bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting Board Independence Mandates: Evidence from Director Reclassifications
Authors: Bowen Donald E , Taillard Jérôme P 
Published: February 2025

Abstract
We provide causal evidence on the effects of mandated board independence. We compare firms that replace existing non-independent directors to firms that retain these directors by reclassifying them as independent. Reclassification eligibility, being largely predetermined, offers quasi-exogenous variation in compliance strategies. We show that firms required to replace insiders perform worse post-mandate, driven by increased operational costs and reduced labor efficiency. Boards of non-reclassifying firms retain fewer former employees and replace them with directors more likely to join monitoring-focused committees, emphasizing the shift from advising to monitoring. Overall, these findings suggest that firm-specific director expertise contributes materially to performance and is consistent with pre-mandate board compositions optimized to balance benefits of enhanced monitoring against costs of reduced advisory capacity. We rule out alternative explanations, including adjustment costs due to director turnover and co-option. Our study underscores the importance of allowing firms flexibility in governance structures and cautions against uniform mandates.
Self-settlement and the Challenges of Local Integration of Syrians in the Absence of Government Support
Authors: Karaoğlu Ezgi , Nawyn Stephanie J 
Published: February 2025

Abstract
Refugees’ opportunities for third-country resettlement have always been limited, but in recent years resettlement opportunities have become scarce. Syrians who sought protection in Türkiye initially expected to either return to Syria or be resettled within several years, but now acknowledge that they must remain in Türkiye. The Turkish government provides humanitarian assistance for registered Syrian refugees who need their basic needs met, but virtually no government programmes address the needs of middle-class Syrians. This article examines the experiences of middle-class Syrians in their efforts to establish settled lives in Istanbul now that resettlement programmes for Syrians in the country have ended. They navigated numerous daily and routine challenges related to identity, language acquisition, residential choices, and entitlement to citizenship. They did all this without support or guidance from formal government policies, pursuing one of two paths. One path involved becoming an expat, still foreign but more elite than a refugee. The other involved becoming “like a Turk” and included more engagement with the host community. These findings offer insights into the complex processes of belonging, visibility, and the interplay of identities within an urban context, and highlight the challenges refugees face when governments fail to support resettlement or local integration.
Bleeding management of thoracic trauma
Authors: Werner Marie , Bergis Benjamin , Duranteau Jacques 
Published: February 2025

Purpose of review
Thoracic injuries are directly responsible for 20–30% of deaths in severe trauma patients and represent one of the main regions involved in preventable or potentially preventable deaths. Controlling bleeding in thoracic trauma is a major challenge because intrathoracic hemorrhagic lesions can lead to hemodynamic instability and respiratory failure.

Recent findings
The aim of managing intrathoracic hemorrhagic lesions is to control bleeding as quickly as possible and to control any respiratory distress. Extended focus assessment with sonography for trauma enables us to identify intrathoracic bleeding much more quickly and to determine the most appropriate therapeutic strategy.

Summary
Thoracic bleeding can result from the diaphragm, intrathoracic vessels (aorta, but also inferior or superior vena cava, and suprahepatic veins), lung, cardiac, or chest wall injuries. Depending on thoracic lesions (such as hemothorax or hemopericardium), hemodynamic instability, and respiratory failure, a pericardial window approach, sternotomy, thoracotomy, or emergency resuscitation thoracotomy may be considered after discussion with the surgeon. Alongside treatment of injuries, managing oxygenation, ventilation, hemodynamic, and coagulopathy are essential for the patient’s outcome.
Nail Plafond Angle: A Novel Technique to Evaluate for Intraoperative Coronal Malalignment in Tibia Fractures
Authors: Jodoin Zachary , Koslosky Ezekial , Williamson Tyler , Karia Ravi , Hand Thomas 
Published: February 2025

Objective:
Orthopedic management of distal tibia fractures presents a difficult challenge with high rates of malignment. Intramedullary nailing demonstrates coronal malalignment rates of 5% to 30%. This malignment has been associated with decreased satisfaction with outcomes. This stresses the importance of obtaining appropriate intraoperative nail alignment. This article helps address the rate of coronal plane malreduction during intramedullary nailing of distal tibial shaft fractures. This novel fluoroscopic technique analyzes the intraoperative angle between the distal end of the tibial nail and the tibial plafond [the nail plafond angle (NPA)].

