bluuebunny/crossref_metadata_2025 huggingface dataset:
Policy interactions at a multiscale geographical space for developing the green economy: Evidence from the international diffusion of environmental goods
Authors: Gui Jingxuan , Mao Xiyan , Wang Peiyu
Published: January 2025

The institutional and multi‐scale perspective provide a promising nexus between economic geography and environmental governance. They help to overcome the duality of the global–local nexus for regions in a globalising world, enabling the rediscovery of the role of states and their governance. This article proposes that the scalar structure of institutional linkages is not continuous from the global to the local, where the state level is a discontinuity. The supra‐national interdependence is horizontal and the sub‐national governance is hierarchical. They interact with each other to affect the path development of new economies. International trade in environmental goods during 2001–19 is used as an empirical case. The results show that the liberalising trade policies (international interdependencies) open a window of opportunity for countries to develop a green economy, while domestic industrial and environmental policies (domestic governance) help to anchor the opportunities by enhancing the effect of trade policies. These results show that an enabling system of environmental governance requires a multi‐scalar structure that includes states. Domestic governance allows the states to adapt to the global governance regime, and then seize the development opportunities offered by international interdependencies. The states play a crucial role in balancing the multi‐scale interactions in the global governance regime. This is different from what the conventional global–local nexus might conclude.
The Experience of Stigma in People Affected by Fibromyalgia: A Metasynthesis
Authors: Colombo Benedetta , Zanella Eleonora , Galazzi Alessandro , Arcadi Paola
Published: January 2025

Aim

To review the qualitative literature regarding how people with fibromyalgia experience and are impacted by stigma.

Design

A systematic review and metasynthesis of qualitative studies was conducted following the Thomas and Harden method.

Methods

The electronic databases PubMed, CINAHL, PsycInfo, Embase and Scopus were queried (September 2023). No publication year limit was set. Twelve studies were included in the final analysis. The findings were reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement.

Findings

Three main themes with 11 sub‐themes were identified: manifestations and roots of stigma, avoidance and coping strategies, and consequences of stigma. Stigma arises from disbelief due to the invisibility of symptoms, protracted time to diagnosis and gender stereotyping, especially against women. Various strategies to avoid or cope with prejudice may involve social isolation, hiding the disease, controlling information, getting closer to or further away from other patients, acknowledging and understanding the disease. Stigmatisation can diminish a person's integrity and dignity, undermine trust in health care professionals and worsen suffering.

Conclusion

The metasynthesis findings align with previous research highlighting the pervasive stigma associated with chronic pain conditions. Greater awareness of the impact of disease‐related stigma on individuals with fibromyalgia is crucial, not only among health care professionals but also within broader societal and institutional contexts.

Implications for the Profession and/or Patient Care

Understanding the stigma experienced by individuals with fibromyalgia can guide health care professionals in adopting more empathtic approaches, potentially improving the diagnostic process and the overall management of the condition.

Impact

This study highlights the profound impact of stigma on individuals with fibromyalgia, emphasising the need for greater awareness and targeted interventions to address stigma in clinical practice and societal contexts.

Patient or Public Contribution

No patient or public contribution.
Graphical Model Selection to Infer the Partial Correlation Network of Allelic Effects in Genomic Prediction With an Application in Dairy Cattle
Authors: Martínez Carlos A. , Khare Kshitij , Rahman Syed , Báez Giovanni M.
Published: January 2025

We addressed genomic prediction accounting for partial correlation of marker effects, which entails the estimation of the partial correlation network/graph (PCN) and the precision matrix of an unobservable m‐dimensional random variable. To this end, we developed a set of statistical models and methods by extending the canonical model selection problem in Gaussian concentration, and directed acyclic graph models. Our frequentist formulations combined existing methods with the EM algorithm and were termed Glasso‐EM, Concord‐EM and CSCS‐EM, whereas our Bayesian formulations corresponded to hierarchical models termed Bayes G‐Sel and Bayes DAG‐Sel. We implemented our methods in a real bull fertility dataset and then carried out gene annotation of seven markers having the highest degrees in the estimated PCN. Our findings brought biological evidence supporting the usefulness of identifying genomic regions that are highly connected in the inferred PCN. Moreover, a simulation study showed that some of our methods can accurately recover the PCN (accuracy up to 0.98 using Concord‐EM), estimate the precision matrix (Concord‐EM yielded the best results) and predict breeding values (the best reliability was 0.85 for a trait with heritability of 0.5 using Glasso‐EM).
YouTube Videos of Pacemaker Implantation: An Assessment of Information Content and Quality
Authors: Tang Pok‐Tin , Camm C. Fielder , Rajappan Saffron , Sale Richard D. , Rajappan Kim
Published: January 2025

Background

Permanent pacemaker (PPM) implantation is a commonly performed procedure. Patients increasingly use the Internet for information on medical interventions. We aimed to assess the quality of videos discussing PPM implantation on YouTube for patient consumption.

Methods

YouTube was searched on October 19, 2022, for “PPM implantation” and “Pacemaker.” The first 100 results from each search were screened: all English language videos containing predominant discussion of transvenous PPMs were included; YouTube shorts and advertisements were excluded. Two authors independently assessed videos for information content based on criteria generated using established patient resources supplemented by expert consensus. Video reliability and quality were assessed using a novel scoring system.

