bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Evaluation of International Medical Graduates’ Verbal and Nonverbal Strategies to Manage Their Lack of Comprehension: Investigating the Role of Goal Inferences
Authors: Liao Danni , Guntzviller Lisa M.
Published: January 2025

Guided by goal understanding theory, we investigated how U.S. patients evaluate communication strategies international medical graduates (IMGs) adopt to manage their lack of comprehension of patient idioms. Participants ( N = 569) watched a video of an IMG and a patient interacting in a 3 (verbal: being blunt, feigning comprehension, providing rationale) × 2 (nonverbal: higher, lower immediacy) × 2 (message variations: “out of sorts,” “frog in the throat”) online experiment. Participants inferred IMG goals of understanding the patient and establishing trust most strongly when IMGs provided rationale with higher nonverbal immediacy and least strongly when IMGs feigned comprehension with lower nonverbal immediacy. These inferred goals were positively associated with participants’ evaluations of IMGs and their satisfaction. The findings suggest that patients may integrate verbal and nonverbal behaviors to infer IMGs’ goals, yielding implications for goals theorizing and IMG communication.
Piriformis muscle abnormalities in sacroiliac MRI of patients with axial spondyloarthritis
Authors: Erol Kemal , Akyildiz Tezcan Ezgi , Erol Seyit
Published: January 2025

Background

Piriformis syndrome, an often-overlooked cause of sciatica, commonly presents as chronic gluteal pain and poses a diagnostic challenge, particularly in patients with axial spondyloarthritis (axSpA).

Purpose

To examine piriformis muscle abnormalities on sacroiliac magnetic resonance imaging (MRI) and their association with clinical outcomes in patients with axSpA.

Material and Methods

This cross-sectional study included 100 axSpA patients (50 radiographic [r-axSpA], 50 non-radiographic [nr-axSpA]), classified by the 2009 ASAS Axial Spondyloarthritis criteria, who underwent MRI evaluations of the sacroiliac joints over a 6-month period. Piriformis evaluation included the measurement of muscle size, signal intensity, and the assessment of fatty infiltration. Sciatic neuritis was assessed by identifying enlarged sciatic nerves or increased signal intensity. Data collection included demographic details, disease activity, and functionality parameters. Statistical analysis was performed using appropriate methods, with P < 0.05 indicating significance.

Results

Piriformis syndrome findings were identified in 10% of patients, with a slightly higher incidence in r-axSpA patients (12%) compared to nr-axSpA patients (8%); however, this difference was not statistically significant ( P = 0.739). Patients with these MRI findings had significantly higher disease activity, as indicated by the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (3.5 vs. 2.82; P = 0.015), and greater functional impairment, measured by the Bath Ankylosing Spondylitis Functional Index (5.45 vs. 2.7; P = 0.041).

Conclusion

This study highlights the presence of MRI findings associated with piriformis syndrome among axSpA patients, which are linked to increased disease activity and reduced function. Recognizing piriformis syndrome as a co-morbidity may improve diagnosis and treatment, leading to better patient outcomes.
High FGF18 expression levels predict poor prognosis in endometrial carcinoma patients and promote tumor growth and metastasis
Authors: Lei Zheng-Yao , Wu Jian , Zhang Bao-Hua , Xiang Wei , Wang Min , Li Bin-bin , Dai Ming-Cheng
Published: January 2025

Objective

To investigate if fibroblast growth factor 18 (FGF18) expression plays an important role in endometrial carcinoma (EC).

Methods

The clinicopathological associations and prognostic value of FGF18 expression were retrospectively analyzed in 190 patients with EC. FGF18 expression was stably knocked down in EC cell lines. Changes in cell proliferation, migration, and invasion rates were examined via cell behavior experiments. Tumor growth was investigated using a xenograft mouse model. RNA sequencing (RNA-seq) was performed to identify differentially expressed genes (DEGs) in HEC-1-B cells after FGF18 knockdown, followed by pathway enrichment analysis of the DEGs.

Results

High FGF18 expression levels were closely correlated with EC clinicopathological features, such as histological subtype, FIGO stage, depth of myometrial invasion, and tumor size. Moreover, EC patients with high FGF18 expression levels had poorer overall survival. FGF18 knockdown in EC cells revealed its role in promoting tumor cell proliferation, migration, and invasion in vitro, as well as tumor growth in vivo. RNA-seq of HEC-1-B cells revealed that the DEGs were enriched in signaling pathways related to cell proliferation and migration.

