bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic impact of depth of response and early tumour shrinkage in patients with BRAFV600E-mutated metastatic colorectal cancer treated with targeted therapy
Authors: Vetere Guglielmo , Germani Marco Maria , Antoniotti Carlotta , Salvatore Lisa , Pietrantonio Filippo , Lonardi Sara , Bensi Maria , Ghelardi Filippo , Calegari Maria Alessandra , Intini Rossana , Minelli Alessandro , Sullo Francesco Giulio , Boccaccio Chiara , Taravella Ada , Puccini Alberto , Lavacchi Daniele , Noto Laura , Salati Massimiliano , Scartozzi Mario , Cremolini Chiara
Published: January 2025

Background:

Encorafenib plus cetuximab (EC) is the standard of care for pre-treated BRAF V600E mutated metastatic colorectal cancer (mCRC). Depth of response (DpR) and early tumour shrinkage (ETS) previously showed a strong correlation with survival outcomes of first-line chemotherapy ± biological agents.

Objectives:

We aimed to assess potential predictors of primary resistance to EC ± binimetinib (B) and relationships of DpR/ETS with survival outcomes and clinical characteristics.

Design:

This is a retrospective real-world cohort study of BRAF V600E mutated mCRC patients treated with second-line EC ± B at 20 Italian centres.

Methods:

Measurable disease according to Response Evaluation Criteria In Solid Tumour (RECIST) 1.1 at baseline and at least one subsequent computed tomography (CT) scan were mandatory for inclusion. Clinical features associated with primary resistance, DpR and ETS were investigated. Relationships of DpR and ETS, both as binary, according to conventional (30% for DpR and 20% for ETS) and median cut-off values, and continuous variables, with progression-free (PFS), overall survival (OS) and duration of response (DoR) were assessed in non-primary resistant patients.

Results:

A total of 105 patients were included. The primary resistance rate was 28% (29/105) and was associated with baseline peritoneal metastases ( p = 0.04). Disease control and overall response rates were 72% (76/105) and 24% (25/105), respectively, with a median DpR of 15% and an ETS rate of 37% (28/76). Mucinous histology was associated with a significantly lower magnitude of DpR ( p = 0.005) and a lower rate of ETS ( p = 0.002). In the multivariable models, DpR significantly correlated with longer PFS as a dichotomous variable, according both to conventional (hazard ratio (HR)DpR ⩾30%: 0.52, 95% CI: 0.30–0.90, p = 0.02) and median cut-off values (HRDpR⩾15%: 0.55, 95% CI: 0.33–0.92, p = 0.03), and as a continuous variable (HR per 10% increment: 0.88, 95% CI: 0.78–0.98, p = 0.02), while correlations with OS were not confirmed. DpR was also significantly associated with longer DoR ( pDpR⩾30% = 0.04; pDpR⩾15% = 0.04; pcont. = 0.02), whereas no relationships of ETS with PFS, OS or DoR were detected.

Conclusion:

A DpR of at least 15% independently predicts PFS benefit in BRAF V600E mutated mCRC patients treated with second-line EC ± B.
The continually evolving landscape of novel therapies in oncogene-driven advanced non-small-cell lung cancer
Authors: Melosky Barbara , Juergens Rosalyn A. , Banerji Shantanu , Sacher Adrian , Wheatley-Price Paul , Snow Stephanie , Tsao Ming-Sound , Leighl Natasha B. , Martins Ilidio , Cheema Parneet , Liu Geoffrey , Chu Quincy S. C.
Published: January 2025

Non-small-cell lung cancer (NSCLC) is a highly heterogeneous disease that is frequently associated with a host of known oncogenic alterations. Advances in molecular diagnostics and drug development have facilitated the targeting of novel alterations such that the majority of NSCLC patients have driver mutations that are now clinically actionable. The goal of this review is to gain insights into clinical research and development principles by summary, analysis, and discussion of data on agents targeting known alterations in oncogene-driven, advanced NSCLC beyond those in the epidermal growth factor receptor (EGFR) and the anaplastic lymphoma kinase (ALK). A search of published and presented literature was conducted to identify prospective trials and integrated analyses reporting outcomes for agents targeting driver gene alterations (except those in EGFR and ALK) in molecularly selected, advanced NSCLC. Clinical efficacy data were extracted from eligible reports and summarized in text and tables. Findings show that research into alteration-directed therapies in oncogene-driven, advanced NSCLC is an extremely active research field. Ongoing research focuses on the expansion of new agents targeting both previously identified targets (particularly hepatocyte growth factor receptor (MET), human epidermal growth factor receptor 2 (HER2), and Kirsten rat sarcoma viral oncogene homolog (KRAS)) as well as novel, potentially actionable targets (such as neuregulin-1 (NRG1) and phosphatidylinositol 3-kinase (PI3K)). The refinement of biomarker selection criteria and the development of more selective and potent agents are allowing for increasingly specific and effective therapies and the expansion of clinically actionable alterations. Clinical advances in this field have resulted in a large number of regulatory approvals over the last 3 years. Future developments should focus on the continued application of alteration therapy matching principles and the exploration of novel ways to target oncogene-driven NSCLC.
“Transformative dynamics of the gig economy: Technological impacts, worker well-being and global research trends”
Authors: Himani Srihita Rachoru , Goli Gurunadham , M Rajyalaxmi , Gobinath R
Published: January 2025

