bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Mitral and Aortic Valve Surgery Through a Right Minithoracotomy: A Single-Center Experience
Authors: Fiorentino Mariafrancesca , Mikus Elisa , Tripodi Alberto , Sangiorgi Diego , Calvi Simone , Tenti Elena , Costantino Antonino , Savini Carlo
Published: February 2025

Objective:

Minimally invasive combined mitral and aortic valve surgery is still uncommon. We report our experience performing multiple valve procedures through a right-sided minithoracotomy.

Methods:

We present an observational case series with a retrospective analysis of 38 patients who underwent double valve surgery through right anterior thoracotomy from November 2013 to November 2023.

Results:

The median age of our population was 72 years, and 61% were female patients. The median EuroSCORE II was 2.27. Three patients (7.9%) had redo operations. The median cardiopulmonary bypass (CPB) and cross-clamp times were 98 and 85 min, respectively. No conversion to full sternotomy was necessary. In-hospital mortality was 2.6% (1 patient); the patient died of septic shock and consequent multiorgan failure. Of the patients, 53% required transfusions with packed blood cells. Postoperative atrial fibrillation was observed in 12 patients (32%), and 2 patients (5.2%) required pacemaker implantation due to third-degree atrioventricular block. Also, 1 stroke (2.6%) and 1 rethoracotomy for bleeding were observed. The median ventilation time was 10 h. The median intensive care unit and postoperative length of stay were 2 days and 7.5 days, respectively. Survival at 1, 3, 5, and 10 years was 93.8%, 86.3%, 86.3%, and 77.2%, respectively, with a median follow-up time of 6.5 years. Freedom from reintervention at 1, 3, 5, and 10 years was 96.8%, 89.5%, 85.0%, and 69.5%, respectively, with a median follow-up time of 5.7 years.

Conclusions:

In our experience, a minimally invasive approach for combined aortic and mitral valve surgery is safe and feasible, with acceptable CPB and cross-clamp times and good outcomes. Therefore, it can be an attractive option for patients with double valve diseases.
EXPRESS: Transfer Asymmetry: Tversky’s Contrast Model of Similarity for Human Perceptual-Motor Learning
Authors: Yamaguchi Motonori
Published: February 2025

In choice-reaction tasks, responses are faster if stimuli and responses are spatially compatible than if they are incompatible, even when the locations of the stimuli are irrelevant to the task. This stimulus-response (S-R) compatibility effect that occurs based on task-irrelevant stimulus and response features is known as the Simon effect. The Simon effect can be eliminated or even reversed after training with spatially incompatible S-R mappings only for a short duration, indicating that newly acquired incompatible S-R associations transfer to the Simon task. This transfer effect is usually reduced when the context of the training task is altered at test, suggesting that the expression of learned S-R associations depends on the similarity between the learning and test contexts. However, there can be cases where transfer occurs from one context to another but not in the reverse direction (i.e. transfer asymmetry). Transfer asymmetry is problematic for many models of psychological similarity, which would predict that transfer is symmetrical between two contexts. The present study shows that Tversky’s set-theoretic model of similarity—the contrast model—is a useful framework for understanding how transfer symmetry arises in human perceptual-motor learning. The results of the two experiments imply that the similarity of contexts depends not only on features that overlap between the contexts but also on features that are distinctive to them.
Nerve grafting or nerve transfer for suprascapular nerve reconstruction in neonatal C5C6 ± C7 brachial plexus palsies
Authors: Heitz Arthemon , Commeureuc Jeanne , Bodin Jean-Francois , Druel Thibault , Mathieu Laurent , Walch Arnaud
Published: February 2025

This retrospective study aimed to compare two methods of reconstruction of the suprascapular nerve in neonatal brachial plexus palsy. Patients who underwent suprascapular nerve reconstruction for neonatal C5–C6 (±C7) brachial plexus palsy were included if they had at least 3 years follow-up. The results obtained after nerve surgery alone and at the end of the follow-up (after shoulder release surgery) were analysed. The primary outcome was the range of external rotation with the arm at the side. Thirty-three patients were included (19 nerve transfers, 14 nerve grafting). At last follow-up (mean 10.5 years), there was no significant difference in terms of active external rotation, range of active movement or Active Movement Scale scores for the shoulder. Active external rotation was obtained in 23 of 33 cases, 21 by nerve repair alone and two after additional shoulder release. In the present series, nerve transfer and nerve grafting provided similar results for the suprascapular nerve.

Level of evidence: III
Adjuvant treatment after neoadjuvant chemoradiotherapy and surgery in patients with esophageal squamous cell carcinoma: a real-world study
Authors: Geng Yuxin , Zhao Junfeng , Li Ying , Li Yintao
Published: February 2025

Background:

Neoadjuvant chemoradiotherapy (NCRT) combined with surgery is the standard treatment option for patients with locally advanced esophageal squamous cell carcinoma (ESCC). However, whether adjuvant chemotherapy (AC) administered postoperatively has a survival benefit remains inconclusive.

Objectives:

To investigate whether AC is necessary after NCRT and esophagectomy and determine which patients might benefit from it.

Design:

A retrospective study.

