bluuebunny/crossref_metadata_2025 huggingface dataset:
Budget Conditionality judgments: A virtuous circle of solidarity to overcome moral hazard?
Authors: Marique Yseult
Published: February 2025

The twin judgments in Budget Conditionality link the EU budget with solidarity, mutual trust and the effective implementation of EU law, marking a significant evolution in EU principles. These judgments elevate solidarity to a foundational stage in the EU's development. This article argues that solidarity is now being interpreted by the Court of Justice of the European Union (CJEU) as a practical tool to counter moral hazard and integrate solidarity into the EU legal cornerstones. The CJEU is operationalizing technically solidarity from a vague concept to one with concrete implications for EU public finances, linking it directly with the budget, rule of law and mutual trust among Member States. By doing so, the CJEU is making solidarity a central element of the EU legal order, transforming the discourse from financial allocations to a broader focus on shared responsibilities and compliance with EU law, thus reinforcing the EU’s foundational values of peace, democracy and the rule of law.
Exploring care of persons with dementia and significant violence risk in Victoria: A Delphi study
Authors: Cousins Zoe , Pang Sam , Rego Thomas
Published: February 2025

Background

Significant violence associated with dementia is uncommon, though care for these people is an important issue. This group is heterogeneous and encompasses people with no forensic history to those living in forensic and custodial settings. It is expected that over the next 40 years, the Australian population aged over 65 years will double, and persons over 85 years will increase threefold. This ageing population will likely mean increased persons living with dementia who may enact significant violence and place increased pressure on services to provide care. To date, there is no research on their specific care needs in Victoria.

Objectives

This study aimed to explore the current service landscape for persons with dementia and significant violence risk in Victoria through a small group of medical practitioners with expertise in dementia, psychiatry of old age, and forensic psychiatry.

Methods

A modified Policy Delphi study was used to interview 12 medical practitioners with backgrounds including Forensic Psychiatry, Psychiatry of Old Age, General Practice, and Geriatric Medicine.

Findings

The research identified five key recommendations to enhance service provision for this population in Victoria, including recommendations for specific care pathways, service agreements, physical environment considerations, educational needs, and consideration of a specialised service.
Dog-Assisted Interventions for Children and Adolescents With Autism Spectrum Disorders
Authors: Erbacher Jasmin C. E. , Bördlein Christoph
Published: February 2025

Purpose: Despite the already extensive scientific literature on dog-assisted interventions, there is still a need to compile further reviews. In this regard, it should be noted that some of the existing reviews no longer reflect the current state of knowledge. The review presented here takes into account the current state of the literature on this topic. Methods: The present systematic literature search, which was supplemented by an open literature search, identified 13 articles from specialist databases dealing with the effects, possibilities, and challenges of dog-assisted interventions and the use of assistance dogs in children and adolescents with autism spectrum disorders. Results: Dog-assisted interventions and the use of assistance dogs can have a positive impact on children and adolescents with autism spectrum disorders, their family system, caregivers, and the environment in various areas. Conclusions: Although the results appear encouraging, it should be noted that there are potential challenges.
Impact of Patient and Caregiver Beliefs on Utilization of Hospice and Palliative Care in Diverse Patients With Advanced Lung Cancer
Authors: Besculides Melanie , Mazor Melissa B. , Moreno Alvarado Carolina , Jain Mayuri , Li Lihua , Morillo Jose , Wisnivesky Juan P. , Smith Cardinale B.
Published: February 2025

Objectives

To evaluate the impact of patient and caregiver hospice care (HC) and palliative care (PC) beliefs and patient/caregiver belief-agreement on subsequent utilization of HC/PC among racially and ethnically diverse patients.

Methods

A prospective cohort study of newly diagnosed patients ≥18 years old with advanced lung cancer and their caregivers was conducted. Participants completed validated surveys at multiple points and electronic health records were reviewed to evaluate utilization. Logistic regression models were used: (i) to estimate the association between caregiver health belief composite scores and utilization of HC or PC; and (ii) to estimate the association between level of agreement between patient and caregivers, and utilization of HC or PC.

Results

Among the 43 patient/caregiver dyads enrolled in the study, 27 (63%) identified as Black and/or Latino (minoritized) and 16 (37%) as Non-Hispanic White (non-minoritized). Mean age was 65.2 ± 10.2 and 52.1 ± 15.2 years among patients and caregivers, respectively. Minoritized patients held more negative health beliefs (2.7 ± 6.7 vs. 7.1 ± 4.9; p = 0.02) than their non-minoritized counterparts however, they were more likely to use HC and/or PC (67% vs. 25%; p = 0.02). Level of health belief agreement between patients and caregivers was lower in minoritized vs non-minoritized dyads (mean (SD) Kappa: 0.31 (0.18) vs. 0.18 (0.18); p < 0.01). Caregiver beliefs and patient/caregiver agreement in beliefs did not predict utilization of HC/PC.