Digital platforms play a vital role in shaping today’s labour market, enabling temporary hires and freelance employment in the gig economy. This on-demand, digital economy spans various professions and remote work opportunities. Technological advancements have significantly evolved gig work since the industrial age, improving work-life balance and psychological well-being. Using the Scopus database, a literature analysis on the gig economy was conducted with 1624 documents narrowed to 549 documents based on subject area, document type, publication stage, keywords, and language and examining social, economic and technological factors. This study highlights the evolving nature of non-traditional, online-platform- driven employment through which author’s explored the gig economy, its challenges, ethical issues, and career development and workers experiences. The analysis used R Studio Software to visualize keyword themes using a strategic thematic map, which signifies the structure and development of themes within the gig economy. This study used Origin Pro for author analysis which found GRAHAM as the top author. VOS Viewer for bibliographic coupling which identified USA and UK as top collaborating countries and also highlight the eight clusters of keyword analysis. For sustainable growth, further research should explore the platform economy, gig employment, and worker well-being, assessing technological innovations to create adaptable job opportunities. This will help the gig economy to accommodate market dynamics and ensure diverse and stable employment across various sectors.
Early Experience With the Quantum Total Ankle Prosthesis
Authors: Christie Lauren M. , Philbin Terrence M.
Published: January 2025

The Quantum total ankle prosthesis is a newer Food and Drug Administration (FDA)-approved fourth-generation 2-component, fixed-bearing implant in its first-generation design. The purpose of this study was to evaluate early outcome data and present our initial experience with the Quantum implant with a minimum of a 1-year follow-up. A retrospective, single-centered chart and radiographic review was performed on all patients who underwent total ankle arthroplasty with the Quantum implant from December 2021 to August 2023. Implant survivorship, radiographic outcomes, clinical outcomes, and complications were evaluated. The survivorship for the implant was 100% for the tibial component and 91.67% for the talar component, respectively. Pre-operatively, there were 3 ankles with a coronal deformity greater than 10 degrees. Post-operatively, coronal plane deformity was 100% corrected into neutral alignment. This study is the first to report on short-term outcomes for the Quantum total ankle prosthesis. Our findings showed promising results of short-term implant survivorship with good clinical and radiographic outcomes.

Level of Evidence: IV
Increasing Hotel Loyalty Through Psychological Ownership
Authors: Yoon Y. Rin , Peck Joann , Shu Suzanne B.
Published: January 2025

The hospitality industry has long emphasized guest satisfaction as key to building loyalty. However, in such a highly competitive and service-oriented market, interventions to increase satisfaction may often be too costly relative to their marginal impact on guest loyalty. This research proposes a new and potentially lower-cost avenue for increasing guest loyalty to the hotel: guests’ sense of ownership of their hotel rooms. An analysis of 14,689 online reviews on TripAdvisor, a naturalistic field experiment in a hotel ( N = 82), as well as two controlled lab simulation studies (combined N = 1,002) jointly demonstrate that increasing psychological ownership of a hotel room significantly increases guest loyalty to the hotel, independent of customer satisfaction. This work extends our current understanding of psychological ownership and customer loyalty by demonstrating how psychological ownership of a tangible service element can enhance brand loyalty via a mechanism that does not rely on changes in satisfaction. In doing so, we highlight the role of psychological ownership as an underexplored and cost-efficient driver of loyalty in hospitality settings.
Occupational health professionals’ and HR specialists’ perceptions of telemental health services in occupational health care settings: A qualitative study
Authors: Kervinen Elina , Vähätalo Lauri , Siukola Anna , Reho Tiia , Winell Klas , Sauni Riitta
Published: January 2025

Objective

The rise in mental health-related work disability pensions highlights the need for more research on how occupational health care (OHC) can support mental health, including the use of telehealth (TH) services in mental health care.

Methods

The research, employing a descriptive qualitative approach through interviews ( n = 42), focused on experiences of professionals from a private OHC service provider in Finland and human resource representatives (HRRs) of OHC client companies. Inductive content analysis was used to analyze the data.

Results

Our research suggests that TH services provided by OHC can enhance access to care and expedite the initiation of work ability support, particularly in mental health cases. However, potential challenges include a perceived sense of distance, superficiality in interactions, and difficulty in forming a comprehensive understanding due to few non-verbal cues.