Results

Thirty‐three videos with a cumulative total of 5 864 488 views were included. No video contained all essential information criteria. The average number of essential criteria covered was 8/32 (standard deviation 4.8). Peri‐operative management was, particularly, poorly covered: no item relating to preoperative management or postoperative care was covered by more than 40% of videos. None of the videos fulfilled all quality criteria, with a median score of 7.5/13 (interquartile range 6.5–8). Videos performed, particularly, poorly on providing balanced messages, creator disclosures, attribution of source content, and indicating when videos were made.

Conclusion

YouTube videos of PPM implantation do not contain sufficient information to allow patients to gain an appropriate understanding of this procedure. Furthermore, the information presented is of insufficient quality to support decision‐making. There is a need for a professionally regulated, comprehensive audiovisual patient resource on PPM implantation.
Dependence matters! Investor sentiment and stock returns: A sliced inverse regression approach
Authors: He Lingyu , Shi Jing , Wang Yizhi , Zhu Qiaoqiao
Published: January 2025

We construct a new investor sentiment index by exploiting the information of the sentiment proxies with the sliced inverse regression approach. We show that the new index is a strong negative predictor of future aggregate stock returns in both in‐sample and out‐of‐sample tests. Further evidence indicates that the new sentiment index generates large utility gains for a mean‐variance investor who optimally allocates between equities and risk‐free assets. In addition, we show that this sentiment index exhibits the strongest return predictability for portfolios sorted on size, value, momentum, and industry.
Nomograph of cancer‐specific survival in elderly patients with endometrial cancer based on SEER database
Authors: Ma Fanghua , Huang Jiesheng
Published: January 2025

Objective

This study aims to identify prognostic factors for elderly patients with endometrial cancer and to develop a nomogram for predicting cancer‐specific survival in this population.

Methods

Clinicopathological data of elderly patients diagnosed with endometrial cancer between 2004 and 2015 were extracted from the SEER database. Patients were randomly assigned to either a training cohort or a validation cohort at a ratio of 7:3. Univariate and multivariable Cox regression analyses were performed to identify independent prognostic factors. A nomogram was then constructed based on these factors, and its predictive accuracy and discriminative ability were assessed using the C‐index, receiver operating characteristic (ROC), and calibration curve.

Results

Multivariate analysis identified age, marital status, grade, Federation of International of Gynecology and Obstetrics, surgery, chemotherapy, radiation, and tumor size as independent prognostic factors for elderly patients with endometrial carcinoma. Nomograms derived from these factors demonstrated excellent calibration and discrimination. The C‐indexes were 0.83 for the training set and 0.82 for the validation set. The area under the curve (AUC) values for the training set were 0.88, 0.87, and 0.86 at 1, 3, and 5 year respectively. Corresponding AUC values for the validation set were 0.89, 0.86, and 0.86. Calibration curves for both cohorts demonstrated close alignment with the diagonal, indicating robust agreement between nomogram predictions and actual outcomes.

Conclusion

A novel nomogram has been developed for personalized prognosis assessment in elderly patients with endometrial carcinoma, aiming to enhance tailored treatment strategies and clinical management.
Clinical outcomes after 2‐year follow‐up of transvaginal radiofrequency ablation of symptomatic uterine fibroids
Authors: Santalla‐Hernández Ángel , Naveiro‐Fuentes Mariña , López‐Criado María Setefilla , Naveiro‐Flores Roi , Fernández‐Parra Jorge
Published: January 2025

Aim

The aim of this study was to evaluate the efficacy after 2 years follow‐up of transvaginal radiofrequency ablation (TVRA) to treat myomas, and to identify factors predictive of the response to the treatment.

Methods

This is a prospective cohort study of a 2‐year follow‐up of 65 patients who underwent TVRA for the treatment uterine fibroids at Virgen de las Nieves University Hospital in Granada, Spain. Ultrasound mean fibroid volume, symptom severity scale, total bleeding days, complications, pregnancy outcomes were recorded.

Results

Statistically significant improvements in symptoms and bleeding were observed at 6, 12, and 24 months after the procedure. The mean myoma volume (cc) was significantly lower (p < 0.05) at 12 and 24 months, with a mean reduction in myoma volume of more than 80% and 60%, respectively. After a 24‐month follow‐up, 5 patients (7.7%) required additional surgical treatment to control symptoms. Patient age (>40 years), initial myoma size, and the timing of radiofrequency were identified as factors related to outcomes in the bivariate analysis.