Conclusion

Minoritized lung cancer patients held more negative beliefs about HC/PC yet were more likely to receive HC/PC. Further work is needed to understand factors that impact utilization among diverse patients with advanced cancer.
Damage evaluation of interfacial materials based on M-integral
Authors: Li Jun , Feng Xiaoman , Hou Junling , Liu Yaohua , Wang Binglei
Published: February 2025

The paper investigates the issue of damage in interfacial materials using M-integral. It demonstrates that the integration path of M-integral can cross the material interface. The numerical calculation of M-integral is realized by using domain integral method. The accuracy of the model was verified using analytical solutions. The factors affecting the M-integral of the interfacial material are explored with the help of finite elements. The study explores the effects of elastic modulus ratio, defects, and load on the M-integral, and proposes an equivalent damage calibration method based on the M-integral. The results suggest that once the elastic modulus ratio exceeds a certain threshold, it is no longer the primary factor influencing the M-integral. The equivalent defect for elastic problems is linked to the original defect configuration and elastic modulus ratio, and is independent of the external load. This study is important for calibrating damage levels of interfacial materials, designing for damage tolerance in structures, and assessing integrity.
A domain-boundary integral equation method for the anisotropic DR equation of spatio-temporal coefficients
Authors: Azis Mohammad Ivan
Published: February 2025

A combined Laplace transform (LT) and domain-boundary element method (DBEM) were utilized to obtain numerical solutions for an unsteady spatio-temporal coefficient diffusion–reaction (DR) equation with arbitrary initial conditions and source terms, addressing problems in a distinct class of anisotropic functionally graded materials (FGMs). The procedure begins by transforming the equation of the time-space variable coefficients into one of the time-variable coefficients. The time variable of the integral equation was reduced by utilizing the Laplace transform and its convolution theorem to obtain a domain-boundary integral equation. Numerical solutions within the framework of the Laplace transform were then obtained using the standard domain-boundary element method. These numerical solutions were inverted using the Stehfest method to obtain solutions for the original time variable. Several problems involving trigonometric, exponential, and quadratic spatial gradation function coefficients were solved. The validity of the analysis used to derive the domain boundary integral equation was verified, and accurate BEM solutions were obtained.
Rejecting the radical right: Local inequality and party support
Authors: Nonnemacher Jeffrey , Fitzgerald Jennifer
Published: February 2025

Does economic inequality motivate support for the populist radical right? Previous studies point in different directions in answer to this question. Some argue that inequality benefits the radical right, while others assert that it instead strengthens parties on the left and undercuts the right. We weigh in on this debate with survey experimental evidence from Sweden. When prompted to think about inequality at the national or local level, respondents on average become less inclined to support the Sweden Democrats, a radical right populist party. These effects are particularly robust and sizable when the matter at hand is local—rather than national—inequality. Furthermore, Sweden Democrat support is weakened the most when the local inequality prompt is received by those who are on the radical right ideologically and who express concerns about law and order in society. We argue that to understand inequality’s effects on voter behavior, it is essential to explore the ways people conceptualize it. This study serves as a reminder to consider the day-to-day implications of macro-economic developments, and it provides a tool for communicating with voters in a way that undercuts the appeals of radical right parties.
A comprehensive approach to enhancing short-term hotel cancellation forecasts through dynamic machine learning models
Authors: Ampountolas Apostolos , Legg Mark
Published: February 2025

Enhancing the accuracy of short-term forecasts for cancellation rates offers revenue managers the opportunity to formulate a pricing strategy for the upcoming day, yielding favorable economic outcomes. This study proposes a methodology based on dynamic models utilizing machine learning methods such as LightGBM, XGBoost, Random Forest, and ANN-MLP, highlighting the importance of data dimensionality reduction while using higher-performing variables to improve predictive accuracy and stability. Notably, lagged variables within a few days of the forecasted date and reservations made through OTAs and BAR-rated reservations exhibit significant predictive power. The results indicate that artificial neural network multi-layer perceptron (ANN-MLP) outperforms other models, especially in longer forecast horizons. The study recommends adaptable strategies considering historical data and temporal trends and leveraging ANN-MLP for superior accuracy. The findings offer valuable insights for industry practitioners, providing a nuanced understanding of cancellation patterns and suggesting strategies to optimize cancellation prediction models in a competitive marketplace.
Predictive career guidance and entrepreneurial development for university students using artificial intelligence and machine learning
Authors: Wen Kate , Zhou Dekui
Published: February 2025