Conclusion

A combined approach of TH and face-to-face services is suggested to provide flexible, and individualized support. Further studies on remote low-threshold discussion mental health services and studies comparing TH and face-to-face services are advised.
The benefits and safety of a virtual reality intervention in patients suffering from acute and chronic pain: A pilot study
Authors: Ma Bingjie , Zhang Libo , Ji Yun , Huang Xuehua , Yao Luandi , Cheng Wei , Hu Li , Lu Xuejing , Ma Ke
Published: January 2025

Background

To overcome the challenge of psychotherapist scarcity in applying pain psychotherapy in clinical practice, we developed a virtual reality (VR) program delivering weeks of pain psychotherapy without psychotherapists, with a focus on minimizing the risk of motion sickness.

Objectives

We conducted a single-arm pilot study to assess the efficacy and motion sickness associated with a VR session delivering guided imagery and breathing techniques selected from the initial course of our VR program, involving patients suffering from various acute and chronic pain.

Methods

Patients underwent a 15-min VR session. Pain-related and anxiety ratings using a 0–10 numerical rating scale were collected pre-, during-, post-VR and in 6-h follow-up. Motion sickness symptoms were assessed using Simulator Sickness Questionnaire pre- and post-VR.

Results

Patients ( n = 73) reported their perceived pain intensity and anxiety reduced significantly from pre- to post-VR by 22.9% and 45.0% (all p < 0.0001), respectively. Such modulatory effects of VR in pain perception and anxiety persisted at 30 min, 1 h, 2 h, and 6 h post-VR (all p < 0.0001). The pre-post beneficial effects of VR were independent from patients’ demographic characteristics and their pain duration. Importantly, only six patients (8.2%) had post-VR motion sickness symptoms, and only one patient reported moderate level of severity.

Conclusion

These findings suggest the selected VR session delivering pain psychotherapeutic techniques may be effective and tolerable for patients with varying pain conditions, which provides initial evidence for the development of future randomized controlled trials of the complete VR program.
Engaging and supporting young adults in smoking cessation: Insights from a mobile-based cessation program in China
Authors: Weng Xue , Yang Hongcui , Song Chuyu , Tu Jiayu , Liu Kefeng , Wang Man Ping
Published: January 2025

Objective

Evidence-based smoking cessation treatments are underutilized by young adult smokers. This study explored young smokers’ experiences with a mobile-based smoking cessation program that included a Quit & Win contest at a university in Zhuhai, China, aiming to identify key engagement and cessation mechanisms.

Methods

Twenty participants (aged 18–25 years) were selected through purposive sampling. Semistructured interviews explored participants’ experiences, motivations, and perceptions of the intervention. Thematic analysis was used to identify major themes from interview transcripts.

Findings

Two main themes emerged: (1) strategies for enhancing program engagement, including the influence of campus-wide smoke-free environments, the appeal of the Quit & Win contest, and the use of peer counselors for recruitment; and (2) strategies for supporting smoking cessation, emphasizing the importance of a multifaceted approach. This approach included financial incentives as a motivator for quitting, sustaining cessation efforts with online group support, and building a therapeutic alliance with cessation counselors.

Conclusion

Mobile-based interventions, combined with peer support, financial incentives, and campus-wide smoke-free activities, can effectively engage young adults in smoking cessation. Future interventions should implement comprehensive programs that incorporate these elements to address the unique challenges faced by this population.
Prediction of acute kidney injury in intensive care unit patients based on interpretable machine learning
Authors: Zhang Li , Li Mingyu , Wang Chengcheng , Zhang Chi , Wu Hong
Published: January 2025

Objective

Acute kidney injury (AKI) poses a lethal risk in intensive care unit (ICU) patients, where early detection is challenging. This study was to establish a prediction model for AKI 24 hours in advance for ICU patients and to help clinicians monitor patients at an early stage by key features.

Methods

In this study, the Medical Information Mart for Intensive Care (MIMIC) databases were used to construct a dataset of critically ill patients. Predictive models were constructed using five machine learning algorithms based on MIMIC-IV data, and the best predictive model was selected by multiple model evaluation metrics. MIMIC-III data were used for external validation. We conducted an interpretability analysis of the model using SHapley Additive exPlanations (SHAP) to clarify key features and decision-making mechanisms.

Results

A total of 18,186 patient data were included in this study. The analysis combining calibration and decision curves demonstrated that the eXtreme Gradient Boosting (XGBoost) exhibited superior performance among the five algorithms, achieving an area under the receiver operating characteristic curve of 0.88. Interpretability analysis based on the XGBoost model showed diuretic use, mechanical ventilation, vasopressor use, age, and antibiotic use as the most important decision factors of the model. The SHAP summary plot was used to illustrate the effects of the top 19 features attributed to the XGBoost.

