bluuebunny/crossref_metadata_2025 huggingface dataset:
Tell me why: The impact of mindful sharenting explanations by momfluencers: An experimental study with mothers
Authors: Van den Abeele Elisabeth , Hudders Liselot , Vanwesenbeeck Ini
Published: February 2025

Given the number of identified risks associated with influencer sharenting, momfluencers are increasingly adopting a more mindful approach to sharing information about their children online. Prior qualitative research suggests that followers respond positively towards these mindful sharenting practices, especially when motives are communicated. However, there is a lack of experimental exploration into this finding and its potential explanations. Therefore, drawing upon theoretical insights regarding self-disclosure and self-determination theory, this experimental study with 176 mothers seeks to investigate the impact of momfluencers providing an explanation regarding mindful sharenting practices, proposing the need for relatedness and empathy as mediators. The findings reveal that when momfluencers disclose their motives, this significantly enhances follower engagement, admiration, and evaluation of the momfluencer. This effect is fully explained by empathy, and partly by the need for relatedness. This study emphasizes the importance of transparency and provides momfluencers strategies to balance privacy protection and the benefits of influencer sharenting.
New life for statehouse reporting? The view from one American state
Authors: Powers Matthew , Doll Meagan , Hansen Russell , Straub-Cook Polly , Moy Patricia
Published: February 2025

This paper examines news organizations’ shifting editorial and commercial strategies towards statehouse reporting – an important but often neglected form of sub-national journalism in the United States. Through interviews with reporters, editors, and management in one state (Washington), we find that many news organizations are adapting their coverage to better align with transformations in both politics and journalism. The specific strategy an organization adopts, however, depends on its position among statehouse news providers. Established news organizations foreground the impact of policy developments on ‘ordinary’ citizens’ lives in an effort to entice audiences assumed to ignore such news. Their upstart peers, by contrast, target what they see as an underserved niche market consisting of individuals already interested in politics and poorly served by current offerings. Without implying a return to any mythical golden age, or declaring without reservations a bright future, we suggest that these developments evince signs of 'new life’ for statehouse reporting. Our analytical emphasis, moreover, underscores the incentives that guide organizations’ editorial and commercial strategies, a point that can apply to many forms of political journalism around the globe.
Striking and the means principle
Authors: Christensen James
Published: February 2025

Some strikes seem insufficiently discriminating. Rather than being aimed exclusively at potentially ‘legitimate’ targets (e.g., employers who, by refusing to pay a fair wage or provide acceptable working conditions, might have made themselves liable to bear certain costs), these strikes are (also) aimed at individuals who do not seem to be liable. Most problematically, such strikes invite the charge that they harm the innocent opportunistically or exploitatively. (Call this the third-party (exploitation) objection.) In other words, those who strike face the charge that they are harmfully using the innocent as a means to further their own ends, thereby violating a central and enduring principle of deontological ethics, namely, the means principle. This paper aims to set out the best case that can be made for the third-party (exploitation) objection.
Comparing Gaussian process enhanced grey-box approaches to detect damage in unknown environmental conditions due to climate change
Authors: Möller Sören , Jonscher Clemens , Grießmann Tanja , Rolfes Raimund
Published: February 2025

In vibration-based structural health monitoring (SHM), it is well known that environmental and operational variations (EOVs) affect the dynamic response of the structure of interest. This fact makes it difficult to distinguish between structural changes caused by damage and those caused by EOVs. In SHM, this issue is addressed by data normalisation, whereby machine learning techniques are commonly applied. However, ensuring their accuracy necessitates capturing a comprehensive range of EOVs within the training data. Collecting these is inherently challenging for real-world applications, especially with new EOV states emerging due to climate change. This study’s unique contribution is applying and comparing two grey-box models based on Gaussian process (GP) regression to remove EOVs with low data coverage and demonstrate their efficiency for damage detection with an open-access benchmark dataset. To this end, the first two bending mode natural frequencies – used as damage-sensitive features – of the Leibniz University Test Structure for Monitoring (LUMO), an outdoor lattice tower, are mapped. Two approaches to embedding physical knowledge in the GP are investigated. The first approach incorporates knowledge through the mean function, while the second involves the selection or design of a kernel. Subsequently, the two approaches are compared with a black-box and a white-box model. For long-term SHM, the repair of a damage mechanism is accounted for by the normal-condition alignment scheme, and damage detection is performed using the Mahalanobis distance. The study demonstrates that applying grey-box models contributes to a more reliable representation of the variations caused by unknown EOVs than pure black-box models, thereby improving damage detectability with sparse and incomplete training data due to climate change. However, as the dependencies modelled for LUMO are primarily linear, further research is required to assess the applicability of these findings to structures where dependencies are expected to be non-linear.
High corrosion resistance chromium-free passivated copper foils for lithium-ion batteries
Authors: Liu Wei-Fei , Song Ning , Huang Jian , Zhao Meng , Zhao Man , Tang Yun-Zhi , Tan Yu-Hui , Fan Xiao-Wei
Published: February 2025