Methods:

This retrospective study examined patients with ESCC treated with NCRT followed by radical esophagectomy at three hospitals between March 2016 and December 2022. Patients were assigned into the adjuvant and non-adjuvant therapy groups based on whether they received postoperative AC, allowing the comparison of disease-free survival (DFS) and overall survival (OS) between the two groups. In addition, based on whether postoperative pathology indicated pathological complete response (pCR), patients were classified into the pCR and non-pCR populations, with DFS and OS separately analyzed for each subgroup.

Results:

Overall, 218 eligible patients were enrolled. No significant advantage was found in DFS ( p = 0.540) and OS ( p = 0.058) between the adjuvant and non-adjuvant therapy groups. In the non-pCR population, the adjuvant therapy groups had a significant advantage in DFS ( p = 0.046) and OS ( p = 0.011) compared to the non-adjuvant therapy group. However, in the pCR population, no significant advantage was found in DFS ( p = 0.490) and OS ( p = 0.110) analyses between the adjuvant and non-adjuvant therapy groups.

Conclusion:

In the real world, patients with ESCC who underwent NCRT combined with radical esophagectomy and whose postoperative pathology was pCR did not benefit from AC. However, AC significantly improved DFS and OS in patients whose postoperative pathology did not reach pCR.
Clinical impact of hypomagnesemia induced by necitumumab plus cisplatin and gemcitabine treatment in patients with advanced lung squamous cell carcinoma: a subanalysis of the NINJA study
Authors: Tanzawa Shigeru , Yoshioka Hiroshige , Misumi Toshihiro , Miyauchi Eisaku , Ninomiya Kiichiro , Murata Yasunori , Takeshita Masafumi , Kinoshita Fumihiko , Fujishita Takatoshi , Sugawara Shunichi , Kawashima Yosuke , Hashimoto Kazuki , Mori Masahide , Miyanaga Akihiko , Hayashi Anna , Tanaka Hisashi , Honda Ryoichi , Nojiri Masafumi , Sato Yuki , Hata Akito , Ishikawa Nobuhisa , Kozuki Toshiyuki , Kawamura Takahisa , Saito Go , Yamaguchi Teppei , Asada Kazuhiro , Tetsumoto Satoshi , Tanaka Hiroshi , Watanabe Satoshi , Umeda Yukihiro , Yamaguchi Kakuhiro , Nishii Kazuya , Tsuruno Kosuke , Misumi Yuki , Kuraishi Hiroshi , Yoshihara Ken , Nakao Akira , Kubo Akihito , Yokoyama Toshihiko , Watanabe Kana , Seki Nobuhiko
Published: February 2025

Background:

The clinical impact of hypomagnesemia induced by necitumumab plus gemcitabine and cisplatin (GCN) as a second-line or later therapy is unclear.

Objective:

We aimed to evaluate the clinical characteristics and survival impact of hypomagnesemia induced by this therapy.

Design:

This was a sub-analysis of the retrospective multicenter NINJA study.

Methods:

Among the 93 patients enrolled in the NINJA study, this subanalysis included 75 patients with baseline serum magnesium concentrations.

Results:

The incidence of grade ⩾2 hypomagnesemia was 18.0% in the patients with normal baseline serum magnesium concentrations and 42.8% in those with low concentrations ( p = 0.073). The discontinuation rates of GCN treatment owing to hypomagnesemia in each group were 0% and 7.1%, respectively ( p = 0.187). The number of necitumumab doses and severity of hypomagnesemia were positively correlated ( r = 0.389, p < 0.001). Patients who developed hypomagnesemia in fewer than 21 days after the first dose of GCN ( n = 12) had significantly poorer progression-free survival (PFS) than those without the condition ( n = 63; median: 4.1 vs 4.4 months, p = 0.048). A similar trend was observed for OS (median: 9.7 vs 15.7 months, p = 0.062). These results were maintained after multivariate analyses (PFS: hazard ratio (HR) 2.46, p = 0.014; OS: HR 2.78, p = 0.021).

Conclusion:

GCN as a second-line or later therapy may be tolerable regardless of the patient’s baseline serum magnesium concentration. On the other hand, early serum magnesium reduction with this therapy is associated with a poor prognosis. However, caution should be needed because our results lacked sufficient information for confounding variables other than those analyzed here that may influence the correlation between hypomagnesemia and survival.
Robot-assisted percutaneous cannulated screw fixation in the treatment of slipped capital femoral epiphysis
Authors: Xu Yunfeng , Fu Gang , Feng Chao , Huang Lin , Ma Yuan , Zhang Yucheng , Zhou Yuan , Luo Xiao , Lu Ming , Yang Jie , Wang Yukun , Lv Xuemin , Jiang Xieyuan , Yang Zheng
Published: February 2025

Purpose:

To investigate robot-assisted percutaneous cannulated screw fixation for treating slipped capital femoral epiphysis, including acute, chronic, and acute-on-chronic slips. Our study included all stable and unstable slips.

Methods:

Thirty-one children with unilateral SCFE were treated from October 2019 to October 2021. All 31 patients were followed up for 12–36 months, with an average follow-up time of 24.56 ± 6.73 months. The femoral epiphysis was fixed with a percutaneous cannulated screw assisted by a surgical robot.