Conclusions

Transvaginal radiofrequency ablation is an effective and safe technique for the treatment of myomas after 2 years of follow‐up, which improves the symptoms of the patients and decreases the final volume of the myoma.
How Imprints Transcend Era and Terra: A Study of Firms' Controversial History and Present‐Day Foreign Market Entry
Authors: Qiao Kunyuan , Xia Jun
Published: January 2025

How do certain historical events transcend generational and geographic boundaries to shape firm strategy? We explore this question by examining how certain German firms' present‐day foreign market entry is influenced by their past leaders' support of Hitler and the Nazi Party, or Nazi imprint. We argue that this imprint persists through two mechanisms: (1) internal organizational alertness to their controversial past and (2) external collective memory sustained by Jewish communities worldwide. When Nazi‐imprinted German firms consider entering locations where their past might provoke controversy, they tend to seek informational cues from peers with the same imprint. This results in a positive relationship between the number of subsidiaries their peers have in such controversial locations and the number of new subsidiaries established by the focal firm. To illustrate these mechanisms, we argue that the communist purge in the former East Germany has reduced organizational alertness to the controversial past and thus weakened the relationship. In contrast, commemorative efforts by synagogues around the world have strengthened the collective memory, thereby reinforcing the relationship. We employ two longitudinal samples to test these hypotheses, focusing on German firms' entries into (1) non‐German cities worldwide with significant Jewish populations and (2) US counties with neo‐Nazi hate groups. We obtain robust evidence supporting our hypotheses. By demonstrating the role of extra‐organizational carriers in maintaining historical imprints and challenging the notion that inertia alone sustains them, our research advances imprinting theory and sheds light on the role of history in international business.
Prediction models for post‐traumatic stress disorder in family members of ICU patients: A systematic review
Authors: Zhang Xinyu , Sun Xiao , Cao Qianqian , Li Qihong , Li Rongqing , Zhang Zikai , Jiang Jinxia , Zeng Li
Published: January 2025

Background

Several predictive models have been developed for post‐traumatic stress disorder (PTSD) in intensive care unit (ICU) family members. However, significant differences persist across related studies in terms of literature quality, model performance, predictor variables and scope of applicability.

Aim

This study aimed to systematically review risk prediction models for PTSD in family members of ICU patients, to make recommendations for health care professionals in selecting appropriate predictive models.

Study Design

China National Knowledge Infrastructure, VIP database, Wanfang database, SinoMed, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase and OVID were searched from inception to 1 May 2024. Two independent researchers conducted literature screening, data extraction and applied a risk of bias assessment tool for predictive models to evaluate included studies. The systematic review was registered on PROSPERO (registration number: CRD42024560815).

Results

Seventeen studies were included, with sample sizes ranging from 32 to 2734. Incidence rates of outcomes ranged from 1.6% to 63.6%. The most frequently used predictors were relative's female sex, longer duration of ICU stay, patient's death in the ICU and type of relationship with the patient. Two models reported area under the receiver operating characteristic curve (AUC) values ranging from 0.73 to 0.74; only three models reported calibration, and one study conducted internal validation. Overall, the 17 studies showed good applicability but exhibited a high risk of bias, particularly in data analysis.

Conclusions

Research on predictive models for PTSD risk in family members of ICU patients is in the developmental stage. Future studies should validate existing models or develop high‐performance localized predictive models.

Relevance to Clinical Practice

PTSD can have a significant impact on the families of ICU patients, making early identification of high‐risk populations essential for health care professionals to implement timely interventions.
Assessment of Insertion Torque, Primary and Secondary Stability in Immediate, Early and Delayed Implant Placement in the Maxilla of Elderly Patients: A Prospective Cohort Study
Authors: Win Kaung Zaw , Pimkhaokham Atiphan , Kaboosaya Boosana
Published: January 2025

Objective

This prospective cohort study assessed the effect of implant placement protocols on the insertion torque (IT), primary and secondary stability placed in maxilla in elderly.

Material and Methods

A total of 26 implants were placed in the maxillary regions, categorised into three groups: immediate placement after tooth extraction (immediate group), placement 2 weeks–6 months after extraction (early group) and placement more than 6 months after extraction (delayed group). The IT and primary stability were recorded at the time of implant placement, while secondary stability was assessed during a follow‐up visit 60–120 days post‐surgery. Additionally, other factors influencing outcomes, such as gender, location of implant placement, macrostructural design, length and diameter of implants, were recorded.

Results

The IT demonstrated a correlation with primary implant stability (rs = 0.504, p = 0.009). However, no significant correlation was observed with secondary stability. There were no significant differences in IT (p = 0.45) and primary stability (p = 0.51) among the three groups. However, the early implant placement group exhibited significantly higher secondary stability compared to the delayed group (p = 0.03). Significant differences were observed among implant placement protocols in terms of secondary stability in females (p = 0.03) and tapered implant (p = 0.008).

Conclusions

The IT and primary stability did not serve as reliable predictors of secondary stability in implant placement in the maxilla of elderly patients. However, the early implant placement protocol showed superiority over both immediate and delayed placement protocols in terms of achieving secondary stability. Specifically, gender and macrostructural design emerged as influential factors affecting secondary stability.
Second‐generation antipsychotic‐induced dystonia: Analysis using the Japanese Adverse Drug Event Report (JADER) database
Authors: Ebina Takumi , Iwamoto Kunihiro , Ando Masahiko , Ikeda Masashi
Published: January 2025

Aim

This study aimed to explore the comparative risks for dystonia among different second‐generation antipsychotics (SGAs), the influence of sex, and the relationship between the time‐to‐onset of dystonia and its outcomes.