In today’s rapidly evolving job market, university students face unprecedented challenges in navigating their career paths. Traditional career guidance approaches sometimes fail to provide students with the knowledge and skills necessary for successful transitions from academics to the profession because of the changing nature of industries and the growing complexity of job possibilities. The study aims to explore the integration of AI and ML in providing predictive career guidance and entrepreneurial development for university students. This study proposes a novel Wild Horse Optimized Resilient Extreme Gradient Boosting (WHO-RXGBoost) model to predict the personalized recommendations that guide students in their career choices and entrepreneurial endeavors. University records and questionnaires are used to collect demographic data about students as well as information about any prior employment or entrepreneurial experience. The data was pre-processed using data cleaning and normalization using a robust scaler for the obtained data. The PCA feature extraction method is utilized to extract the datasets. By using this methodology, students can efficiently travel a massive amount of employment information by creating an information recommendation system that is customized to satisfy their requirements. The results indicate the proposed method outperforms traditional algorithms in providing relevant and timely career insights with metrics, such as F1-score (90%), precision (93%), accuracy (95%), and specificity (91%). User satisfaction indicates that technology considerably increases students’ experiences in entrepreneurship and CP. This research contributes to enhancing career outcomes and encouraging an entrepreneurial spirit among university students by providing a practical and effective response to the job issues experienced by students.
Efficacy of Chinese Medicine on Postoperative Rehabilitation of Non-small Cell Lung Cancer (NSCLC), a Randomized Controlled Study
Authors: Gu Yifeng , Wang Yichao , Zhou Huiling , Qi Ao , Wu Guanjin , Li Jiaqi , Zhang Congmeng , Yang Yong , Yao Jialin , Yang Wenxiao , Su Lingzi , Liu Yi , Tian Xueqi , Song Jiajun , Gong Yabin , Qin Xiong , Jiao Lijing , Xu Ling
Published: February 2025

Background:

With an increasing number of non-small cell lung cancer (NSCLC) patients being offered surgical treatment, postoperative rehabilitation is also being increasingly emphasized. Traditional Chinese medicine (TCM) holds promise for enhancing postoperative recovery, with treatment methods still in refinement. This study aims to evaluate the efficacy of Chinese herbal decoction and Liuzijue exercises in NSCLC patients during the rapid postoperative recovery period.

Methods:

A randomized, parallel-group clinical trial assigned 50 patients to receive Chinese herbal medicine and Liuzijue exercise plus symptomatic treatment, and 49 to symptomatic treatment alone. Treatment continued until postoperative complications resolved, chest tubes were removed, and no abnormal examination findings were reported. The primary outcome was Quality of Life Questionnare-Core 30 (QLQ-C30) score. Secondary outcomes included MOS item short form 36-Item Short Form Health Survey (SF-36) score, rate of complications, six-minute walk test (6MWT) distance, Leicester Cough Questionnaire (LCQ) score, numerical rating scale (NRS) score, and functional activity score (FAS).

Results:

Significant improvements in role (MD: 12.15, 95%CI: 2.99-21.32, P < .05) and social functioning (MD: 10.25, 95%CI: 1.72-18.78, P < .05) were observed in the intervention group vs. controls, as measured by QLQ-C30. The intervention group showed better post-treatment SF-36 scores in Role-Physical (RP), Social Function (SF), Role-Emotional (RE), and Mental Health Summary (MCS) ( P < .05). The complication rate was lower in the intervention (20.00%) than the control group (44.44%) ( P < .05). The intervention group also had a significant increase in FAS scores ( P < .05) and covered a better 6MWT distance ( P < .05).

Conclusion:

Chinese herbal decoction and Liuzijue exercises during the rapid recovery period after lung cancer surgery enhanced patients’ QoL and physical endurance, and mitigated complications. Trial registration: This tial was registered with chictr.org.cn (Registration number:ChiCTR2100044776).
Employment situation and the formation of stigmatising attitudes towards people with intellectual disabilities
Authors: Bennett Roger , Vijaygopal Rohini
Published: February 2025

This study questioned whether knowledge of the employment situation of a person with an intellectual disability affected stigmatising attitudes towards that individual among a sample of 507 people who did not have intellectual disabilities. A hypothetical individual with a mild intellectual disability was described as either (i) in paid employment, or (ii) living entirely on state social security benefits. Sample members, none of whom were themselves intellectually disabled, unemployed, or living on social security benefits, completed a questionnaire concerning their attitudes towards the person. Many participants who were informed that a person with an intellectual disability worked for a living exhibited more positive attitudes towards the individual than participants advised that the person relied on welfare. The results suggest the existence of a “welfare slur” among some sample members. The level of an observer’s self-reported social status impacted on the favorability of certain attitudes.
Facial Nerve Palsy Amid the SARS-CoV-2 Pandemic: A Pooled Analysis
Authors: Mirza Ahmad A. , Almalki Abdulaziz H. , Noori Faisal A. , Neazy Sultan A. , Dahm Valerie , Bajin Münir Demir , Lin Vincent Y.
Published: February 2025

Importance

Idiopathic facial nerve palsy (FNP) has devastating sequelae and is potentially linked to coronavirus disease-19 (COVID-19).

Objective

The rate of FNP was compared in the pandemic versus pre-pandemic periods. Furthermore, the risk of FNP was estimated among the COVID-19 vaccinated group.

Design

Systematic review and meta-analysis.

Setting

An electronic search was conducted in 7 databases: Scopus, Web of Science core collection, PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL.

