bluuebunny/crossref_metadata_2025_split huggingface dataset:
“It's a good idea, but…”: a qualitative evaluation of the GoldiCare intervention in Norwegian home care services
Authors: Fischer Heike , Lohne Fredrik Klæboe , Fimland Marius Steiro , Redzovic Skender Elez 
Published: January 2025

BackgroundAddressing high levels of physical strain among Norwegian home care workers is crucial if home care services are to continue to provide cost-effective and high-quality health care for people in their homes. Excessive physical demands may contribute to poor long-term musculoskeletal health and high sick leave rates among home care workers. Based on the Goldilocks Work Principle of redistributing an uneven distribution of physical demands to promote a working environment with a “just right” physical demands conducive to promoting long-term health, the GoldiCare intervention in home care services was conducted. The objective of this qualitative process evaluation study was to gain insights into how the implementation outcomes of acceptability, appropriateness, feasibility, adoption and fidelity, respectively, impacted the implementation of the GoldiCare intervention.MethodsWe conducted ten individual interviews with operations managers and five focus group interviews with home care workers from the intervention units. Interviews were transcribed verbatim and a three step-content analysis was employed to analyze interview material.ResultsOur analysis identified that although the intervention was considered broadly acceptable, there were several challenges corresponding to the dimensions of appropriateness, feasibility, adoption and fidelity. Major barriers were identified in particular with regard to appropriateness, that is underlying ways of measuring physical demands; and feasibility, that is barriers to implementing the tool. Further synthesis of these findings resulted in four core issues that need to be addressed if the GoldiCare intervention is to be successfully implemented in comparable Norwegian home care settings: proxy issues; complexity and unpredictability; organization-level issues; and operational autonomy.ConclusionThe findings provide valuable insights for future attempts to implement GoldiCare interventions in home care settings, highlighting the need to further integrate GoldiCare and other comparable types of intervention into the political, economic, sociocultural, professional, and technological context of home care services. Performed in the right way, such integration will also allow for more participatory input from those enacting such interventions.
Trial registrationThis clinical trial was registered on 08/05/2022 under NCT05 487027.
Heterogeneous foraging swarms can be better
Authors: Kaminka Gal A. , Douchan Yinon 
Published: January 2025

IntroductionInspired by natural phenomena, generations of researchers have been investigating how a swarm of robots can act coherently and purposefully, when individual robots can only sense and communicate with nearby peers, with no means of global communications and coordination. In this paper, we will show that swarms can perform better, when they self-adapt to admit heterogeneous behavior roles.MethodsWe model a foraging swarm task as an extensive-form fully-cooperative game, in which the swarm reward is an additive function of individual contributions (the sum of collected items). To maximize the swarm reward, previous work proposed using distributed reinforcement learning, where each robot adapts its own collision-avoidance decisions based on the Effectiveness Index reward (EI). EI uses information about the time between their own collisions (information readily available even to simple physical robots). While promising, the use of EI is brittle (as we show), since robots that selfishly seek to optimize their own EI (minimizing time spent on collisions) can actually cause swarm-wide performance to degrade.ResultsTo address this, we derive a reward function from a game-theoretic view of swarm foraging as a fully-cooperative, unknown horizon repeating game. We demonstrate analytically that the total coordination overhead of the swarm (total time spent on collision-avoidance, rather than foraging per-se) is directly tied to the total utility of the swarm: less overhead, more items collected. Treating every collision as a stage in the repeating game, the overhead is bounded by the total EI of all robots. We then use a marginal-contribution (difference-reward) formulation to derive individual rewards from the total EI. The resulting Aligned Effective Index (AEI) reward has the property that each individual can estimate the impact of its decisions on the swarm: individual improvements translate to swarm improvements. We show that AEI provably generalizes previous work, adding a component that computes the effect of counterfactual robot absence. Different assumptions on this counterfactual lead to bounds on AEI from above and below.DiscussionWhile the theoretical analysis clarifies both assumptions and gaps with respect to the reality of robots, experiments with real and simulated robots empirically demonstrate the efficacy of the approach in practice, and the importance of behavioral (decision-making) diversity in optimizing swarm goals.
Automated classification of elongated styloid processes using deep learning models-an artificial intelligence diagnostics
Authors: Ganesan Anuradha , Gautham Kumar N. , Natarajan Prabhu Manickam , Gauthaman Jeevitha 
Published: January 2025