Results:

All 31 femoral head epiphyses underwent successful fixation in one attempt. The average operation time and bleeding were 98.25 ± 15.13 min and 21.65 ± 11.25 ml, respectively. The average distance between the actual and planned entry points was 1.13 ± 0.58 mm and 0.91 ± 0.72 mm in the anteroposterior (AP) and lateral views, respectively. The actual insertion trajectory deviated from the planned position by 3.61 ± 1.34° and 2.33 ± 1.32° in the AP and lateral views, respectively. The average fluoroscopy time was 6.56 ± 3.23 times per screw. The Non-Arthritic Hip Score improved from 28.53 ± 9.17 preoperatively to 67.34 ± 6.21 at the last follow-up ( P < 0.05), and the Harris hip score improved from 46.47 ± 15.34 to 89.63 ± 7.52 ( P < 0.05). The wounds healed without avascular necrosis or chondrolysis of the femoral head.

Conclusion:

Robot-assisted percutaneous cannulated screw fixation is effective for treating pediatric SCFE. Screw fixation was accurate and safe, and clinical outcomes were satisfactory.

Level of Evidence:

Level 4, Case Series.
Availability of Open Dynamic Glycemic Data in the Field of Diabetes Research: A Scoping Review
Authors: Del Giudice Libera Lucia , Piersanti Agnese , Göbl Christian , Burattini Laura , Tura Andrea , Morettini Micaela
Published: February 2025

Background:

Poor data availability and accessibility characterizing some research areas in biomedicine are still limiting potentialities for increasing knowledge and boosting technological advancement. This phenomenon also characterizes the field of diabetes research, in which glycemic data may serve as a basis for different applications. To overcome this limitation, this review aims to provide a comprehensive analysis of the publicly available data sets related to dynamic glycemic data.

Methods:

Search was performed in four different sources, namely scientific journals, Google, a comprehensive registry of clinical trials and two electronic databases. Retrieved data sets were analyzed in terms of their main characteristics and on the typology of data provided.

Results:

Twenty-five data sets were identified including data from challenge tests (5 of 25) or data from Continuous Glucose Monitoring (CGM, 20 of 25). As for the data sets including challenge tests, all of them were freely downloadable; most of them (80%) related only to oral glucose tolerance test (OGTT) with standard duration (2 h), but varying for timing and number of collected blood samples, and variables collected in addition to glucose levels (with insulin levels being the most common); the remaining 20% of them also included intravenous glucose tolerance test (IVGTT) data. As for the data sets related to CGM, 7 of 20 were freely downloadable, whereas the remaining 13 were downloadable upon completion of a request form.

Conclusions:

This review provided an overview of the readily usable data sets, thus representing a step forward in fostering data access in diabetes field.
A Case of Extended Duration Triple Antithrombotic Therapy in a Patient With an Intracranial Stent and Atrial Fibrillation
Authors: Greer Samuel C. , Wells Drew A. , Osehobo Ehizele , Jones Kerri
Published: February 2025

Our case report presents the clinical management of a 77-year-old female with recurrent acute ischemic stroke (AIS) due to severe intracranial large artery atherosclerosis (LAA), requiring intracranial stenting complicated by new-onset atrial fibrillation (AF). This clinical scenario necessitated the use of triple antithrombotic therapy (TAT) with aspirin, ticagrelor, and apixaban. While guidelines recommend minimizing the duration of TAT or favoring alternative regimens due to bleeding risks, this case highlights the safe application of an extended duration TAT course in a high-risk patient. The patient initially presented with recurrent AIS despite dual antiplatelet therapy (DAPT). Subsequent intracranial stenting and AF diagnosis posed challenges in balancing ischemic and bleeding risks. Multidisciplinary, shared decision-making guided the initiation of TAT. Despite a history of early recurrent strokes and high-risk stenting, no major, life-threatening, or minor bleeding complications were observed during the extended duration of TAT. This case underscores the need for tailored antithrombotic regimens in neurovascular patients with AF and high ischemic risk.
Results of urethral reconstruction in neglected urethral foreign bodies with associated urethral strictures
Authors: Trivedi Sameer , Goel Nitin , Pal Harish , Reddy Koti Sridhar , M Rinaldo , Nayak Pradeep , Singh Yashasvi , Kumar Ujwal
Published: February 2025

Objective:

Urethral foreign bodies with associated urethral strictures are unusual entities. Although few case studies have reported the management of urethral foreign bodies, the management of neglected foreign bodies with resultant urethral strictures has not been addressed in the literature.

Materials and Methods:

A retrospective review of 15 patients diagnosed with strictures and associated urethral foreign bodies was performed for collection of data, viz., demographic and clinicopathological factors; details of urethral reconstruction procedures; perioperative and postoperative events; and follow-up data.

Results:

Underlying aetiology was self-insertion for sexual gratification in nine patients (metallic safety pins – 3, wooden splinters – 2, electric cables – 2, and plastic rods in two patients), gunshot injuries with embedded pellets in 4, and iatrogenic foreign bodies in two patients. Three patients had complete urethral obstruction, six had bulbar strictures, four had penile urethral strictures, and two had pan urethral strictures. Seven strictures were managed by primary end-to-end anastomosis, three by augmented roof-strip anastomosis using oral mucosal grafts, while the remaining five patients required augmentation urethroplasty using oral mucosal grafts. The overall success rate of urethral reconstruction was 93.3%.