Participants

English observational studies investigating an association between idiopathic FNP and COVID-19 or its vaccination were included, irrespective of patients’ demographics.

Exposures

COVID-19 or COVID-19 vaccine.

Main Outcome Measures

Change in FNP incidence between the pre-pandemic and pandemic periods; risk of developing FNP in individuals vaccinated against COVID-19 compared to those who were unvaccinated against COVID-19.

Results

After excluding duplicates, the search yielded 906 related articles, of which 118 articles were included. The risk of FNP was statistically significantly higher during the COVID-19 pandemic than the pre-pandemic period (RR: 1.68, [95% CI: 1.16-2.43], P = .01). A nonsignificant increase in FNP risk was identified among COVID-19 vaccinated individuals compared to unvaccinated individuals (overall OR: 1.07, [95% CI: 0.85-1.35], P = .55).

Conclusions and Relevance

A remarkable increase in FNP rates was identified during the pandemic compared to pre-pandemic, which seemed unlikely to be attributed to COVID-19 vaccination.
Stitching Theory: An Artful Inquiry of Black Womanhood
Authors: Boylorn Robin M. , Hartley Jameka Y.
Published: February 2025

In this essay, we consider the emancipatory potential and power of creativity that has been passed down intergenerationally between Black women. From foremothers to grandmothers, we reflect on the life-giving and life-sustaining power of Black women’s creativity to highlight how their artistry is an inheritance and means of everyday survival. By focusing on the generative and generational potential of found art, we propose stitching theory as an opportunity to enact artful inquiries of Black women’s lived experience and to capture the pedagogical lessons, warnings, and instructions that Black women model as a praxis of freedom.
Beyond Septic Encephalopathy: A Case Report of Severe RCVS and PRES in a Patient With HLH due to Appendicitis
Authors: Swider Kathryn , Tadevosyan Aleksey , Kunst Mara M. , Burns Joseph D.
Published: February 2025

Background and Objectives: We report a rare case of severe posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) in an adult patient with hemophagocytic lymphohistiocytosis (HLH), and speculate that these three diagnoses are related by similar mechanisms of vascular endothelial dysfunction.

Methods: Informed consent for this case report was obtained from the patient’s legally authorized surrogate decision maker.

Discussion and Practical Implications: Our patient initially presented with HLH secondary to intra-abdominal sepsis, and was later found to have severe PRES and RCVS resulting in extensive border-zone cortex infarction. Improvement of the severe systemic inflammatory syndrome characteristic of HLH and arrest of PRES and RCVS progression occurred only after HLH-specific treatment was initiated. In addition to illustrating the potential of HLH to manifest as PRES and RCVS, this case emphasizes the importance of prompt recognition and treatment of HLH and the role the neurologist can play in this process. This case also sheds light on the pathophysiological links between PRES, RCVS, and HLH. These three diagnoses may be related by similar mechanisms of vascular endothelial dysfunction caused by uncontrolled and severe systemic inflammation.
Visual Emotive Meaning in Conservation Advocacy: An Analysis of WWF’s Public Service Announcements
Authors: Song Xu , A. Bakar Kesumawati
Published: February 2025

World Wildlife Fund (WWF) has developed a diverse range of emotionally-charged print Public Service Announcements (PSAs) to draw the public’s attention to wildlife conservation. These PSAs contain images of powerful visual effects, which can resonate with people’s emotions, and thereafter influence their behaviors. This research seeks to unveil how emotions are delivered by these PSAs. To achieve this aim, 144 multimodal print WWF PSAs on wildlife conservation were selected as the corpus. The visuals are prominent in each PSA, with English serving as the accompanying language. The visual emotive meaning of these PSAs was examined by using Martin and Rose’s appraisal system combined with Painter et al.’s theory. The findings revealed that WWF’s persuasive strategies predominantly revolve around evoking negative emotions through negative attitudes, unmediated perspectives, enlarged graduations, and activated ambiance in the PSAs. The use of contrast and metaphor was also revealed to be powerful tools for enhancing emotion. In general, this research expanded the application of appraisal theory to the interpretation of the emotive meaning of images. Meanwhile, by uncovering the emotive meaning of WWF print PSAs, it also contributes to the study of PSAs. Additionally, the framework of analyzing the emotive meaning of visual images in this research can also be applied to assess visual emotions in other types of advertising, textbook illustrations, cartoons, the visual scenes in videos, as well as conservationists’ visual design.
Wage Effect and Workers’ Skill Mismatch: Paths and Mechanisms
Authors: Zhao Xin , Wu Dan , Wang Lijin
Published: February 2025