Presently, the widely electronic copper foil passivation technology in the field of lithium-ion batteries mostly adopts chromate-containing treatment, but there are serious environmental pollution problems. Here, a novel organic-inorganic chromium-free passivation formula was developed by utilising benzotriazole (BTA), 3-chloropropyltriethoxysilane (CPTES) and taking advantage of the corrosion resistance of nickel. The best passivation formula for corrosion resistance treatment was realised by an orthogonal experiment, consisting of 6 g/L BTA, 5 mL/L CPTES and 6 g/L NiSO4. Through Tafel and impedance tests, the copper foil treated with the passivation solution possesses the most excellent corrosion resistance. The corrosion current density is 1.06 × 10−6 A·cm−2, and the corrosion inhibition efficiency reaches 99.5%. Moreover, the surface of the copper foil transformed from hydrophobicity to hydrophilicity. Surface characterisation through X-ray photoelectron spectroscopy, scanning electron microscope etc . results indicate that BTA, CPTES and Ni in the passivation solution participate in the formation of the passivation film. The chromium-free passivation film has been successfully prepared on the surface of copper foil.
Variety or Similarity: The Typology and Frequency of Occurrence of Certain Kinds of Puzzles Present in Puzzle-Based Gamebooks
Authors: Łączyński Marcin , Gackowski Tomasz , Gołębiowski Michał
Published: February 2025

This paper presents a research project oriented on the qualitative and quantitative analysis of puzzles present in the modern-day (published after 2015) puzzle-oriented gamebooks (i.e., Journal 29) and book escape rooms (i.e., Cypher Files). The research presented included two stages. The qualitative stage aimed to apply the concepts from the fields of ludology and interaction design to interpret the play experience in selected gamebooks. This part resulted in research notes describing the interaction process with each puzzle in analyzed gamebooks. The result of the analysis of those notes is the proposition of the typology of riddles and puzzles present in those books and a general reflection on the puzzle-solving process structure. In the second part of the project, we intended to apply the typology to address research questions of a quantitative nature related to puzzle uniqueness, dissemination of particular puzzle types, and similarity of design practice between authors.
Position-Agnostic Smartphone Placement Detection for Improved Reliability in Human Activity Recognition
Authors: Shehzad Saba , Buriro Attaullah , Ullah Subhan , Ahmad Tahir
Published: February 2025

This research aims to solve the problem of position-independent activity recognition, a critical aspect in accurately identifying human activities using smartphones. Our study addresses this challenge by employing Convolutional Neural Networks to classify activities such as walking, sitting, running, and more, regardless of the smartphone’s position on the body. Leveraging a real-world publicly available dataset, we demonstrate 98% accuracy obtained solely from accelerometer data, surpassing state-of-the-art techniques by 5.77%. This advancement holds promise for enhancing smartphone-based human activity recognition, particularly in security-related applications like adaptive user authentication. Overall, our research demonstrates progress toward improving the reliability and adaptability of activity recognition systems across diverse contexts.
Trace elements: Clinical perspectives in the critically ill
Authors: Karunakaran Varshan , Harding Keri , Sarnowski Alexander , Walter Edward
Published: February 2025

Trace elements are required in minute quantities in the diet but play a vital role in a wide variety of functions, such as co-factors in antioxidant reactions and normal immune function to DNA and protein synthesis and skeletal and tissue remodelling and repair. Critically ill patients are at risk of trace element deficiency or excess, due to changes in intake, absorption, metabolism or excretion. Deficiency or excess can lead to a wide range of cellular and organ dysfunction that may be seen in patients with an acute or critical illness, including cardiomyopathy, impaired glucose tolerance and reduced oxygen delivery. In addition, various diseases, such as systemic inflammation and renal and intestinal failure, and intensive care treatments, such as parenteral nutrition, renal replacement therapy and diuretics, can increase the likelihood of deficient or excessive amounts of micronutrient levels. This narrative review discusses sources and normal physiology of trace element handling and how this may be impaired in critically ill patients. It then discusses various conditions seen in critically ill patients that may be caused or exacerbated by abnormal trace element status and the current evidence around whether supplementation is of benefit in particular critical illnesses.
How financial constraints influence the preference for material versus experiential purchases: A compensatory control mechanism
Authors: Wang Yan , Liu Shengyu , Kong Shuhong , Liu Lin
Published: February 2025

When individuals face financial constraints, do they tend to choose experiential or material purchases? Adopting a compensatory perspective, this study hypothesizes that financial constraints heighten individuals’ perception of losing control. To restore this sense of control, individuals are more likely to prefer material goods, which offer greater predictability and stability, over experiential purchases. Studies 1–3 in this paper consistently show that financial constraints increase the preference for material over experiential purchases. This effect is mediated by a sense of control over one's situation (Study 2). Furthermore, using the moderation-of-process method, Study 3 reveals that boosting the sense of control mitigates the effect of financial constraints on preference for material over experiential purchases. That effect is also found to be reversed by framing experiential purchases as enhancing one's sense of control, which reinforces the proposed underlying mechanism (Study 4). Overall, the findings suggest that financially constrained consumers prefer material over experiential purchases as a way to compensate for reduced sense of control. Our studies contribute to research on financial constraints, sense of control, and experiential versus material purchases, with implications for marketers.
Biological definitions of synucleinopathies should be anchored in clinical trajectories and encompass the complex biology of the disease
Authors: Bendetowicz David , Planche Vincent , Bezard Erwan , Dehay Benjamin , Meissner Wassilios G
Published: February 2025

