bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic factors in SME leadership orientation towards initiating exports: India context
Authors: Jose Saju , Buchanan F. Robert
Published: February 2025

Purpose

This paper aims to examine characteristics of emerging market small and medium-sized enterprise (SME) decision makers in their entry to exporting. What prior experience is significantly related to an export orientation? How influential are factors that would both aid and inhibit exports? What about the decision to not initiate exporting.

Design/methodology/approach

In total, 319 surveys were collected from managers in South India for quantitative and qualitative analysis. Structural equation modelling was used to test the model.

Findings

Fluency in English was the only significant managerial characteristic associated with a positive perception of export benefits. Education and export experience were not significant strategic factors. SMEs who only serve their domestic market were not averse to exporting but were satisfied with the performance of their home markets. Once deciding to export, use of export intermediaries helped them to move towards presence in multiple markets. None of the inhibiting costs or constraints involved with exporting, other than labour, transportation differentials and export controls, were significantly influential in the export decision process. However, exports were favourably influenced by perceptions of the firms’ quality, pricing, selection and business relationships.

Practical implications

The value of export intermediaries and government agencies is clearly indicated from this study. Such providers could use these findings to target decision makers and assist in overcoming objections to branching out beyond a domestic-only strategy. One strategy option is to establish a strong market presence in the home state and then “export” to adjoining states. The findings might be generalised to other emerging markets as well.

Originality/value

Export entry decision-making is an under-researched area in emerging markets.
The optoelectronic, phonon, structural and thermoelectric attributes of full-Heusler Te2AcGa alloy: a DFT approach
Authors: Munir Junaid , Qaid Saif M.H. , Firdous Faiza , Asemi Nassar N. , Ali Ahmed Abdullah Ahmed , Ain Quratul
Published: February 2025

Purpose

To determine the electrical, structural, optical and transport properties calculated using WIEN2k code.

Design/methodology/approach

By employing the WIEN2k code, we have theoretically examined the physical properties of the full-Heusler Te2AcGa alloy. The FP-LAPW technique is utilized for theoretical calculations.

Findings

An indirect bandgap of 0.42 eV is seen with the GGA potential. An enhancement in bandgap with a value of 0.97 eV is observed with mBJ potential. The density of states is determined to verify the band structure profile. The dynamical and structural stability is attained through the computations. The electron density contour plot is utilized to explore the bonding nature of the compound. Optical properties have been calculated with respective potentials showing significant absorption in the visible region. Furthermore, thermoelectric properties have been evaluated to confirm the potential of Te2AcGa for thermoelectric devices. At elevated temperatures, the ZT with mBJ potential obtained a large value of 0.8.

Research limitations/implications

High absorption and ZT values make the Te2AcGa alloy have potential for optoelectronic and renewable energy devices.

Originality/value

In the submitted manuscript, first principle calculations are carried out for the first time to study the structural, dynamic, electronic, optical and thermoelectric properties of the full-Heusler Te2AcGa alloy. Modified Becke–Johnson (mBJ) exchange-correlation potential provides very accurate results. The bandgap profiles and related properties are calculated in the present work. The entire work gives useful results of fundamental importance, which can be utilized for the fabrication of optoelectronic and thermoelectric applications.
The impact of presentation modalities on perceived accuracy and sharing of fake news: the role of perceived diagnosticity and involvement
Authors: Toder Alon Anat , Rahimi Ilan Daniels , Tahar Hila
Published: February 2025

Purpose

This study investigates how different presentation modalities (text-only, image with text and video with text) influence the perceived accuracy and sharing intentions of climate change-related fake news, examining the mediating role of perceived diagnosticity and the moderating effect of personal involvement.

Design/methodology/approach

An online experiment was conducted with 456 participants, who were presented with fake climate change news stories in various formats through Facebook posts. The study measured perceived accuracy, sharing intentions, perceived diagnosticity and personal involvement.

Findings

The experimental outcomes reveal the following: (1) Video with text significantly increased perceived accuracy compared to text-only modality, while the image with text modality had no significant effect; (2) The effect of presentation modality on perceived accuracy is mediated by perceived diagnosticity; (3) Personal involvement moderates these relationships, with highly involved individuals being less influenced by presentation modality and (4) Perceived accuracy positively correlates with sharing intentions across all presentation modalities.

Practical implications

Media literacy programs should emphasize the critical evaluation of multimedia content, particularly video, to mitigate the influence of fake news. Policymakers and platform developers should implement robust video content verification tools and tailored interventions to support users based on their involvement levels.

Originality/value

This research offers novel insights into the psychological mechanisms behind the believability of fake news across various presentation modalities. These findings have significant implications for researchers, practitioners and policymakers aiming to improve digital literacy in an increasingly AI-driven media landscape.
Can intubate, cannot ventilate: A proposed algorithm to handle problems with ventilation and oxygenation after intubation
Authors: Fosse Kjetil , Salomonsen Magnus , Gisvold Sven Erik , Gundersen Bjørnar , Nordseth Trond
Published: February 2025

Background and Methods

Few guidelines address how to handle unanticipated ventilatory problems and hypoxemia in a successfully intubated patient. We will refer to this situation as “can intubate–cannot ventilate.” The situation may occur immediately after intubation or later during general anaesthesia. The aim of this paper is to describe an algorithm for handling this situation. In an intubated patient, the airway can be considered a continuum from the ventilator to the alveoli, and the problem is somewhere along this route: Ventilator → Hoses → Filter → Tracheal tube (TT) → Tracheae → Bronchi → Bronchioles → Alveoli. The proposed algorithm is based on clinical experience and has not been externally validated.