BackgroundThe styloid process (SP), a bony projection from the temporal bone which can become elongated, resulting in cervical pain, throat discomfort, and headaches. Associated with Eagle syndrome, this elongation can compress nearby nerves and blood vessels, leading to potentially severe complications. Traditional imaging-based methods for classifying various types of elongated styloid processes (ESP) are challenging due to variations in image quality, patient positioning, and anatomical differences, which limit diagnostic accuracy. Recent advancements in artificial intelligence, particularly deep learning, provide more efficient classification of elongated styloid processes.ObjectiveThis study aims to develop an automated classification system for elongated styloid processes using deep learning models and to evaluate the performance of two distinct architectures, EfficientNetB5 and InceptionV3, in classifying elongated styloid processes.MethodsThis retrospective analysis classified elongated styloid processes using Ortho Pantomograms (OPG) sourced from our oral radiology archives. Styloid process lengths were measured using ImageJ software. A dataset of 330 elongated and 120 normal styloid images was curated for deep learning model training and testing. Pre-processing included median filtering and resizing, with data augmentation applied to improve generalization. EfficientNetB5 and InceptionV3 models, utilized as feature extractors, captured unique styloid characteristics. Model performance was evaluated based on accuracy, precision, recall, and F1-score, with a comparative analysis conducted to identify the most effective model and support advancements in patient care.ResultsThe EfficientNetB5 model achieved an accuracy of 97.49%, a precision of 98.00%, a recall of 97.00%, and an F1-score of 97.00%, demonstrating strong overall performance. Additionally, the model achieved an AUC of 0.9825. By comparison, the InceptionV3 model achieved an accuracy of 84.11%, a precision of 85.00%, a recall of 84.00%, and an F1-score of 84.00%, with an AUC of 0.8943. This comparison indicates that EfficientNetB5 outperformed InceptionV3 across all key metrics.ConclusionIn conclusion, our study presents a deep learning-based approach utilizing EfficientNetB5 and InceptionV3 to accurately categorize elongated styloid processes into distinct types based on their morphological characteristics from digital panoramic radiographs. Our results indicate that these models, particularly EfficientNetB5, can enhance diagnostic accuracy and streamline clinical workflows, contributing to improved patient care.
Robotic pedicle screw placement for minimal invasive thoracolumbar spine surgery: a technical note
Authors: Gatam Luthfi , Phedy Phedy , Husin Syafruddin , Mahadhipta Harmantya , Rizki Gatam Asrafi , Mitchel Mitchel , Gani Karina Sylvana , Kholinne Erica 
Published: January 2025

BackgroundPedicle screw placement in spine surgery is a complex and delicate procedure that requires precise and accurate placement of pedicle screws. This technical note describes the steps involved in performing robotic assistance pedicle screw insertion in thoracolumbar spine surgery using the ExcelsiusGPS platform.MethodsThis paper outlines the surgical techniques and intraoperative workflow for pedicle screw placement using the ExcelsiusGPS system. It also covers the surgical process, including patient positioning, dynamic reference placement, intraoperative cone-beam tomography, screw planning, exposure, and insertion techniques for spinal stabilization.DiscussionA meta-analysis highlighted the significant advantages of robotic spine surgery over traditional freehand techniques, including a notably lower complication rate (4.83% vs. 14.97%) and up to a tenfold reduction in surgeon radiation exposure compared to fluoroscopy. Additionally, robotic systems enhance pedicle screw placement accuracy, achieving a 91.7% success rate. This higher accuracy is attributed to real-time screw planning, trajectory guidance, and precise adjustments in robotic-assisted surgery. These advantages establish robotic assistance as a crucial innovation for enhancing surgical precision and patient safety, although it requires careful handling of technical challenges like alignment changes in highly flexible bones and ensuring accurate instrument trajectory during screw placement.ConclusionRobotic-assisted spine surgery improves pedicle screw accuracy with real-time planning and trajectory adjustments, reducing complications and radiation exposure. However, higher costs and increased screw use warrant careful evaluation of its cost-effectiveness and impact on healthcare resources.
Log odds of positive lymph nodes compared to positive lymph node ratio and number of positive lymph nodes in prognostic modeling for patients with NSCLC undergoing lobectomy or total pneumonectomy: a population-based study using Cox regression and XGBoost with SHAP analysis
Authors: Huang Qiming , Chen Shai , Li Zhenjie , Wu Longren , Yu Dongliang , Xiong Linmin 
Published: January 2025