Conclusion:

Neglected urethral foreign bodies with associated urethral strictures are uncommon. Surgical management, although challenging owing to an unhealthy local milieu, has satisfactory outcomes.

Level of Evidence:

Not applicable.
The evolution of images grounded in sand: Case study of a 16-year-old girl with adverse childhood experiences in sandplay therapy lacking miniatures
Authors: Guo Ruitong , He Yiqing
Published: February 2025

To explore how sandplay therapy (SPT) lacking miniatures in schools can help adolescents with adverse childhood experiences (ACEs). The study will provide a reference and framework for school psychologists and counsellors to use imaginative formations (especially kinaesthetic images) in SPT lacking miniatures to understand and help student-clients with ACEs. The case study method is used to describe the actions taken and image data obtained during the SPT and analyse the themes and kinaesthetic images created. Kinaesthetic images provide an embodiment of emotion and self-regulation. Dynamic scene images evoked by kinaesthetic imagination offer an embodiment of self-development. Co-transference images arising from co-relationships embody self-renewal. Three imaginative formations in SPT: (1) clients’ kinaesthetic images; (2) dynamic (sandpicture) scene images and (3) co-transference images generated in the relationship between therapist and client (images emerging in the psyches of both sides, each other’s images of dreams during SPT). Psychologists and counsellors in schools can use SPT within the framework of three imaginative formations and parental interviews to help improve the internal psychological and external interpersonal and family environments of adolescents with ACEs.
Hiding in the Folds: Case Report Highlighting the Role of Imaging in Detecting Dermatofibrosarcoma Protuberans
Authors: Aurubin Carlie A. , Decosma Lorvens , Sokumbi Olayemi , Garrett Aneesah P. , Prier Cara C.
Published: February 2025

Dermatofibrosarcoma protuberans (DFSP) is a rare slow-growing skin cancer with a great capacity for local destruction. DFSP can manifest in a myriad of ways. This case report aims to contribute to the literature by increasing awareness of this condition, along with common diagnostic practices and treatment regimens. We present a 52-year-old Filipino woman who was evaluated for dyspnea with an incidental finding of an indeterminate nodule on imaging. A comprehensive diagnostic workup confirmed dermatofibrosarcoma protuberans (DFSP), which was ultimately treated with surgical resection. Clinically, about 52% of patients are misdiagnosed, leading to poor outcomes. Therefore, awareness, early detection, multidisciplinary treatment, and lifelong screening are essential for optimal outcomes.
Advocating Submission of Case Reports in Family Medicine: An Analysis of Case Report Submissions in Journals Related to Family Medicine
Authors: Wattanapisit Apichai , Sirirak Kosin , Wattanapisit Sanhapan , Jenn Ng Chirk , Hai Teo Chin , Wiwatkunupakarn Nutchar , Aramrat Piyachon , Angkurawaranon Chaisiri
Published: February 2025

Introduction:

Family medicine embraces a wide range of principles. Identifying appropriate journals for publishing family medicine case reports can be challenging for authors. This study aims to identify journals related to family medicine that publish case reports and summarize the requirements of case report submissions.

Methods:

Journals related to family medicine were identified from the subject categories: “family practice” in Scopus and “primary health care” in Web of Science. The author’s instructions on the journal websites regarding the criteria for case report submissions were reviewed, and the specific requirements for case reports of each journal were recorded. Journals were excluded if family medicine was not the main aim and scope.

Results:

Among the 80 journals focused on family medicine, 30 (37.5%) were found to accept submissions of case reports. These reports were classified into various article types, such as case reports, patient studies, clinical case studies. The length of the main text varied between 400 and 3000 words, and some journals did not mandate an abstract. However, for those that did, abstracts typically ranged from 50 to 300 words. The number of references cited ranged from 5 to 30.

Conclusions:

Less than half of the journals in the family medicine field accept case report submissions. It is advisable for authors to choose their target journal early in the preparation process, as each journal typically provides specific submission guidelines and instructions.
Temporary Visitors or Permanent Residents? The Settling and Returning of International Students in China
Authors: Gao Chenyu , Tang Shuangshuang , Huang Xu
Published: February 2025

With the rapid development of international education, China has become a popular destination for international students. In this context, whether students settle in China or return to their hometowns after graduation is a matter of interest. Based on a recent questionnaire survey circulated among international students in Nanjing, Jiangsu Province, and on interviews conducted there, this study applies logistic regression models to examine the determinants of their intentions and the mechanism of their decision to either settle or return. In addition, the gender gap is studied to explore how male and female international students are differently influenced by various determinants. The results show that most international students are satisfied with their experience of studying in China and with their social environment but have less understanding of Chinese policies. The results also indicate that family obligation, social ties, working conditions, and social and policy environment have a significant impact on international students’ intentions. From the gender perspective, family ties and labor market play different roles in the decisions of male and female students, while marital status and policies influence both genders. The results reveal the mechanisms of settling and returning, which may have implications for the Chinese government in its desire to retain foreign talents.
Pronunciation Teaching in English Language Classrooms in Saudi Arabia: Teachers’ Cognition and Practice
Authors: Algethami Ghazi , Al Kamli Hadeel
Published: February 2025