Methods

We analyzed data from the Japanese Adverse Drug Event Report database from April 2004 to November 2023. Cases involving oral SGAs, excluding clozapine, were extracted. We used the odds ratios to assess the reporting proportions among SGAs and sex, analyzed the median time‐to‐onset and interquartile ranges (IQRs), and conducted a receiver operating characteristic (ROC) curve analysis to investigate the time‐to‐onset of dystonia and its relationship to outcomes.

Results

We extracted 9837 cases involving oral SGAs. Lurasidone was associated with a significantly higher proportion of dystonia reports than risperidone, aripiprazole, quetiapine, and olanzapine. The reporting proportion of dystonia associated with aripiprazole was lower than that of paliperidone and risperidone, but higher than that of quetiapine and olanzapine. Female sex was significantly associated with a higher reporting proportion of dystonia compared with males. Among the 148 cases of oral SGA‐induced dystonia, the median time‐to‐onset was 125 days (IQR, 19.75–453.25 days). Divided into the three outcome groups (recovered, improved, and unrecovered/residual), those with better outcomes had a shorter time‐to‐onset than those with poorer outcomes. ROC curve analysis suggested a threshold of 91.5 days for discriminating outcomes, with a sensitivity of 71.7% and specificity of 69.9%.

Conclusions

The risks of dystonia may vary among SGAs and between sexes. SGA‐induced dystonia often manifests in the tardive form.
General Classes of GEKS‐Type Price Indices With Application to Scanner Data
Authors: Białek Jacek
Published: January 2025

This article addresses the problem of selecting a price index dedicated to scanner data, with attention directed toward multilateral GEKS‐type indices. The article proposes three general classes of GEKS‐type indices, the special cases of which are reduced to the well‐known GEKS, CCDI, or GEKS‐W formulas. The main purpose of the article is to analyze the axiomatic properties of the proposed index classes. The practical conclusion of the analysis seems to be the recommendation of a general class of GEKS‐type indices, which is based on the Lloyd‐Moulton index and of which the recently published GEKS‐L and GEKS‐GL indices are special cases.
Aesthetic rehabilitation in lower mandibular area for agenesis in site 4.2: A case report and literature review
Authors: Palmacci Matteo , Saverino Marco , Pancrazi Gian Luca , Ferraro Costanza , Ceresoli Lara , Manica Umberto , Nagni Matteo
Published: January 2025

Agenesis, or congenital absence of one or more dental elements, is one of the most frequently occurring craniofacial disorders in humans and is a clinical problem that compromises aesthetics and dental function from an early age. It is a condition that can involve both deciduous and permanent dentition, with contextually different prognoses and treatment solutions.
In both cases, the clinical management of this issue involves a multi-disciplinary approach designed to cover the comprehensive dental needs of patients with agenesis. Among the elements of the permanent dentition less commonly affected by this malformation are the lower lateral incisors, whose absence may be rare but, at the same time, aesthetically and functionally debilitating for the patient.
Aim: The current study presents a review of the existing literature regarding the prevalence, etiology, and classification of the various clinically detectable dental agenesis, with a focus especially directed toward absent mandibular lateral incisors and possible clinical dental management to resolve the problem. This article’s description of a case report aims to outline a possible aesthetic rehabilitation approach in the presence of these rare cases of agenesis and then present the clinical results obtained through implant-prosthetic rehabilitation combined with orthodontic therapy.
Interceptive orthodontic treatment with elastodontic appliance for open bite in early childhood: a case series
Authors: Vena Filippo , D'Amico Giorgia , Cardarelli Filippo , Cianetti Stefano , Severino Marco
Published: January 2025

This case series explores the effectiveness of interceptive orthodontic treatment using A.M.C.O.P elastodontic appliances for open bite correction in early childhood. The study included three patients aged 3-5 years with primary dentition open bite and associated oral habits, treated at the Odontostomatological Centre, University of Perugia. Treatment utilized A.M.C.O.P Bio-Activators, tailored for early intervention, leveraging light and biological elastic forces to guide jaw growth and correct dental alignment.
The study highlights the role of timely intervention using A.M.C.O.P Bio-Activators in managing malocclusions, demonstrating significant improvements in occlusion and functional disorders. Early treatment with these devices not only corrects open bite efficiently but also reduces the need for future orthodontic interventions, emphasizing the importance of accurate diagnosis and patient compliancein achieving lasting results.
A Pterygoid Implants in severe posterior maxillary atrophy: a case report
Authors: Iacomino Enzo , Rastelli Sofia , Capogreco Mario , Severino Marco , Gallottini Sofia Germana , Grivetto Fabrizio
Published: January 2025

A good clinician must be able to make a diagnosis and on the basis of this identify the ideal treatment plans. The choice of treatment plan depends on both the patient's needs and the clinical and anatomical conditions. Therefore, in order to have multiple alternatives it is advisable to enlarge clinical acknowledgement. The placement of pterygoid implants to rehabilitate the posterior maxillae region is little used.  Pterygoid implants are non-traditional dental implants, longer than normal (up to 25mm), which are inserted into the pterygoid process of the sphenoid bone. The pterygoid bone is a very hard and compact bone and guarantees dental implant high primary stability and a safer immediate loading. To obtain a better stability of dental rehabilitation, pterygoid implants can also be used in combination with traditional dental implants and / or zygomatic implants or trans-sinus tilted implants.
This technique is ideal because it has better bone quality than tuber maxillae, the patient can count teeth down to the second molar, immediate loading is possible, treatment times are limited and it is a predictable treatment.
The presentation of this case report aims to highlight how and why it is necessary to consider the option of inserting pterygoid implants as a valid alternative.
Evaluation of a single non-surgical approach in the management of peri-implantitis: glycine powder air-polishing versus ultrasonic device
Authors: Memè Lucia , Bambini Fabrizio , Pizzolante Tommaso , Sampalmieri Francesco , Bianchi Alessia , Mummolo Stefano
Published: January 2025