BackgroundMethods such as the number of positive lymph nodes (nPLN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) are used to predict prognosis in patients with non-small cell lung cancer (NSCLC). We hypothesized that LODDS could be a superior independent predictor of prognosis and aimed to compare its effectiveness with nPLN and LNR in predicting survival outcomes in stage I-IIIA NSCLC patients.MethodsWe utilized data from the Surveillance, Epidemiology, and End Results (SEER) 17 registry (2010–2019) to study NSCLC patients, focusing on those who underwent surgery with confirmed lymph node involvement (N1 or N2 disease). We aimed to compare overall survival (OS) and cancer-specific survival (CSS) based on nPLN, LNR, and LODDS. Kaplan-Meier and Cox regression analyses were employed to evaluate survival, with thresholds determined using X-tile software. An XGBoost model was constructed to predict overall survival in patients using three features: LODDS, LNR, and PLN. SHapley Additive exPlanations (SHAP) analysis was applied to assess feature importance and provide interpretable insights into the model's predictions.ResultsThe study analyzed 3,132 eligible NSCLC patients from the SEER database, predominantly male (53.07%) with adenocarcinoma (43.65%) or squamous cell carcinoma (29.76%). Survival outcomes were assessed using nPLN, LNR, and LODDS. LODDS showed superior predictive value for both OS and CSS compared to nPLN and LNR, as indicated by a larger Log Likelihood Ratio (LLR) and smaller Akaike Information Criterion (AIC). Higher scores on npLN, LNR, and LODDS were strongly related with a poorer prognosis, according to Kaplan-Meier analyses (P &lt; 0.001). The SHAP (SHapley Additive exPlanations) analysis of the XGBoost model demonstrated that the LODDS exhibited the highest SHAP values (0.25) for predicting overall survival in patients, consistently outperforming the LNR and the number of nPLN across both training and validation datasets.ConclusionsCompared to the nPLN and LNR staging systems, LODDS demonstrates superior prognostic power for patients with stage I–IIIA NSCLC undergoing lobectomy or pneumonectomy. By integrating both positive and negative lymph node information, LODDS offers a refined risk stratification that is particularly valuable in cases with high lymph node heterogeneity.
Effect of epileptiform discharges and hippocampal volume on cognitive dysfunction following clipping of ruptured aneurysms in the anterior circulation
Authors: Otsuka Kunitoshi , Sunaga Shigeki , Jimbo Hiroyuki , Suzuki Yoshinori , Kohno Michihiro 
Published: January 2025

IntroductionCognitive dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains unclear due to various neurological impairments. This study aimed to evaluate the changes in hippocampal volume, cognitive function, and interictal epileptiform discharges after clipping in patients with aSAH of anterior circulation.MethodsPatients with modified Rankin Scale scores of 0–3 points who underwent clipping were evaluated. Aneurysmal locations were classified as middle cerebral artery (MCA), internal carotid artery (ICA), and anterior cerebral artery (ACA). Surgery was performed using the transsylvian approach or interhemispheric approach. Hippocampal volume measurement, neuropsychological assessments, and interictal electroencephalogram evaluations were performed postoperatively at the subacute phase. Epileptiform discharges were assessed using the spike index (SI).ResultsWe included 60 patients (23 men, 37 women; median age, 57.4 years). Aneurysmal locations were found in the MCA, ICA, and ACA in 23, 19, and 18 patients, respectively. The postoperative hippocampal volume was significantly reduced on the clipping approach side in the MCA and ICA groups (MCA, p &lt; .001; ICA, p &lt; .001). There was no correlation between hippocampal volume and cognitive function. A significant difference was noted in elevated SI on the approach side of the MCA (p &lt; .001), ICA (p &lt; .001), and ACA (p &lt; .001) in the transsylvian approach group. The elevated SI on the left approach side showed significant differences in some neuropsychological assessments (performance intellectual quotient, p = .028; perceptual organization, p = .045; working memory, p = .003).DiscussionCognitive dysfunction in the subacute phase after clipping for aSAH was not correlated with hippocampal volume reduction but was correlated with interictal epileptiform discharges.
Rabies vaccinations at the rural–urban divide: successes and barriers to dog rabies vaccination programs from a rural and urban campaign in Zambia
Authors: Chazya Ricky , Mulenga Chilufya Aneta Susan , Gibson Andrew D. , Lohr Frederic , Boutelle Cassandra , Bonaparte Sarah , Sinywibulula Oline , Thomas Gareth , Bwalya Patricia , Dautu George , Munsimbwe Linous , Muuka Geoffrey , Gamble Luke , Wallace Ryan M. , Waltenburg Michelle A. 
Published: January 2025