Materials and Methods:
Retrospective review study of 100 subjects with distal tibia fractures at a single level 1 trauma center. Coronal nail alignment was measured on intraoperative fluoroscopic films utilizing the NPA. This measurement was then compared with full-length film alignment postoperatively analyzing for overall malreduction and correlation between the measurements. All measurements were completed by at least 2 orthopedic trained physicians.

Results:
Coronal alignment was compared, and there was a strong correlation between the measured varus and valgus angulation using the intraoperative technique and the full-length postoperative films (R = 0.74). The overall coronal malalignment while utilizing the NPA technique was 8% (8/100 patients).

Discussion:
The overall malalignment utilizing the NPA intraoperatively was 8%, which is substantially lower than the generally accepted literature malreduction rate of distal tibia fractures treated with intramedullary fixation. This novel technique could be added to the armamentarium of tools to assist in preventing the malreduction of distal tibia shaft fractures.
Awakening the Spiritual Identity in Adolescents With Cancer
Authors: Alshakhshir Nadeen Sami , Hendricks-Ferguson Verna L. , Ward Earlise , Ersig Anne L. , Montgomery Kathleen E. 
Published: February 2025

Background
Awakening the spiritual identity in adolescents with cancer is a phenomenon that has not been fully explored. Nevertheless, empirical research shows that spirituality is associated with positive health outcomes for adolescents with cancer. This finding indicates that awakening the spiritual identity can serve as a coping mechanism in health contexts.

Objective
In this study, we (1) describe the essential structure of the process of awakening the spiritual identity as experienced and perceived by adolescents with cancer and (2) explore factors that facilitate or hinder the process.

Methods
We used a qualitative empirical phenomenological approach to explore the process of awakening the spiritual identity of adolescents with cancer. Ten adolescents completed a graphing-timeline activity and participated in semistructured interviews. We analyzed the data with an adapted version of Colaizzi’s method.

Results
Regarding the process of awakening the spiritual identity, we identified 4 theme categories corresponding to 12 themes. The essential structure of the process is cyclical and ongoing: once a triggering moment initiates the awakening, adolescents navigate it through connectedness with the transcendent while drawing strength from preexisting spiritual foundations and family.

Conclusions
We reveal the essential structure of the process of awakening the spiritual identity among adolescents with cancer and highlight factors affecting the process.

Implications for Practice
Expanding our understanding of the phenomenon of awakening the spiritual identity among adolescents may support nurses in addressing and fostering adolescents’ use of spirituality as a coping mechanism during cancer treatment.
Impact of oral sensory function including proprioception on swallowing in patients with stroke
Authors: Park So-Hyun , Ham Dae-Hoon , Shin Joon-Ho 
Published: February 2025

Abstract

Objective
To assess oral sensory deficits and their correlation with mastication and swallowing in patients with stroke.

Design
This prospective observational study was conducted in the stroke unit of a rehabilitation hospital. The inclusion criterion was first occurrence of stroke with a unilateral lesion. Patients underwent oral sensory tests, including tactile sensation (light touch, two-point discrimination) and proprioception, along with mastication and swallowing assessments via videofluoroscopic swallowing study (VFSS) and Test of Masticating and Swallowing Solids (TOMASS).

Results
Among 36 patients, contralesional sides exhibited reduced oral sensory function (light touch, two-point discrimination, and proprioception of lips) compared with ipsilesional sides (p = 0.003, p = 0.001, p = 0.046, respectively). Oral proprioception was negatively correlated with mastication and swallowing. Proprioception of tongue showed negative correlation with mastication (p = 0.035), while combined value of proprioception of teeth, lip, and tongue showed negative correlation with time per swallow. Contralesional light touch and two-point discrimination influenced swallow items in TOMASS and pharyngeal phase items in VFSS.