Recently, two proposals for defining Parkinson's disease and its related pathogenic processes have been published. In this viewpoint, we discuss the primary drivers behind these efforts, the future directions, and the challenges that must be addressed. While finding biomarkers is a mandatory step for better precision medicine and optimal patient stratification in therapeutic trials, we argue that a biological definition of Parkinson's disease based on a single biomarker will struggle to account for the complexity of the mechanisms involved in developing the disease. Additionally, a biological definition of asymptomatic patients should rely on a thorough understanding of patients’ clinical trajectories, which is currently not the case in synucleinopathies.
Absolute and Relative Agreement Between Radiographic and Sonographic Calcaneal Ossification Staging: A Pilot Study
Authors: DeJong Lempke Alexandra F. , Whitney Kristin E. , Jackson Sarah S. , Le Hung M. , Hanlon Shawn L.
Published: February 2025

Background:

Radiographic evaluations are commonly used to determine calcaneal ossification staging throughout pediatric development. Sonographic imaging may offer a less expensive, noninvasive, clinically feasible option for calcaneal developmental assessments. Here, we assessed (1) inter-rater agreement of radiographic and sonographic calcaneal ossification staging of children and adolescent patients with Sever’s disease and (2) agreement between radiographic and sonographic calcaneal ossification staging scores.

Hypothesis:

There would be substantial agreement of radiographic and sonographic calcaneal ossification staging across raters, and between imaging measures.

Study Design:

Retrospective cohort study.

Level of Evidence:

Level 3.

Methods:

Adolescent patients (<18 years of age) with physician-diagnosed Sever’s disease who had complete calcaneal sonographic and radiographic imaging available on a retrospective chart review were included. Three independent reviewers with advanced training in musculoskeletal ultrasound each separately assessed radiographic and sonographic imaging data and assigned calcaneal calcification stages (0-5) to blinded images based on established criteria. Fleiss’ Kappa analyses were used to determine inter-rater staging agreement for both imaging approaches. Cohen’s Kappa analyses were used to determine the agreement between radiographic and sonographic staging. Absolute agreement, and relative agreement within each stage were assessed for both analyses.

Results:

Data from 19 patients (13 female, 6 male; 12.2 ± 2.3 years) were included. Absolute inter-rater agreement for radiographic and sonographic calcaneal ossification staging was comparable across the 3 raters (radiographs, κ = 0.692, z = 9.02; P < .01; sonographs, κ = 0.713, z = 7.95; P < .01), and perfect relative agreement (κ = 1.0, z = 10.6; P < .01). Consensus scores for radiographic and sonographic staging had moderate (κ = 0.535, z = 4.2; P < .01, and perfect relative (100% relative agreement, z = 6.22; P < .01) agreement.

Conclusion:

Sonographic evaluations of calcaneal ossification staging was comparable across assessors, and similar to radiographic staging.

Clinical Relevance:

Clinicians may consider incorporating ultrasound imaging for calcaneal ossification staging for young patients.
Powering the pluriverse: Possibilities and limits to decolonial energy transitions in the Sierra Norte de Puebla, Mexico
Authors: Post Erik , Rosas Pérez Marisol , Sánchez Martínez Bardomiano , Mora Báez María Edith , González García Eugenia , Crisóstomo Salgado Luis Mario , Hernández Pérez Lázaro
Published: February 2025

In the face of the genocidal and ecocidal trajectory of climate change and “green” climate change solutions, overcoming the coloniality embodied in energy regimes is of the utmost importance. Because energy regimes are co-constitutive of power structures, energy transitions present opportunities to challenge and transform power structures of domination into more liberatory configurations of power. Through a situated analysis of the Energía para yeknemilis project, which is executed by the Union of Cooperatives Tosepan Titataniske in the Sierra Norte de Puebla, Mexico, we argue that energy transitions can articulate decolonial praxis. Based on eight months of collaborative participatory action research involving a researcher of European descent and the project's team of investigadores comunitaries sentipensantes, we make two contributions to the literature concerned with energy transitions and decolonial praxis. First, we provide empirical evidence to substantiate decolonial critiques of environmental, climate, and energy justice. Second, we propose that the Energía para yeknemilis project challenges the coloniality present in most of the current energy transition discourses and “green” transition projects. To do so, we discuss how the project contributes to constructing an Indigenous-led and rural energy regime oriented towards achieving energy sovereignty and realizing yeknemilis / xatlaan latamaat, which are local articulations of Buen Vivir. We also analyze some of the possibilities and limits to decolonial transformations in the Sierra Norte de Puebla that the Energía para yeknemilis project illustrates to strengthen the project and provide reflections for others struggling towards energy regimes that sustain life and power Indigenous self-determination and flourishing.
Toward Digital Transformation: Insights into Chinese Cross-Border E-Commerce SMEs During the COVID-19 Pandemic and the Post-Pandemic Era
Authors: Fodouop Kouam Arthur William
Published: February 2025