IntroductionDog vaccination against rabies is considered one of the most effective strategies at preventing human deaths from rabies and is a key strategy for eliminating dog-mediated human rabies deaths. Traditional vaccination approaches in Zambia rarely collect operational data to assess coverage and inform subsequent campaigns.MethodsFollowing mass vaccination campaigns in rural (Itezhi tezhi) and urban (Lusaka) communities, we evaluated vaccination coverage achieved during the campaigns and characterized and estimated the dog population in these communities.ResultsHerd immunity (i.e., 70% vaccination coverage) was not achieved in the Lusaka campaign, likely due to challenges in pre-campaign community sensitization and distance to vaccination sites in the central point campaign approach. Dog population density showed a strong exponential association with human density (R2 = 0.89). Extrapolating this relationship nationally, there are an estimated 3.2 million dogs in Zambia (human-to-dog ratio 5.8:1) with 86% residing in rural communities at a very low density of less than 6 dogs per square kilometer.DiscussionAs most dogs were found to reside at very low densities, unique challenges to large-scale dog vaccination approaches may impact Zambia, due to high logistical costs associated with these settings. Prioritizing vaccinations in higher-density free-roaming dog populations could maximize effectiveness in resource-limited settings. Private veterinary services were commonly utilized among surveyed dog owners in urbanized communities in Lusaka, suggesting that they are an important collaborator for achieving rabies herd immunity. With improved knowledge of dog population and ownership characteristics, Zambia is well-prepared to design more effective vaccination campaigns as the rabies elimination program expands.
Socio-economic assessment of dog population management systems: a scoping review
Authors: Ghimire Rabina , Mohanty Parimala , Hiby Elly , Larkins Andrew , Dürr Salome , Hartnack Sonja 
Published: January 2025

IntroductionDog Population Management (DPM) systems primarily aim to reduce the free-roaming dog population, improve the health and welfare of humans and dogs, and foster their peaceful coexistence. A key challenge to resource allocation and evidence-based policy making in DPM is the rare evaluation of the associated socio-economic impacts. This scoping review identifies, maps, and summarizes published parameters and methods on the socio-economic aspect of DPM systems.MethodsFollowing PRISMA-ScR guidelines, and with a protocol registered on the Open Science Framework, this review explores (i) types of DPM services, (ii) types of parameters (intervention, impact, monetized, or non-monetized), (iii) methodological approaches (such as cost–benefit or cost-effectiveness analysis), and (iv) gaps and challenges in socio-economic DPM assessments. Relevant publications were identified through a systematic search of PubMed, Embase, Scopus, and Web of Science.ResultsOur review identified 14 out of more than 7,200 studies indicating the limitation of socio-economic data associated with DPM systems. The studies revealed diverse approaches to DPM, sterilization being the most frequently used service, often combined with vaccination and community awareness. Culling was also used by several studies as a DPM intervention, though considered unethical. The review highlighted a range of intervention, impact, and monetary parameters to evaluate the economics of DPM systems, demonstrating the complexity and varied scope of the services. Varied categorizations of the dog population were observed, making comparative evaluation challenging. Economic methods such as cost–benefit and cost-effectiveness analyses were observed, identifying several associated economic metrics. Studies highlighted gaps mostly related to data availability and accessibility.ConclusionThe limitations of socio-economic data arise from a lack of standardized methodologies across regions and contexts and limited data collection efforts. Prioritizing systematic collection of data on costs, benefits and social impacts allows for a more robust analysis of DPM systems. Developing tools and standardized reporting methods would further facilitate consistent evaluation of impacts, efficient resource allocation and evidence-based policy making to implement the most cost-effective DPM systems.Systematic review registrationDOI: 10.17605/OSF.IO/NHE3X
“Don’t Even Smoke But I’ll Buy That” Twitch as a New Venue for E-Cigarette Promotion
Authors: Küçükali Hüseyin 
Published: January 2025