Conclusions

The XGBoost algorithm can predict the occurrence of AKI more accurately. Interpretative analysis of the model reveals the mechanisms of key features, and reflects the individual differences between patients, providing an important clinical reference.
Spatial-Racial Disparities in California's Capital Punishment: Examining the Influence of Geography and Race on Death Sentencing from 1987 to 2019
Authors: Petersen Nick
Published: January 2025

Although a vast literature has documented racial or geographic disparities in capital punishment, scholars have largely ignored the intersecting influences of race and geography on death sentencing that perpetuate spatial-racial inequalities. Building off research identifying racialized “hotspots” in non-capital sentencing, we developed a novel dataset linking all homicides and death sentences in California over three decades (1987–2019) to examine racial disparities in death sentencing within and across counties. In contrast to prior studies using non-exact matching to link death sentence and homicide data, our use of exact matching allowed us to include more control variables, especially aggravators. According to multi-level logistic regression models, the odds of a death sentence are much higher in some counties, aligning with insights from the literature on court communities. In line with focal concerns theory, death sentencing rates are highest among homicides with White victims and/or offenders of color, especially inter-racial homicides with White victims and non-White offenders. While these racial disparities are remarkably consistent within all California counties, their magnitude varies across counties. Such spatial-racial disparities raise constitutional concerns about the arbitrariness of California death sentences and highlight racialized death penalty “hotspots” that seem to violate the state's Racial Justice Act.
Depersonalized Harmony and Sustained Belonging: Shaping Online Collective Identities in a University Sports Team
Authors: Ni Chenyu , Bruce Toni , Henley Margaret
Published: January 2025

This study investigates the role of digital spaces in shaping and maintaining the collective identity around a university shuai-jiao (traditional Chinese wrestling) team, a niche sport with deep cultural roots but limited visibility. Utilizing symbolic interactionism and self-categorization theory, the study explores the dynamics and evolution of the team’s social media chat group, which includes current and former team members. The results offer insights into how identity and relationships are sustained over time and beyond physical interactions. The findings reveal that depersonalized harmony plays a crucial role in fostering group cohesion, as members prioritize group unity by avoiding divisive topics. Additionally, former members’ ongoing engagement through the chat group highlights how engaging via a digital platform preserves their sense of belonging and athletic identity. These mechanisms ensure the transmission of cultural heritage and support the team’s continuity. This research contributes to understanding online collective identity formation by emphasizing the importance of maintaining both common bonds and identity in niche sports. It offers practical insights into how sports organizations can use digital tools to sustain participation, build resilience, and ensure cultural continuity, even in the absence of face-to-face interactions.
Surgical Outcomes of Lateral Ulnar Collateral Ligament Reconstruction Versus Repair for Posterolateral Rotatory Instability of the Elbow: A Systematic Review and Meta-analysis
Authors: Kholinne Erica , Ng Zhan Herr , Anastasia Maria , Singjie Leonard Christianto , Kwak Jae-Man , Jeon In-Ho
Published: January 2025

Background:

The aim of surgical treatment for posterolateral rotatory instability (PLRI) of the elbow is to restore the integrity of the lateral ulnar collateral ligament (LUCL), with ligamentous reconstruction being the preferred option for recurrent symptomatic PLRI. However, there is no clinical evidence demonstrating the superiority of reconstruction versus repair. Treatment options currently depend on the cause of the LUCL injury and surgeon preference.

Purpose:

To review studies comparing surgical outcomes of LUCL reconstruction versus repair in treating PLRI of the elbow.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was conducted on PubMed, Medline (via EBSCO), ProQuest, and ScienceDirect databases using the following keywords: “(lateral ulnar collateral ligament reconstruction)” OR “(lateral ulnar collateral ligament repair)” AND “(outcome).” Excluded were studies in languages other than English, those that included terrible triad injury, transolecranon fracture, radial head arthroplasty involvement, associated procedures, animal studies, and biomechanical studies. A total of 193 studies were identified after the initial search. The primary outcome measure was the Mayo Elbow Performance Score, which was compared between studies using a random-effects model.

Results:

Overall, 20 studies (N = 646 patients) were included, with 445 of 646 patients (68.8%) in the LUCL reconstruction group and 201 of 646 patients (31.1%) in the LUCL repair group. All injuries in the included studies were traumatic. The LUCL reconstruction group had a longer follow-up period compared with the LUCL repair group (72.05 ± 43.51 vs 36.86 ± 21.19 months, respectively). The postoperative range of motion arc was similar in both the repair and reconstruction groups (135.02°± 15.33° vs 133.60°± 8.84°, respectively). Both LUCL repair and LUCL reconstruction resulted in good to excellent outcomes on patient-reported outcome measures; however, a superior rate of return to activity and a lower complication rate were found after LUCL reconstruction versus LUCL repair (8.3% vs 14.9%). Ulnar nerve event (2.3%) was the most common complication in both groups.

