February 2025

Although the negative effects of employee overtime have received academic attention, the relationship between overtime work and social workers’ turnover intention and its underlying mechanisms have been less studied. Hence, this study examined the mediating effect of organizational identity in the relationship between overtime work and turnover intention, and the moderating effect of income in the relationship between overtime work or organizational identity and turnover intention. Using the Process method, this study examined a sample of 5,427 participants in the CSWLS, and the results showed that overtime work positively influenced social workers’ turnover intention. The moderated mediation analysis found that organizational identity mediating the relationship, and individual income negatively moderated the relationship between overtime work or organizational identity and turnover intention. These findings suggest that social work agencies need to reduce the number of overtime shifts, create a positive organizational climate and increase income to reduce social workers’ turnover intention.
Exploratory Bifactor Analysis of Symptoms and Traits Highlights Aspects of Psychopathology Inaccessible by Other Methods
Authors: Levin-Aspenson Holly F. , Watson David , Clark Lee Anna , Smith David A.
Published: February 2025

Bifactor analysis has the distinct ability to model general versus specific psychopathology liabilities and the extent to which these liabilities are involved in manifest symptoms. However, overreliance on confirmatory models of diagnostic covariance hampers substantive implications. We undertook an exploratory bifactor approach to symptom-level epidemiological data ( N = 8,405) to critically examine known issues in bifactor analysis and contribute to the development of more finely grained psychopathology models. The resulting model included Distress, Harmful Alcohol Use, Antisocial Behavior, Attention Seeking, Social Alienation, and Psychosis specific factors. Within diagnostic categories, symptoms showed substantial heterogeneity regarding their degree of generality versus specificity and in their primary loadings on specific factors. Results clarify the extent to which shortcomings of bifactor models persist beyond the limitations of diagnosis-level data and/or confirmatory methods. These findings suggest additional layers of complexity and nuance to quantitative dimensional taxonomies and offer new insights into critical debates in the bifactor literature.
The Causal Role of Esophageal Cancer and Gut Microbiota: A Bidirectional Mendelian Randomization Study
Authors: Su Wei , Chen Han , Hu Die , Ye Bixing , Zhang Weifeng , Zhang Guoxin , Si Xinmin , Zhou Xiaoying
Published: February 2025

Aims

Gut microbiota are reported to be associated with the incidence and prognosis of Esophageal cancer (EC) but their genetic association is unclear. We carried out a bidirectional MR analysis to assess the causal relationship between EC and gut microbiota from fecal samples.

Methods

The microbiome genome-wide association studies (GWAS) data of 18,340 individuals provided by MiBioGen consortium and the EC GWAS data (740 esophageal cancers cases and 372 016 controls) provided by UK Biobank were respectively utilized as exposure and/or outcome data. Reliable single nucleotide polymorphisms (SNPs) were obtained after rigorous screening. A bidirectional Mendelian randomization (MR) analysis was conducted using the inverse-variance weighted (IVW) method. The sensitivity analyses including the MR-Egger method, weighted median, weighed mode and leave-one-out method were performed to examine the stability, heterogeneity and pleiotropy of the results.

Results

Forward MR analysis revealed the increase in abundance of the microbial trait by each standard deviation was associated with a higher risk of EC ( Coprobacter (OR = 1.001,95%CI = 1.000-1.002, P = .0281, FDR = 0.0424); Ruminococcus1(OR = 1.001,95%CI = 1.000-1.002, P = .0318, FDR = 0.0424); Senegalimassilia (OR = 1.002,95%CI = 1.000-1.003, P = .0062, FDR = 0.0372); Veillonella (OR = 1.001,95%CI = 1.000-1.002, P = .0182, FDR = 0.0372)) or a lower risk of EC ( Eubacterium oxidoreducens (OR = 0.999, 95%CI = 0.998-1.000, P = .0379, FDR = 00 433); Lachnospira (OR = 0.998,95%CI = 0.996-1.000, P = .0186, FDR = 0.0372); Romboutsia (OR = 0.999,95%CI = 0.998-1.000, P = .0482, FDR = 0.0482); Turicibacter (OR = 0.999,95%CI = 0.998-1.000, P = .0133, FDR = 0.0372)). Reverse MR analysis showed that genetic liability to EC was also causally linked toincreased susceptibility of changes in the gut microbiome (genera Eggerthella (Beta = 37.63,95%CI = 4.76-70.50, P = .0248, FDR = 0.0331); Coprococcus 2 (Beta = 23.90,95%CI = 1.65-46.15, P = .0353, FDR = 0.0353); Christensenellaceae R.7 (Beta = 22.75,95%CI = 4.22-41.28, P = .0161, FDR = 0.0322); Intestinimonas (Beta = −33.24,95%CI = −54.90-11.58, P = .0026, FDR = 0.0104)).