Conclusions

Overexpression of FGF18 may serve as a prognostic biomarker for EC patients and is a potential therapeutic target for treating this disease.
The mechanism of team-member exchange and its relationship to ethical leadership and team commitment
Authors: Abu Bakar Hassan , Connaughton Stacey L
Published: January 2025

In today’s volatile business environment, team-based commitment remained important and helped organization to perform better and be more adaptable. Therefore, team-based structures are increasingly important to organization, in part that due to their ability to leverage team leadership and individuals’ abilities to work collaboratively. This study contributes to what is known about team-based structures by examining the underlying process of team-member exchange as a mechanism for linking ethical leadership and team commitment. Drawing on social identity and social exchange theories, we develop a mediation model and demonstrate the link between team-member exchange, ethical leadership, and team commitment. The model was tested on a sample of 100 team leaders and 370 team members in the Malaysia aviation industry. Results from a hierarchical linear modeling analysis provided support for the model. That is, ethical leadership was positively related to team commitment through team-member exchange, conceptualized and operationalized as team members sharing and exchanging information, helping each other, and recognizing each other’s contributions towards the team. The study contributes to the literature on ethical leadership and enhances our understanding of the relationship between leadership and team behavior through team-member exchange.
Relationship of perfluoroalkyl chemicals with chronic obstructive pulmonary disease: A cross-sectional study
Authors: Li Xuefang , Li Zhijun , Ye Jian , Ye Wu
Published: January 2025

Perfluoroalkyl chemicals are one of the most stable substances in industry and have become ubiquitous contaminants owing to their persistence in the environment. This study enrolled 1,953 participants aged ≥40 years old using data from the National Health and Nutrition Examination Survey (NHANES). We selected four perfluoroalkyl chemicals with a detection frequency of more than 80%, including perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), and perfluorooctane sulfonic acid (PFOS). Multivariate logistic regression was performed to determine the relationship of serum perfluoroalkyl chemicals with COPD and airflow limitation. We evaluated the interaction between perfluoroalkyl chemicals and lung function using multivariate linear regression analyses. Our results showed that the prevalence of COPD was not significantly related to serum PFHxS, PFNA, PFOA, and PFOS. Airflow limitation was positively linked with serum PFHxS, PFOA, and PFOS. However, these significant differences were not robust after adjustment of all confounders of interest. Serum PFHxS, PFOA, and PFOS were all positively related to the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). However, only PFOA remained significantly linked with the FEV1 and FVC after covariate adjustment. These results indicated that there was no significant interaction between exposure to perfluoroalkyl chemicals and the prevalence of COPD. Higher levels of serum PFOA appeared to be related to higher measures of FEV1 and FVC.
Breathing Easy in Maricopa County, Arizona: Empowering K-12 Schools With a Novel Nurse Coaching Model to Facilitate Implementation of a County-Wide School-Based Stock Albuterol Inhaler Program
Authors: Lowe A. A. , Mottern N. , DiGioia O. , Dobbins D. , Ivich K. , Jovich R. , Lindstrom Johnson S. , Park K. , Peters J. , Peterson M. , Ravi P. , Rocha N. , Staab N. , Sunenshine R. , Waldron E. , Ward J. , Gerald L. B.
Published: January 2025

To reduce chronic school absenteeism and morbidity and mortality among school-aged children, the prompt administration of albuterol sulfate in schools remains vital. School-based stock inhaler programs are a practical approach to ensure equitable access to life-saving rescue medication for students. School and community partnerships can potentially strengthen program implementation and fidelity by integrating evidence-based practices into routine care. We report the findings of a novel practice facilitation model developed by the Maricopa County Department of Public Health to facilitate the implementation of the Stock Inhaler for Schools Program in K-12 Schools. Three-hundred twenty-four schools participated in the program, with 153 schools reporting a stock inhaler event for a total of 1,310 events across four school years. Most events (78%) were compliant with the protocol for administering the stock inhaler to a student. These findings suggest that implementing a practice facilitation model is feasible and important for enhancing fidelity to program requirements.
Effect of telemental health adoption on mental health services utilization in federally qualified health centers
Authors: Gadag Khyathi , Arora Kanika , Zahnd Whitney E
Published: January 2025

Introduction

Mental health issues disproportionately affect rural and low-income populations, where access to prevention and treatment is limited. Implementing telemental health services (TMHS) in Federally Qualified Health Centers (FQHCs) could improve accessibility to mental healthcare. This study assessed the effect of TMHS on mental health services utilization in FQHCs, comparing centers with and without TMHS and examined differences in TMHS effect between FQHCs that adopted TMHS before and during the pandemic.

Methods

The study utilized FQHC-level data from Uniform Data Systems annual performance reports ( N = 9540 FQHC-year) and county-level demographic, health status, and provider characteristic data from 2016 to 2022. A two-way fixed effects model was applied to examine the effect of TMHS on mental health visit rates, supplemented by the Sun and Abraham difference-in-differences estimator. The analysis included both pre-COVID and during-COVID TMHS adopters.

Results

FQHCs offering TMHS showed 1.04 times increase in overall mental health visit rates compared to those without TMHS. Centers serving higher proportions of Medicaid-insured (1.07 times) and low-income (below 200% FPL; 1.05 times) populations showed even higher visit rates. During-COVID TMHS adopters showed a significant increase (1.05 times), particularly in urban areas, whereas rural adopters did not see significant changes.