Conclusion:

Findings indicated that LUCL reconstruction had a superior rate of return to activity and a lower complication rate compared with LUCL repair.
The Theological Foundations of the Right to Stay in Catholic Social Teaching
Authors: Lemos Antônio
Published: January 2025

Executive Summary

The right to stay emerged as a fundamental principle in modern Catholic social teaching (CST) in the twentieth century, even preceding the right to migrate. This right is rooted in the condemnation of forced migration and three theological principles: 1 — salvation of souls, 2 — universal destination of goods, 3 — dignity of the human person. This paper traces the development of the right to stay within CST, identifying three distinct stages. The first stage, spanning from the late nineteenth century to the mid-twentieth century, is characterized by an implicit recognition of the right to stay, embedded in the critique of the treatment of forced migration. During this period, CST primarily addressed the concerns of Catholic migrants, offering pastoral care and emphasizing the salvation of souls as theological foundations for protection. The second stage, from the mid-twemtieth century to the 1960s, sees a growing emphasis on the universal destination of goods as a key theological principle. While the right to stay remains implicit, CST begins to advocate for the protection of all migrants, regardless of their faith. The third stage, commencing in the 1960s, is marked by the explicit articulation of the right to stay, notably by Pope John XXIII. Its theological foundation expands to include the dignity of the human person, firmly establishing the right to stay as a central tenet of Catholic migration ethics. The study concludes that the right to stay has evolved from an implicit concept to a clearly articulated principle in CST. This evolution is underpinned by a growing theological foundation, shifting from a focus on pastoral care of Catholic migrants, to a broader emphasis on the universal destination of goods and the inherent dignity of every human person.
Reasons to Stay: A Review of Community-Led Efforts to Generate Rootedness
Authors: Aviel Sara , S. Ryan Kelly , S. Gomes Raquel
Published: January 2025

Executive Summary

Lack of livelihood opportunities, violence, and other pressures lead many youth from across El Salvador, Guatemala, and Honduras to migrate without documentation, with significant numbers attempting to reach the United States. Yet other youth, facing similar obstacles, find or create opportunities closer to home. This article complements the emerging research on what motivates individuals in high-migration areas to remain in their country of origin by reviewing how community-led organizations across these countries have contributed to creating opportunities for youth locally. After briefly reviewing the evidence on factors associated with rootedness (the combination of economic, social, civic, and cultural ties to one’s homeland), we describe the experience of 17 community-led organizations, all grantees of the Inter-American Foundation (IAF), and identify how the organizations have contributed to income generation, education, and civic engagement, factors often associated with greater likelihood of remaining in one’s locality or country. Much of the effectiveness of these organizations derives from their locally-led efforts to provide increasingly comprehensive approaches to youth development that boosts how young people perceive themselves and their potential in the world, while strengthening their connection to their communities. This comprehensive approach, more than any single intervention, makes the difference in allowing youth to remain in their home countries.
Supporting Scholarship of Teaching and Learning in Public Health: An Ecosystem Approach
Authors: Kruger Jessica S. , Godley Sophie , Neubauer Leah C.
Published: January 2025

Educators can fulfill multiple roles in the realm of teaching and learning, such as scholars, learners, practitioners, and advocates. Public health educators can engage in the Scholarship of Teaching and Learning (SoTL) through various methods and levels, ranging from teacher-centered and informal approaches to student-centered and reflective practices. However, effective teaching practices are frequently not emphasized or included in public health graduate program curricula. The SoTL is rarely included in faculty onboarding and public health graduate programs and information on effective teaching practices is omitted from the curriculum or not a major focus. With the lack of training in the SoTL there comes a lack of dissemination of these practices to others. While many educators in public health are engaging in innovative projects or educational strategies, many lack the knowledge of how to study this or how to disseminate results from their work. Specifically, this paper advocates for an “ecosystems” approach—that is—understanding that public health education is taking place in living environments where students, faculty, and administrators are all engaged in acting upon one another and being acted upon simultaneously. An ecosystem approach to promoting the SoTL recognizes that teaching about public health is a naturalistic, living interaction that is influenced by events within the system and outside the system. This paper seeks to call to attention the need for institutional support for the SoTL practices and possible strategies for increasing the SoTL in public health.
Improving Patient Experience by Understanding Barriers and Incentives to Telehealth Adoption Among Physicians at a Large Academic Medical Center
Authors: Luna Alessandro , Sewell Taylor B
Published: January 2025

Patients benefit from and appreciate the option to use telehealth with their providers. Such patient expectations have therefore led to new questions about the factors that affect providers’ willingness to adopt telehealth as part of their clinical practice. We interviewed 19 physicians across four specialties with differential rates of telehealth use (Psychiatry, Anesthesiology, Physical Medicine & Rehabilitation [PM&R], and Ophthalmology) to discern the barriers and incentives to telehealth adoption among physicians. We then conducted a qualitative analysis of interview transcripts, following precepts of Directed Content Analysis. Conclusions drawn from matrix building and thematic analysis were verified with negative evidence searches and if-then tests. Robust investigations for outliers and rival explanations in responses were used to disconfirm findings. The results of this analysis revealed distinct barriers and incentives to telehealth adoption for the four specialties. Physicians in psychiatry and anesthesiology are refining the strengths and applications of telehealth based on the characteristic needs of their specialties. Physicians in PM&R and ophthalmology face additional barriers to acquiring physical exam data, leading them to use telehealth as a supplement to, rather than as a replacement for, core functions of patient care. The insights stemming from these barriers and incentives can be used to build thoughtful telehealth applications for physicians, allowing them to provide effective clinical care while also improving the patient experience.
What standards do and whom they serve: Fixing, practising and delivering per capita water supply standards in cities in India
Authors: Tiwale Sachin
Published: January 2025