Skill mismatch, a manifestation of poor job matching quality, is becoming an essential factor that hinders workers from realizing their productive potential and obtaining reasonable remuneration. This study investigated the internal relation between skill mismatches and wages, including the influencing processes and mechanisms. Findings showed that excessive vertical mismatches and horizontal skill mismatches result in wage losses for workers. Both mismatches affect the final wage level by changing the degree of job negativity. Additionally, excessive vertical skill mismatches mitigate the wage penalty effect by increasing the degree of job control. The possibility of occurrence of both skill mismatch types increases as job competition becomes more intense and job prospects become more promising; taking these factors into account, the degree of wage impact will be weakened. These findings further clarify the relation between skill-matching status and wage return and provide value judgment for increasing workers’ job satisfaction.
All Play and No Work: The Case of Revitalizing Career Perceptions in Canada’s Tourism Industry
Authors: Lever Michael W.
Published: February 2025

This case analyzes the challenges facing the Canadian tourism industry workforce following the COVID-19 pandemic, fueled by perceptions of careers in the tourism industry as temporary, low-wage, and unsatisfactory for long-term prospects. According to Tourism HR Canada, a pan-Canadian organization focused on supporting the recovery and growth of the Canadian tourism industry, these declines have created significant challenges for employers struggling to recruit and retain employees. This case study aims to equip students with the necessary tools to analyze data collected by Tourism HR Canada and its partners to identify Canadians’ perceptions of jobs in the tourism industry and develop actionable recommendations for tourism employers. Students will use this data to uncover patterns in the provided data and compare their findings across different contexts, with the ultimate goal of developing a robust Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis to transform the public’s perceptions and reshape the Canadian tourism workforce.
Inter- and Intrarater Agreement of the AO Spine-DGOU Osteoporotic Fracture Classification System Using Radiography and Computed Tomography Imaging
Authors: Ba-Ali Shakib , Bech Rune Dueholm , Hallager Dennis Winge
Published: February 2025

Study Design

Cross-sectional rater agreement.

Objectives

This study assessed whether inter- and intra-rater agreement for the AO spine-DGOU Osteoporotic Fracture (OF) Classification system differs between classifications based on computed tomography (CT) or radiography.

Methods

Radiography and CT were retrieved for 64 consecutive patients with a single osteoporotic vertebral fracture (OVF) treated at our institution having both imaging modalities performed on the same date. Four spine surgeons independently classified the fractures twice 1 week apart after training on 10 cases. Classifications were based on radiography and CT separately. Crude (%) and Fleiss’ Kappa (k) agreements were calculated for radiography and CT, respectively, and for intrarater agreement between radiography and CT within each rater. The proportion of cases with complete agreement among raters (concordant cases) was compared between radiography and CT using McNemar’s test. Fracture-type distribution differences were analyzed using McNemar’s test as well.

Results

Intra-rater agreement ranged 75%–81% (k = 0.49-0.64) for radiography and 64%–77% (k = 0.42-0.63) for CT. Inter-rater agreement was 56% (k = 0.49) with radiography and 50% (k = 0.51) with CT. No significant difference in the proportion of concordant cases was found between imaging modalities ( P = 0.37). Fractures were classified as higher-order OF types with CT ( P < 0.001).

Conclusions

We found moderate to substantial reliability of the OF system for radiography and CT. Using CT over radiography for classification did not increase the rater agreement. However, fractures are likely to be categorized as a higher-order OF type when the classification is based on CT compared to radiography.
Outcomes After Posterior Cruciate Ligament Reconstruction With Suture Tape Augmentation and an Accelerated Rehabilitation Protocol: A Retrospective Cohort Study
Authors: Paroneto Arthur Cardoso , Gomes Pedro Soneghet , Carrijo Paulo Vitor , Cohen Moises , Ramos Leonardo Addeo
Published: February 2025

Background:

Although posterior cruciate ligament (PCL) reconstruction is often performed for grade 3 PCL injuries, the effectiveness of different surgical techniques and rehabilitation protocols is a topic of debate.

Purpose/Hypothesis:

The purpose of this study was to evaluate and compare functional outcomes and residual instability in patients who underwent PCL reconstruction with versus without suture tape augmentation. It was hypothesized was that adding high-resistance suture tape to PCL reconstruction would improve functional scores and reduce postoperative laxity.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 48 patients were included in the study; all patients underwent PCL reconstruction with an autologous quadriceps tendon graft and had a minimum follow-up of 2 years. Overall, 23 patients were treated with a graft only, while 25 were treated with a graft and suture tape. Patients in the suture tape augmentation group also underwent an accelerated rehabilitation program with earlier range of motion and weightbearing. Patient characteristics, Lysholm scores, posterior tibial laxity on stress radiographs at 90° of knee flexion, and postoperative complications were compared between treatment groups.

Results:

No statistically significant differences were found between groups in terms of patient characteristics. Similar results were seen in both groups in terms of postoperative complications. Furthermore, on average, the Lysholm score increased from 1- to 2-year follow-up by 6.99 points (standard error = 0.97 points; P < .001), indicating progressive functional improvement, and posterior tibial laxity decreased from preoperatively to postoperatively by 7.55 mm (standard error = 0.24 mm; P < .001), indicating an improvement in knee stability. Patients in both treatment groups saw significant improvements during the follow-up period in the Lysholm score and posterior tibial laxity ( P < .001 for both).