Conclusion

FQHCs offering TMHS showed increased mental health visit rates, especially among low-income and Medicaid-insured populations. FQHCs that adopted TMHS during the pandemic experienced a marked rise in mental health visits, but rural-urban disparities persist, highlighting the ongoing challenges in expanding access to mental healthcare in rural settings.
The effect of altruism on attitude to organ donation in health workers in Türkiye
Authors: Ari Damlanur , Aydan Seda
Published: January 2025

Organ donation is a very important issue due to its life-saving feature. The purpose of this study is to reveal the effect of the altruism levels of health workers in a public hospital in Türkiye on their organ donation attitudes. This research is a descriptive cross-sectional survey study. The survey includes questions regarding the sociodemographic information, “Organ Donation Attitude Scale” and the “Altruism Scale.” According to the findings, while the “helping” dimension significantly and positively affected the organ donation attitude, the “philanthropy” dimension did not. Organ donation attitude is lower in women, young people, married people, those with lower education levels, health workers other than doctors, and units other than the emergency department. The level of altruism was lower in younger employees, those with lower education levels, doctors and those working in intensive care services. Helping sub-dimension positively affects organ donation attitudes. For policies to increase organ donation, factors that will increase altruism need to be determined.
Providing feedback in simulated investigative interviews with adult witness avatars increases the use of free recall and open questions
Authors: Tohvelmann Mari-Liis , Kask Kristjan , Palu Annegrete , Haginoya Shumpei , Santtila Pekka
Published: January 2025

Previous research has indicated that investigative interviews with adult victims and witnesses are often of low quality. Earlier findings also indicate that interviewing skills exhibit improvement when the interviewers are given feedback on their performance. Technological innovations make it possible to implement such an approach in a scalable manner. Simulated interviews with child avatars have shown that repeated feedback improves the proportion of recommended questions in those interviews. We created adult witness avatars (AWA) to simulate investigative interviews with adult victims and witnesses. We examined whether avatar interviews coupled with feedback (vs no feedback) would result in improvements in interview quality. Of the 60 participants, half received process feedback after each of four simulated interviews. The avatars revealed predefined memories and made errors as a function of algorithms formulated based on previous empirical research on the response behavior of adult witnesses in experimental studies. Results showed that receiving feedback after the simulated interviews increased the proportion of recommended questions (free recall and open questions) in avatar interviews compared with not receiving feedback (90.3% vs 72.6%, respectively). There was also a significant correlation between the question types and accuracy of details, even when analyzed separately for feedback and control groups. We demonstrated that with feedback after each AWA interview, the proportion of recommended questions was significantly higher in the AWA group than in the control group. The implications for practice are discussed.
Researching Organized Crime: A Novel Approach Combining Inductive and Storyline Paradigms
Authors: Allum Felia
Published: January 2025

This article examines the methodological process employed in two recent research projects about mafias and organized crime groups (OCGs) and considers the self-reflexion that took place as part of the research process. Whereas most contemporary studies that focus on mafias and OCGs use theoretically informed approaches, which follow a hypothetical-deductive model, here a novel approach of combining an inductive model based on a Grounded Theory Method (GTM) with a storyline approach is presented. This results in perhaps a more thorough understanding of mafias and OCGs and produces a clear knowledge and evidence-based account of these realities that could be useful for practitioners. This article presents an innovative research design used in the general study of organized crime, the combination of a GTM with a storyline approach. Firstly, it explains the rationale and the steps involved in this combination. Secondly, its application in two specific research projects on organized crime is explained, empirically and theoretically. Thirdly, a critical reflection on the suitability of these two paradigms for the study of contemporary social phenomena is presented. Lastly, the conclusions suggest that while a GTM may be considered to lack positivist rigour, the contribution it makes to our understanding of mafias and OCGs must not be underestimated, in particular when combined with the storyline approach, which anchors evidence to theory.
Terra Colonia? The Global South in comparative and international education as reflected in the comparative education review
Authors: Wolhuter CC , Espinoza Oscar , McGinn Noel
Published: January 2025

The aim of this article is to provide an analysis of continuity and change dynamics in knowledge production in the field of Comparative and International Education (CIE). In addition to a general review of the field, the objective is to assess the extent and effects of dominance of the field by scholars in the Global North. The article investigates the dominance of northern hegemony in the scholarly field of Comparative and International Education, both from a literature survey of the field and from the content of analysis of articles published in the Comparative Education Review (CER). Strong criticism of northern hegemony was found, taking the following forms: criticism of the imposition of one model of development; criticism of foreign aid and of international agencies; anti-globalization; criticism of neoliberal economics and its impact on education; calls for the decolonization of education and of Comparative and International Education; criticism of racism in education and in CIE; lack of appreciation of indigenous knowledge systems; and allegations that scholars of the Global South find themselves on an unequal playing field. The 246 articles that were published in the CER during the decade 2010-2019 were analyzed under the following rubrics: geographical focus; authorship and themes/topics. The results indicate that while acknowledgment and criticism of northern hegemony has grown, the predominance of a Global North perspective persists. A majority of articles marked by a unique authorship pattern and geographic and thematic foci of research continue to be authored by scholars located in the North. In conclusion, the authors recommend a renewed effort to present the Global South in its true importance in the field of Comparative and International Education.
Gender influence on career trajectory as a shoulder and elbow surgeon
Authors: Haff Christopher W , Childers Justin T , Forbes Jessica M , Lack Benjamin T , Jackson Garrett R , Sabesan Vani J
Published: January 2025

Background

Women continue to make up a minority of orthopedic surgeons, especially shoulder and elbow surgeons. There exists no study that investigates the effect of gender on one's academic career as a shoulder and elbow orthopedic surgeon, which was the purpose of this cross-sectional study.