Conclusion
Patients with stroke demonstrated contralesional oral sensory deficits, which were associated with impaired mastication and swallowing. Oral proprioception was correlated with mastication and swallowing, whereas tactile sensation correlated with the pharyngeal phase.
Measuring adult mortality from mobile phone surveys in Burkina Faso, Malawi and the Democratic Republic of the Congo
Authors: Dianou Kassoum , Masquelier Bruno , Luhar Shammi , Lankoandé Bruno , Oren Ashira Menashe , Soura Abdramane , Bassinga Hervé , Tlhajoane Malebogo , Dulani Boniface , Akilimali Pierre , Reniers Georges 
Published: February 2025

AbstractIn many low and middle-income countries, adult mortality estimates are derived from surveys and censuses conducted through face-to-face interviews. These interviews can be time-intensive and are often impractical during health crises or humanitarian emergencies. The expansion in cellphone ownership and network coverage has created new opportunities for collecting demographic data through mobile phone surveys, but our understanding of selection biases and reporting errors of such data remains incomplete. This study reports on adult mortality estimates obtained through mobile phone surveys conducted in Burkina Faso, Malawi, and the Democratic Republic of the Congo in 2021 and 2022. To mitigate respondent fatigue and network interruptions, we used a shortened version of the set of questions generally used in surveys to ask about the survival of respondents’ siblings. We found substantial differences between mortality estimates obtained from mobile phone interviews and those from face-to-face demographic surveys. Mortality rates from the mobile phone surveys were also approximately half those expected from United Nations estimates. We attribute this underestimation to inaccuracies in reporting of ages and the timing of sibling deaths in the shortened sibling instrument. After imputing ages and dates based on full sibling histories collected in previous face-to-face surveys, mortality rates were more consistent with other data sources. Mobile phone surveys are promising for the measurement of adult mortality in settings where face-to-face surveys are hindered, but they are susceptible to reporting errors. More research is needed on the best set of questions to use for capturing recent adult deaths.
Exploration of the Social Determinants of Diarrhoea, Rotavirus Vaccine Uptake, and Vaccine ‘Fatigue’ in Ethiopia, Kenya, and Malawi
Authors: Phiri Mackwellings , Osman Rahma , Weldegebriel Shewit , Sabola Steven , Ongadi Beatrice , Beavis Catherine , Mwendera Chikondi , Nyirenda Deborah ,   GHRG-GI Consortium
Published: February 2025

AbstractDiarrhoea due to rotavirus remains a significant cause of child mortality in developing regions. Caregivers’ perspectives on the social determinants of gastroenteritis and childhood vaccination, including the rotavirus vaccine, were explored through focus group discussions in Ethiopia (n=6), Kenya (n=14), and Malawi (n=10), using a combination of thematic and framework analysis approaches. The results show that diarrhoea was perceived to be a burden in all three countries, particularly among infants, due to challenges in WASH (water, sanitation, and hygiene) infrastructures and poverty. Prevention strategies mentioned by the caregivers focussed on enhancing WASH interventions without mention of vaccination. Participants however expressed a lack of agency to address WASH at community level in informal settlements where the studies were conducted. Antibiotics were seen as “strong medications” and often purchased without prescription for treatment of diarrhoea, raising concerns on Anti-Microbial Resistance (AMR), while home remedies such as rice porridge were used for less severe diarrhoea symptoms. Perceived or experiential benefits and safety of previous vaccines promoted vaccine uptake in all three countries. On the other hand, limited understanding of vaccines, concerns about side effects, perceived excessive vaccination, mistrust of vaccines or suspicions of existing vaccines undermined individuals’ willingness to vaccinate children. Our results highlight that a lack of attention to socio-determinants of poor health in contexts where there are several vaccines and yet a high incidence of vaccine-preventable diseases may undermine vaccine confidence. Multi-sectoral interventions to tackle social determinants of diarrhoea and improve community understanding of vaccines are required to improve overall community health outcomes.
Data-Driven Insights on Opioid Use and Health Behavior Trends Following Decriminalization: Zero-Shot Sentiment and Behavior Analysis
Authors: Moridani Sepehr Harfi , Yang Chan Pang , Noaeen Mohammad , Shakeri Zahra 
Published: February 2025