Results

The first critical decision to be made is whether the TT has been placed correctly in the trachea or not. Positive wave‐formed capnography is the primary marker for correct intubation. Video and/or direct laryngoscopy can be used for further verification. The patient should be disconnected from the ventilator and manually ventilated with bag‐valve and 100% oxygen. An open tube should then be verified by applying a suction catheter through the tube. If these measures do not improve the situation, a fibreoptic scope should be inserted to further assess possible causes of difficult ventilation. If no obvious treatable cause is detected at this point, bronchospasm, anaphylaxis, or pneumothorax should be ruled out or treated. Further handling should focus on optimizing gas exchange in the lungs and considering more advanced treatment options to improve oxygenation and circulation.

Conclusions

We have proposed an algorithm to handle unanticipated problems with ventilation and oxygenation in a patient who has been successfully intubated. Equipment failure and a blocked TT should be ruled out before diagnosing and treating medical or surgical causes of ventilatory problems.

Editorial Comment

This article presents a logical approach to the time‐sensitive and critical situation where, for some reason, after intubation, ventilation of the lungs is not succeeding. The authors propose steps for a systematic approach, and recognition of different possible explanations for ventilation not working is informative.
Far From Help: Exploring the Influence of Regional and Remote Residence on Coastal Visitation and Participation, Risk Perception and Safety Knowledge and Practices
Authors: Pratt Ella G. , Peden Amy E. , Lawes Jasmin C.
Published: February 2025

Objective

To explore how self‐reported coastal visitation, participation, risk perception, safety knowledge, experiences and safety practices differed between regional and remote, and major city residents to inform remoteness‐specific coastal drowning prevention efforts.

Methods

This study used data obtained from the annual National Coastal Safety Survey from 2018 to 2023. Data were postweighted proportionally according to age, gender and Australian Statistical Geography Standard classification using 2021 census population data. Descriptive statistics and chi‐square analyses were used to identify key differences in the behaviours, knowledge, and experiences of regional and remote respondents as compared to major city respondents.

Results

A total of 14 210 respondents were included in this dataset. Regional and remote respondents were more likely to visit an unpatrolled beach, particularly when swimming/wading (n = 929, 42.3%; χ2 = 502.14, p < 0.001). However, similar proportions of regional and remote and major city respondents reported following safety practices on patrolled beaches. Regional and remote respondents were more likely to consider sea and weather conditions for all coastal activities, but there was little difference between remoteness groups regarding rip current identification, perceptions and experiences.

Discussion

This study demonstrates that future coastal safety research should consider the impact of remoteness to corroborate the findings of this study: that a significant contributor to the regional and remote drowning burden is a lack of access to patrolled beaches.

Conclusions

Regional and remote residents are more likely to frequent unpatrolled beaches but, if able to visit a patrolled beach, are just as likely as major city residents to adhere to safety practices.
The Leadership Style of Fidel Castro: A Decolonial Perspective
Authors: Baden Denise , Prakasam Naveena , Wilkinson Stephen
Published: February 2025

Leadership theory stands accused of being Western‐centric. To address this, we investigate Fidel Castro's leadership through 32 semi‐structured interviews with Cuban people. Narratives reveal his decolonial leadership as he led the Cuban Revolution, and then Cuba for over 50 years, resisting Western hegemony. Findings problematise the applicability of conceptions of charismatic–transformational leadership (CTL) to non‐Western cultures. Benevolent paternalism emerged as a key additional aspect in the Cuban context. Western critiques of CTL as leader‐centric and prone to hero‐worship were not seen as problematic in the Cuban sample. We explain this with reference to the unifying effects of Castro's decolonial project.
Sculponeatin A induces mitochondrial dysfunction in non‐small cell lung cancer through WWP2‐mediated degradation of mitochondrial STAT3
Authors: Wan Fang , Qian Chen , Liu Xuewen , Zhong Yifan , Peng Wenkang , Zhang Liang , Zhan Xiangrong , Huang Yongtong , Zhang Chengyu , Wang Jiu , Si Yuan , Liu Ying
Published: February 2025

Background and Purpose

The phosphorylation of signal transducer and activator of transcription 3 (STAT3) monomer at S727 promotes its mitochondrial localisation and regulates mitochondrial function, thus exerting a protective effect on tumour cells. However, no inhibitor drugs targeting mitochondrial STAT3 (mitoSTAT3) or S727‐STAT3 phosphorylation have been identified. Here, we report a novel diterpenoid extracted from Isodon sculponeatus, sculponeatin A (sptA), induces mitochondrial dysfunction in non‐small cell lung cancer (NSCLC) by targeting mitoSTAT3 degradation.