The pandemic and its restrictions have forced businesses to rethink their strategies and daily operations. The originality of this research lies in assessing the unique challenges cross-border e-commerce Small and Medium Enterprises (SMEs) faced during the pandemic and the strategies they developed to survive. This study also explores the novel practices that emerged during the same period and the digital transformation of these SMEs. Data were gathered through interviews, observation, and questionnaires from 104 cross-border e-commerce SMEs based in China. The study used thematic analysis and descriptive statistics to interpret data. Qualitative Comparative Analysis (QCA) was also used to obtain insights into the configurations of resilience strategies leading to SMEs’ digital transformation. Findings show that cross-border e-commerce SMEs suffered financially during the pandemic. In addition, they faced marketing, logistics, and supply chain challenges. However, they developed various strategies to cope with those challenges and survive in a period of uncertainty. This research suggests a new business model of cross-border e-commerce based on SMEs’ novel practices and configuration strategies to obtain digital transformation. Cross-border e-commerce SMEs should upgrade their marketing, financial, supply chain, and logistics strategies based on the findings of this study. They should leverage technology, diversify their supply chain, adopt online marketing strategies, focus on customer service, optimize their cash flow, and explore new markets.
An Evaluation of Lettersmith: A Technology Tool to Support Transparency of Assigned Public Health Writing
Authors: Gersten Zachary P. , Zamora Astrid N. , August Ella , Anderson Olivia S.
Published: February 2025

Educational technology can be used in the design of transparent writing assignments to support students in meeting learning outcomes. Lettersmith is a free online educational technology that aims to assist students in understanding and completing their writing assignments. In this Original Research paper, we describe a transparently designed public health writing assignment that used Lettersmith and evaluate whether undergraduate public health students perceived improvements in their writing skills after incorporating Lettersmith into a semester-long writing assignment and whether students perceived Lettersmith and its features as useful for supporting their writing. To implement the transparent design, student participants ( n = 64) received explicit instructions about the purpose of the blog writing assignment and used Lettersmith as a tool to support their writing. We used pre- and post-surveys with closed- and open-ended questions to collect participant responses. Participants perceived that their writing skills improved after using Lettersmith to complete the blog writing assignment. The skills that participants prioritized while writing were highly pertinent to public health practice, such as communicating scientific research to a general audience. Most participants recommended that public health instructors use Lettersmith in other courses and specified that the tagging function of Lettersmith improved their writing process. This evaluation of Lettersmith integrated into a transparently designed public health writing assignment suggests that the implementation of such tools can support the writing process, improve the writing of undergraduate public health students, and foster public health communication skills.
Small hydropower, slow violence, and gendered struggles in Northwest Vietnam
Authors: Dao Nga
Published: February 2025

Small hydropower has widely been considered a renewable energy source with minimum adverse social and environmental impacts. However, the expansion of small hydropower in the northwest uplands of Vietnam over the last two decades has created and even normalized persistent and multidimensional water injustice for ethnic minority groups in the region. For some, this expansion has meant persistent, but silent, generational, and cumulative experiences of marginalization and impoverishment as well as the erosion of a way of life. Extractive activities reconstruct identities and redistribute resources and decision-making power, but not without igniting resistance. Local ethnic minority households struggle in negotiating their everyday realities, which are occupied with livelihood maintenance, social interactions, and fights over their use and control of resources. This paper unravels the particular gendered workings in responding to slow violence, drawing on photovoice and over a decade of fieldwork in the northwest uplands where hundreds of small hydrodevelopment projects have been planned and implemented since the early 2000s. The paper argues that the seemingly mundane tasks that women carry out, including cooking, weaving and dyeing fabrics, and growing crops, which are revealed through a gendered perspective to be foundational in cultivating community resilience, self-help, solidarity, resistance, and reworking in the face of ongoing structural injustices and hardships brought about by small hydropower development in Vietnam’s northwest uplands.
Intermediate-Dose Post-Transplantation Cyclophosphamide for Myeloablative HLA-Haploidentical Bone Marrow Transplantation
Authors: Hyder Mustafa A. , Dimitrova Dimana , Sabina Ruby , DeVries Ashley , McCune Jeannine S. , McAdams Meredith J. , Flomerfelt Francis A. , McKeown Christi , Sadler Jennifer L. , Chai Amy , Hughes Thomas E. , Napier Scott , Stokes Anita , Sponaugle Jennifer , Rechache Kamil , Parta Mark J , Cuellar-Rodriguez Jennifer , Figg William D. , Choo-Wosoba Hyoyoung , Steinberg Seth M. , Kanakry Jennifer A. , Kanakry Christopher G.
Published: February 2025

