bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Scintigraphy Prediction of Postoperative Femoral Head Avascular Necrosis in Children With Hip Trauma and Slipped Capital Femoral Epiphysis
Authors: Grewal Rajvarun S. , Hollnagel Katharine F. , Curran Patrick F. , Bomar James D. , Upasani Vidyadhar V. 
Published: January 2025

Background:
Femoral head avascular necrosis (AVN) is a devastating complication that can occur in the setting of trauma to the pediatric hip. Bone scintigraphy (BoS) can be used to evaluate femoral head perfusion, but current evidence in support of its use in the pediatric population is lacking. The purpose of this study was to evaluate the sensitivity and specificity of BoS to diagnose femoral head AVN in children.

Methods:
We retrospectively reviewed patients who underwent BoS to assess femoral head perfusion following treatment of traumatic femoral neck fracture, hip dislocation, or SCFE at a single pediatric hospital. All patients had a minimum radiographic follow-up of 1 year. Assessment of intraoperative femoral head perfusion was also recorded if performed. Results of BoS and intra-op assessments were compared with RAVN (radiographic findings of AVN) at final follow-up.

Results:
Forty-eight hips were included, and 75% were male. The mean age at the time of surgery was 12.5±1.6 years. The mean age at BoS was 12.7±1.7 years. The mean follow-up was 23.3±13.1 months. RAVN developed in 15% (7/48) of hips. Nine hips had an abnormal BoS: 7 hips had absent perfusion and 2 hips had diminished perfusion. All 7 hips with absent perfusion on BoS went on to develop RAVN with collapse. Neither hip with diminished perfusion on BoS went on to femoral head collapse. No hip with normal BoS developed radiographic evidence of AVN at the final follow-up. BoS demonstrating absent perfusion had a sensitivity of 100% and a specificity of 95% in predicting RAVN. Evidence of femoral head perfusion at the time of surgery (drilling or IOP) had a sensitivity of 17% and a specificity of 80% in predicting RAVN.

Conclusions:
BoS demonstrates high sensitivity and specificity for predicting postoperative RAVN. Clinicians should have increased suspicion of impending femoral head collapse if there is absent perfusion on BoS at 6 to 12 weeks post-op, even with evidence of preserved femoral head perfusion at the time of surgery.
Punctate Inner Choroidopathy (PIC)-like Reaction in Stage 3 Extensive Macular Atrophy with Pseudodrusen-like Appearance (EMAP)
Authors: Trinco Andrea , Romano Francesco , Invernizzi Alessandro , Zaffalon Chiara , Bosello Francesca , Casati Stefano , Zicarelli Federico , D'Introno Rossella , Staurenghi Giovanni , Salvetti Anna Paola 
Published: January 2025

Purpose:
To describe a rare complication in a patient with extensive macular atrophy with pseudodrusen-like appearance (EMAP), suggesting immune dysregulation in advanced stages of the disease.

Methods:
Case Report. Multimodal imaging –including true-color fundus photography, blue autofluorescence, high-resolution optical coherence tomography (Hi-Res OCT), swept-source OCT angiography, and dye-based angiography– was used to evaluate retinal alterations.

Results:
A 53-year-old woman with stage 3 EMAP presented with moderately hyperreflective subretinal material co-localizing with a large rupture of the Bruch’s membrane (BrM) in the right eye. Multimodal imaging ruled out macular neovascularization, suggesting a diagnosis of punctate inner choroidopathy (PIC)-like reaction. Treatment with oral steroids led to complete regression of the subretinal inflammatory lesion.

Conclusions:
This case highlights a novel inflammatory complication in EMAP. Our findings emphasize a potential role of immune dysregulation in late-stage EMAP and underscore the value of multimodal imaging in the management and follow-up of these patients.
Prognostic value of systemic immune-inflammation index in older patients with acute coronary syndrome
Authors: Gürdal Ahmet , Serin Ebru , Sarilar Mert , Sümerkan Mutlu Çağan , Kalender Erol , Değirmenci Hasan , Şahin Sinan , Keskin Kudret 
Published: January 2025

Objectives
Contemporary studies assessing the importance of the systemic immune-inflammation index (SII) in older patients presenting with acute coronary syndrome (ACS) are scarce. This study investigated the impact and prognostic value of the SII regarding long-term mortality in older patients with ACS.