Research over the last two decades has shown that teaching pronunciation is both effective and important in language education. Nowadays, therefore, many English language textbooks include pronunciation activities. It is not clear yet how this has affected or changed teachers’ beliefs and practices in different teaching contexts. The current study examined English teachers’ beliefs and practices regarding pronunciation instruction in Saudi Arabia. Semi-structured interviews with Saudi teachers were conducted and analyzed in 2023. The teachers acknowledged the importance of pronunciation but had mixed opinions about how it should be taught, with most emphasizing the effectiveness of listening extensively to native input. Their teaching practice was limited to teaching the activities included in textbooks, which some described as insufficient for addressing their students’ needs. The teachers also mentioned they correct students’ pronunciation mistakes only when they affect intelligibility, with a primary focus on individual sounds. They reported prioritizing the teaching of other language skills over pronunciation due to limited class time and exams being focused on other aspects of language. The teachers unequivocally expressed the need for further training. Three areas of professional development were mentioned: a good knowledge base in phonetics, pronunciation teaching strategies, and English pronunciation. The present study concludes that pronunciation is still marginalized in English classrooms in Saudi Arabia, and teachers’ lack of training, as well as limited class time, play a role in this marginalization.
The Association of Modic Changes and Disc-Endplate-Bone Marrow Complex Classification in Patients With Cervical Degenerative Disc Disease
Authors: Jagadish T , Murugan Chandhan , Ramachandran Karthik , Thippeswamy Pushpa Bhari , Anand K S Sri Vijay , Kanna Rishi Mugesh , Shetty Ajoy Prasad , Rajasekaran Shanmuganathan
Published: February 2025

Study design

Observational cohort study.

Objective

To assess the association of Modic changes and DEBC classification in patients with cervical degenerative disc disease.

Methods

The study includes 2 groups, neck pain patients presenting to the out-patient services (neck pain group) (n = 301) and polytrauma patients without cervical spine injury or a history of neck pain, who underwent whole spine MRI (control group) (n = 200). Degenerative changes in the MRI were classified according to the Modic changes (MC) and DEBC classification. Modifiers including End-Plate (EP) erosion and herniation (H+) presence were documented.

Results

3612 EPs of 301 patients with neck pain and 2400 EPs of 200 controls were assessed. The incidence of MC and DEBC in the neck pain group was 20.93% and in the control group, it was 12%, ( P < 0.05). In the neck pain group with DEBC changes, the distribution was Type A-6.51%; Type B-20.71%; Type C-71.6%; and Type D - 1.18%, while in the controls the distribution was Type A-10.29%, Type B-29.41%, Type C-54.41%, and Type D - 5.88%, The co-occurrence of H+ with DEBC in cases and controls was 13.95% vs 5.5% ( P < 0.005). The odds ratio for the need for surgery was highest (OR: 6.8) when H+ and DEBC change co-occurred.

Conclusion

Our study highlights that patients with DEBC changes and disc herniation were more likely to experience neck pain and require surgical intervention, indicating the reliability and clinical significance of the DEBC classification in degenerative cervical spine patients.
The Free Trade Argument and Development Strategy
Authors: Patnaik Prabhat
Published: February 2025

The argument that free trade enhances the output bundle of countries is based on the assumption of full utilization of factors of production and, in turn, on the idea that supply creates its own demand (Say’s Law). However given that involuntary unemployment prevails, the free trade argument for development strategy becomes invalid. Not only is it impossible, due to constrained demand, for all trading partners to benefit from trade, but autonomous sources of expenditure are also constrained, such that if expenditure does not increase after trade, trade-surplus countries will be imposing “beggar-thy-neighbour” policies on the trade-deficit countries. Historically, external stimuli for capitalist expansion relied on the colonial market. It is argued in this article that trade between countries should promote actual cooperation by ensuring that their economies are not demand-constrained. This, in turn, requires that the hegemony of globalized finance be eliminated and capital controls instituted. Growth must be essentially home-market-oriented, and trade should be not free but a matter of discretion.
Changes in the World Geopolitical Order and the Reconfiguration of Productive Systems: The Mexican Case
Authors: Guillén Arturo , Torres Ivan Cortés
Published: February 2025

This article examines the geopolitical shifts and economic transformations over the past five decades, emphasizing the decline of US hegemony, the rise of China as a global leader, and the impacts on global value chains. The analysis focuses on Mexico’s role within North American economic integration amidst the transition from neoliberal globalization to regionalized production. It explores how nearshoring strategies, driven by geopolitical imperatives and supply chain disruptions, reshape Mexico’s economy. Infrastructure projects like the Maya Train and Trans-Isthmus Train aim to leverage Mexico’s geographic advantages and attract investment. However, challenges persist, including dependence on imported inputs, low domestic value-added, and regional disparities. The study highlights the potential of nearshoring to drive economic development while cautioning against perpetuating dependency and inequality. Ultimately, Mexico’s success hinges on coordinated strategies that balance national development and regional integration within evolving geopolitical dynamics.
Adiposity and domain-specific stroke recovery: A Mendelian randomization study
Authors: Wang Mengmeng , Daghlas Iyas , Aldridge Chad M , Zhang Zhizhong , Ren Yi
Published: February 2025

Introduction:

While adiposity is an established risk factor for incident ischemic stroke, its influence on functional recovery after stroke is uncertain. We leveraged Mendelian randomization (MR) to examine the causal effects of body mass index (BMI) and waist-to-hip ratio (WHR) on post-stroke motor, cognitive, and global recovery.