AbstractOpioid decriminalization has taken on renewed urgency in regions grappling with high mortality and health-care costs. Traditional assessments often focus on legal or epidemiological data, leaving gaps in understanding how the public actually perceives and reacts to such policies. This paper introduces an AI-driven approach that applies Mistral, a Large Language Model (LLM), to a corpus of over 22,000 Reddit comments discussing British Columbia’s decriminalization policy. Our method uses zero-shot classification to track shifts in sentiment and self-reported behaviors related to opioid use and harm reduction. The findings suggest that online conversations initially reflected optimism about reduced stigma and broader acceptance of harm reduction measures, but sentiment became more mixed as policy details and lived experiences surfaced. This pattern indicates that advanced LLM-based text analysis can yield deep insights into the evolving public narrative on health interventions, informing future policymaking and healthcare strategies.
Leveraging Large-Scale Biobanks for Therapeutic Target Discovery
Authors: Ferolito Brian R , Dashti Hesam , Giambartolomei Claudia , Peloso Gina M , Golden Daniel J , Gravel-Pucillo Kai , Rasooly Danielle , Horimoto Andrea RVR , Matty Rachael , Gaziano Liam , Liu Yi , Smit Ines A , Zdrazil Barbara , Tsepilov Yakov , Costa Lauren , Kosik Nicole , Huffman Jennifer E , Tartaglia Gian Gaetano , Bini Giorgio , Proietti Gabriele , Ioannidis Harris , Hunter Fiona , Hemani Gibran , Butterworth Adam S , Di Angelantonio Emanuele , Langenberg Claudia , Ghoussaini Maya , Leach Andrew R , Liao Katherine P , Damrauer Scott , Selva Luis E , Whitbourne Stacey , Tsao Philip S , Moser Jennifer , Gaunt Tom , Cai Tianxi , Whittaker John C , Program Million Veteran , Casas Juan P , Muralidhar Sumitra , Gaziano J Michael , Cho Kelly , Pereira Alexandre C 
Published: February 2025

AbstractLarge biobanks, including the Million Veteran Program (MVP), the UK Biobank, and FinnGen, provide genetic association results for more than 1,000,000 individuals for hundreds of phenotypes. To select targets for pharmaceutical development, as well as to improve the understanding of existing targets, we harmonized these studies, and performed two-sample Mendelian Randomization (MR) on 2,003 phenotypes using genetic variants associated with gene expression (derived from GTEx and eQTLGen) and plasma protein levels (derived from ARIC, Fenland, and DeCODE) as proxies of target modulation. We found 69,669 gene-trait pairs with evidence (p ≤ 1.6 x 10-9) for causal effects. From the selected gene-trait pairs, we observed 6,447 genes with strong causal evidence for at least one of 2,003 investigated traits. As expected, being identified as a gene-trait pair in our approach was significantly associated with higher odds of being an approved drug target and indication. We were able to rediscover 9% of approved drug targets in ChEMBL 34. Moreover, identified gene-traits were significantly associated with higher odds of being previously described as a gene-trait pair in OMIM, ClinVar, mouse knock-out data, and rare variant burden studies. To enhance the translational potential of the resource, we developed a predictive ranking model trained using approved drug targets described in ChEMBL 34 as well as several different biological annotations. This model was able to accurately predict the odds of a particular significant MR result being developed into an approved drug and its clinical indication (precision-recall AUC 0.79). We make our results publicly available inCIPHER.
Large language model-assisted causal machine learning for identifying fatigue-related poor glycated hemoglobin in type 2 diabetes
Authors: Sufriyana Herdiantri , Romadlon Debby Syahru , Kurniawan Rudy , Al Baqi Safiruddin , Ekpor Emmanuel , Osei Eric Peprah , Chiu Hsiao-Yean , Su Emily Chia-Yu 
Published: February 2025