Conclusions

Our findings supported a bidirectionally causal relationship between gut microbiota and EC, implying the potential role of gut microbiota in preventing the occurrence and development of EC.
Action research for patient safety improvement in pediatric emergency department
Authors: Ghabousi Parsa , Borimnejad Leili , Gorji Hassan Abolghasem , Moayedfard Ahmad , Nejadsalarie Mina , Jafarnejad Shabahang , Rezai Mahdi , Pourasghari Hamid , Qane Samira , Khoshnezhad Ebrahimi Hamidreza
Published: February 2025

Background

Patient safety is defined as the absence of preventable patient harm. Despite significant advances, enhancing the safety of pediatric patients is of particular importance. Thus, this study aimed to diagnose the current situation of patient safety and plan, implement, and evaluate patient safety initiatives in the emergency department (ED) of Ali Asghar Pediatrics Hospital.

Methods

Two action research cycles were conducted during 2023–2024 in the ED of Ali Asghar Hospital. Participants were nurses, physicians, and medical residents. In the first cycle, actions such as providing equipment and training in patient safety were carried out. In the second cycle, handoff standardization by I-PASS and continuing staff training were implemented. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC), semi-structured interviews, and incident reports. Quantitative data were analyzed using the T-Test, and the Wilcoxon signed-rank test. Qualitative data were analyzed using content analysis.

Results

In the first cycle, the patient safety culture score was 48.1%. After training sessions, the patient safety test score significantly increased from 65.5% to 87.83% ( P < .001). In the second cycle, according to interviewees’ opinion, handoffs and in-service training were improved. The patient safety culture score increased to 62.6%, and overall patient safety perception, communication openness, staffing, handoff, and nonpunitive responses to errors significantly improved ( P < .05).

Conclusion

During this study, patient safety knowledge and culture among ED staff improved. Moreover, the standardization of handoff using the I-PASS tool improved the process by comprehensive information transfer, prioritizing critical patients, and reducing information loss.
Whereativity comes of age:A commentary
Authors: Lubart Todd , Lubin Jeffrey
Published: February 2025

This commentary examines issues raised about creativity and aging based on the target article. It looks at several ways that this topic can be studied.
A multi-centre, participant-blinded, randomized, 3-year study to compare the efficacy of Virtual Surgical Planning (VSP) to Freehand Surgery (FHS) on bony union and quality of life outcomes for mandibular reconstruction with fibular and scapular free flaps: study protocol for a randomized phase II/III trial
Authors: Tran Khanh Linh , Turkdogan Sena , Dinur Anat Bahat , Milner Thomas D. , Wang Edward , Nichols Anthony , MacNeil Danielle , Mendez Adrian , Jervis-Bardy Jake , De Almeida John , Yao Christopher , Goldstein David , Gilbert Ralph , Eskander Antoine , Higgins Kevin , Enepekides Danny , Gupta Michael , Zhang Han , Au Michael , Nguyen Sally , Fels Sidney , Hodgson Antony , Brasher Penelope , Mitton Craig , Sabiq Farahna , Fisher Charles , Yang David , Wong Angela , Garnis Cathie , Poh Catherine , Durham J. Scott , Prisman Eitan
Published: February 2025

Background

Advanced head and neck malignancies with underlying bony involvement often require aggressive oncological resection of large segments of the oral cavity including the mandible. These patients require vascularized donor osseous free tissue transfer to reconstruct significant defects. Traditionally, the donor bone is harvested on its vascular supply and shaped to the defect in a free hand fashion (FHS). However, virtual surgical planning (VSP) has emerged as a method to optimize reconstructive outcomes and decrease operative time. The goals of this study are to assess superiority of VSP to FHS by comparing bony union rates at 12 months, short and long-term complication rates, reconstruction accuracy, quality of life (QOL), functional outcomes, and economic analysis.

Methods

This is a multicenter phase II/III study randomizing four hundred twenty head and neck patients undergoing mandibulectomy in a 1:1 ratio between VSP and FHS. Intention-to-treat analysis will be performed for patients enrolled but unable to undergo VSP-aided reconstruction. The primary endpoint is bony-union rates at 1 year post-operatively. Secondary outcomes include complication rates, QOL, functional outcomes, and economic burden.

Discussion

This study will provide an assessment of two different surgical approaches to the reconstructive methods of mandible defects using fibular or scapular free flaps on bony-union rates, complications, QOL and economics.

Trial registration

Clinicaltrials.gov identifier: NCT05429099. Date of registration: June 23, 2022. Current version: 1.0 on March 6, 2024.
Expression and clinical significance of CCN5 and the oestrogen receptor in advanced breast cancer
Authors: Zhou Guofeng , Qu Wei , Yang Liu , Huang Aili , Gui Xinxing
Published: February 2025

Purpose

The aim of this study was to investigate the expression and clinical implications of CCN family member 5 (CCN5) and the oestrogen receptor (ER) in advanced breast cancer (BC).