Dental implants are often used to replace lost teeth and present a high level of predictability, patient satisfaction and long-term success. Biological complication such as peri-implant mucositis and peri-implantitis have, however, become major challenges to the profession.
The definition of peri-implant mucositis is an inflammation of the soft tissues adjacent to a dental implant diagnosed with bleeding on gentle probing (<0.20 N). if the clinical signs are combined with bone loss the condition is referred as peri-implantitis.
The treatment goal of peri-implant disease is to remove or significantly depress the levels of pathogens to allow healing of the soft and hard tissues. As peri-implant mucositis is a common clinical entity that may develop into peri-implantitis early recognition and proper diagnosis of peri-implant disease is of high importance in the treatment.
The aim of the presence study was to evaluate the clinical outcome (probing depth PD, bleeding on probing BoP, plaque index PI) following treatment of peri-implantitis with single non-surgical approach using a glycine powder air-polishing (GPAP) or an ultrasonic device over a 2-months period.
Thirty implants were enrolled and randomly assigned to test (GPAP) and control (ultrasonic device) groups. Significant differences were found in the mean of the clinical outcome evaluation but further observations of larger sample size of patients are needed.
Clinical and histomorphometric comparison of autologous dentin graft versus a deproteinized bovine bone graft for Socket Preservation
Authors: Meme Lucia , Grilli Filippo , Pizzolante Tommaso , Capogreco Mario , Bambini Fabrizio , Sampalmieri Francesco , Mummolo Stefano
Published: January 2025

Dentin has been a significant focus of research due to its potential as a bone substitute, owing to its higher mineral content than any material derived from bone. Additionally, dentin shares two key similarities with autologous bone: it is both osteocompatible and osteoconductive, providing a physical framework for the deposition of new bone. This comparative study assessed the osteoinductive and osteoconductive capabilities of various materials commonly used in “socket preservation” or alveolar ridge preservation. The results showed that the autologous dentin matrix and bovine-derived xenografts (Bio-oss) achieved superior bone regeneration, with a greater volume of newly formed bone (measured by the BV/TV parameter) and reduced fibrous bone, which has undesirable characteristics for implant biomechanics.
Necesidad de la ética comunitarista en el Derecho Comercial: estudio a partir del Derecho Comercial colombiano y los estudios de Michael Sandel
Authors: Wilches Durán Rafael Eduardo
Published: January 2025

El autor plantea la necesidad de incorporar la perspectiva de la ética comunitarista, por encima de la perspectiva de la ética liberal, de la ética republicana, y hasta de la ética cosmopolita, dentro de la redefinición del Derecho Comercial, para lo cual toma el Derecho Comercial colombiano y los trabajos de Michael Sandel, como elementos a partir de los cuales demostrar su planteamiento.
Triple M overlap syndrome following pembrolizumab treatment: importance of multidisciplinary approach
Authors: Gómez Lucía , Lozano Teresa , Jovani Vega , Martínez-Banaclocha Natividad
Published: January 2025

The increasing use of immune checkpoint inhibitors in clinical practice is associated with a broad spectrum of immune-related adverse events, such as cardiac, rheumatological and neurological toxicities. Myocarditis is a life-threatening complication, and the concurrent development of myocarditis, myositis and/or myasthenia leads to difficulties in diagnosis, management and treatment. We describe a case presenting with this triple M overlap syndrome following pembrolizumab treatment.

A man in his 80s with a background of chronic ischaemic heart disease, receiving pembrolizumab as first-line treatment for microsatellite instability locally advanced gastric cancer, presented after the second dose of treatment with muscle weakness, binocular diplopia and left ptosis. Elevated transaminases, creatine kinase and high-sensitivity troponin-T levels were revealed. ECG monitoring showed the development of an atrioventricular block, needing a temporary pacemaker. Immune-related myocarditis, myasthenia and myositis were suspected. High-dose corticosteroids were administered without clinical benefit, so an escalation of immunosuppression was needed, using infliximab and immunoglobulins.
Predicting 90-day return to the emergency department in orthopaedic trauma patients in the Southeastern USA: a machine-learning approach
Authors: Valan Bruno , Therien Aaron , Peairs Emily , Ayehu Solomon , Taylor Joshua , Zeng Daniel , Olson Steven , Reilly Rachel , Pean Christian , DeBaun Malcolm
Published: January 2025

Introduction

Return-to-acute-care metrics, such as early emergency department (ED) visits, are key indicators of healthcare quality, with ED returns following surgery often considered avoidable and costly events. Proactively identifying patients at high risk of ED return can support quality improvement efforts, allowing interventions to target vulnerable patients. With its predictive capabilities, machine learning (ML) has shown potential in forecasting various clinical outcomes but remains underutilised in orthopaedic trauma. This study uses a random forest model to predict 90-day ED return in orthopaedic trauma patients, aiming to identify high-risk individuals and elucidate risk factors associated with returns. This study hypothesised that a highly accurate model could be developed to predict patients at high risk of ED return within 90 days of surgery.