Conclusion:

PCL reconstruction with suture tape augmentation and an accelerated rehabilitation protocol did not result in significantly improved functional scores or postoperative laxity compared with isolated PCL reconstruction. The results showed no disadvantage of a more aggressive rehabilitation protocol.
Cam Morphology and Sex-Based Differences in the Proximal Femur Anatomy of Collegiate Athletes Without Hip Pain: A 3-Dimensional Statistical Shape Modeling Analysis
Authors: Braun Bergen , Mozingo Joseph D. , Atkins Penny R. , Foreman K. Bo , Metz Allan K. , Aoki Stephen K. , Maak Travis G. , Anderson Andrew E.
Published: February 2025

Background:

Radiographic studies have reported a high prevalence of cam morphology in athletes, especially in male athletes, suggesting these individuals are at an elevated risk of developing femoroacetabular impingement syndrome (FAIS). However, recent research has shown that 2-dimensional measurements do not accurately characterize cam deformities, motivating the need for 3-dimensional (3D) analyses.

Purpose:

To develop a 3D statistical shape model of the proximal femur to evaluate cam morphology in collegiate athletes through (1) quantifying shape variation, (2) establishing sex-based shape differences, and (3) comparing shapes between male athletes and male cam FAIS patients.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Double-echo steady-state magnetic resonance images were prospectively acquired of the hips of Division I collegiate athletes (28 male, 23 female). An existing data set of computed tomography scans of cam FAIS patients (26 male) and morphologically screened controls (30 male, 17 female) was also evaluated. The proximal femur was segmented, reconstructed into a 3D surface, and analyzed to generate a correspondence model using ShapeWorks. Principal component analysis, parallel analysis, and linear discriminant analysis quantified variation in proximal femoral shape.

Results:

Variation in the full cohort primarily occurred in the head-neck junction, femoral offset, and location of the greater trochanter relative to the head/neck (mode VIII, adjusted P = .01; modes I and IV, adjusted P = .002 and adjusted P = .003, respectively; modes IV and VIII, adjusted P = .0003 and adjusted P = .0007, resepctively. P < .001). Modes represented anatomic variation significantly different between pairs within a group. Variation between male and female athletes occurred in the concavity of the head at the head-neck junction, length of the femur, and length of the femoral offset (modes I and II, adjusted P = .006 and adjusted P = .009, respectively). Variation between male athletes and male patients and between male patients and male controls occurred in the concavity of the head at the head-neck junction and femoral torsion (mode IV, adjusted P = .02 and adjusted P = .003, respectively). Shape scores, which represented a generalized value of the entire shape, were significantly different between athletes and patients (adjusted P = .003) and patients and controls (adjusted P < .0001).

Conclusion:

Athletes in our study had a proximal femur shape more similar to morphologically screened controls than FAIS patients. Sex-based differences occurred in athletes in regions where cam morphology typically occurs.
Awareness and Attitudes of Medical Students, Interns, and Residents Toward Telemedicine in Medical Education During the COVID-19 Pandemic: Survey-Based Cross-Sectional Study From Northern Iran
Authors: Sharififar Rahmat Allah , Mazandarani Mahdi , Lashkarbolouk Narges , Ghorbani Somayeh
Published: February 2025

BACKGROUND

Telemedicine is widely used in medical treatment and education systems. Therefore, it is essential to investigate the attitudes and awareness of medical students about it. We aimed to examine the awareness and attitudes of medical students, interns and residents toward telemedicine in medical education during the COVID-19 pandemic.

METHOD

This cross-sectional study was conducted after new educational approaches were implemented due to the COVID-19 pandemic. Two questionnaires were used to assess the new educational methodologies. Participants included residents (R), interns (I), and students (S) from the internal medicine department. A census sampling method was employed, inviting all medical education members who met the entry criteria to participate. The data were analyzed descriptively, and group differences were tested using chi-square, independent samples T-test, Mann–Whitney, and Kruskal–Wallis tests.

RESULT

Out of 278 medical education members eligible to participate, 249 (89.5%) completed the study. The mean score for participants’ attitudes was above 3 ( M = 3.78, SD = 0.24) indicating a generally favorable view of telemedicine. A significant gap was noted between participants’ awareness and attitudes, with residents showing the lowest scores in both areas ( P-value = .02). Our assessment revealed that “Satisfaction with the platform and facilities for e-classes” received the highest consensus from residents and interns, rated moderately agreeable by students (R: 64.5%, I: 59.7%, S: 48.8%). Responses to “Using e-learning courses alongside postcrisis face-to-face courses” and “Using e-learning courses alone postcrisis” varied among the groups (R: 58.1% and 54.9%, I: 59% and 58.2%, S: 47.6% and 45.3%).