Methods

A total of 130 patients with advanced BC were selected for the study. Samples of normal breast tissue, ductal carcinoma in situ (DCIS), and invasive carcinoma were collected. The expression levels of CCN5 and ER in these tissues were examined using immunohistochemical methods. The correlation between expression of CCN5 and ER in different tissues and also differences in expression in invasive carcinoma were analysed. In addition, the relationship between CCN5 expression in advanced BC tissues and clinical pathological features was examined.

Results

CCN5 and ER had low expression in normal breast tissues and invasive carcinoma tissues, but high expression in DCIS, with this difference being statistically significant (X2 = 119.899, P < 0.001; X2 = 113.524, P < 0.001, respectively). The expression of CCN5 and ER in different tissues of patients with advanced BC showed a positive correlation. Significant differences were also observed in the positive and negative expression of CCN5 and ER (X2 = 56.358, P < 0.001). Moreover, the expression of CCN5 protein in advanced BC showed a statistically significant associations (P < 0.05) with the expression of the progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), Ki-67, and P53, tumor diameter, histological grade, lymph node metastasis, pathological molecular subtype, and clinical staging.

Conclusion

High expression of CCN5 and ER was observed in DCIS tissues of patients with advanced BC, with their expression being positively correlated. These findings suggest that CCN5 and ER may have a potential synergistic role in the progression of BC that influences the progression of advanced BC and can also be used to predict the effectiveness of endocrine therapy.
Occupational violence against nursing staff in the surgical wards of Murzuq locality hospitals, Libya (2024)
Authors: Rahama Eltagi Elsadeg Sulliman , Elmadani Mohammed , Mohammed Malak Mokhtar , Osman Eqrer Zainab Ali
Published: February 2025

Background

Occupational violence is a significant issue for nurses worldwide, impacting their well-being, job satisfaction, and patient care quality. This study investigated the prevalence, types, and effects of such violence on nursing staff in surgical wards in Murzuq locality hospitals, Libya, to inform effective prevention strategies.

Methods

This cross-sectional study examined occupational violence against nursing staff in surgical wards across three hospitals in Murzuq, Libya. Using a convenience sampling approach, data were collected from 50 nurses in general surgical and emergency surgical wards over four weeks through a self-administered questionnaire. The variables included demographic data (gender, experience) and information on violence types, sources, impacts, and reduction strategies. The data were analysed via SPSS v27, with descriptive statistics applied. For inferential statistics, the chi-square test and Fisher’s exact test were conducted at a significance level of 0.05. Ethical approval was obtained from the academic research committee of Fezzan University, and informed consent was secured from all participants.

Results

Verbal insults (60%) and discrimination (64%) were the most reported types of violence. Patient companions (68%) were identified as the primary source, followed by patients (40%) and colleagues (28%). Occupational violence significantly impacted nurses’ lives, with 62% reporting stress, 48% experiencing decreased job satisfaction, and 28% considering leaving their jobs. Additionally, 40% reported difficulty concentrating due to violence. Significant associations were found between gender and sources of violence (p ≤ 0.001) and between years of experience and types, sources, and impacts of violence (p ≤ 0.001).

Conclusion

These findings underscore the need for gender-sensitive interventions, comprehensive training, and support mechanisms to address workplace violence. Future research should explore the long-term effects of violence on nursing staff and the effectiveness of tailored interventions in different healthcare settings. The results highlight the critical role of improving work conditions and organizational policies to enhance workplace safety for nurses.
Detection and genetic characterization of equine viruses in Sweden using viral metagenomics
Authors: Blomström Anne-Lie , Källse Annika , Riihimäki Miia
Published: February 2025

Background

Viral infections pose a significant challenge to the equine population, compromising welfare and causing substantial economic losses for the global equine industry. While numerous equine viral pathogens have been identified, many suspected viral infections remain undiagnosed. This highlights the need for further identification and characterization of viruses circulating within the equine population.

In this study, we utilized viral metagenomics to investigate viruses present in serum samples and nasal swabs collected from horses in Sweden. The primary focus was on horses presenting with fever, although control horses were also included for comparison.

Result

The viral metagenomic analysis identified several viruses in the investigated samples. Among nasal swabs, the majority of the viral reads were classified as various equine herpesvirues (EHVs), mainly EHV-2 and EHV-5. Other viruses in nasal swabs include but are not limited to EHV-4, Torque teno equus virus 1 (TTeqV1) and equine copiparvovirus (eqCopV). Both TTeqV1 and eqCopV were also detected in the serum samples together with equine circovirus and equine pegivirus. A number of the detected viruses were further genetically characterized and were shown to display high sequence similarity to viruses from the US and/or China. qPCR screening of a selected number of the detected viruses revealed a rather low detection rate (1.6%–9.4%) in individual horses.