This paper examines how the per capita standards of water supply are fixed, practised and delivered in cities in India. The per capita standard of water supply is a key figure in deciding the quantum of water cities can extract from adjacent regions and the amount of water individual citizens are entitled to consume. It is one of the critical parameters determining the sizing of the urban water infrastructure from the source to tap. The analysis of the per capita standard of water supply reveals a disconnect between setting per capita standards, practising these standards during the planning and designing of water supply infrastructure and delivering water as per these standards to the citizens. The per capita standards are prescribed with multiple objectives, changed frequently without providing any rationale and lack theoretical or empirical evidence substantiating them. The convenient values of per capita standards are used by the standard prescribing authorities, planners and engineers to achieve their own goals. Moreover, these standards are not monitored during service delivery to ensure water supply according to the design standards for all citizens. As a result, the per capita standard of water supply, a useful metric for planners (to allocate financial resources) and engineers (to design infrastructure), remains a fictitious number during service delivery for citizens.
Imagining a desired future in the context of illness or disability
Authors: Hänninen Vilma , Pohjola Hanna , Tarvainen Merja
Published: January 2025

This study investigates the imagination of the future in the context illness or disability, using the letters from the future method (LFM) and reading the letters from the perspective of the concept of possibility. The data comprise 30 letters from the participants of an online adaptation enhancement training program called Etäsope, which was organized by Invalidiliitto (The Finnish Association of People with Physical Disabilities) in Finland from 2020 to 2021. Through thematic analysis, the study identified the following six main themes regarding a path toward a desired future: the self, relationship with others, life circumstances, actions, vivid imageries of the future, and philosophies of life. This study suggests that the LFM is a feasible method for possibility studies as well as for facilitating the construction of future views among people for whom viewing the future in a positive light might be challenging.
Patient-Reported Improvements in Patients with PNH Treated with Iptacopan from Two Phase 3 Studies
Authors: Risitano Antonio Maria , de Castro Carlos , Han Bing , Kulasekararaj Austin G , Maciejewski Jaroslaw P. , Scheinberg Phillip , Ueda Yasutaka , Vallow Susan , Bermann Georgina , Dahlke Marion , Kumar Rakesh , Peffault de Latour Regis
Published: January 2025

Iptacopan, a first-in-class, oral, selective complement factor B inhibitor, demonstrated efficacy and safety as monotherapy in C5 inhibitor (C5i)-experienced (APPLY-PNH [NCT04558918]) and C5i-naive (APPOINT-PNH [NCT04820530]) patients with paroxysmal nocturnal hemoglobinuria (PNH). In APPLY-PNH and APPOINT-PNH, changes in fatigue (FACIT-Fatigue) and health-related quality of life (HRQOL; EORTC QLQ-C30) from baseline to Day 168 were evaluated. The proportion of patients achieving meaningful within-patient change (MWPC) on the FACIT-Fatigue and 4 EORTC QLQ-C30 subscales (physical functioning, role functioning, fatigue, dyspnea) was evaluated using anchor-based thresholds. Correlations between FACIT-Fatigue scores, lactate dehydrogenase (LDH), and hemoglobin (Hb) levels were also assessed. In APPLY-PNH (iptacopan, n=62; C5i, n=33), more patients in the iptacopan group reached the MWPC threshold for FACIT-Fatigue than in the C5i group (51% vs 11%). More patients achieved MWPC on domains of the EORTC QLQ-C30 in the iptacopan group (39%-49%) than the C5i group (9%-20%). In APPOINT-PNH (N=40), 56% achieved MWPC on the FACIT-Fatigue, and the proportion of patients who achieved MWPC on the EORTC QLQ-C30 ranged from 41% to 55%. In C5i-experienced patients, increased Hb levels correlated with improvement in FACIT-Fatigue scores (R=0.48, P<0.001). In C5i-naive patients treated with iptacopan, increased Hb (R=0.42, P<0.001) and decreased LDH (R=−0.53, P<0.001) correlated with improved FACIT-Fatigue scores. C5i-experienced and -naive patients receiving iptacopan exhibited meaningful improvement in fatigue, HRQOL, and disease-related symptoms, which correlated with clinical improvement in hematologic markers of disease control. These trials are registered at www.ClinicalTrials.gov as NCT04558918 (APPLY-PNH) and NCT04820530 (APPOINT-PNH).
Home mechanical ventilation in children: evolving indications in an era of new treatment options
Authors: Tan Hui-leng , Chawla Jasneek
Published: January 2025

Worldwide, there has been a dramatic increase in the use of paediatric home mechanical ventilation (HMV). In this review, we examine this rapid evolution in clinical practice through the prism of two distinct groups of children: those with neurodisability/medical complexity and patients with neuromuscular disease. We illustrate the changes in service provision for these two groups that are driven by a recognition that early intervention with HMV can enhance quality of life for these children and may complement the beneficial effects of novel disease-modifying medications to improve survival. Alongside this, we highlight the importance of balancing patient expectations with clinical need and discuss the ethical challenges that may be encountered when delivering HMV to this increasing population of children.
Differential expression of plasma proteins and pathway enrichments in pediatric diabetic ketoacidosis
Authors: Spagnolo Paolo , Cela Enis , Patel Maitray A. , Tweddell David , Daley Mark , Clarson Cheril , Stranges Saverio , Cepinskas Gediminas , Fraser Douglas D.
Published: January 2025