High-dose post-transplantation cyclophosphamide (HD-PTCy), given at 50 mg/kg/day on days +3/+4, is a standard-of-care graft-versus-host disease (GVHD) prophylaxis for allogeneic hematopoietic cell transplantation (HCT). Our murine MHC-haploidentical HCT studies suggested intermediate-dose PTCy produces superior GVHD control compared with HD-PTCy and PTCy is maximally effective on day +4. We conducted a single-institutional prospective phase I/II trial (NCT03983850) to reduce PTCy dosing to 25 mg/kg/day on days +3/+4 or on day +4 only for myeloablative HLA-haploidentical bone marrow HCT using PTCy, sirolimus, and mycophenolate mofetil. Among 35 patients, 89% were ethnic/racial minorities, 46% had high/very-high-risk disease, and median comorbidity-score was 3. The phase I dose-limiting-toxicity, grade III-IV acute GVHD, was not observed after either reduced-PTCy dose-level. PTCy 25 mg/kg/day on days +3/+4 (intermediate-dose (ID)-PTCy; n=23), the phase II dose, resulted in no grade II-IV acute GVHD; 2-year cumulative incidences of chronic GVHD requiring systemic immunosuppression, non-relapse mortality, and relapse were 13%, 17%, and 22%, and 2-year overall survival, disease-free survival, and GVHD-free/relapse-free survival were 61%, 61%, and 52%. In exploratory analysis compared with HD-PTCy (n=5), ID-PTCy resulted in significantly faster engraftment and T-cell reconstitution, fewer transfusions, less mucositis, and reduced severity of BK-virus-associated cystitis; area-under-the-curve exposure of 4-hydroxycyclophosphamide (4HCY), a key cyclophosphamide metabolite, correlated with these outcomes but not with chronic GVHD occurrence. Ideal-body-weight-based PTCy dosing best approximated 4HCY exposure. Intermediate-dose PTCy is effective and has apparent clinical benefits compared with HD-PTCy. Before broader implementation, further studies are needed to confirm these findings and define optimal PTCy dosing across various donor/graft types. NCT03983850
The role of vascularity and the fibrovascular interface in interstitial lung diseases
Authors: Dietrich Jana , Kang Alice , Tielemans Birger , Verleden Stijn E. , Khalil Hassan , Länger Florian , Bruners Philipp , Mentzer Steven J. , Welte Tobias , Dreher Michael , Jonigk Danny D. , Ackermann Maximilian
Published: February 2025

Interstitial lung disease (ILD) is a clinical term that refers to a diverse group of non-neoplastic lung diseases. This group includes idiopathic and secondary pulmonary entities that are often associated with progressive pulmonary fibrosis. Currently, therapeutic approaches based on specific structural targeting of pulmonary fibrosis are limited to nintedanib and pirfenidone, which can only slow down disease progression leading to a lower mortality rate. Lung transplantation is currently the only available curative treatment, but it is associated with high perioperative mortality. The pulmonary vasculature plays a central role in physiological lung function, and vascular remodelling is considered a hallmark of the initiation and progression of pulmonary fibrosis. Different patterns of pulmonary fibrosis commonly exhibit detectable pathological features such as morphomolecular changes, including intussusceptive and sprouting angiogenesis, vascular morphometry, broncho-systemic anastomoses, and aberrant angiogenesis-related gene expression patterns. Dynamic cellular interactions within the fibrovascular interface, such as endothelial activation and endothelial–mesenchymal transition, are also observed. This review aims to summarise the current clinical, radiological and pathological diagnostic algorithm for different ILDs, including usual interstitial pneumonia/idiopathic pulmonary fibrosis, non-specific interstitial pneumonia, alveolar fibroelastosis/pleuroparenchymal fibroelastosis, hypersensitivity pneumonitis, systemic sclerosis-related ILD and coronavirus disease 2019 injury. It emphasises an interdisciplinary clinicopathological perspective. Additionally, the review covers current therapeutic strategies and knowledge about associated vascular abnormalities.
Incident prescriptions for common cardiovascular medications: comparison of recent versus pre-2020 medication adherence and discontinuation in three universal health care systems
Authors: McNaughton Candace D. , Austin Peter C. , Jackevicius Cynthia A. , Chu Anna , Holodinsky Jessalyn K. , Hill Michael D. , Norris Colleen M. , Kumar Mukesh , Kamal Noreen , Lee Douglas S. , Khan Nadia , Vyas Manav V. , Joundi Raed A. , Kapral Moira K. , Yu Amy Y. X.
Published: February 2025

Background

Health system disruptions since onset of the COVID-19 pandemic may have adversely impacted adherence to medications for common cardiovascular risk factors.

Methods

We examined adherence to and discontinuation of incident prescriptions for medications treating hypertension, dyslipidemia, diabetes, and atrial fibrillation in Ontario, Alberta, and Nova Scotia, Canada. We compared the recent period (April 1, 2020 through most recently available follow-up: September 30, 2021 for Ontario; March 31, 2021 for Alberta; and March 31, 2022 for Nova Scotia) to the baseline, pre-pandemic period (April 1, 2014 through March 31, 2019). In each province, people aged ≥66 years with a valid health number and corresponding incident prescription were included. For each medication class, adherence in the recent period, defined as ≥ 0.80 proportion-of-days-covered (PDC), was compared to the pre-pandemic period using modified Poisson regression with robust error variance, adjusted for patient characteristics. Similarly adjusted Cox proportional hazards models compared hazard of discontinuation over one year of follow-up between the two time periods.