Purpose

To develop and validate an ML model that predicts 90-day ED returns after orthopaedic trauma surgery using input data readily available in the electronic health record.

Methods

This is a retrospective model development and validation study. The study used data from a registry that includes information on all orthopaedic surgeries conducted at a level 1 academic medical centre. Patients who underwent orthopaedic trauma between 1 January 2017 and 1 March 2023 were identified using common procedural terminology code. The model used demographic, comorbid and perioperative variables. Return to the ED was captured as a binary outcome. Model performance was evaluated using the area under the receiver operator curve (AUROC).

Results

A total of 12 069 patients met the inclusion criteria. Patients were predominantly female (53%) and white (70%), with a median age of 55. The 90-day ED return rate was 14% (table 1). The random forest model identified body mass index, distance from the patient’s residence to the hospital, age, length of hospital stay and complexity of procedure (work relative value unit) as significant predictors of ED return, each accounting for greater than 10% of the total importance across all features in the model (table 2). Further, the model displayed strong discrimination of patients returning to the ED (AUROC=0.74) (figure 1).

Conclusions

The random forest model demonstrated predictive discrimination of 90-day ED returns. Critical predictors such as patient distance from the hospital suggest considering geographical and socioeconomic factors in postdischarge care planning. Operational factors such as length of stay or complexity of the procedure also predicted return to the ED. The study lays the groundwork for future predictive models in clinical decision-making and healthcare resource utilisation.

Level of evidence

Level III, retrospective model development and validation study.
Retrospective multicenter analysis of the Trenza Embolization Device for endovascular therapy of intracranial aneurysms: initial results and short-term follow-up
Authors: Wolf Marcel N , Valvassori Luca , Gioppo Andrea , Rautio Riitta , Hoeltje Jan , Schramm Peter , Jovanovic Ivan , Ozretic David , Buhk Jan-Hendrik , Allegretti Luca , Ernst Marielle , Brockmann Marc A , Othman Ahmed E
Published: January 2025

Background

Intrasaccular devices are increasingly used in endovascular therapy of intracranial aneurysms, in particular wide-necked and ruptured aneurysms. The Trenza Embolization Device (TED) is an innovative intrasaccular device for medium- to large-sized aneurysms. Currently, literature about the TED is scarce.

Methods

In eight participating European centers, 25 aneurysms (3 ruptured) in 25 patients (18 females, mean age 62.4 years) treated with the TED outside the currently recruiting prospective, post-market, multicenter study were included in this retrospective, multicenter analysis. Primary endpoints for clinical safety were the absence of stroke and death. Primary endpoint for technical success was implantation of TED without necessity of adjunct stenting. Primary and secondary endpoints for efficacy were adequate angiographic occlusion according to the Modified Raymond–Roy Classification (MRRC) immediately after the procedure and at first follow-up (FU).

Results

Stent-assistance was required in two cases. Thus primary endpoint for technical success was reached in 23/25 (92%) cases. With one symptomatic thrombotic event, primary safety endpoint was reached in 24/25 (96%) cases. At the end of the procedure, complete occlusion (MRRC I) was achieved in 12/25 (48%), and a small residual neck (MRRC II) remained in 13/25 (52%) cases. In 19 cases FU (mean 6 months) was available, showing adequate occlusion in 17/19 (89.5%) cases (MRRC I in 8/19 and stable MRRC II in 9/19 cases) and relevant reperfusion MRRC IIIa with indication to retreatment in 2/19 (10.5%) cases.

Conclusions

The results of this first retrospective, multicenter experience with the TED appear promising. Further prospective, multicenter studies with larger patient cohorts, as well as long-term FU, are required.
‘Captivating voices’: evaluation of a patient-centred animated video on excessive physical exercise and eating disorders
Authors: Brandt Gerrit , Bartel Heike , Paslakis Georgios
Published: January 2025

This project aimed to evaluate the acceptance of a short, animated video addressing excessive exercise within the context of eating disorder (ED) behaviours among diverse target groups, assess its impact and explore potential associations with disordered eating risk. An online survey was conducted, recruiting 170 participants who were shown a 3-minute and 11-second long animated video portraying narratives of individuals with lived experiences related to excessive exercise and ED. Participants provided demographic information, engaged in the video evaluation answering a 9-item questionnaire and completed a subsequent ED screening and a drive for muscularity questionnaire. In an optional open-ended comment section, participants provided suggestions, feelings, ideas and criticism. Individuals identified as at risk for disordered eating reported a significantly higher personal impact of the video, including the motivation to self-reflect on their personal exercise habits. Qualitative analyses revealed themes related to suggestions for the video’s use, general reflections on sports behaviours and ED, and reactions to the video’s artistic design. This interdisciplinary project underscores the potential of artistic animated short videos co-designed with individuals with lived experience in conveying narratives and fostering introspection among individuals at risk for ED and excessive exercise behaviours. Further exploration and refinement of interdisciplinary artistic approaches are recommended to enhance effectiveness and inclusivity in addressing ED and associated behaviours.
Predictive value of myositis antibodies: role of semiquantitative classification and positivity for more than one autoantibody
Authors: Kerola Anne M , Pietikäinen Annukka , Barantseva Julia , Pajander Annaleena , Hänninen Arno
Published: January 2025

Objectives

We assessed the positive predictive value (PPV) of 17 myositis antibodies for having a diagnosis of myositis and other myositis-spectrum conditions (interstitial lung disease (ILD), connective tissue diseases (CTD), malignancy) and evaluated the impact of semiquantitative classification and antibody overlap on the PPVs.