Background

In children with type 1 diabetes (T1D), diabetic ketoacidosis (DKA) triggers a significant inflammatory response; however, the specific effector proteins and signaling pathways involved remain largely unexplored. This pediatric case–control study utilized plasma proteomics to explore protein alterations associated with severe DKA and to identify signaling pathways that associate with clinical variables.

Methods

We conducted a proteome analysis of plasma samples from 17 matched pairs of pediatric patients with T1D; one cohort with severe DKA and another with insulin-controlled diabetes. Proximity extension assays were used to quantify 3072 plasma proteins. Data analysis was performed using multivariate statistics, machine learning, and bioinformatics.

Results

This study identified 214 differentially expressed proteins (162 upregulated, 52 downregulated; adj P < 0.05 and a fold change > 2), reflecting cellular dysfunction and metabolic stress in severe DKA. We characterized protein expression across various organ systems and cell types, with notable alterations observed in white blood cells. Elevated inflammatory pathways suggest an enhanced inflammatory response, which may contribute to the complications of severe DKA. Additionally, upregulated pathways related to hormone signaling and nitrogen metabolism were identified, consistent with increased hormone release and associated metabolic processes, such as glycogenolysis and lipolysis. Changes in lipid and fatty acid metabolism were also observed, aligning with the lipolysis and ketosis characteristic of severe DKA. Finally, several signaling pathways were associated with clinical biochemical variables.

Conclusions

Our findings highlight differentially expressed plasma proteins and enriched signaling pathways that were associated with clinical features, offering insights into the pathophysiology of severe DKA.
Insights into semi-continuous synthesis of iron oxide nanoparticles (IONPs) via thermal decomposition of iron oleate
Authors: Höfgen Egon Götz , Bandyopadhyay Sulalit
Published: January 2025

The increasing demand for magnetic iron oxide nanoparticles (IONPs) in biomedicine necessitates efficient and scalable production methods. Thermal decomposition offers excellent tailoring of the particle properties but its discontinuous batch-operation is restricting scale-up and industrial application. To overcome these challenges, several studies have demonstrated semi-continuous thermal decomposition by slowly injecting the precursor, though only half of them produce magnetite IONPs and even fewer use iron oleate precursors. The available studies are limited, often focusing on single synthesis variables and a comprehensive mapping of the physicochemical properties to reaction conditions is missing. Here we present our investigation of semi-continuous thermal decomposition of iron oleate as a route for the synthesis of magnetic IONPs. We achieved the semi-continuous synthesis of spherical IONPs with properties matching those obtained via the conventional heat-up method. We explored the the effect of multiple synthesis variables, namely addition rate, dwell time, iron oleate amount, oleic acid amount, temperature and consistently report magnetic saturation of our samples. We found that the dwell time seemingly has a stronger effect on particle sizes and magnetic saturation than the addition speed, within moderate addition rates, and further are we the first to report the effect of reaction temperature on semi-continuous synthesis. The iron oleate precursor obtained from salt exchange was employed without pretreatment or dilution thereby facilitating a streamlined synthesis process. An oxidative phase transfer was used to mitigate the key challenge of hydrophobicity of oleate-capped IONPs, enabling their potential use in biomedical applications. Our work advances the understanding of of synthesis-property relationships of IONPs by demonstrating the translation of established synthesis protocols into more efficient and scalable processes through which it provides insights for developing and optimizing future production protocols for various applications.

Graphical abstract
Floral diversity and conservation status of vascular plants in arid mountainous areas
Authors: Hassanen Sara , Eldin Elsayeda Gamal , Kamel Wafaa , Zaghloul Mohamed Saad , Hassan Yasmin M.
Published: January 2025

Background

The destructive human activities, encroachment of natural habitats, and hyperarid climate threaten the wild flora of the unprotected mountainous areas facing the Gulf of Suez, Egypt. So, this study aims to revise and give an updated systematic status of the flowering plants growing there to conserve and utilize valuable biodiversity.

Results

This study showed the presence of 136 species, including 7 sub-species of vascular plants, 12 species of monocots, and 124 species dicots belonged to 98 genera and 37 families. The most species-rich families were Asteraceae (22 species) and Amaranthaceae (19 species). Therophytes and Chamaephytes were the most dominant life- forms in the study area, representing 38.2%. They were followed by Phanerophytes, Hemicryptophytes, and Cryptophytes, which represented 11%, 8.8%, and 2.9%, respectively. Five plant assemblages were identified by TWINSAPN classification namely, Zygophyllum coccineum –Haloxylon salicornicum assemblage, Zilla spinosa -Zygophyllum coccineum assemblage, Zygophyllum coccineum-Tamarix nilotica assemblage, Tamarix nilotica – Phargmites australis assemblage and Tamarix nilotica–Chenopodium murale assemblage. Several invasive species were recorded in some wadis. However, their presence is unusual to the floristic composition of the wadis in general and acts as an alarm to protect the native species from anthropogenic interference. Moisture content, organic matter, electrical conductivity, pH, cations, anions, and total carbonate were identified as the significant factors controlling distribution of plant clusters by detrended correspondence analysis. This study recorded Tribulus mollis as a new addition to Egypt’s flora of Eastern desert.