Methods
The study included 401 older patients aged 75 years and above admitted with ACS between May 2015 and December 2022. Predictors of mortality were determined using multivariate Cox regression analysis. Survival curves were generated using the Kaplan–Meier method.

Results
The patients’ median age was 81 (77–85) years, and 197 (49.1%) were male. The median follow-up was 23 months (Q1–Q3 : 4–43, maximum: 102). All short- and long-term deaths, including in-hospital deaths, were significantly high in patients with high SII (P = 0.001). Inflammatory variables, including C-reactive protein, SII, the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, were positively correlated with the SYNTAX score (for SII; R = 0.492, P = 0.001). Multivariate Cox regression analysis revealed that age [hazard ratio (HR): 1.082, 95% confidence interval (CI): 1.051–1.114, P = 0.001], estimated glomerular filtration rate (HR: 0.988, 95% CI: 0.982–0.994, P = 0.001), SII (HR: 1.004, 95% CI: 1.001–1.006, P = 0.001), and left ventricular ejection fraction (HR: 0.959, 95% CI: 0.947–0.97, P = 0.001) were independent predictors of mortality in older patients with ACS. Kaplan–Meier analysis also showed that patients with high SII had a significantly higher mortality rate (P = 0.001).

Conclusion
A high SII is an independent predictor of long-term mortality in older patients with ACS.
Adding New Components to a Composite Quality Metric
Authors: Salerno Stephen , Yang Eileen , Dahlerus Claudia , Hirth Richard A. , Han Peisong , Xu Tao , Eckard Ashley , Agbenyikey Wilfred , Horton Golden M. , Clark Stephanie , Messana Joseph M. , Li Yi 
Published: January 2025

Objectives:
This study illustrates how the statistical reliability of an individual measure relates to the overall reliability of a composite metric, as understanding this relationship provides additional information when evaluating measures for endorsement.

Background:
National quality measure endorsement processes typically evaluate individual metrics on criteria such as importance and scientific acceptability (eg, reliability). In practice, quality measures may be used in composite rating systems, which aid in the interpretation of overall quality differences.

Methods:
We define an individual measure’s reliability by its intraclass correlation and analytically establish the relationship between a composite’s reliability and the reliability of its components. We use real data to confirm this relationship under various scenarios. We are motivated by 8 quality measures, which comprise the Quality of Patient Care Star Ratings on Dialysis Facility Care Compare. These measure 4 primary outcomes (mortality, hospitalizations, readmissions, and blood transfusions), vascular access (2 measures), and facility processes (2 measures).

Results:
Depending on the reliability of the individual measures, their respective weights in the composite, and their pairwise correlations, there are circumstances when adding a new measure, even if it is less reliable, increases the composite’s reliability. For the dialysis facility Star Ratings, we find that the combined reliability of measures grouped within certain domains of care exceeded the reliability of the individual measures within those domains.

Conclusions:
New quality measures may add utility to a composite rating system under certain circumstances—a consideration that should, in part, factor into quality measure endorsement processes.
Learning Health Systems Research
Authors: Tisdale Rebecca L. , Sarkar Urmimala 
Published: January 2025

Background:
Learning health systems research (LHSR) builds on concepts of systems-based participatory research to form a new paradigm for partnered research.

Objective:
Defines LHSR and its ongoing challenges and future directions.

Research Design:
Qualitative description of relevant dimensions of LHSR.

Results:
In LHSR, researchers and health system stakeholders co-create research with dual aims of producing internal quality improvement and generalizable, disseminable knowledge. This approach aligns research priorities with community and health system needs, resulting in interventions that are both feasible and acceptable in real-world settings and effective. LHSR methods and outcomes reflect elements of implementation science, particularly participatory implementation science and the use of mixed methods, but the field is distinct in its emphasis on co-creation with health system leaders and the use of theory to inform rather than drive the work. Practitioners of LHSR face challenges related to the complex and multi-stakeholder nature of the field, including the time-intensive nature of building partnerships, conflicting project time horizons, imprecision inherent in real-world data, and barriers to publication of the smaller studies that typically result from LHSR.