Methods

The American Shoulder and Elbow Surgeons website was used to identify surgeons. Demographics, education, and current professional roles were obtained using the websites of institutions, hospital employers, physicians, LinkedIn, and Doximity. Research productivity metrics were obtained using SCOPUS and Google Scholar. Outcome measures included current academic/leadership roles, and research productivity. Statistical analysis was performed using the Chi-squared test and Mann–Whitney U test.

Results

Totally, 893 surgeons were identified, 60 being female (6.7%). Males had a significantly higher average h-index ( P = 0.003), total number of publications ( P = 0.019), citations ( P = 0.03) and ASES membership ranks than female surgeons ( P = 0.037; P = 0.004). There were no significant differences between genders in current professional or leadership roles.

Discussion

Female surgeons had a significantly lower number of citations, publications, and h-index but equal leadership positions such as fellowship director, residency director, chief of service, and department chair compared to their male counterparts.

Level of evidence

Level III, cross-sectional study.
The Cycle Continues: An Assessment of Democratic Transitions in Latin America with New Data and Indicators
Authors: Barberia Lorena G , Piazza Kelly Senters , Avelino Filho George
Published: January 2025

This study examines how theoretically driven indicators modify our understanding of transition dynamics in Latin America. Our indicators show that a noticeable wave of reversion to authoritarian rule in Latin America occurred during the last two decades. Moreover, unlike the past, where authoritarian regimes were established with military coups, the Democracy-Dictatorship Reprise for Latin America (DDRLA) confirms that the region's recent experience with democratic reversion has been brought about by presidents who secured office through elections and who manipulated rules to remain in office for more than two terms. For the period from 1946 to 2022, we discuss how the minimalist conception of democratic regimes can be further advanced with our reformed political regime indicator, as well as measures of initial elections and political regime transitions. We then demonstrate the utility of the DDRLA by replicating studies recently published in leading journals.
Dental rehabilitation of cleft palate patients using zygomatic implants: A case report
Authors: Creo-Martinez Teresa , Canivell-Zabaleta Maitena , Sanjuan-Sanjuan Alba , Caro Manuel
Published: January 2025

Edentulous patients with history of cleft palate and severe maxillary atrophy are challenging patients to rehabilitate through an oral approach. The difficulty of rehabilitating these patients lies in the unusual anatomy they present and the alteration of the vascular supply of local tissues caused by the previous performed surgeries, along with other causes. This report describes the successful dental rehabilitation with zygomatic implants of a patient with complete bilateral cleft palate who was edentulous and had severe maxillary atrophy.
Planetary environing: The return of boundaries as a category in global environmental governance
Authors: Sörlin Sverker
Published: January 2025

Global Environmental Governance (GEG) has been a growing phenomenon since the middle of the 20th century, although the concept itself and its acronym are more recent and were in fact rarely used before 2000. The early interest in GEG was much preoccupied with environmental diplomacy and international legal agreements from the Stockholm UN conference 1972 onwards. The addition of the ‘global’ reflected the general rise in awareness of the significance of globalization since the 1980s. The further growth, and the transformation of GEG, in earnest since the Millennium has been increasingly marked by yet another category, ‘the planetary’, mirroring the increasing influence of Earth System Science on environmental and climate discourse. This has affected both GEG and ‘the environment’ itself. The conceptual shifts, including the rising interest in the Anthropocene, reflected profound changes in the human-Earth relationship. To analyze these shifts, which is the aim of this paper, I will use the ‘Planetary Boundaries’-concept, launched in a highly cited paper in the journal Nature in 2009 and further developed in later publications, seminally in 2015 and 2023. I will consider the PB-concept, and versions of the often shown diagram that accompanied it, as both a case of ‘planetary modelling’ and, at the same time an ‘environing technology’ that is performative and shapes what the environment ‘is’ while modelling it. I also emphasize that the PB-model has led a ‘social life’, which has defined its continued evolution as a key agency in the formation of an Anthropocene Weltanschauung, with normative properties. I posit that the model helped shape the shift towards the epistemic and temporal ‘environment’ that has become mainstreamed in the UN Sustainable Development Goals and other goal setting projects.
Enhancing prostate cancer segmentation in bpMRI: Integrating zonal awareness into attention-guided U-Net
Authors: Wei Chao , Liu Zheng , Zhang Yibo , Fan Lianhui
Published: January 2025

Purpose

Prostate cancer (PCa) is the second most common cancer in males worldwide, requiring improvements in diagnostic imaging to identify and treat it at an early stage. Bi-parametric magnetic resonance imaging (bpMRI) is recognized as an essential diagnostic technique for PCa, providing shorter acquisition times and cost-effectiveness. Nevertheless, accurate diagnosis using bpMRI images is difficult due to the inconspicuous and diverse characteristics of malignant tumors and the intricate structure of the prostate gland. An automated system is required to assist the medical professionals in accurate and early diagnosis with less effort.