Materials and methods:

Genetic proxies for BMI and WHR were obtained from a genome-wide association study (GWAS) meta-analysis of the GIANT consortium and the UK Biobank ( n = 806,834). The primary outcomes were longitudinal trajectories of three National Institutes of Health Stroke Scale (NIHSS) measures assessed over a 2-year period: motor function subscores, cognitive performance subscores, and total NIHSS scores (as a measure of global recovery). Genetic associations with these stroke recovery outcomes were obtained from a GWAS conducted within the VISP trial of mild ischemic stroke ( n = 1270). MR effects were estimated using the inverse-variance weighted method.

Results:

A 1-standard deviation (SD) increase (~4.8 kg/m2) in genetically predicted BMI associated with lower odds of post-stroke motor improvement (OR = 0.37, 95% CI = 0.19-0.72; p = 0.003). Similarly, a genetically predicted increase in BMI was associated with worse cognitive (β = −0.12, 95% CI = −0.21, −0.03; p = 0.009) and global recovery (β = −0.36, 95% CI = −0.59, −0.13; p = 0.002). Associations between genetically predicted WHR and post-stroke recovery were directionally concordant but were not statistically significant ( p > 0.05).

Discussions and conclusions:

Human genetic evidence suggests that elevated adiposity negatively impacts multiple post-stroke outcomes, including motor function, cognition, and overall recovery. The biological pathways underlying these associations warrant further investigation.
Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching
Authors: Musmar Basel , Adeeb Nimer , Abdalrazeq Hammam , Roy Joanna M , Tjoumakaris Stavropoula I , Salim Hamza Adel , Kondziolka Douglas , Sheehan Jason , Ogilvy Christopher S , Riina Howard , Kandregula Sandeep , Dmytriw Adam A , El Naamani Kareem , Abdelsalam Ahmed , Ironside Natasha , Kumbhare Deepak , Ataoglu Cagdas , Essibayi Muhammed Amir , Keles Abdullah , Muram Sandeep , Sconzo Daniel , Rezai Arwin , Alwakaa Omar , Tos Salem M , Erginoglu Ufuk , Pöppe Johannes , Sen Rajeev D , Griessenauer Christoph J , Burkhardt Jan-Karl , Starke Robert M , Baskaya Mustafa K , Sekhar Laligam N , Levitt Michael R , Altschul David J , McAvoy Malia , Aslan Assala , Abushehab Abdallah , Swaid Christian , Abla Adib A , Sizdahkhani Saman , Koduri Sravanthi , Atallah Elias , Karadimas Spyridon , Gooch M Reid , Rosenwasser Robert H , Stapleton Christopher , Koch Matthew , Srinivasan Visish M , Chen Peng R , Blackburn Spiros , Cochran Joseph , Choudhri Omar , Pukenas Bryan , Orbach Darren , Smith Edward , Mosimann Pascal J , Alaraj Ali , Aziz-Sultan Mohammad A , Patel Aman B , Cuellar Hugo H , Lawton Michael , Guthikonda Bharat , Morcos Jacques , Jabbour Pascal
Published: February 2025

Introduction:

The impact of multiple feeding arteries on clinical outcomes of cerebral arteriovenous malformations (AVMs) is not well understood. This study aims to compare outcomes between AVMs with multiple versus single feeding arteries.

Patients and Methods:

Data from the Multicenter International Study for Treatment of Brain AVMs (MISTA) consortium were analyzed. Propensity score matching (PSM) was used to balance cohorts. Subgroup analysis was conducted for ruptured and unruptured AVMs and different treatment options, and multivariable logistic regression was applied to assess the impact of feeding artery origin.

Results:

Among 953 patients, 661(69.4%) had multiple feeding arteries, and 292 (30.6%) had a single feeding artery. After PSM, which included 422 matched patients (211 in each group), the differences in obliteration rates (68.7% vs 74.8%, OR 0.73, 95% CI: 0.48–1.12, p = 0.16) and symptomatic complications (15.6% vs 11.8%, OR 1.37, 95% CI: 0.78–2.41, p = 0.25) were not significant. Subgroup analysis comparing ruptured and unruptured AVMs and different treatment options showed no significant differences across all subgroups. Multivariable analysis identified PICA feeders as significantly associated with increased odds of all complications (OR 7.33, 95% CI: 2.14–25.1, p = 0.002).