Results

In the recent period, PDC ranged from 48.9% for dyslipidemia medications in Alberta to 82.2% for anticoagulants in Nova Scotia. Adherence was not different between periods, with the following exceptions: higher adherence in the recent period for antihypertensives (adjusted risk ratios [aRR] 1.08, 95% CI 1.06–1.10) and dyslipidemics (aRR 1.07, 95% CI 1.04–1.09) in Nova Scotia, and for antihyperglycemics (aRR 1.10, 95% CI 1.08–1.14) and anticoagulants (1.15, 95% CI 1.12, 1.18) in Alberta. Adherence was lower in the recent period only for antihypertensives in Alberta (aRR 0.95, 95% CI 0.93, 0.97). One-year rates of discontinuation ranged from 20.9% for anticoagulants in the Alberta recent period to 56.7% for antihypertensives in the Ontario baseline period. The adjusted hazard of discontinuation was lower or unchanged in the recent period for all medication classes.

Conclusions

Despite significant health system disruptions since 2020, recent adherence to incident cardiovascular prescriptions was similar or better than before and rates of medication discontinuation were lower. However, interventions are still needed to improve existing, suboptimal adherence.
A population-based study on the burden of hospitalized pediatric pneumococcal disease in Taiwan before and after the introduction of 13-valent pneumococcal conjugate vaccine into the childhood immunization program in 2015
Authors: Yen Ting-An , Wu Jhong-Lin , Wang Chi-Chuan , Huang Ling-Ya , Yeo See-Hwee , Patel Dony , Lim Cindy Thiow Koon , Lin Hung-Wei , Yamada Eriko , Sukarom Isaya
Published: February 2025

Background

To estimate the burden of invasive pneumococcal disease, non-bacteremic pneumococcal pneumonia, and acute otitis media before and after inclusion of the 13-valent pneumococcal vaccine (PCV13) into Taiwan’s Childhood Immunization Program in 2015.

Methods

Episodes of eligible children aged < 18 years hospitalized with invasive pneumococcal disease, non-bacteremic pneumococcal pneumonia, or acute otitis media between 1 January 2011 and 31 December 2019 were identified from the National Health Insurance Research Database. Annual hospitalized incidence rate, case fatality rate, and healthcare resource utilization and costs were estimated. Incidence time trends were assessed with interrupted time series analyses.

Results

1,284 invasive pneumococcal disease episodes, 25,074 non-bacteremic pneumococcal pneumonia episodes, and 23,139 acute otitis media episodes were identified. The overall annual incidence rates of invasive pneumococcal disease, non-bacteremic pneumococcal pneumonia, and acute otitis media were 3.31, 64.61, and 59.62 episodes per 100,000 person-years, respectively. Interrupted time series analyses results showed a significantly lower baseline incidence rate (incidence rate ratio [IRR]:0.58, p-value = 0.001) for invasive pneumococcal disease, and significantly higher baseline incidence rate (IRR:1.17, p-value < 0.001) for non-bacteremic pneumococcal pneumonia in the post-PCV13 period. Baseline incidence rates between the two periods were comparable for acute otitis media. A significant increase in trend of incidence rate was observed for all three diseases. Case fatality rate was 1.79%, 0.09%, and 0.00% for invasive pneumococcal disease, non-bacteremic pneumococcal pneumonia, and acute otitis media, respectively. Median length of hospitalization per inpatient visit was comparable between the two periods for invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia, but significantly shorter in the post-PCV13 period for acute otitis media. In the post-PCV13 period, average total costs per episode was lower for invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia, but higher for acute otitis media.

Conclusions

Residual clinical and economic burden of pneumococcal diseases remained substantial after PCV13 inclusion into Taiwan’s Childhood Immunization Program. To further reduce the disease burden among children, additional research to investigate the cause of increasing trends of hospitalized invasive pneumococcal disease, non-bacteremic pneumococcal pneumonia and acute otitis media in the post-PCV13 era will be required.
Donafenib combined with sintilimab for advanced hepatocellular carcinoma: a single arm phase II trial
Authors: Hong Xiaoyang , Guo Yongjian , Shi Wenbo , Zhu Kangshun , Liang Licong , Lin Liteng , Chen Ye , Zhou Jingwen , Huang Jingjun , Huang Jiabai , Wu Yaozhu , Huang Wensou , Cai Mingyue
Published: February 2025

Background

Previous studies evaluating antiangiogenic agents plus immune checkpoint inhibitors for unresectable hepatocellular carcinoma (HCC) have shown encouraging results. This study was conducted to investigate the efficacy and safety of donafenib combined with sintilimab (Don-Sin) for advanced HCC.

Methods

This was a single-center, single-arm phase II trial recruiting patients with BCLC stage C HCC. A safety run-in cohort was planned with the first 6 patients receiving oral donafenib 200 mg twice daily and intravenous sintilimab 200 mg once every 3 weeks. Dose-limiting toxicities (DLTs) were evaluated to determine the recommended dose of donafenib for those enrolled thereafter. The primary endpoint of this study was progression-free survival (PFS) per mRECIST.