Conclusion

The comparative analysis of the present and past floral studies in the study area reveals a significant change in the plant community composition. This shift is likely attributed to the adverse impacts of climate change and anthropogenic activities. Thus, this area has to be safeguarded with practical strategies that aid in preserving the significant uncommon flora.
The association of social media use and other social factors with symptoms of attention-deficit/hyperactivity disorder in Egyptian university students
Authors: Hassan Mustafa Mohammed , Orebi Hisham Ahmed , Salama Basem , Kabbash Ibrahim Ali
Published: January 2025

Background

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood. Many studies reported that excessive social media use is more likely to develop symptoms of ADHD.

Methods

A cross-sectional study was carried out at Tanta University. The study recruited a total sample of 933 college students from Tanta University from five randomly selected colleges. Data was collected using self-administrated questionnaires made in Google Forms sent to social media groups of students. We used the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist instructions.

Results

The total number of respondents was 933. Those at risk of ADHD represented 30.5%. All sociodemographic variables were not found to significantly affect the risk for ADHD except for the presence of the father in the family. This of ADHD significantly increased to 42.3% and 44.4% for those whose fathers were traveling abroad or separated from their mothers, respectively (p = 0.031). The risk for ADHD significantly decreased among those who practice sports to reach 24.1% compared to 33.8% for those who did not (p = 0.002). The risk for ADHD increased significantly among those who used mass media to watch reels. ADHD risk was found to increase with increased hours of watching media during the study period (p < 0.001) during weekends (p = 0.001) and holidays (p = 0.038). Multivariate analysis showed that practicing sports independently reduces the risk for ADHD (Exp B = 0.679). Meanwhile, both watching reels and hours of using media during the study period independently increase the risk (Exp B = 1.493 and 1.390, respectively).

Conclusion

There are many factors affecting ADHD, we found that watching reels, status, stories, and shorts and the number of hours spent on social media during the study period are independent risk factors. Practicing sports is an independent protective factor. Most of the factors need further studies.
Do coping strategies mediate the effects of childhood adversities and traumata on clinical high-risk of psychosis, depression, and social phobia? A cross-sectional study on patients of an early detection service
Authors: Chang Zhixiong , Osman Naweed , Doll Carolin Martha , Lichtenstein Theresa Katharina , Rosen Marlene , Meisenzahl Eva , Kadel Hanna , Kambeitz Joseph , Vogeley Kai , Schultze-Lutter Frauke
Published: January 2025

Background

Childhood adversities and traumata (CAT) increase the risk for various mental disorders, including the clinical high-risk of psychosis (CHR-P) state and its main comorbidities, i.e., depression, and social phobia. However, these relations are likely mediated by personal coping behaviors. This cross-sectional study investigates the relationships between the main CAT domains, coping, CHR-P, depression, and social phobia.

Methods

Using path analyses, we analyzed data of 736 patients (mean age 24 years, 67% male) who presented at an early detection service between 2002 and 2013, answered questionnaires on CAT, coping, depressiveness, and social phobia, and underwent clinical examination for CHR-P according to the recommendations of the Guidance project of the European Psychiatric Association.

Results

All path models (total sample, males and females) showed good to excellent fit to the data. In all models, higher scores on maladaptive coping mediated the negative effect of emotional abuse on mental health outcomes. Additionally, in the total sample and males, lower scores on adaptive coping mediated the negative effect of emotional abuse and neglect, and physical neglect was associated with lower scores on adaptive coping that, in turn, were linked to depression and social phobia but not CHR-P. Overall, effects of maladaptive coping were higher than those of adaptive coping, although adaptive coping was more diversely associated with CAT. Furthermore, the interrelated depression and social phobia were more widely explained by the models than CHR-P, which was not significantly associated with them.

Conclusions

Our findings underscore the complex interplay of the CAT domains and their relevant mediators with mental health outcomes that likely reflect underlying sex-specific psychological, social, cultural and neurobiological mechanisms. Supporting a broader view on CAT than the traditional focus on sexual abuse, results indicate an important role of emotional abuse that, descriptively, is most strongly mediated by maladaptive coping strategies on mental health outcomes. A detailed understanding of the effects of CAT will in future help to develop a multi-dimensional, holistic and sex-specific approach to the treatment of patients who have experienced CAT.

Trial registration

The study was registered in the German Clinical Trial Register (https://drks.de/) as DRKS00024469 at 02/24/2021.