Discussion and Conclusion:

AVMs with a single feeding artery were more likely to present with rupture, but no significant differences in obliteration rates or complications were observed between the groups after PSM. These findings suggest that while the number of feeding arteries may influence the initial presentation, it does not appear to impact overall treatment success or patient prognosis. Further prospective studies are needed to confirm these findings.
These boots are made for walking: A reflexive analysis of negotiating unavoidable risks during fieldwork as a woman
Authors: Infante-Vargas Diana , Mesta-Rodríguez Óscar
Published: February 2025

In the summer of 2023, I (Author 1, lead researcher, young adult, cis female, Mexican) began fieldwork in Saltillo, Mexico, researching the public transport infrastructure in relation to women’s differentiated mobility and their perception of safety from gender-based violence. During fieldwork, I was catcalled, followed, and harassed on multiple occasions. In this paper, Author 2 (research assistant, young adult, cis male, Mexican) and I explore issues of researcher’s positionality and vulnerability. We engage in a dialogue to provide a retelling of events, and we reflect on our differentiated experiences of fieldwork due to gender-based violence and the aftermath of being harassed while conducting research. We reflect on our differentiated degrees of vulnerability and perceptions of the city while walking the streets of Saltillo and how that reshaped our understanding of the research process. I highlight the importance of talking about these types of experiences openly in academia and queer/feminist activism, especially so when combined methodologies reformulate the relationship of the researcher with the research(ed). In this paper we critique the current fieldwork preparation processes in place at higher education institutions that focus mostly on safeguarding participants, arguing that current ethical approval forms and travel risk assessments do not provide a space where true reflection on risks and vulnerabilities can occur, therefore failing to prepare researchers for the impact that fieldwork can have on us. We conclude that academia should foster and incentivise spaces where real reflection on the researcher’s positionality can occur without the limitations of administrative processes.
Tractional Retinal Detachment in a Patient With a History of Methamphetamine Use
Authors: Kim Angela J. , Sabbagh Omar , Sabbagh Osama , Abou-Jaoude Michelle , Kitchens John W.
Published: February 2025

Purpose: To describe the development of tractional retinal detachments (TRD) in a patient with diabetic retinopathy (DR) and a history of methamphetamine use. Methods: A single case was evaluated. Results: A 38-year-old man with type 2 diabetes mellitus presented to the clinic with worsening blurry vision in both eyes. A fundus examination, fundus photography, and optical coherence tomography were performed. The patient’s bilateral TRDs were attributed to poorly controlled DR; thus, he was administered 1 intravitreal aflibercept injection in each eye and scheduled for surgery. His glycosylated hemoglobin A1c was only 6.3% and was controlled with metformin. In the interim, the patient was admitted for a stroke workup and diagnosed with Moyamoya disease and methamphetamine abuse. Conclusions: In patients with underlying DR and presumed Moyamoya disease, TRDs can be exacerbated by methamphetamine use.
Safety and efficacy of travoprost intracameral implant administered in combination with cataract surgery
Authors: Singh Inder Paul , Voskanyan Lilit A. , Barber Kevin M. , Burden James H. , Connolly LeAnne , Katz L. Jay , Usner Dale W. , Kothe Angela C. , Navratil Tomas
Published: February 2025

Background:

The travoprost intracameral implant and cataract surgery both lower intraocular pressure (IOP).

Objectives:

We evaluated the safety and IOP-lowering effect at 3 months following administration of travoprost intracameral implant in combination with cataract surgery.

Design:

Prospective, 12-month, open-label, single-arm trial.

Methods:

We enrolled patients with age-related cataracts and open-angle glaucoma or ocular hypertension in the same eye. At baseline, patients were required to have an unmedicated mean diurnal IOP (average of 8:00 am, 10:00 am, and 4:00 pm IOPs) of 24 mmHg or greater, and an IOP of 36 mmHg or less at each of these three timepoints. On the day of the combined procedure (day 1), patients who had uncomplicated phacoemulsification cataract surgery received a travoprost intracameral implant. Follow-up evaluations occurred on day 2–3, week 2, week 6, and month 3 visits.

Results:

Sixty patients had uncomplicated cataract surgery and received a travoprost intracameral implant. There were no serious adverse events. Study eye adverse events were reported in 8.3% of patients. The most frequently reported adverse event was dry eye (6.7%). At month 3, the mean diurnal IOP change from baseline was −10.6 mmHg (95% confidence interval: −11.2, −9.9; p < 0.0001) from an unmedicated baseline mean diurnal IOP of 25.2 mmHg. In addition, at month 3, 97% of eyes had a 20% or greater mean diurnal IOP reduction from baseline, and 91.0% of eyes had a mean diurnal IOP of 18 mmHg or less.

Conclusion:

Administration of a travoprost intracameral implant combined with routine cataract surgery was safe. The sizable −10.6 mmHg IOP change from baseline at month 3 was both statistically significant and clinically relevant.