Results

30 patients were enrolled. As 3 patients (50.0%) experienced DLTs during safety run-in, the initial dose of donafenib was adjusted to 200 mg once daily for subsequent patients. The primary endpoint was met with a median PFS of 6.2 (95% confidence interval [CI], 4.4-8.0) months per mRECIST (6.3 [95% CI, 5.4–7.2] months per RECIST 1.1). The objective response rate was 23.3% per mRECIST and 16.7% per RECIST 1.1, while the disease control rate reached 76.7% per mRECIST/RECIST 1.1. The median overall survival was 16.0 (95% CI, 13.5–18.5) months. Treatment-related adverse events (TRAEs) occurred in 28 patients (93.3%) and grade 3 TRAEs were observed in 9 patients (30.0%).

Conclusions

Don-Sin showed promising antitumor effects with an acceptable safety profile in patients with advanced stage HCC. The preliminary findings need to be further evaluated in phase III randomized controlled trials.

Trial registration

ClinicalTrials.gov (identifier: NCT05162352; date of registration: December 4, 2021).
The relationship between vision status and its influencing factors among primary and secondary school students: The masking effect of physical activity level and the moderating effect of academic stress
Authors: Xu Jiyan , Li Yanjun , Ma Siyuan , Dai Shimeng , Xu Weiwei , Sang Mengjiao , Feng Kaijie
Published: February 2025

Background

The global youth myopia rate continues to rise, and the vision health of primary and secondary school students has become a global concern. This cross-sectional study aims to explore the vision status of primary and secondary school students in the Ningxia Hui Autonomous Region, China, and its internal relationship with influencing factors under regional characteristics.

Methods

A survey was conducted among 1,670 primary and secondary school students in the Ningxia Hui Autonomous Region of China using a snapshot method and random sampling techniques from September to October 2023. The survey instruments included vision examination, the International Physical Activity Questionnaire, the Lifestyle Behavior Scale, and the Student Academic Stress Questionnaire. The data was tested with descriptive statistics, difference test, correlation analyses, regression analyses, and so on using SPSS 25.0 and SPSSAU, and the target model was established and tested for the goodness-of-fit with AMOS 23.0.

Results

There was a significant negative correlation between vision status and lifestyle behaviors (r=-0.360, p < 0.01), physical activity level (r=-0.058, p < 0.05). The physical activity level played a significant masking effect between lifestyle behaviors and vision status (a*b = 0.002, c’=-0.044), and academic stress played a moderating role in the process of lifestyle behaviors affecting physical activity level and vision status. A moderated mediator model was constructed and fitted well (RMSEA = 0.028, CFI = 0.953, NFI = 0.934).

Conclusions

The prevalence rate of myopia among primary and secondary school students in Ningxia Hui Autonomous Region is lower than the national average, and its prevalence is related to lifestyle behaviors, physical activity level, and academic stress. The impact of lifestyle behaviors on vision status is controlled by physical activity level and academic stress. A strategy of coordinated education involving families, schools, and communities should be implemented. Parents should avoid having excessive expectations and additional academic burdens on their children and encourage them to actively participate in sports; schools should fully implement the ‘’Double Reduction’’ policy, making myopia prevention and control an important part of health education; communities should carry out publicity work for myopia prevention and control, raising adolescents’ awareness of eye health.
Effect of different ceramic materials and dentin sealing on occlusal veneers bond strength and fracture resistance
Authors: Nasr Dina Mohamed , AboElHassan Rewaa Gaber
Published: February 2025

Background

The effect of immediate dentin sealing (IDS) or delayed dentin sealing (DDS) on bond strength of different ceramic occlusal veneer restorations, was not examined yet, but the digital quantification of surface area of preparations helped in the calculation of the actual bond strength of these restorations, besides that, dentin sealing could influence the fracture resistance values of different ceramic occlusal veneer restorations.

This study aimed to examine the effect of different dentin sealing strategies and different restorative materials on the debonding forces, bond strength and fracture resistance of occlusal veneer restorations.

Materials and methods

Human mandibular molars (N = 64/test) were prepared for occlusal veneer restorations fabricated from Lithium disilicate ceramic (LS) (control group), Zirconia-reinforced lithium Silicate ceramic (ZLS), High translucent zirconia ceramic (HZ), and Resin nano ceramic (LU) (n = 16). Each material was subdivided according to IDS or DDS application, (n = 8). Bond strength testing and fracture resistance values were measured using universal testing machine. Two-way ANOVA was performed to investigate the effects of the two variables, dentin sealing and material selection, and their interaction (α = 0.05), followed by One-way ANOVA and post hoc or Student t-test for further determination of significance.

Results

For debonding forces and bond strength testing there were significant differences regarding different materials and dentin sealing strategies, while for fracture resistance, the material selection had a significant effect on it with no significant effects of dentin sealing strategies. The interaction between materials and dentin sealing showed no significant differences concerning all tests. For debonding forces and bond strength there was a higher result related to IDS application than DDS (p < 0.001*), and there was a significant effect of material selection on them (LS > ZLS > HZ > LU), (p = 0.001*). Regarding the fracture resistance there was significant increase of all studied materials than LU (p = 0.002*).