Conclusion

This study identified several viruses that circulate in the horse population in Sweden, some of which have not been previously detected in Sweden or Europe. Furthermore, the complete or nearly complete genomes of several of these viruses have been genetically characterized. These new data provide a valuable foundation for developing improved detection assays and conducting larger prevalence studies to assess the potential impact of these viruses on the equine population. Such efforts could ultimately contribute to enhanced equine welfare.
CANDI: a web server for predicting molecular targets and pathways of cannabis-based therapeutics
Authors: Ekambaram Srinivasan , Wang Jian , Dokholyan Nikolay V.
Published: February 2025

Background

Cannabis sativa L. with a rich history of traditional medicinal use, has garnered significant attention in contemporary research for its potential therapeutic applications in various human diseases, including pain, inflammation, cancer, and osteoarthritis. However, the specific molecular targets and mechanisms underlying the synergistic effects of its diverse phytochemical constituents remain elusive. Understanding these mechanisms is crucial for developing targeted, effective cannabis-based therapies.

Methods

To investigate the molecular targets and pathways involved in the synergistic effects of cannabis compounds, we utilized DRIFT, a deep learning model that leverages attention-based neural networks to predict compound-target interactions. We considered both whole plant extracts and specific plant-based formulations. Predicted targets were then mapped to the Reactome pathway database to identify the biological processes affected. To facilitate the prediction of molecular targets and associated pathways for any user-specified cannabis formulation, we developed CANDI (Cannabis-derived compound Analysis and Network Discovery Interface), a web-based server. This platform offers a user-friendly interface for researchers and drug developers to explore the therapeutic potential of cannabis compounds.

Results

Our analysis using DRIFT and CANDI successfully identified numerous molecular targets of cannabis compounds, many of which are involved in pathways relevant to pain, inflammation, cancer, and other diseases. The CANDI server enables researchers to predict the molecular targets and affected pathways for any specific cannabis formulation, providing valuable insights for developing targeted therapies.

Conclusions

By combining computational approaches with knowledge of traditional cannabis use, we have developed the CANDI server, a tool that allows us to harness the therapeutic potential of cannabis compounds for the effective treatment of various disorders. By bridging traditional pharmaceutical development with cannabis-based medicine, we propose a novel approach for botanical-based treatment modalities.
Assessing Clinical Value of New Treatment Strategies: ESMO-MCBS and ASCO-VF Evaluation in Phase III Trials at ASCO Annual Meeting 2022
Authors: Seghers Sofie , Mandó Pablo , Eid Marc , Tan Charles J. , Jayraj Aarthi , Jatwani Karan , Faisal Muhammad Salman , Luong Vi , Young Joanna A. , Teuwen Laure-Anne , Prenen Hans , Segelov Eva
Published: February 2025

PURPOSE

The European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) and the ASCO Value Framework (ASCO-VF) are tools designed to assess the value of anticancer therapies. International conferences are the primary venues for sharing trial outcomes, often influencing clinical practices even before full publications are available. This analysis compares the ESMO-MCBS and ASCO-VF in evaluating the benefit of all phase III trials presented at the 2022 ASCO Annual Meeting (AM) and to examine the level of agreement between these scales.

METHODS

A systematic search of abstracts from the 2022 ASCO AM was conducted, focusing on phase III trial data presented. The clinical benefit of each abstract was assessed using both ESMO-MCBS and ASCO-VF, and Cohen's κ coefficients were calculated to analyze concordance between the tools.

RESULTS

Out of 239 phase III trial abstracts, 90 trials involving 49,721 patients met the inclusion criteria. Of these, 36 (40%) could not be graded by ESMO-MCBS, mainly because of nonsignificant results. Among the 54 gradable abstracts, 61.1% (n = 33) were deemed to provide substantial clinical benefit. ASCO-VF was unable to grade 40 (44.4%) abstracts, with nonsignificant results being the leading cause. Of the 50 gradable abstracts, 20% (n = 10) were considered to offer substantial clinical benefit. Moderate agreement between ESMO-MCBS and ASCO-VF was observed (Cohen's kappa, 0.4783 [95% CI, 0.3673 to 0.6034]). No significant association was found between clinical benefit and research funding or the economic status of the trial's origin country.

CONCLUSION

Both frameworks showed a high rate of nongradable studies, primarily because of nonsignificant results. ESMO-MCBS identified more studies with substantial clinical benefit, and the agreement between the two tools was moderate.