Conclusions:
Continued advancement of the field requires confronting these challenges with a variety of interventions, including explicit institutional support and incentives for this type of work, training and career development opportunities, a diversity of funding sources, investment in data resources and expertise, and inclusive research governance structures.
Discovering Novel Genome Mutations Associated with Liver and Pancreas Disorders: Insights from a Radiogenomics Study
Authors: Koohi-Moghdam Mohamad , Vardhanabhuti Varut , Wang Junwen , Chan Albert , Bae Kyongtae Tyler 
Published: January 2025

AbstractRadiogenomics provides a powerful approach to identify genetic variants linked to imaging-derived phenotypes, offering insights into the genetic underpinnings of organ function and disease susceptibility. The liver and pancreas are critical to metabolism, digestion, and detoxification, with their dysfunction leading to conditions such as pancreatitis, diabetes, and cancer. This study used a genome-wide association study (GWAS) to identify genetic variants associated with liver and pancreas radiomics phenotypes derived from magnetic resonance imaging (MRI). We conducted a cross-sectional study using data from 38,844 unique subjects in the UKBiobank, each with available MRI scans and genome sequences. We identified several novel single nucleotide polymorphisms (SNPs) associated with liver and pancreas characteristics. Notable findings include associations with rs1800562 (HFE gene), rs58542926 (TM6SF2 gene), rs738409 (PNPLA3 gene), and rs855791 (TMPRSS6 gene). These findings may contribute to our understanding of the genetic basis of organ function and could potentially help in future preventive healthcare.
Structural basis for the evolution of a domesticated group II intron-like reverse transcriptase to function in host cell DNA repair
Authors: Park Seung Kuk , Guo Mo , Stamos Jennifer L. , Kim Wantae , Lee Sidae , Zhang Y. Jessie , Lambowitz Alan M. 
Published: January 2025

SummaryA previous study found that a domesticated bacterial group II intron-like reverse transcriptase (G2L4 RT) functions in double-strand break repair (DSBR) via microhomology-mediated end joining (MMEJ) and that a mobile group II intron-encoded RT has a basal DSBR activity that uses conserved structural features of non-LTR-retroelement RTs. Here, we determined G2L4 RT apoenzyme and snap-back DNA synthesis structures revealing novel structural adaptations that optimized its cellular function in DSBR. These included a unique RT3a structure that stabilizes the apoenzyme in an inactive conformation until encountering an appropriate substrate; a longer N-terminal extension/RT0-loop with conserved residues that together with a modified active site favors strand annealing; and a conserved dimer interface that localizes G2L4 RT homodimers to DSBR sites with both monomers positioned for MMEJ. Our findings reveal how a non-LTR-retroelement RT evolved a dedicated cellular function and suggest new ways of optimizing these RTs for genome engineering applications.
I buy green because I feel green pressure: the effect of destination social responsibility on tourists’ green product purchase behavior
Authors: Liu Danping , Fang Hedan , Huang Mei , Jiang Changchun , Ma Jingchen 
Published: January 2025

PurposeEncouraging green consumption is a proven strategy for supporting destination sustainability. Nonetheless, extant research approaches destination sustainability mainly from an economic perspective. In this study, we explore the effectiveness of destination social responsibility (DSR) as a way to encourage green consumption among tourists from a social interaction perspective.Design/methodology/approachWe used a mixed-method approach with two studies (i.e. a scenario experiment and a survey) to test our hypotheses. The scenario experiment included four versions of a narrative scenario with 40 samples each, and 421 valid questionnaires were obtained in the survey.FindingsOur findings indicate that there is a significant relationship between DSR and green pressure. And DSR positively influences tourists’ green product purchase behavior (GPB). Tourists who have a high fear of negative evaluation (FNE) experience more pressure when exposed to DSR than those with low FNE.Originality/valueThis study sheds light on the mechanisms through which DSR influences tourists’ GPB from a stress transaction perspective and also offers practical implications for tourism marketing and destination management.
The role of the rework cycle from system dynamics modelling for project management: challenges and future research agenda
Authors: Calderon-Téllez Javier Andrés , Herrera Milton M. , Bell Gary 
Published: January 2025