Method

This study recognizes the impact of zonal features on the advancement of the disease. The aim is to improve the diagnostic performance through a novel automated approach of a two-step mechanism using bpMRI images. First, pretraining a convolutional neural network (CNN)-based attention-guided U-Net model for segmenting the region of interest which is carried out in the prostate zone. Secondly, pretraining the same type of Attention U-Net is performed for lesion segmentation.

Results

The performance of the pretrained models and training an attention-guided U-Net from the scratch for segmenting tumors on the prostate region is analyzed. The proposed attention-guided U-Net model achieved an area under the curve (AUC) of 0.85 and a dice similarity coefficient value of 0.82, outperforming some other pretrained deep learning models.

Conclusion

Our approach greatly enhances the identification and categorization of clinically significant PCa by including zonal data. Our approach exhibits exceptional performance in the accurate segmentation of bpMRI images compared to current techniques, as evidenced by thorough validation of a diverse dataset. This research not only enhances the field of medical imaging for oncology but also underscores the potential of deep learning models to progress PCa diagnosis and personalized patient care.
The Influence of Discourse Participation Styles on Marginalization in Intercultural Meetings
Authors: Williamson Josef
Published: January 2025

The problem of discourse marginalization in intercultural meetings is usually attributed to linguistic or pragmatic shortcomings of marginalized second language English speakers who are seen as either “learners,” in contrast to first-language English speakers, as uncommunicative, or even as professionally incompetent. The influence of culturally oriented participation styles, distinct patterns of turn-taking behavior, has so far not been considered as a contributing factor. The present study examines intercultural meeting discourse and reveals how diverse participation styles can lead to marginalization. Pedagogical implications are discussed.
Measuring Speech Discrimination Ability in Sleeping Infants Using fNIRS—A Proof of Principle
Authors: Lee Onn Wah , Gao Demi , Peng Tommy , Wunderlich Julia , Mao Darren , Balasubramanian Gautam , McKay Colette M.
Published: January 2025

This study used functional near-infrared spectroscopy (fNIRS) to measure aspects of the speech discrimination ability of sleeping infants. We examined the morphology of the fNIRS response to three different speech contrasts, namely “Tea/Ba,” “Bee/Ba,” and “Ga/Ba.” Sixteen infants aged between 3 and 13 months old were included in this study and their fNIRS data were recorded during natural sleep. The stimuli were presented using a nonsilence baseline paradigm, where repeated standard stimuli were presented between the novel stimuli blocks without any silence periods. The morphology of fNIRS responses varied between speech contrasts. The data were fit with a model in which the responses were the sum of two independent and concurrent response mechanisms that were derived from previously published fNIRS detection responses. These independent components were an oxyhemoglobin (HbO)-positive early-latency response and an HbO-negative late latency response, hypothesized to be related to an auditory canonical response and a brain arousal response, respectively. The goodness of fit of the model with the data was high with median goodness of fit of 81%. The data showed that both response components had later latency when the left ear was the test ear ( p < .05) compared to the right ear and that the negative component, due to brain arousal, was smallest for the most subtle contrast, “Ga/Ba” ( p = .003).
Heterogeneous focal adhesion cytoskeleton nanoarchitectures from microengineered interfacial curvature to oversee nuclear remodeling and mechanotransduction of mesenchymal stem cells
Authors: Fan Huayu , Zhao Hui , Hou Yan , Meng Danni , Jiang Jizong , Lee Eon-Bee , Fu Yinzheng , Zhang Xiangdong , Chen Rui , Wang Yongtao
Published: January 2025

Background

Interfacial heterogeneity is widely explored to reveal molecular mechanisms of force-mediated pathways due to biased tension. However, the influence of cell density,, curvature, and interfacial heterogeneity on underlying pathways of mechanotransduction is obscure.

Methods

Polydimethylsiloxane (PDMS)-based stencils were micropatterned to prepare the micropores for cell culture. The colonies of human mesenchymal stem cells (hMSCs) were formed by controlling cell seeding density to investigate the influences of cell density, curvature and heterogeneity on mechanotransduction. Immunofluorescent staining of integrin, vinculin, and talin-1 was conducted to evaluate adhesion-related expression levels. Then, immunofluorescent staining of actin, actinin, and myosin was performed to detect cytoskeleton distribution, especially at the periphery. Nuclear force-sensing mechanotransduction was explained by yes-associated protein (YAP) and laminA/C analysis.