Experimental Approach

xCELLigence real‐time cell analysis assay and high‐content analysis were performed to measure cytotoxicity. Mitochondrial function was assessed by transmission electron microscopy, mitochondrial permeability transition pore opening and Seahorse cellular flux assays. The effects of sptA on the upstream signalling pathway of mitochondrial dysfunction were measured by Western blot, gene alterations and other approaches. Immunofluorescence and live cell imaging were performed to visualise the expression and position of mitoSTAT3. Nude mice and zebrafish were modelled with subcutaneous xenografts. Pharmacokinetics of sptA were examined in rats. Drug toxicity was evaluated in zebrafish.

Key Results

sptA inhibited mitochondrial respiration in NSCLC cells. sptA induced mitochondrial dysfunction by promoting the degradation of mitoSTAT3. sptA promoted WW domain containing E3 ubiquitin protein ligase 2 (WWP2)‐mediated ubiquitination and degradation of mitoSTAT3 through direct binding. sptA inhibited tumour growth in vivo. Evaluation of drug toxicity in zebrafish showed that overdose of sptA may cause heart damage.

Conclusions and Implications

These findings suggest that pharmacological targeting the degradation of mitoSTAT3 by sptA may provide therapeutic benefits against NSCLC.
Children of Divorced Parents—The Limitations of One‐Size‐Fits‐All Interventions
Authors: Hansen Pernelle Rose
Published: February 2025

The political agenda of the Danish School Reform in 2014 provides a heightened awareness of pupils' mental health–including children of divorced parents. The primary focus is to support children's emotion management, and in that regard, conversation groups are offered to children experiencing divorce. The conversation groups are primarily built on manual‐based and therapeutic concepts, rooted in well‐intentioned care work. In service of good intentions, the metaphor of the lump is employed as a significant tool to describe children's difficult emotions. This can be linked to an overall therapeutic tendency that has developed within institutional arenas for children and adolescents. However, these understandings position children between normalization and problematization. In order to provide help and support for children living their everyday lives with divorce, professionals can (unintentionally) be the bearers of problematized understandings. However, the well‐meaning intentions of care can paradoxically act as a ‘power of goodness’. This article stems from a qualitative research project involving 23 children and adolescents who participated in conversation groups at four Danish schools.
Incorporating cyclone risk in the design of marine protected and conserved areas as an ecosystem‐based adaptation approach
Authors: Giffin Alyssa L. , Tulloch Vivitskaia J. D. , Andradi‐Brown Dominic A. , Connolly Rod M. , Malani‐Tagicakibau Unaisi , Areki Francis , Brown Christopher J.
Published: February 2025

Marine protected and conserved areas (MPCAs) are promoted as an ecosystem‐based adaptation (EbA) approach to increase community and ecosystem resilience to climate change. However, traditional approaches to MPCA design typically do not consider climate risk or habitat condition under a climate threat. We used the Great Sea Reef (GSR) in Fiji as a case study to develop a land–sea prioritization framework that links modeled sediment runoff from rainfall during extreme cyclone events to the probability of coral reefs being in good condition. We incorporated this information in an MPCA prioritization scenario intending to achieve 90% certainty of good‐condition coral cover under cyclone risk while minimizing cost to fishers and meeting ecosystem conservation targets. We explored the trade‐offs between sites selected for protection, the relative opportunity cost to fishers, and the representation of conservation feature targets between the MPCA scenario that included cyclone risk and a baseline scenario that did not. The cyclone risk scenario's best solution required larger areas of protection (5% more GSR area) than the baseline scenario and additional protection in areas with moderate to high probability of good‐condition coral cover. Some areas prioritized for protection in the cyclone risk scenario had relatively high turbidity. Large sections around Vanua Levu were consistently selected for protection across both prioritization scenarios due to high concentrations of all ecosystem conservation features, particularly sea turtle feeding grounds. Overall, the cyclone risk MPCA design had a higher fisher opportunity cost but protected a larger amount of ecosystem conservation features and buffered against habitat condition uncertainty. We explored the potential outcomes of expanding on threat‐avoidance and cost‐effective conservation prioritization by including habitat responses to threats in the prioritization process. Our findings can inform MPCA design during EbA planning in regions at risk from climate change.
The Interplay of School Cultural Dynamics and Change: Exploring the Resistance to School Change
Authors: Bakır Dilşad , Altunay Esen
Published: February 2025

This study aimed to explore the cultural barriers to change in public primary and secondary schools in Türkiye. The study is based on a qualitative research approach. The participants consist of 42 school leaders working in various primary and secondary schools in Türkiye. Data originated from semi‐structured interviews and observations, and content analysis was conducted during the data analysis. Regarding the characteristics of school cultures, the participants emphasised an organisational culture that is open to innovation and solidarity among individuals. Concerning the cultural barriers to change in schools, the resistance to innovation was highlighted as linked to individual behaviour. Finally, the way in which school members resist change is important. The results highlight a lack of cooperation as one of the main barriers to change. Resistance to collaboration and lack of development of professional learning networks currently inhibit school change in Türkiye. The results show that cultural factors affect the success of change initiatives in schools that are open systems, and understanding and overcoming obstacles. Starting the change process in this way can transform schools into learning and developing organisations.
Plant Species Better Adapted to Climate Change Need Agricultural Extensification to Persist
Authors: Poinas Isis , Meynard Christine N. , Fried Guillaume
Published: February 2025