PurposeThis paper aims to contribute to a better understanding of the relationship between the rework cycle with system dynamics (SD) models and the Project Management Institute (PMI) process group.Design/methodology/approachTo achieve the aim of this paper, 84 articles that blended SD models and project management (PM) were analysed to identify key variables used in PM modelling. The key variables were utilised to build an extended SD model with multiple rework cycles to explain the link between the rework cycle SD model and PMI process group.FindingsThe results show that SD might be a favourable approach to capture the reality of the project life cycle when it is extended to represent front-ending, delivery and back-ending. In fact, SD models could potentially be extended to the agile and hybrid methodologies for improving the PM.Research limitations/implicationsAlthough this paper provides a better understanding about the extended project life cycle by SD modelling, the results reported herein should be considered in future research that comprises the design of a SD model considering the agile and hybrid methodologies for PM.Practical implicationsThis paper shows how the rework cycle can be applied to the extended project life cycle and the PMI process groups. Additionally, it highlights why SD modelling is a crucial tool for assisting managers with long-term decision-making in PM.Originality/valueThis study is among the first to explore the integration of rework cycle SD models within the PMI process groups. Specifically, it may prove valuable in supporting decision-making for project managers at each stage of a project’s extended life cycle. As a result, the research also contributes to the ongoing discussion on integrating PM with sustainability and innovation considerations.
An investigation into bio-digester toilet facilities and their environmental effect on ageing in Accra, Ghana
Authors: Pim-Wusu Mark , Simpeh Eric Kwame , Kortto Mansfield Selasi 
Published: January 2025

Purpose
Bio-digester toilet handling in Ghana has become a modern trend, shadowing the traditional septic tank approach and other sewage methods. This practice raises environmental concerns that could affect human ageing. This study aims to investigate the effectiveness of bio-digester toilet facilities and their environmental effect on ageing in Accra, Ghana.

Design/methodology/approach
The study adopts quantitative and qualitative strategies. A purposive sampling technique was used to select households with bio-digester toilet facilities across the study area through a field survey questionnaire during Phase 1. A semi-structured interview was adopted for an in-depth perspective of the respondents, and laboratory analysis was performed on bio-digester effluent samples to validate phase one as a third stage. The quantitative data was analysed using descriptive statistics and laboratory analysis using standard methods for Escherichia coli, total coliform, dissolved oxygen, potential of hydrogen and temperature. The qualitative data was analysed using content analysis.

Findings
Laboratory analyses of effluent samples revealed that the bio-digester toilet facility could harm human health when its effluent is discharged into public drains. The study further discovered that only district and municipal assembly-certified technicians must construct the bio-digester toilet facilities, and households need regular education on the proper use and maintenance of the facility.

Originality/value
The revelation of this research means that it is essential for the country at large to make appropriate bylaws to regulate toilet waste handling and their environmental effect on ageing regarding households that discharge bio-digester toilet effluents into public drains for the betterment of the global agenda of sustainable development.
A qualitative exploration of motivations for entry into the firefighting profession in Trinidad and Tobago
Authors: Salina Sharlene J. D. , Wallace Wendell C. 
Published: January 2025