CONCLUSION

The results of this survey reveal that medical students and interns may demonstrate a favorable awareness and attitude toward telemedicine. Consequently, developing educational programs and enhancing exposure to telemedicine should be considered since these elements could be vital for the future training of medical professionals.
“Just because we speak with an accent does not mean we think with one”: Immigrant and Refugee Leadership Experiences in Human Services
Authors: Kirsch Jaclyn , Maleku Arati , Padilla Yesenia Alvarez , Haran Hanna , Raut Shambika
Published: February 2025

Immigrants and refugees resettling in the United States face persistent challenges to integration which are often filled by community-based ethnic organisations (CBEOs) and their leaders, who are often immigrants and refugees themselves. There is a dearth of research on how these CBEO leaders make meaning of their leadership role based on their lived experiences and intersecting identities. Seven purposively selected immigrant and refugee CBEO leaders were interviewed to expand our understanding of the impact of immigrant and refugee positionalities on philosophies of leadership, contextual human services conditions that impact diverse perspectives and construction of leadership diversity in the human services environment. Four salient themes emerged: (a) leadership on our terms: building bridges through collective action and empowerment; (b) the honour of serving immigrant and refugees communities; (c) intersection of multisystem challenges on immigrant and refugee leadership functioning and (d) reimagining CBEOs: aspirations of immigrant and refugee leadership. The analysis has implications for the functioning of human services organisations and their leaders.
“Don’t leave us behind”: a qualitative study exploring the feasibility of a palliative care training program for non-health caregivers in Honduras
Authors: Ruiz Sheryl , Stafström Martin , Parham Leda , Orellana Luis
Published: February 2025

Background:

Palliative care (PC) can alleviate suffering and improve quality of life. Yet, disparities persist, particularly in Honduras. Training efforts in PC for non-health caregivers have proven to reduce burnout and stress while enhancing the quality of life for both caregivers and patients.

Purpose:

This study aimed to explore the feasibility of a PC training program for non-health caregivers in Honduras.

Methods:

This exploratory study utilized latent content analysis within an interpretivist paradigm. Data was collected through individual semi-structured interviews with 25 participants belonging to different key groups: patients diagnosed with cancer, non-health caregivers, PC experts, and health-related decision makers. Interviews were conducted in Honduras’ three main cities: Tegucigalpa, San Pedro Sula, and La Ceiba. The sampling technique employed was maximum variation.

Results:

PC patients and caregivers face significant emotional challenges, often worsened by poverty and resource limitations, which leads to a strain in family dynamics. A lack of education, driven by inadequate healthcare education and policies, contributes to widespread misconceptions about PC. However, progress through various sectors aligned with the same goals proves Honduras is a country with potential. A program with a bottom-up approach, with intersectoral collaboration and training tailored to the needs of caregivers and patients, is urgently needed.

Conclusion:

It highlights the feasibility, necessity, and potential replicability of implementing a PC training program for non-health caregivers in Honduras, which could offer significant benefits at both individual and national levels. A program that truly accounts for health determinants may help mitigate PC shortages in similar regions. Further research and policy advocacy are essential to empower underserved populations and foster health equity across low- and middle-income settings, to ensure no one is left behind.
Blue carbon cycling in the coastal areas of Qatar
Authors: Strakhov Ivan , Elsayed Hadil , DiLoreto Zach A. , Avetisyan Khoren , Al Disi Zulfa Ali , Naja Khaled , Al-Kuwari Hamad A. S. , Sadooni Fadhil N. , Alkhayat Jassim , Dittrich Maria
Published: February 2025

Coastal wetland sediments are vital to the global carbon cycle as they represent large sinks of blue carbon – carbon from atmospheric and oceanic sources – which are threatened by ecosystem loss. The forms of sequestered carbon and the sequestration capability are affected by many bio- and geochemical factors that change unpredictably along coastal locales. In the present study, we investigated three unique coastal sites – a coastal mangrove and two sabkhas with contrasting geology and tidal influence in the Qatar peninsula – for their carbon capture ability to determine how biogeochemical indices affect their blue carbon sequestration potential. We applied a suite of biological and geochemical tools, collecting the sediment cores of approximately 40 cm depth; analysed sediment porewater; performed depth-profiling of the organic matter, sedimentary minerals, microbial community and analysis of sediment surface for pH, oxygen (O2); redox potential and hydrogen sulfide (H2S) by microsensors. High-resolution transmission electron microscopy with energy-dispersive X-ray spectroscopy (TEM-EDXS) and scanning transmission X-ray microscopy (STXM) revealed templating effects that promoted Mg-carbonate nucleation in coastal hypersaline environments. Microsensing reveals the intricacy of the oxic/anoxic transition at the sediment surface. Microbial DNA sequencing at various sediment depths shows the occurrence of microbial genera, whose functions explain the geochemical trends and carbon sequestration pathways observed at each site. Notably, we found that carbon sequestration in the mangrove and carbonate-sand sabkha was correlated with organic matter degradation and inorganic carbon content, while in the siliciclastic sabkha it was solely influenced by sediment density and depth.
The JAK2 46/1 haplotype influences PD-L1 expression.
Authors: Carreño-Tarragona Gonzalo , Tiana Maria , Rouco Raquel , Leivas Alejandra , Victorino Jesús , Garcia-Vicente Roberto , Chase Andrew J , Maidana Andrea , Tapper William J , Ayala Rosa , Cross Nicholas C.P. , Martínez-López Joaquín , Manzanares Miguel
Published: February 2025