Agricultural intensification and climate change have led to well‐known vegetation shifts in agricultural landscapes. However, concomitant plant functional changes in agroecosystems, especially at large scales, have been seldom characterised. Here, we used a standardised yearly monitoring of > 400 agricultural field margins in France to assess the temporal response of vegetation diversity and functional traits to variations in climate and intensity of agricultural practices (herbicides, fertilisation and mowing) between 2013 and 2021. We observed clear temporal trends of increasing warming and aridity, but trends towards agricultural extensification were weak or nonsignificant. Our results showed functional changes in plant communities over time, driven mostly by climate change and suggested selective forces opposing climate change to agricultural intensification. This translated as a temporal decline of competitive and ruderal species in favour of stress‐tolerant species, putting plant communities in agroecosystems in a difficult position to escape both climate and agricultural pressures at the same time.
Beyond the hanger: Investigation of consumers' sustainable disposal behavior of clothing items
Authors: Jahura Fatema Tuj , Sadachar Amrut
Published: February 2025

This study investigated the personal and situational factors that influence consumers' sustainable clothing disposal behavior using the theory of interpersonal behavior. Data were collected via an online survey of 293 U.S. participants and analyzed using regression techniques. The results supported five of the six hypotheses, indicating that both attitudes toward environmentally friendly clothing and positive affect toward sustainable disposal behavior are significant predictors of disposal intentions. However, perceived social pressure was not found to have a significant impact. Furthermore, perceived convenience, sustainable disposal intentions, and established recycling habits were identified as key predictors of actual sustainable clothing disposal behavior.
T1‐T2 Interplay in the Complex Immune Landscape of Severe Asthma
Authors: Gauthier Marc , Kale Sagar L. , Ray Anuradha
Published: February 2025

Asthma is orchestrated by an aberrant immune response involving a complex interplay between multiple inflammatory cell types. An increase in Th2 cells in the asthmatic airway is a hallmark of asthma, and biologics blocking their effector functions have been life‐changing for many severe asthma patients who poorly respond to immunosuppression by corticosteroids. However, studies in the past decade have highlighted not only other cell types that also produce Th2 cytokines boosting the Type 2/T2 phenotype but also a heightened IFN‐γ response, primarily from T cells, referred to as a Type 1/T1 immune response. Data derived from studies of immune cells in the airways and mouse models of severe asthma suggest a role of IFN‐γ in corticosteroid resistance, airway hyperreactivity, and also airway remodeling via effects on other cell types including mast cells, eosinophils, airway epithelial cells, and airway smooth muscle cells. The simultaneous presence of T1 and T2 immune responses is detectable in the sickest of asthma patients in whom corticosteroids suppress the T2 but not the T1 response. This article has reviewed our current understanding of the complex T1–T2 interplay in severe asthma highlighting mediators that impact both arms which may be targeted alone or in combination for disease alleviation.
Location, Location, Location: Spatial Immune‐Stroma Crosstalk Drives Pathogenesis in Asthma
Authors: Joulia Régis , Lloyd Clare M.
Published: February 2025

Chronic lung diseases including asthma are characterized by an abnormal immune response and active tissue remodeling. These changes in the architecture of the tissue are a fundamental part of the pathology across the life course of patients suffering from asthma. Current treatments aim at dampening the immune system hyperactivation, but effective drugs targeting stromal or acellular structures are still lacking. This is mainly due to the lack of a detailed understanding of the composition of the large airways and the cellular interactions taking place in this niche. We and others have revealed multiple aspects of the spatial architecture of the airway wall in response to airborne insults. In this review, we discuss four elements that we believe should be the focus of future asthma research across the life course, to increase understanding and improve therapies: (i) specialized lung niches, (ii) the 3D architecture of the epithelium, (iii) the extracellular matrix, and (iv) the vasculature. These components comprise the main stromal structures at the airway wall, each playing a key role in the development of asthma and directing the immune response. We summarize promising future directions that will enhance lung research, ultimately benefiting patients with asthma.
Unveiling Patterns of Interaction With Automated Feedback in Writing Mentor and Their Relationships With Use Goals and Writing Outcomes
Authors: Jiang Yang , Klebanov Beata Beigman , Hao Jiangang , Deane Paul , Livne Oren E.
Published: February 2025

Background

Writing is integral to educational success at all levels and to success in the workplace. However, low literacy is a global challenge, and many students lack sufficient skills to be good writers. With the rapid advance of technology, computer‐based tools that provide automated feedback are being increasingly developed. However, mixed results have been obtained so far on the effects of writing feedback, and little is known about how various types of feedback are used by users who access feedback with different goals.

Objectives

Leveraging both process and response data, the present study investigated students' interactions with feedback in Writing Mentor (WM), an app designed to support academic writing through automated feedback and NLP techniques.