Results

The micropatterned colony of hMSCs demonstrated the coincident characters with engineered micropores of microstencils. The cell colony obviously developed the heterogeneous morphogenesis. Heterogeneous focal adhesion guided the development of actin, actinin, and myosin together to regulate cellular contractility and movement by integrin, vinculin, and talin-1. Cytoskeletal staining showed that actin, actinin, and myosin fibers were reorganized at the periphery of microstencils. YAP nuclear translocation and laminA/C nuclear remodeling were enhanced at the periphery by the regulation of heterogeneous focal adhesion (FA) and cytoskeleton arrangement.

Conclusions

The characters of the engineered clustering colony showed similar results with prepared microstencils, and colony curvature was also well adjusted to establish heterogeneous balance at the periphery of cell colony. The mechanism of curvature, spreading, and elongation was also investigated to disclose the compliance of FA and cytoskeleton along with curvature microarrays for increased nuclear force-sensing mechanotransduction. The results may provide helpful information for understanding interfacial heterogeneity and nuclear mechanotransduction of stem cells.
Severe fever with thrombocytopenia syndrome complicated with aspergillus endocarditis and multiple organ infarctions after glucocorticoid treatment in an immunocompetent man: a case report
Authors: Zhao Yuxi , Wu Xiaoxin , Wang Xinyu , Li Lanjuan
Published: January 2025

Background

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease characterized by leukopenia and thrombocytopenia, and aspergillosis is a common complication in severe cases. Previous studies have reported cases of SFTS complicated with invasive pulmonary aspergillosis (IPA) and central nervous system aspergillosis. Here, we present the first case of an immunocompetent patient with SFTS who progressed to IPA and Aspergillus endocarditis after glucocorticoid treatment, and embolism of the vegetations from the left ventricle led to multiple infarctions in the brain, kidney, and spleen.

Case presentation

A 66-year-old male farmer developed altered mental status during SFTS. His consciousness improved during the treatment of glucocorticoids, intravenous immunoglobulin, and ribavirin, but he developed embolisms in the spleen and right kidney, initially attributed to atrial fibrillation, and the anticoagulant agent was not administered due to the high risk of bleeding. Later, He was diagnosed with SFTS-associated IPA (SAPA), for which voriconazole was administered. However, he subsequently experienced a recurrence of altered mental status, accompanied by headache, blindness, and muscle weakness. Brain magnetic resonance imaging (MRI) revealed multiple cerebral embolisms and abscess. The echocardiography showed the vegetations in the left ventricle, suggesting multi-organ embolism caused by infective endocarditis (IE). Aspergillus fumigatus was confirmed through pathology and culture of the excised vegetations. The patient was eventually discharged with improved consciousness and muscle strength, but his vision showed minimal recovery.

Conclusion

Clinicians should be wary of aspergillosis in severe patients with SFTS, particularly those receiving glucocorticoid treatment. In patients with SAPA, cerebral aspergillosis and embolic stroke caused by Aspergillus endocarditis should also be considered when mental status alters. Furthermore, the possibility of Aspergillosis in other organs should be considered in high-risk patients.
Biomechanical models in the lower-limb exoskeletons development: a review
Authors: Firouzi Vahid , Seyfarth Andre , Song Seungmoon , von Stryk Oskar , Ahmad Sharbafi Maziar
Published: January 2025

Lower limb exoskeletons serve multiple purposes, like supporting and augmenting movement. Biomechanical models are practical tools to understand human movement, and motor control. This paper provides an overview of these models and a comprehensive review of the current applications of them in assistive device development. It also critically analyzes the existing literature to identify research gaps and suggest future directions. Biomechanical models can be broadly classified as conceptual and detailed models and can be used for the design, control, and assessment of exoskeletons. Also, these models can estimate unmeasurable or hard-to-measure variables, which is also useful within the aforementioned applications. We identified the validation of simulation studies and the enhancement of the accuracy and fidelity of biomechanical models as key future research areas for advancing the development of assistive devices. Additionally, we suggest using exoskeletons as a tool to validate and refine these models. We also emphasize the exploration of model-based design and control approaches for exoskeletons targeting pathological gait, and utilizing biomechanical models for diverse design objectives of exoskeletons. In addition, increasing the availability of open source resources accelerates the advancement of the exoskeleton and biomechanical models. Although biomechanical models are widely applied to improve movement assistance and rehabilitation, their full potential in developing human-compatible exoskeletons remains underexplored and requires further investigation. This review aims to reveal existing needs and cranks new perspectives for developing more effective exoskeletons based on biomechanical models.
Parental perception of treatment options for mucopolysaccharidosis: a survey to bridge the gap for personalized medicine
Authors: Wiesinger Anna-Maria , Lagler Florian B.
Published: January 2025

Background

Mucopolysaccharidosis (MPS) are a group of lysosomal storage diseases with substantial unmet medical needs—for both patients and caregivers. Approved therapies are limited, and the perception of investigative ones remains enigmatic.