Trial registration:

NCT06061718, Travoprost Intraocular Implant in Conjunction with Cataract Surgery, https://clinicaltrials.gov/study/NCT06061718 .
Exploring Self-Objectification Among Queer Community in India—A Qualitative Study
Authors: Saini Harsha , Majumdar Ilika Guha
Published: February 2025

The objectification theory proposes that membership in sexually objectifying societies gradually socializes queer individuals to adopt an observer’s perspective on their physical self, which in turn leads to negative emotional and behavioral consequences. The queer community in India has existed for centuries, but their rights have only received attention recently. They still continue to be deprived of societal and legal status. With an aim to understand self-objectification among the queer community in India, this qualitative study attempts to explore the interplay of external factors and their relationships in shaping self-image and self-acceptance. This phenomenological study used an interpretive paradigm on the self-objectification of members of the queer community in India. The study was conducted on 10 individuals from the queer community using semi-structured interviews, and the obtained data was analyzed using thematic analysis. Findings indicate the profound impact of societal beauty norms, family dynamics, peer interactions, and media influence on their self-esteem, body image, and identity. Implications of these findings call for increased awareness, education, and support to create a more inclusive and accepting environment for the queer community. Future recommendations include the development of interventions, educational programs, and mental health support services tailored to the needs of this community.
Unsupervised Assessment of Frailty Status Using Wearable Sensors: A Feasibility Study among Community-Dwelling Older Adults
Authors: Giggins Oonagh Mary , Vavasour Grainne , Doyle Julie
Published: February 2025

Objectives:

This study examined whether community-dwelling older adults can independently capture wearable sensor data that can be used to classify frailty status.

Methods:

Fifty-one older adults (age 77.5 ± 8.4 years, height 163.6 77.5 ± 8.4, weight 72.0 ± 13.5 kg, female 76%) took part in this investigation. Participants independently captured physical activity and physical function data at home using a smartwatch and a research-grade inertial sensor system for 48-hours. Machine learning classifiers were used to determine whether the data obtained can discriminate between frailty levels.

Results:

Models incorporating variables from both the smartwatch and inertial sensor system were successful in the prediction of frailty status.

Discussion:

This study has demonstrated the ability of older adults to collect data which can be used to indicate their frailty risk. This may enable earlier intervention and lessen the impact of frailty on the individual and society as a whole.
The serial mediation effect of perceived quality and customer satisfaction on the relationship between trust and repurchase intention: a research on private health insurance owners
Authors: Gün İbrahim , Söyük Selma
Published: February 2025

Background

This study examined the serial mediating roles of perceived quality and customer satisfaction in the relationship between trust and repurchase intentions among private health insurance owners.

Methods

This cross-sectional study included 525 private health insurance owners. The data were collected between 15.12.2023 and 15.03.2024, and SPSS AMOS was used to analyze the direct and indirect estimates. The study utilized structural equation modeling (SEM) to examine the relationships among the constructs. The proposed model was tested using maximum likelihood estimation. Model fit indices and statistical significance levels were reported to ensure the robustness of the findings. Using an online survey, the participants completed self-reported measures of perceived quality, customer satisfaction, trust, and repurchase intention.

Results

Trust significantly affected perceived quality, customer satisfaction and repurchase intention. Furthermore, perceived quality acted as a mediator in the relationship between trust and customer satisfaction. Additionally, customer satisfaction played a partial mediating role in the relationship between trust and repurchase intention. Both perceived quality and customer satisfaction play a serial mediating role in the relationship between trust and repurchase intention.

Conclusions

This study highlighted the significance of perceived quality and customer satisfaction in the relationship between trust and repurchase intention. Private health insurance agencies both alleviate the burden on public health services and operate as profit-driven entities. Considering their indirect benefits to healthcare services, maintaining existing customer portfolios and acquiring new customers are important for both the health system and the profitability of insurance businesses.
Engagement of health and social care employers in professional regulatory fitness to practise – missed regulatory and organisational opportunities?
Authors: Wallace Louise M. , Greenfield Mari
Published: February 2025

Background

Health and social care professional regulators are organisations that ensure their registrants have the correct qualifications and experience to practise in their profession. There are 13 statutory regulators in the United Kingdom (UK) and 29 voluntary accredited registers. Referrals of serious concerns about registrants’ Fitness to Practise (FtP) are investigated by regulators, and can lead to a public hearing. Employers may refer their employee to the regulator, and provide evidence about the concerns about their practice. Communication between the regulator and employer is central to ensure fitness to practise procedures are timely and effective, contributing to patient safety and to the improvement of health and social care professional and organisational practices.

Methods

In this mixed-methods research, semi-structured interviews were conducted with 25 participants who held senior management roles in health and social care organisations in the UK and were responsible for communicating with professional regulators. Descriptive statistics were produced relating to participants’ roles and organisations, and qualitative data was analysed using Template Analysis methodology.

Results

Four themes relating to communication between employers and regulators were identified: Process of regulatory investigation, Point of contact with employers, Local level/informal resolutions, and Organisational learning. Employers frequently described the processes as protracted and stressful for all concerned, and communication with regulators as sporadic and unidirectional during investigations. This style of communication hampered organisational learning from Fitness to Practise cases. Regulators’ employer liaison officers, where they existed, improved communications.

Conclusions

Fitness to Practise processes create the opportunities for not only the determination of whether an individual professional is fit to practise and the supportive measures that might need to be taken if they continue to practice, but also for health and social care organisations to prevent occurrence and re-occurrence of misconduct, thereby improving their services. Regulators’ communication patterns resulted in these employers’ organisational opportunities being missed. It may also lead to over-referral thereby leading to burden on employers, registrants and regulators. Improvements in communication by regulators such as via dedicated employer liaison functions could help organisations access these opportunities as well as promote the objectives of regulators to uphold trust in regulation.