Methods

We identified 1857 documents submitted by middle‐ and high‐school students among users‐in‐the‐wild and explored the activities that students engaged in while using WM and the quality of their submitted written products. Students' interaction processes and behaviours were compared across groups of students with different goals for using WM. In addition, sequential pattern mining was applied to identify interesting sequential patterns of student interactions with the writing feedback features that are differentially frequent across goal groups.

Results and Conclusions

Results indicated that students with different goals for using WM displayed different patterns of interaction. Furthermore, the effects of the various types of feedback on writing quality vary by students' purposes for using the tool. Findings from this study shed light on the design of computer‐based writing tools and automated writing feedback for learners of various needs.
Effect of Multidimensional Integrated Lung Protection Measures in Elderly Patients With Fragile Lungs or Combined Lung Dysfunction by Regulating AMPK/SIRT1 Pathway
Authors: Cui Yinghui , Tao Haiyong , Hu Shejun , Zhang Yan , Li Hao , Wang Jinhuo , Wu Mandi , Guo Jianrong
Published: February 2025

Fragile lungs or lung dysfunction can significantly impact a patient's quality of life. Currently, no specific treatment exists to prevent lung dysfunction in elderly patients. The detailed mechanism of fragile lungs or lung dysfunction in elderly patients remains elusive, and this study aimed to clarify it. General data and blood specimens were obtained from patients with fragile lungs or lung dysfunction. The mice were exposed to cigarette smoke using a smoking apparatus to induce fragile lungs or lung dysfunction mice model. Blood samples and lung tissues were collected from all groups for further testing. haematoxylin–eosin (HE) staining, immunofluorescence, Western blot, flow cytometry and quantitative reverse transcriptase PCR (qRT‐PCR) were used to elucidate the molecular mechanisms of multidimensional integrated lung protection measures (MILPM) in fragile lungs or lung dysfunction mice by targeting the AMP‐activated protein kinase (AMPK)/Sirtuin 1 (SIRT1) pathway. The results indicated that upregulation of the AMPK/SIRT1 signalling pathway accelerates the fragile lungs or lung dysfunction process, whereas downregulation of the AMPK/SIRT1 signalling pathway can prevent it. Similarly, the change of forced vital capacity (FVC), total lung capacity (TLC) levels is associated with the fragile lungs or lung dysfunction process, whereas reducing their levels can serve as a preventative method against fragile lungs or lung dysfunction development. Upregulation of the AMPK/SIRT1 pathway can accelerate the process of fragile lungs or lung dysfunction.
Shock Anticipation: Voluntary Turnover by Foreign Directors in Response to Sanctions on Peer Firms
Authors: Liu Xiaomeng , Zhou Abby Jingzi , Zhou Steven Shijin , Bai Tao , Tan Xue
Published: February 2025

This paper proposes a new turnover mechanism, namely shock anticipation, which explains how the anticipation of potential shocks triggers voluntary turnover by individuals in organizations. Drawing on the context of US sanctions on China initiated in 2018, we analyse a sample of foreign directors (FDs) from Chinese‐listed firms between 2014 and 2021. We suggest sanctions on peer firms lead FDs to anticipate potential sanctions on their own organizations and become concerned about the associated negative effects on their careers, which in turn motivates their turnover. We further argue that FDs at state‐owned enterprises (SOEs) anticipate a higher risk and, consequently, are more likely to leave after observing sanctions imposed on their peer firms. In contrast, FDs with shorter career horizons are less inclined to leave as they perceive diminished damage to their future career. Our empirical results provide robust support for these hypotheses. This study enriches the literature on turnover and sanctions while also offering practical implications.
Neuroinvasion via Peripheral Nerves in Epidemic Viral Encephalitis Caused by Enterovirus, Orthoflavivirus and SARS‐Coronavirus
Authors: Hooi Yuan Teng , Fu Tzeh Long , Tan Soon Hao , Ong Kien Chai , Tan Chee Yang , Wong Kum Thong
Published: February 2025

Pathogens invade the central nervous system (CNS) and cause infections either through the haematogenous route or via peripheral nerves. Neuroinvasion via peripheral nerves, involving spinal or cranial somatic nerves, is well‐established for certain viral encephalitides such as rabies, herpes simplex encephalitis, and poliomyelitis. Advances in understanding emerging and re‐emerging viruses that cause epidemic CNS infections have highlighted the growing importance of peripheral nerve pathways in viral neuroinvasion. This review focuses on epidemic viral encephalitides caused by three groups of RNA viruses, viz., enteroviruses (enterovirus A71 and enterovirus D68), orthoflaviviruses (West Nile virus and Japanese encephalitis virus), and severe acute respiratory syndrome coronaviruses (mainly severe acute respiratory coronavirus‐2). We examine evidence supporting the hypothesis that peripheral nerve viral transmission may play an increasingly significant if not more critical role than the haematogenous route in neuroinvasion.
The Effects of Pursed Lip Breathing Exercises on Patients' Post‐Bronchoscopy Recovery Parameters: A Nurse‐Led Quasi‐Experimental Study
Authors: Alqadi Rasha Abdulhalim , Habiba Azza Ibrahim Abdelkader , El Sayed Akl Hanaa Hamad Mohamed , Khamis Engy AbdelRhman , Berdida Daniel Joseph E.
Published: February 2025