Method

Using an innovative survey concept based on the discrete choice experiment method (DEC) with neuronopathic and non-neuronopathic patient scenarios, we aimed to evaluate how parents of children with MPS perceive different approved and innovative therapies. The questionnaire was distributed via patient organizations in Germany, Switzerland, and Austria.

Results

Most likely parents would choose an approach to repurposed treatments for their child (neuronopathic: 82%, 14/17 and non-neuronopathic: 94%, 16/17), followed by enzyme replacement therapy (ERT, both 88%, 15/17), hematopoietic stem cell therapy (HSCT, 70%, 12/17 and 76%, 13/17), and finally gene therapy (GT, 58%, 10/17 and 53%, 9/17). The general attitudes strongly influenced decision-making regarding treatment options. While over 80% of respondents who held a positive attitude toward ERT, HSCT, and ITTs indicated they would opt for these therapies in both neuronopathic and non-neuronopathic cases, only about half of the parents with a favorable general view of gene therapy (GT) expressed a positive perception of its likelihood as a treatment option. Furthermore, most parents found mild infections, injection site reactions (ISRs), hypertonia, and treatment-related hospitalizations acceptable and indicated patient organizations as their main source of information.

Conclusions

This study provides an innovative survey method, thereby offering the rationale for a quantitative risk–benefit model and the importance of patient and caregiver-centered information dissemination, especially for innovative therapies.
Dynamic analysis of SPAFIR epidemic model considering pseudoinfection and perturbations
Authors: Nie Xiaoqian , Hu Yuhan , Yan Weijun
Published: January 2025

In this paper, the “pseudoinfection phenomenon” and “individual behavioral responses” are taken into account in the SIR epidemic model, and the deterministic and stochastic models are analyzed dynamically. Through the exploration of the deterministic SPAFIR (Susceptible-Pseudoinfected-Alert-Fragile-Infected-Recovered) model, the conditions for the equilibrium points’ existence and stability are determined. With the assistance of the Pontryagin maximum principle, this paper introduces a Hamiltonian function with a penalty term and the optimal control strategy is obtained by comparing the three groups of strategies. The optimal control strategy requires multiple control measures to inhibit the infectious disease spread. Further considering the stochastic SPAFIR model, the existence of the uniqueness of a global positive solution and the existence of a stationary distribution for the stochastic model are proved, and the condition for disease extinction is also verified. Random perturbations of the effective contact rates can slow the pace of spreading the infectious diseases. Results of theoretical analysis and the system’s responsiveness to variations in effective contact rates are verified by numerical simulations, and the outcomes indicate that active prevention education and community encouragement can both inhibit infection spread.
Effects of spray dried plasma on litter growth performance and oxidative stress and inflammation of sows kept in a hot environment
Authors: Bailey Hannah M. , Fanelli Natalia S. , Campbell Joy M. , Stein Hans H.
Published: January 2025

Background

Feeding spray dried plasma (SDP) to weanling pigs improves growth, but there is a lack of research on how SDP impacts oxidative stress and inflammatory response in lactating sows, and performance of their piglets after weaning. Therefore, an experiment was conducted to test the hypothesis that sows fed a diet with SDP in late gestation and lactation have improved reproductive performance and reduced inflammation compared with sows fed no SDP. The second hypothesis was that pigs weaned from sows fed 0.5% SDP in lactation have reduced diarrhea incidence and improved growth performance during the initial 14 d of the nursery period regardless of dietary SDP.

Results

The percent of low vitality or starved pigs during lactation was less (P < 0.05) from sows fed 0.5% dietary SDP compared with sows fed the diet without SDP. Dietary SDP did not influence oxidative stress markers in the plasma of sows, but serum cytokines increased (P < 0.05) in sows fed the diet with 0.5% SDP compared with sows fed the diet without SDP. Pigs weaned from young sows fed no SDP or from mature sows fed 0 or 0.5% SDP had a greater gain to feed ratio when fed a phase 1 diet containing 6% SDP compared with pigs fed a diet without SDP, but the gain to feed ratio of pigs weaned from young sows fed 0.5% dietary SDP was not affected by dietary SDP in phase 1 (interaction, P < 0.05). Regardless of sow treatment, pigs fed a phase 1 diet with 6% SDP had greater (P < 0.05) growth performance than pigs fed a phase 1 diet without SDP, and pigs fed the phase 1 diet with 6% SDP had reduced (P < 0.05) diarrhea incidence in phase 1.

Conclusions

Feeding 0.5% dietary SDP to sows may reduce the number of mummified pigs and increase pig vitality during lactation, but adding 0.5% SDP to sow diets during lactation did not improve post-weaning performance of pigs fed a starter diet with 6% SDP.
Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study
Authors: Choi Byung Sun , Kwon Soon Bin , Jeon Sehyeon , Kim Myeongjun , Ku Yunseo , Ro Du Hyun , Han Hyuk-Soo
Published: January 2025

Background

Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activation and kinetic gait patterns in patients with PFPS.