Materials and methods

We retrospectively identified 1068 individuals ≥18 years who tested positive for ≥1 antibody in the EUROLINE myositis line blot assay or positive for anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) in an ELISA-based test between 2015 and 2020 in 15 out of the 20 hospital districts in Finland. We extracted clinical diagnoses from the Care Register for Health Care between January 2013 and June 2022.

Results

The PPV for a myositis diagnosis (ever during data collection) was highest for anti-HMGCR antibodies (94%), followed by anti-MDA5, anti-Jo-1 and anti-TIF1-γ (49–54%). Regarding other myositis antibodies, 18–42% of cases had myositis. Anti-synthetase antibodies, anti-MDA5, anti-PM-Scl100, anti-SAE1 and anti-Ro52 had a PPV for ILD of 25–47%. A PPV for CTD was highest for anti-Ro52 (57%). The PPV for malignancy was highest for anti-TIF1-γ (38%), followed by anti-PL-7 (32%). Stronger antibody band intensity was associated with higher PPVs for myositis and CTD but not for ILD or malignancies. Simultaneous positivity for ≥2 antibodies compared with single antibody was associated with higher PPVs for myositis, CTD and ILD.

Conclusion

The PPV of myositis antibodies for diagnoses of myositis or other myositis spectrum diseases vary considerably between individual autoantibodies. Higher PPVs can be expected with stronger band intensities and with the presence of ≥2 overlapping myositis antibodies.
Prevalence and potential implications of HPV infection in transgender women with gender reaffirming genital surgery: a systematic literature review and meta-analysis
Authors: Elasifer Hana , Toledo Gabriel , Graham Catriona , Cuschieri Kate
Published: January 2025

Background

Human papillomavirus (HPV) is a common infection of the anogenital tract. Although most infections clear, persistent infections with oncogenic types can predispose to cancer. While the natural history of anogenital HPV infection in cisgendered women is relatively well understood, there are significant knowledge gaps regarding HPV prevalence and clinical implications of genital HPV infection in transgender women (TGW) with neovagina(s).

Methods

A systematic review, including meta-analysis, of studies available in the literature with data on HPV prevalence in TGW with neovaginas was performed. Additionally, a narrative analysis of the clinical manifestations of genital HPV infections in TGW with neovagina(s) was performed.

Results

21 studies were included; six focused on the prevalence of HPV in TGW, and data were pooled in a meta-analysis of prevalence; 15 were case reports/series, which were included in a narrative analysis of clinical implications. The meta-analysis showed the prevalence of genital HPV in TGW with neovaginas was 15% (95% CI 9% to 21%). The most frequently detected HPV type was HPV 16. 18 TGW were included in case reports/series and the median age was 42; 12 presented with condylomata acuminata and six had squamous carcinoma.

Conclusion

Data on genital HPV prevalence in TGW with neovaginas are sparse, with many studies having small denominators. We report higher HPV prevalence compared with cisgendered women. Symptomatic genital HPV infection in TGW with neovaginas was largely associated with benign condylomata, although some carcinoma was detected. Future longitudinal studies are required to elucidate the clinical impact of genital HPV infection and examine its implications in TGW with neovaginas in order to inform prevention and management strategies.
Vaping among young adults in Singapore: a qualitative study of motivations, challenges and antivaping intervention perceptions
Authors: Ahmad Iqbal Saifuddin , Lim Raymond Boon Tar
Published: January 2025

Introduction

The increasing use of electronic cigarettes among young adults in Southeast Asia is concerning. This study explores the motivations and challenges faced by young adults in quitting vaping and their perceptions of current public health messages and interventions in Singapore, which has stringent antivaping laws and active public health campaigns.

Methods

A qualitative descriptive study was conducted involving in-depth interviews with 15 participants aged 18–35. Thematic analysis was performed by two independent researchers trained in qualitative methods.

Results

Participants identified negative health outcomes and legal risks as major motivations for quitting vaping. Challenges included nicotine addiction, psychological dependency and entrenched vaping routines. The study revealed general scepticism towards current antivaping messages, which were seen as too generic and lacking credibility. Participants recommended that public health messages be more specific, transparent and engaging, incorporating independent research and visual aids to highlight vaping risks. They also suggested regulating e-cigarette sales instead of implementing blanket bans, ensuring anonymity for those seeking help and providing comprehensive nicotine cessation support. Additionally, the use of real-life testimonials and influencers was proposed to improve message relatability and effectiveness.