Pursed‐lip breathing (PLB) exercises are used as a nursing intervention among post‐bronchoscopy patients. However, there is limited evidence of their effectiveness in improving post‐bronchoscopy recovery status. This study investigated the effect of the PLB exercise program on patients' post‐bronchoscopy recovery parameters. A nurse‐led quasi‐experimental research involving study and control groups involving 60 adult participants who were randomly divided into two equal groups. A three‐part questionnaire was used for data collection from October 2022 to April 2023. Shapiro–Wilk test, chi‐square test, Fisher's exact test, Cochran's test, post hoc test (Dunn's), student's t‐test, and Friedman test were employed for data analyses. There were significant improvements in temperature, pulse, respiration, blood pressure, oxygen saturation, chest pain, and peak expiratory flow in the study group, with statistically significant difference after 30 min. PLB exercises enhanced the clinical outcomes of the study group participants compared to the control group in improving respiratory and cardiac status post‐bronchoscopy. Nursing service units may conduct in‐service training programs for nursing staff about applying PLB techniques and endorse this as a part of routine care to improve patients' clinical outcomes post‐bronchoscopy.
Trade‐off between spring phenological sensitivities to temperature and precipitation across species and space in alpine grasslands over the Qinghai–Tibetan Plateau
Authors: Li Xiaoting , Guo Wei , He Hao , Wang Hao , Classen Aimée , Wu Donghai , Ma Yixin , Wang Yunqiang , He Jin‐Sheng , Xu Xiangtao
Published: February 2025

Elucidating climatic drivers of spring phenology in alpine grasslands is critical. However, current statistical estimates of spring phenological sensitivities to temperature and precipitation (βT and βP) might be biased and their variability across sites and species are not fully explained.

We benchmarked species‐level βT and βP statistically inferred from historical records with observations from a field manipulative experiment. We then analyzed landscape scale βT and βP estimated from the best statistical approach in the benchmark analysis across 57 alpine grassland sites in the Qinghai–Tibetan Plateau.

Compared with manipulative experiment results, process‐agnostic regression‐based approaches underestimate βT by 2.36–3.87 d °C−1 (54–88%) while process‐based phenology model fitting predicts comparable βT and βP. Process‐based estimates of βT and βP are negatively correlated across species (R = −0.94, P < 0.01) and across sites (R = −0.45, P < 0.01). βT is positively correlated with mean annual temperature, and βP is negatively correlated with elevation at the regional scale.

Using process‐based model fitting can better estimate spring phenological sensitivities to climate. The trade‐off between βT and βP contributes to species‐level and site‐level variabilities in phenological sensitivities in alpine grasslands, which needs to be incorporated in predicting future phenological changes.
Surgical Outcomes of Full‐Endoscopic Degenerative Lumbar Lateral Recess Stenosis Decompression Through an Interlaminar Approach
Authors: Huang Chengqian , Qin Yingying , Huang Yizhu , Wei Xijiang , Zhuo Jing , Wu Shaofeng , Chen Jiarui , Zhu Jichong , Chen Tianyou , Zhang Bin , Feng Sitan , Zhou Chenxing , Xue Jiang , Zhan Xinli , Liu Chong
Published: February 2025

Objective

The conventional open decompression surgery for degenerative lumbar lateral recess stenosis (DLLRS) yields definitive therapeutic outcomes; however, it confronts numerous challenges, including extensive surgical trauma and iatrogenic spinal instability. The purpose of this study is to investigate the surgical outcomes of full‐endoscopic DLLRS decompression by an interlaminar approach.

Methods

A consecutive cohort of 275 patients, including 148 males and 127 females, with an average age of 64.62 (55–82) years, with DLLRS between July 2021 and December 2022, was reviewed in this retrospective study. The involved segments were L4/5 in 126 patients and L5/S1 in 149 patients. The computed tomography (CT) and magnetic resonance imaging (MRI) of the lumbar were examined before and after surgery to evaluate the degree of decompression. The VAS score of back and leg pain and the ODI scale were recorded preoperatively, 1 day, 1, 3, 6, and 12 months after surgery, and at the last follow‐up. The modified Macnab score was determined at the last follow‐up. One‐way analysis of variance (ANOVA) was used to compare the VAS and ODI scores of back/leg pain at various time points before and after surgery.

Results

All of the patients underwent surgery successfully. The average duration of surgery was 84.90 min, the average blood loss was 47.33 mL, and the length of hospitalization was 3–4 (3.31 ± 0.46) days, with no nerve injury, infections, or other complications. One‐way ANOVA results showed significantly improved VAS and ODI scores for back/leg pain at each time point after surgery compared to those preoperatively (p < 0.05). The mean follow‐up was 23.6 ± 2.3 (range, 15–32) months; at the last follow‐up, the modified Macnab was excellent in 143 patients, good in 102 patients, fair in 18 patients, and poor in 12 patients.