Methods

This study included 31 patients with PFPS and 28 healthy volunteers without any symptoms. The sagittal plane motion of the knee joint, representing primary movement of the knee joint, was evaluated to identify changes in gait patterns. Electromyography (EMG) was used to measure muscle activation of vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and gastrocnemius (GCM) muscles during gait analysis. Biomechanical features were analyzed during the three phases of the gait cycle; weight acceptance (WA), single limb support (SLS), and swing limb advancement (SLA) (0 ~ 12%, 13 ~ 50%, and 51 ~ 100% of the gait cycle, respectively).

Results

The average knee extension moment (KEM) during WA was lower in the patient group and no significant differences were observed in the knee flexion angle (KFA). With respect to muscle activation, the patient group showed significantly higher muscle activation of the ST muscle in all phases. As the absolute value of the moment increased, the activation of the VM, VL, and ST muscles increased more rapidly in the patient group, especially when KEM was under −1% body weight × height (Bw × Ht) or over 5% Bw × Ht.

Conclusions

Patients with PFPS exhibit elevated muscle activation, particularly in response to changes in the knee extension moment, which is likely a compensatory mechanism to manage knee joint loading during gait. These results highlight altered neuromuscular adaptations in PFPS, suggesting targeted therapies may help improve functional outcomes.

Level of evidence III, cross-sectional study
Understanding social behaviours across neurodiverse young people: roles of social cognition and self-regulation
Authors: Iturmendi-Sabater Iciar , Anagnostou Evdokia , Fournier Marc A. , Crosbie Jennifer , Schachar Russell , Nicolson Robert , Georgiadis Stelios , Kelley Elizabeth , Jones Jessica , Brian Jessica , Lin Hsiang-Yuan , Lai Meng-Chuan
Published: January 2025

Background

Differences in social behaviours are common in young people with neurodevelopmental conditions (NDCs). Recent research challenges the long-standing hypothesis that difficulties in social cognition explain social behaviour differences.

Aims

We examined how difficulties regulating one's behaviour, emotions and thoughts to adapt to environmental demands (i.e. dysregulation), alongside social cognition, explain social behaviours across neurodiverse young people.

Method

We analysed cross-sectional behavioural and cognitive data of 646 6- to 18-year-old typically developing young people and those with NDCs from the Province of Ontario Neurodevelopmental Network. Social behaviours and dysregulation were measured by the caregiver-reported Adaptive Behavior Assessment System Social domain and Child Behavior Checklist Dysregulation Profile, respectively. Social cognition was assessed by the Neuropsychological Assessment Affect-Recognition and Theory-of-Mind, Reading the Mind in the Eyes Test, and Sandbox continuous false-belief task scores. We split the sample into training (n = 324) and test (n = 322) sets. We investigated how social cognition and dysregulation explained social behaviours through principal component regression and hierarchical regression in the training set. We tested social cognition-by-dysregulation interactions, and whether dysregulation mediated the social cognition–social behaviours association. We assessed model fits in the test set.

Results

Two social cognition components adequately explained social behaviours (13.88%). Lower dysregulation further explained better social behaviours (β = −0.163, 95% CI −0.191 to −0.134). Social cognition-by-dysregulation interaction was non-significant (β = −0.001, 95% CI −0.023 to 0.021). Dysregulation partially mediated the social cognition–social behaviours association (total effect: 0.544, 95% CI 0.370–0.695). Findings were replicated in the test set.

Conclusions

Self-regulation, beyond social cognition, substantially explains social behaviours across neurodiverse young people.
Diabetes Technology Trends: A Review of the Latest Innovations
Authors: Lundgrin Erika L , Kelly Clare A , Bellini Natalie , Lewis Claudia , Rafi Ebne , Hatipoglu Betul
Published: January 2025

Context

Over the last decade, diabetes management tools such as continuous glucose monitors, automated insulin delivery systems, and connected insulin pens have experienced exponential growth. These technologies are more readily being adopted to manage diabetes due to increased availability. This mini-review provides information about recent innovations available in the United States for diabetes management to improve patient outcomes.

Evidence Acquisition

A systematic search was conducted using Medline, PubMed, ScienceDirect, and Embase databases, as well as the Cochrane Library to identify peer-reviewed articles published between 2014 and 2024, in English, and focused on treatment using technology in diabetes care.

Evidence Synthesis

Diabetes technology has significantly eased the burden of both glucose measurement and insulin delivery, which has, overall, improved diabetes management. Advancements in accuracy and glycemic outcomes have been demonstrated through rigorous clinical and observational trials, underscoring their potential to transform diabetes care. The literature suggests that the use of diabetes technologies promotes patient self-efficacy and enhances the quality of life for individuals with both type 2 and type 1 diabetes.

Conclusion

Diabetes technology has been shown to improve important aspects of diabetes care, from glycemic control to patient satisfaction and quality of life. It is important to assess the role of technology in type 1 and type 2 diabetes and individualize treatment goals and objectives.