PurposeThis study explored the motivations of individuals who entered the firefighting profession in Trinidad and Tobago in an attempt to gauge their stimulus for entry into the profession. The research was conducted due to the unavailability of literature on the phenomenon under inquiry in the Caribbean, more specifically, Trinidad and Tobago.Design/methodology/approachThis qualitative phenomenological study was conducted using semi-structured interviews with 24 male and female firefighters from the 4 divisions of the Trinidad and Tobago Fire Service (TTFS), namely north, south, central and Tobago divisions, and the personal motivations for entry into the TTFS were explored.FindingsThe findings indicate that motivations for males who entered the firefighting profession were job security, opportunity to assist people, benefits, salary and job stability, while the motivations for females were opportunity to assist people, family, benefits, job security and job stability. Several themes emerged, namely altruism, job security, benefits and job stability.Research limitations/implicationsAs with most studies, this research has limitations. The main limitations were the small sample size of the study’s population and the use of a lone jurisdiction (Trinidad and Tobago) to situate the study. Despite the aforementioned limitations, the study is useful as it appears to be the first of its kind in the Caribbean and thus provides useful insights as well as a starting point for future research. Looking forward, research on motivations to become a firefighter should examine the phenomenon via a more expansive Caribbean lens, as firefighting units are an undeniable feature of the national security landscape in the region.Originality/valueThe current study appears to be the first of its kind in the Caribbean, as voracious searches failed to unearth similar studies.
The role of leadership in digital transformation – a paradox way to improve operational performance
Authors: Dióssy Kitti , Losonci Dávid , Aranyossy Márta , Demeter Krisztina 
Published: January 2025

PurposeLeadership has been identified as a crucial driver of efficient deployment of any Operations Management (OM) paradigm. Our work focuses on digitalisation, a recent OM paradigm, and analyses the mediating effect of digital transformation (DT) on the relationship between task-oriented and relationship-oriented leadership styles (LSs) and operational performance (OP) improvements in the manufacturing context.Design/methodology/approachThe authors employed survey data from Hungarian manufacturing firms. Hypotheses are tested using structural equation modelling.FindingsTask-oriented and relationship-oriented LSs exert distinct influences on DT and OP improvements. The results indicated that task-oriented LS drives OP improvements through its impact on DT. The relationship-oriented LS does not influence DT. Regarding the implications for OP improvements, we revealed a leadership paradox as the indirect positive impact of task-oriented LS may be offset by the direct negative influence of relationship-oriented LS.Research limitations/implicationsThe results are most pertinent to manufacturing firms that have already started their digital journey. Further studies must clarify how managers’ cultural embeddedness (i.e. general perceptions about efficient leadership in their country or region, national culture) could influence findings. Finally, to learn about the effective long-term behaviours of leaders might require different empirical methods.Originality/valueTo the best of the authors’ knowledge, this study represents one of the first survey-based examinations of CEOs on the ways how LSs drive the effective deployment of DT in manufacturing firms. Our findings demonstrate a leadership paradox at the nascent stages of DT in manufacturing firms.
Does intellectual capital predict future stock returns? An Indian perspective
Authors: Ghazal Sameena , Aziz Tariq 
Published: January 2025

PurposeThe purpose of the present research is to explore the relationship between intellectual capital and subsequent stock returns.Design/methodology/approachThe present study has applied the Fama–French (1993) portfolio formation technique to calculate the portfolios and find the relationship with future stock returns for the duration of 22 years, i.e. 2000–2021, on all listed nonfinancial firms of India.FindingsThe findings suggest that intellectual capital proxied by VAIC (Pulic, 2000) shows a negative relationship with subsequent stock returns. Along with overall VAIC, components of VAIC, i.e. value-added human capital (VAHU), value-added capital employed (VACA) and Structural capital value added (SCVA) have also been explored. The results suggest that Indian firms still rely on financial and physical capital as compared to human and structural capital. There exists heterogeneity across industries while predicting the subsequent stock returns. Sub-period analysis shows that the latest duration is positively, however, insignificantly impacting the VAIC and stock return relationship. Age and size as control variables have also been explored. The results show that young-low VAIC and small-low VAIC firms are more significant as compared to high VAIC firms.Practical implicationsThe paper reveals that physical capital plays an important role in predicting future stock returns.Originality/valueThe present study will prove to be an impetus in finding the relationship between intellectual capital and future stock returns, as it is an unexplored area both in the global as well as in the Indian context.