Conclusion

Full‐endoscopic lumbar lateral recess decompression through an interlaminar approach is a safe and effective approach for DLLRS.
Modic Changes in Patients Who Have Undergone Anterior Cervical Discectomy and Fusion: The Correlation With Fusion Success and Subsidence
Authors: Deng Yifei , Zhang Xiang , Sheng Xiaqing , Wang Beiyu , Hong Ying , Rong Xin , Ding Chen , An Jingjing , Liu Hao
Published: February 2025

Objective

There is a lack of research on modic change (MC) in the cervical spine, especially regarding its impact on patients following anterior cervical discectomy and fusion (ACDF). Some researchers strongly believe that MC may affect the prognosis after anterior cervical surgery. Thus, this study aimed to assess MC in patients who underwent ACDF, investigating its incidence, risk factors, and correlation with fusion success and subsidence rate.

Methods

We retrospectively reviewed 154 patients who underwent single‐level ACDF from January 2010 to December 2020, with a minimum follow‐up of 12 months. Preoperative and postoperative clinical and radiological parameters were recorded at pre‐operation, 1 week, 3 months after operation, and the last follow‐up. The primary outcomes were the fusion rate and cage subsidence. Radiological measurements, including overall (Cobb C) and segmental cervical angle (Cobb S), anterior disc height (ADH), and posterior disc height (PDH) were also recorded. The independent t‐test or Mann‐Whiteny U test was used to compare continuous data, and categorical variables were assessed using the Pearson's chi‐square test of Fisher's exact test. Logistic regression analysis was also adopted to distinguish corresponding factors related with the progress of MC.

Results

Of the 154 patients, the incidence of MC was 44.2% (68/154). The group with MC showed a larger proportion of males and osteoporosis. The fusion rate of those with MC was 88.2% (60/68) while that in the non‐MC group was 97.7% (84/86, p = 0.02). The MC group presented a subsidence rate of 27.9%, which was substantially higher than in the non‐MC group (9.3%, p < 0.01). NDI and VAS neck was significantly higher in the MC group than in the non‐MC group (p = 0.014; p = 0.039). Sex and osteoporosis were distinguished as independent factors related to MC by regression analysis (p = 0.006; p = 0.026).

Conclusion

Preoperative MC could adversely hinder the fusion process and may increase the incidence of subsidence, affecting clinical outcomes of those underwent ACDF. Patients with MC, especially type 1 MC, are more easily suffered from neck pain than those without MC. Male sex and osteoporosis were risk factors for MC. In order to achieve a better bony fusion and avoid cage subsidence in those with MC, we encourage patients to prolong their immobilization duration with a cervical collar and precisely manage osteoporosis during the peri‐operative period.
Non‐Invasive Auricular Vagus Nerve Stimulation Decreases Heart Rate Variability Independent of Caloric Load
Authors: Kaduk Kristin , Petrella Alessandro , Müller Sophie J. , Koenig Julian , Kroemer Nils B.
Published: February 2025

The vagus nerve is crucial in regulating physiological functions, including the cardiovascular system. While heart rate (HR) and its variability (HRV) may provide non‐invasive proxies of cardiac vagal activity, transcutaneous auricular vagus nerve stimulation (taVNS) has yielded mixed effects, with limited research on right branch stimulation. In a randomized crossover study with 36 healthy participants, we investigated taVNS effects on HR and HRV indexed by SDRR, RMSSD, HF‐HRV, and LF/HF ratio. To assess the impact of the stimulation side (left vs. right ear) on cardiovascular indices and interaction with the physiological state, we recorded electrocardiograms in four sessions per person, covering three session phases: baseline, during stimulation (taVNS vs. sham), and post‐milkshake consumption with stimulation. First, we found moderate evidence against taVNS affecting HR (BF10 = 0.21). Second, taVNS decreased HRV (multivariate p = 0.004) independent of physiological state, with strong evidence for RMSSD (BF10 = 15.11) and HF‐HRV (BF10 = 11.80). Third, taVNS‐induced changes were comparable across sides and stronger than sham, indicating consistent cardiovascular effects independent of the stimulation side. We conclude that taVNS reduces HRV as indexed by RMSSD, HF‐HRV, and SDRR without altering HR, contradicting the assumption that taVNS per se increases cardiovagal activity as indexed by increased HRV due to stimulating vagal afferents. Instead, our results support the role of vagal afferent activation in arousal. Crucially, taVNS on both sides can safely modulate the cardiovascular system without increasing the risk of bradycardia or causing adverse events in healthy participants, offering new treatment possibilities.
Evaluations of clinical practice guidelines, protocols, and pathways used in rural and remote Australia, Canada, and Aotearoa New Zealand: a scoping review protocol
Authors: Arkapaw Luke , Hines Sonia , Brand Anthea , Black Oliver , Byrne Mary , Harvey Gillian , Smith James A.
Published: February 2025

Objective:

The objective of this review protocol is to scope the extent and type of evidence describing evaluations of clinical practice guidelines, protocols, and pathways that are used in the rural and remote areas of Australia, Canada, and Aotearoa New Zealand.