AbstractBackgroundFatigue is common but mostly untreated in type 2 diabetes, since it requires a diagnostic workup which is hardly justified by fatigue alone. Individually identifying fatigue-related cause help decide effective follow-up and prioritize resource utilization. This study aimed to determine whether glycated hemoglobin (HbA1c) level contributes to fatigue for each individual case using a fatigue prediction model based on large language model (LLM)-assisted structural causal modeling (SCM).MethodsRetrospective cohort design was applied to collect data from diabetes management centers in Indonesia. We conducted SCM to select predictors among HbA1c and other variables for fatigue predictive modeling. Causal diagram was constructed by inferring the causal direction for each pair of correlated variables via LLM, i.e., GPT-4. The models were trained using eight machine learning (ML) algorithms. The best one was selected among the models that fulfilled sufficient sample size, was well-calibrated, and had positive net benefit using threshold closest to 95% specificity in our data. We chose the best model based on the area under curve (AUC) of receiver operating characteristics (ROC) and the concordance between the feature impact on model output based on the beeswarm plot of the Shapley additive explanation (SHAP) values and the effect size based on SCM. The SHAP waterfall plot was utilized to quantify HbA1c contribution to fatigue for each individual case.ResultsIndividuals with type 2 diabetes receiving OHA last 3 months (n=281) were more likely to report fatigue when they had poor HbA1c (adjusted odds ratio [aOR]=6.1, 95% CI 2.5, 14.4), comorbidity (aOR=25.2, 95% CI 12.1, 52.4), or a need for insulin treatment (aOR=3.6, 95% CI 2.0, 6.4). The best model used random forest algorithm (AUC-ROC=0.966, 95% CI 0.962, 0.969). Fatigue-related poor HbA1c could be individually identified among 95.1% (95% CI 94.5, 95.7) of those who reported fatigue.ConclusionsWe have developed a web application and nomogram for identifying fatigue-related poor HbA1c for each individual case. Future studies are warranted for external validation and randomized trials to examined the validity and impact of the cause identifier of fatigue in this study.
Glucose, insulin, and brain health in the UK Biobank: A Mendelian randomisation study
Authors: Garfield Victoria , Fatih Nasri , Rentsch Christopher T. , Smeeth Liam , Bhaskaran Krishnan , Chaturvedi Nish 
Published: February 2025

AbstractPrevious research suggests that HbA1cand diabetes are unlikely to be causally related to brain health and dementia outcomes. With the availability of better genetic instruments for additional glycaemic-related markers (i.e., insulin resistance (IR), fasting glucose (FPG), fasting insulin (FI) and 2hr post-glucose (2hPG), there is scope to more thoroughly examine how diabetes-related mechanisms are causally related to specific neuroimaging brain health outcomes, and/or all-cause dementia and/or Alzheimer’s dementia (AD). Data were from the UK Biobank (maxn= 349,288) with our sample consisting of an average age of 56 years (54% women). We constructed genetic instruments for 2hPG (15 variants), FPG (109 variants), FI (48 variants) and examined their relationships with neuroimaging outcomes such as total brain volume (TBV), hippocampal volume (HV), white matter hyperintensity volume (WMHV), Alzheimer’s dementia (AD) and all-cause dementia. We ran a two-sample MR and used conventional inverse-variance–weighted (IVW), weighted median estimator (WME), as well as MR-Egger intercept for horizontal pleiotropy. We found an association between 2hPG and higher risk of AD in both the IWV (OR: 1.49 [1.17, 1.90]) and WME (OR: 1.54 [1.12, 2.10]) models. However, we did not find that this association replicated in the International Genomics of Alzheimer’s Project (IGAP) data. We also observed an association between higher FI and higher TBV (β 15.25 (3.43, 27.07) in the IVW model. MR analyses of FPG and 2hPG with volumetric brain measures showed no evidence of a causal relationship with TBV, WMHV or hippocampal volume. These findings provide interesting results in how diabetes-related markers are causally related to brain health albeit the precise mechanisms through which postprandial hyperglycaemia increases AD risk and higher insulin preserves brain volumes warrant further research.