ObjectivesThis study examines the covert promotion of e-cigarettes, specifically Juul, on the video live-streaming platform Twitch, focusing on the content and platform-specific dynamics that may influence its effectiveness.MethodsThis qualitative case study of a non-gaming Twitch stream included data from influencer conversations, viewer comments and visual elements. Thematic analysis, coding, and categorisation were conducted using ATLAS.ti.ResultsThe livestream, which attracted over ten thousand viewers, featured three friends vaping and discussing their personal experiences with Juul. Themes included curiosity, device sharing, and smoking cessation benefits. The stream fostered a casual, engaging atmosphere, with viewers interacting extensively with the influencers and also other viewers. Despite suspicions of industry sponsorship, viewers reacted positively and even joked about the sponsorship. Several viewers, including those who claimed not to smoke, expressed interest in Juul.ConclusionThe study highlights concerns about the promotion of harmful commodities on Twitch, where strong community engagement, monetary incentives, and a lack of specific content policies create a conducive environment for such practices. This underscores the need for greater scrutiny and regulation of e-cigarette promotions on the platform.
Comparison of COVID-19 and Non-COVID-19 Tracheostomised Patients: Complications, Survival, and Mortality Risk Factors
Authors: Mesalles-Ruiz Marta , Alonso Maitane , Cruellas Marc , Plana Martí , Penella Anna , Portillo Alejandro , Gumucio Víctor Daniel , González-Compta Xavier , Mañós Manel , Nogués Julio 
Published: January 2025

Objectives: To compare the outcomes of tracheostomised COVID-19 patients with non-COVID-19 tracheostomised patients to identify factors influencing severity and mortality. Methods: A retrospective, single-centre cohort study was conducted on COVID-19 tracheostomised patients admitted from May 2020 to February 2022, compared with a cohort of non-COVID-19 tracheostomised patients. Results: COVID-19 tracheostomised patients had a higher mortality rate (50% vs. 27.3% in non-COVID-19 patients). Mortality risk factors in COVID-19 tracheostomised patients included female sex (HR 1.99, CI 1.09–3.61, p = 0.025), ischemic heart disease (HR 5.71, CI 1.59–20.53, p = 0.008), elevated pre-tracheostomy values of PEEP (HR 1.06, CI 1.01–1.11, p = 0.017) and INR (HR 1.04, CI 1.01–1.07, p = 0.004), and ventilatory complications (HR 8.63, CI 1.09–68.26, p = 0.041). No significant differences in complication rates were found based on Sars-CoV-2 infection or tracheostomy type. Conclusions: Tracheostomy technique did not impact complications, discharge circumstances, or mortality, supporting the safety of bedside percutaneous tracheostomies for COVID-19 patients. COVID-19 tracheostomised patients exhibited a higher mortality rate.
Deletion of bZIP Transcription Factor PratfA Reveals Specialized Metabolites Potentially Regulating Stress Response in Penicillium raistrickii
Authors: Zhang Anxin , Zhang Shu , Xu Xinran , Yin Wen-Bing 
Published: January 2025

Fungal secondary metabolism (SM) is highly correlated with physiological processes that are typically regulated by pleiotropic regulators. In this study, we purposefully altered PratfA, a crucial regulator associated with oxidative stress in Penicillium raistrickii CGMCC 3.1066. After the knockout of PratfA, a novel polyketide (PK) raistrilide A (1) and the known nonribosomal peptide (NRP) tunicoidine (2) subsequently disappeared. Notably, compound 1 is a rare octaketone derivative and contains two unsubstituted cis-double bonds, demonstrating its unique biosynthetic mechanism. The knockout of PratfA resulted in the disappearance of 1–2 and greatly increased the susceptibility of ΔPratfA mutant strain to oxidative stress, rendering it nearly impossible to survive in such environments. At present, the OE⸬PratfA strain showed no phenotypic or oxidative stress sensitivity differences compared to the wild-type strain. Our findings highlight that the oxidative-stress-related transcription factor (TF) PratfA influences SM pathways in P. raistrickii. The manipulation of regulatory factors can guide the discovery of novel natural products (NPs).