Conclusion

This study provides valuable insights into the motivations and barriers of quitting vaping among young adults. Enhancing the transparency and specificity of antivaping messages, along with more tailored and supportive interventions, could increase their effectiveness and offer guidance for other Southeast Asian countries facing similar issues.
Loop quantum effects on direct detection prediction in two-scalar dark matter scenario
Authors: Ghorbani Karim , Ghorbani Parsa
Published: January 2025

We investigate the effect of quantum corrections on the elastic scattering cross section of dark matter off nucleus in two-scalar dark matter model. Among two extra singlet scalars in the two-scalar model, the lighter one is stable and plays the role of dark matter candidate and the heavier one contributes in dark matter co-annihilation processes in thermal history of the early universe. It is already known that the two-scalar model at tree level, unlike the single-scalar dark matter model, can easily evade the bounds from direct detection (DD) experiments. The claim here is that taking into account the loop effects, in some regions of the parameter space, the DM-nucleon cross section becomes larger than the tree level contribution. Therefore, loop effects move the regions which were below the neutrino floor at tree level, up to the regions which are detectable by future DD experiments.
Shadows and accretion disk images of charged rotating black hole in modified gravity theory
Authors: Zheng He-Bin , Wu Meng-Qi , Li Guo-Ping , Jiang Qing-Quan
Published: January 2025

In this paper, we study the shadows and images of the accretion disk of Kerr–Newman (KN) black hole (BH) in modified gravity (MOG) theory by using the backward ray-tracing method. And, the influence of spin parameter (a), charge (Q), and MOG parameter (

$$\alpha $$

α

) on the observed features of BHs are carefully addressed. Interestingly, as

$$\alpha $$

α

increases, the flat edge of the BH’s shadow gradually becomes more rounded, the size of shadow enlarges, and the deviation rate (

$$\delta s$$

δ
s

) correspondingly decreases. By tracing the photon around BH, we observe that the trajectory of photon exhibits distortion behavior, i.e., the formation of two “tails” near the Einstein ring, which elongate as a increases. For the accretion disk, it shows that the inner shadow expands with

$$\alpha $$

α

, while decreases with Q. The increase of

$$\alpha $$

α

exhibits an increasing effect on redshift. At the same parameter level,

$$\alpha $$

α

has a more obvious effect on inner shadow and image of BH by comparing with that of Q. Our study implies that both

$$\alpha $$

α

and Q have relatively significant effects on the image of the KN-MOG BH with the thin disk accretion, but the influence of

$$\alpha $$

α

is much greater. So, this indicates that

$$\alpha $$

α

plays a dominant role in this spacetime.
New models of quintessential inflation featuring plateau and hilltop potentials
Authors: Mishra Swagat S. , Sahni Varun
Published: January 2025

We introduce a new class of hilltop and plateau potentials which can successfully unify inflation and dark energy resulting in quintessential inflation (QI). Interestingly these new potentials are related through an inverse transformation. Namely, if

$$V(\phi ) = V_0 \, v(\phi )$$

V

(
ϕ
)

=

V
0

v

(
ϕ
)

is a plateau potential then the inverse potential

$$V(\phi ) = V_0 \left[ v(\phi )\right] ^{-1}$$

V

(
ϕ
)

=

V
0

v
(
ϕ
)

-
1

describes hilltop QI. A simple example is provided by the KKLT-inspired potential

$$v(\phi ) = \left[\frac{M^{2n} + \phi ^{2n}}{N^{2n} + \phi ^{2n}}\right]\,$$

v

(
ϕ
)

=

M

2
n

+

ϕ

2
n

N

2
n

+

ϕ

2
n

. When

$$M/N \ll 1$$

M
/
N
≪
1

this potential describes plateau QI, while its inverse,

$$\left[ v(\phi )\right] ^{-1}$$

v
(
ϕ
)

-
1

describes hilltop QI. Other simple models of QI arise for the class of potentials

$$V(\phi ) \sim \exp \left[\mp f(\phi )\right]$$

V

(
ϕ
)

∼
exp

∓
f
(
ϕ
)

, where the − (

$$+$$

+

) sign is associated with a plateau (hilltop). A key feature of this new class of QI models is the near absence of small dimensionless parameters, or small mass parameters (relative to the energy scale of the Standard Model of particle physics) – which are usually associated with the presence of dark energy. A forecast for the gravitational wave background generated in these models is provided.
Design of College English Online Learning Platform Based on MVC Framework
Authors: Chi Meiying
Published: January 2025

The rapid development of online learning platforms has transformed traditional English education by enabling flexibility, affordability, and accessibility. This study introduces an innovative English online learning platform, designed using the model–view–controller (MVC) framework — a software architectural pattern that separates the application into three interconnected components: Model (data management), view (user interface), and controller (business logic) — and a three-tier architecture. The platform integrates five core functions: user service, educational administration, online learning, platform operation management, and course recommendation. A novel English online test system was developed within this framework, featuring an intelligent recommendation engine that combines association rule-based and user-based collaborative filtering (CF) algorithms to enhance personalized learning. Comprehensive system analysis, including requirements specification, modular construction, database design, and user interface development, was conducted. Experimental evaluations demonstrate improved recommendation accuracy and system performance, offering valuable insights for optimizing English learning platforms.