Conclusion

Immediate dentin sealing increased the required debonding forces of occlusal veneers made of different materials and their bond strength without significant effect on their fracture resistance, however this improvement was found to be material dependant. All the used materials can withstand lateral and occlusal forces higher than the values recommended for restoring posterior teeth.
Healthcare trajectories of aging individuals during their last year of life: application of process mining methods to administrative health databases
Authors: Bosson-Rieutort Delphine , Langford-Avelar Alexandra , Duc Juliette , Dalmas Benjamin
Published: February 2025

Context

World is aging and the prevalence of chronic diseases is raising with age, increasing financial strain on organizations but also affecting patients’ quality of life until death. Research on healthcare trajectories has gained importance, as it can help anticipate patients’ needs and optimize service organization. In an overburdened system, it is essential to develop automated methods based on comprehensive and reliable and already available data to model and predict healthcare trajectories and future utilization. Process mining, a family of process management and data science techniques used to derive insights from the data generated by a process, can be a solid candidate to provide a useful tool to support decision-making.

Objective

We aimed to (1) identify the healthcare baseline trajectories during the last year of life, (2) identify the differences in trajectories according to medical condition, and (3) identify adequate settings to provide a useful output.

Methods

We applied process mining techniques on a retrospective longitudinal cohort of 21,255 individuals who died between April 1, 2014, and March 31, 2018, and were at least 66 years or older at death. We used 6 different administrative health databases (emergency visit, hospitalisation, homecare, medical consultation, death register and administrative), to model individuals’ healthcare trajectories during their last year of life.

Results

Three main trajectories of healthcare utilization were highlighted: (i) mainly accommodating a long-term care center; (ii) services provided by local community centers in combination with a high proportion of medical consultations and acute care (emergency and hospital); and (iii) combination of consultations, emergency visits and hospitalization with no other management by local community centers or LTCs. Stratifying according to the cause of death highlighted that LTC accommodation was preponderant for individuals who died of physical and cognitive frailty. Conversely, services offered by local community centers were more prevalent among individuals who died of a terminal illness. This difference is potentially related to the access to and use of palliative care at the end-of-life, especially home palliative care implementation.

Conclusion

Despite some limitations related to data and visual limitations, process mining seems to be a method that is both relevant and simple to implement. It provides a visual representation of the processes recorded in various health system databases and allows for the visualization of the different trajectories of healthcare utilization.
Targeting the G-quadruplex as a novel strategy for developing antibiotics against hypervirulent drug-resistant Staphylococcus aureus
Authors: Sultan Maria , Razzaq Maria , Lee Joohyun , Das Shreyasi , Kannappan Shrute , Subramani Vinod Kumar , Yoo Wanki , Kim Truc , Lee Hye-Ra , Chaurasia Akhilesh K. , Kim Kyeong Kyu
Published: February 2025

Background

The rapid emergence of multiple drug-resistant (MDR) bacterial pathogens and the lack of a novel antibiotic pipeline pose a serious threat to global healthcare. The limited number of established targets further restricts the identification of novel antibiotics to treat life-threatening MDR infections caused by Staphylococcus aureus strains. Therefore, novel targets for developing antibiotics are urgently required. In this study, we hypothesized that the G-quadruplex (G4)-binding ligands can be used as novel antibiotics as their binding can possibly downregulate/block the expression of vital genes.

Methods

To test this, first we screened the antibiotic properties of representative G4-binding ligands against hypervirulent and MDR S. aureus USA300 and determined the in vitro and in vivo antibacterial activity; and proposed the mechanism of action by applying various microbiological, infection, microscopic, and biophysicochemical techniques.

Results

Herein, among screened G4-binding ligands, N-methyl mesoporphyrin IX (NMM) showed the highest antibacterial activity against S. aureus USA300. NMM exhibited a minimum inhibitory concentration (MIC) of 5 μM against S. aureus USA300, impacting cell division and the cell wall by repressing the expressions of genes in the division cell wall (dcw) gene cluster. Genome-wide bioinformatics analysis of G4 motifs and their mapping on S. aureus genome, identified the presence of G4-motif in the promoter of mraZ, a conserved master regulator of the dcw cluster regulating the coordinated cell division and cell wall synthesis. Physicochemical assessments using UV–visible, circular dichroism, and nuclear magnetic resonance spectroscopy confirmed that the G4-motif present in the mraZ promoter formed an intramolecular parallel G4 structure, interacting with NMM. In vivo reporter followed by coupled in vitro transcription/translation (IVT) assays confirmed the role of mraZ G4 as a target interacting NMM to impose extreme antibacterial activity against both the gram-positive and -negative bacteria. In-cell and in vivo validation of NMM using RAW264.7 cells and Galleria mellonella; respectively, demonstrated that NMM exhibited superior antibiotic activity compared to well-established antibiotics, with no observed cytotoxicity.

Conclusions

In summary, the current study identified NMM as a broad-spectrum potent antibacterial agent and elucidated its plausible mechanism of action primarily by targeting G4-motif in the mraZ promoter of the dcw gene cluster.