Introduction:

Given the important role that clinical guidance resources can play in minimizing health disparities, it will be useful to understand what resources are being used in rural and remote health contexts and how these are being developed, implemented, and evaluated.

Inclusion criteria:

Records will be included from 3 high-income countries which have rural or remote regions and First Nations populations. Records will only be included if they explicitly identify the clinical guidance resource, have the resource as a primary focus of the evaluation, and show that the resource has been endorsed or implemented for use in the rural or remote health service. Evaluations of point-of-care testing instruments will be excluded, as well as records from aged care facilities, even if they are from rural and remote areas.

Methods:

The JBI methodology for scoping reviews will be followed. Searches will be conducted in MEDLINE (Ovid), CINAHL (EBSCOhost), Emcare (Ovid), Scopus, ProQuest Dissertations and Theses, and Google. Records in English will be considered for inclusion. Covidence will be used to remove duplicates and organize the selection review process. Data will be extracted using a data charting tool created by the authors. The results will be analyzed using simple descriptive statistics and presented as a series of tables and a narrative summary.

Review registration:

The review has been registered on Open Science Framework: https://doi.org/10.17605/OSF.IO/6EM32
OPTIMIZING BIFACIAL SOLAR MODULES FOR ENHANCED ENERGY CAPTURE ON CLOUDY DAYS
Authors: Lu Jianqing , Xiao Tingyi , Su Xiao , Huang Caiyuan , Jiang Yipeng , Liu Wenyang , Ao Runchun , Zhang Wei , He Jianjun
Published: February 2025

To improve the utilization of solar irradiance by a bifacial photovoltaic (PV) flat single-axis tracking system under complex weather conditions, a dynamic optimization model for bifacial PV modules, a hybrid tracking algorithm was developed. Scattering coefficients is defined to differentiate weather conditions consistently so as to select different algorithms for tracking. The sun's position is tracked by using the visual sun trajectory model on sunny days, while the maximum sum of irradiance of bifacial modules is used as the tracking angle setting principle for high scattering weather. A month-long controlled field experiment was conducted at a PV plant in Ningxia. Data under typical cloudy and overcast conditions was selected to analyze and verify whether the proposed model can improve the power generation efficiency of the planar single-axis tracking system. The experiment results show that the tracking system using the all-weather dynamic optimization model for bifacial modules has an irradiance gain of 8.174% and 4.81%, and a daily power generation gain is 10.529% and 6.20% respectively under typical cloudy and overcast conditions. This demonstrates that the hybrid tracking model proposed in this paper can improve the power generation of the bifacial flat single-axis tracking system under complex weather.
Conformal Transformation-Based Mechanical Modelling for Continuous Blood Pressure Monitoring
Authors: Wang Shuo , Zhang Yangyang
Published: February 2025

Continuous blood pressure monitoring is essential for individuals, particularly those with cardiovascular diseases. Numerous studies have focused on the continuous measurement of blood pressure using versatile, flexible wearable sensors. However, the analytical relationship among blood pressure, arterial properties, and the pressure sensed by these flexible sensors remains unclear, leading to potential misdiagnoses or missed early warnings. This paper presents a mechanical model that establishes the relationship between blood pressure and the pressure sensed by flexible sensors for continuous blood pressure monitoring, utilizing the conformal transformation method. The blood artery and surrounding tissues are modeled as an elastic half-plane with a circular cavity, subjected to uniform radial pressure at the cavity's inner boundary. By combining conformal transformation and inverse conformal transformation techniques, we derive explicit expressions for stress and displacement in the tissues surrounding the blood vessel and on the skin surface. These findings are validated through finite element analysis and experimental results obtained using digital image correlation methods. Additionally, we establish a simple scaling law relating the normalized pressure perceived by the sensor to the normalized artery depth and radius. The mechanical model established in this paper provides an analytical relationship among the pressure perceived by the sensor, blood pressure and artery parameters, paving the way for analytically extracting accurate blood pressure values from the output electrical signals of flexible wearable sensors.
Experimental study on force and surface morphology of additive manufacturing FeCoNiCrAl0.5 high entropy alloy
Authors: Wen Xue-Long , Zhang Wen-Bo , Gong Ya-Dong , Xu Ru-Chu
Published: February 2025

FeCoNiCrAl0.5 HEA specimens were prepared by L-PBF under different laser process parameters, and their physical phases, microstructures, and defects were investigated. Micro-grinding experiments were designed to explore the effects of varying laser parameters on the micro-grinding performance of L-PBF-HEAs by analyzing the micro-grinding force and roughness and observing the surface morphology. The experimental results show that the internal defects of L-PBF-HEA FeCoNiCrAl0.5 decrease as the laser power increases, and increase when the laser scanning spacing and scanning speed increase. When the laser power is increased, the micro-grinding force shows a growing trend, the Ra decreases and then increases, and the surface morphology flatness improves; when the laser scanning spacing increases, the micro-grinding force decreases, the Ra increases, and the surface morphology deteriorates; when the laser scanning speed increases, the micro-grinding force increases and then decreases, and the Ra decreases and then increases, and the surface morphology improves relatively.