Although described more than a decade ago, the mechanism by which the JAK2 46/1 haplotype increases the risk of developing JAK2-mutated myeloproliferative neoplasms (MPN) remains unexplained. Inflammation and immunity are linked to MPN development and thus could be relevant to the mechanism by which 46/1 mediates its effect. Here, we show that PD-L1 expression is elevated in 46/1 haplotype both in healthy carriers and CD34+ cells from MPN patients. Using circular chromosome conformation capture (4C-seq) we observed that PD-L1 and the neighboring PD-L2 loci physically interact with JAK2 in a manner that differs between 46/1 and non-risk haplotypes. CRISPR/Cas9 genome editing identified a region within JAK2 intron 2 that influences both JAK2 and PD-L1 expression. We suggest that increased PD-L1 expression may be relevant to the mechanism by which 46/1 leads to an increased inherited risk of developing MPN.
Osteoperiosteal versus osteochondral for autologous transplantation in the treatment of large cystic osteochondral lesions of the talus
Authors: Liu Lequan , Jin Jiangtao , Pan Jinping , Guo Huikang , Li Sen , Li Jisheng , Zhang Zheng
Published: February 2025

Background

Osteochondral lesions of the talus (OLTs) with a large subchondral cyst have been shown to have inferior clinical outcomes after reparative techniques. Replacement techniques such as autologous osteoperiosteal transplantation (AOPT) and autologous osteochondral transplantation (AOCT) are indicated for large lesions. The aim of the study was to compare the short-term clinical and radiographic outcomes between patients undergoing AOPT and those undergoing AOCT for large cystic OLTs.

Methods

Patients who underwent AOPT or AOCT for medial large cystic OLTs between May 2019 and June 2023 were retrospectively evaluated. According to their characteristics, 1:1 propensity‐score matching was performed, and 65 pairs of patients with ages ranging from 18 to 60 years old were recruited. Clinical outcomes were compared between both groups with the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS). The Ankle Activity Score (AAS), time to return to sports activity (RTA), rate of return to sports level, complications, and results of a subjective evaluation were also collected. The integrity of subchondral bone and the quality of repaired cartilage were evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score 12 months postoperatively. Second-look arthroscopy was performed 12 months postoperatively, and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society (ICRS).

Results

The within-group comparison showed significant improvements in pain severity and function in both groups post-treatment compared with pre-treatment. Between-group analysis, however, showed no significant statistical difference between groups in any of the variables for clinical and radiographic outcomes, except for donor-site morbidity of the AOPT group, which showed a better outcome compared to the AOCT group.

Conclusions

In the treatment of large cystic OLTs, for patients with a chondral lesion of the patellofemoral joint that is unsuitable for AOCT, AOPT may be a safe and effective choice, with lower donor-site morbidity of the normal knee joint.
Genomic patterns of strain-specific genetic structure, linkage, and selection across fall armyworm populations
Authors: Tessnow Ashley E. , Nagoshi Rodney N. , Meagher Robert L. , Gilligan Todd M. , Sadd Ben M. , Carrière Yves , Davis Holly N. , Fleischer Shelby J. , Richers Kelly , Palumbo John C. , Porter Patrick , Verle Rodrigues Jose Carlos , Sword Gregory A.
Published: February 2025

Background

Molecular genetic approaches have become vital to understanding the evolutionary processes that act on insect pest populations. From mapping the development of resistance to monitoring and predicting pest movement, genomic tools can inform and enhance pest management programs. Here, we used whole genome sequencing population genomics to unravel novel patterns of population structure, linkage, and selection across the genome of a notorious agricultural pest, the fall armyworm.

Results

Our data strongly support the existence of two genetically distinct strains of fall armyworm in North America, which have previously been referred to as the C-strain and the R-strain. Although these strains have diverged genetically, we find that differentiation is not uniform across the genome. The Z-chromosome appears to drive divergence between strains with high levels of linkage observed across this chromosome. We also show that a region of the Z-chromosome containing a circadian clock gene implicated in allochronic reproductive isolation is under strain-specific selection. Our data indicates that strains differ in their geographic distributions and exhibit distinct patterns of geographic sub-structuring indicative of unique dispersal patterns. We provide the first evidence for nuclear genomic differentiation between the two major overwintering populations of fall armyworm in the US. Finally, our data reveal population-specific patterns of selection on genomic regions containing putative insecticide resistance alleles, which could relate to their biogeography.

Conclusions

Our results support the existence of the fall armyworm as a pest dyad in the US, with genetically-distinct strains differing in their population structure, dispersal patterns, and genomic signatures of selection on regions likely involved reproductive isolation and insecticide resistance. These differences should be considered when devising and implementing management strategies.