bluuebunny/crossref_metadata_2025 huggingface dataset:
Early brain MRI changes following transvenous embolization of cerebrospinal fluid-venous fistulas in spontaneous intracranial hypotension
Authors: Cagnazzo Federico , Le bars Emmanuelle , Risi Gaetano , Lonjon Nicolas , van Dokkum Liesjet E H , Corti Lucas , Costalat Vincent , Ducros Anne
Published: February 2025

Objective

To evaluate early and mid-term imaging and clinical outcomes following transvenous embolization of cerebrospinal fluid-venous fistulas (CSFVFs) in patients with spontaneous intracranial hypotension (SIH).

Methods

From November 2022 to November 2024, 60 consecutive patients with SIH and confirmed CSFVF underwent transvenous embolization using Onyx. Of these, 40 patients underwent brain MRI pre-treatment, 24 hours post-treatment, and at a 3-month follow-up. The primary outcome was regression of brain MRI abnormalities at 24 hours and 3 months. Secondary outcomes included rates of symptom improvement, predictors of clinical improvement, and complication rates.

Results

The mean patient age was 61 years, and 65% were female. All procedures were technically successful. The median SIH score significantly decreased from 6 pre-treatment to 3.5 at 24 hours (P=0.01) and to 2 at 3 months (P=0.004). Early improvement in SIH score correlated with clinical improvement at 24 hours (P=0.002), which was observed in 77.5% of patients. Pachymeningeal enhancement (87.5%) and venous sinus engorgement (75%) were the most common MRI abnormalities. Both findings regressed in approximately 50% of patients at 24 hours and in 80% of patients at 3 months. At 3 months, 82.5% of patients achieved complete clinical recovery. Rebound post-treatment headaches occurred in 32.5% of patients but resolved within 7 days. The morbidity rate was 0%.

Conclusions

Transvenous embolization of CSFVFs results in early and sustained clinical and imaging improvements in patients with SIH. These findings support the efficacy of this intervention as a primary treatment for CSFVFs.
The Evaluation Framework and Benchmark for Large Language Models in the Government Affairs Domain
Authors: Liu Shuo , Zhang Lin , Liu Weidong , Zhang Jianfeng , Gao Donghui , Jia Xiaofeng
Published: February 2025

The rapid evolution of artificial intelligence (AI) has driven advancements across numerous sectors. In the domain of government affairs, large language models (LLMs) hold significant potential for applications such as policy analysis, data processing, and decision support. However, their adoption in government settings faces considerable challenges, including data accessibility issues, the absence of standardized evaluation criteria, and concerns regarding model accuracy, reliability, and security. To address these challenges, we propose a comprehensive evaluation framework specifically designed for LLMs in government affairs. Built on modular principles, this framework ensures adaptability across various industries. Additionally, we introduce the Multi-Scenario Government Affairs Benchmark (MSGABench

1

)dataset, a Chinese-language dataset specifically crafted to meet the practical needs of government professionals. Employing the proposed framework and the MSGA dataset, we conducted an empirical evaluation of 15 prominent LLMs, revealing critical insights: (1)Performance: many models demonstrated low accuracy and reliability, particularly under minor input variations, with some dropping below 35% accuracy, whereas GPT-4 achieved above 95% reliability; (2) Security and Compliance: significant concerns were identified, including privacy vulnerabilities, legal compliance risks, and persistent biases, which may hinder secure deployments in government contexts; (3)Task Avoidance: certain models exhibited excessive caution, often avoiding responses to basic tasks like document classification and government-related inquiries, which restricts their usability. These findings highlight essential limitations and opportunities for improvement, contributing to the safe and effective application of LLMs in the government sector.
Reproductive Behavior in Odontobutis potamophila (Günther, 1861)
Authors: Xiang Miao , Li Li , Xu Hongliang , Li Bo , Guo Hongxi , Yang Zhanhu , Zhu Chuankun , Wang Man , Wang Jie , Xin Wei , Xie Songguang , Zhu Xiaoming , Zhang Lei
Published: February 2025

An animal’s behavior can directly reflect its psychological or physiological condition. The in‐depth understanding of fish behavior, especially reproductive behavior, is an important safeguard to promote sustainable aquaculture. In this study, we used the Posture‐Act‐Environment (PAE) coding system to construct an ethogram of Odontobutis potamophila to help people better judge and identify O. potamophila behaviors; and we designed two groups of experiments to figure out the individual factors affecting the reproduction of O. potamophila. These were the selection of female O. potamophila for male O. potamophila of different sizes, with or without nests, and with or without parental care behaviors, as well as the selection of male O. potamophila for female O. potamophila of different sizes. The results showed that we recorded 14 postures, 22 movements, and 29 behaviors of O. potamophila. Based on their biological functions, the recorded behaviors of O. potamophila were divided into nine types, that is, exploration, territoriality, attack, courtship, mating, parental care, ingestion, stationary behavior, and others. O. potamophila had nocturnal habits, and all the nighttime activities were significantly higher than those during the daytime (p < 0.001). The mating system of O. potamophila was polygamous, and the average mating duration for successful spawning was 9.99 ± 1.23 h. In mate choice experiments, both females and males spent significantly more time stationary than activity (p < 0.001). Females exhibited a slight preference for males with large individuals (strength of preference [SOP] = 53.46%), no nests (SOP = 50.51%), and no parental care behavior (SOP = 55.58%). The results of male mate choice were similar. Although the standard length of females was positively correlated with fecundity (r = 0.61), there were no significant differences in the number of male‐to‐female choices or duration of association (p > 0.05). This indicated that males showed no preference for larger or high‐fertility females (SOP = 47.10%). Therefore, it is likely that males may not be selective for females with different fecundity levels. This study enhances the current understanding of the behavioral patterns of O. potamophila. It establishes a foundation for further research on its reproductive behavior and contributes to the advancement of captive breeding for this species.
Análise comparativa da regulação para Autorização de Uso Emergencial de medicamentos e vacinas no Brasil e no mundo
Authors: Pitta Luciana , Delgado Isabella Fernandes , Paumgartten Francisco José Roma
Published: February 2025

O desenvolvimento de medicamentos e vacinas e a análise das informações sobre a segurança e eficácia dos novos produtos que precede a disponibilização para uso exigem tempo considerável. Quando surge uma emergência sanitária, para a qual não há medicamentos e vacinas eficazes, a demora pode ter um alto custo em sofrimento e vidas. A Autorização de Uso Emergencial é uma alternativa regulatória concebida para equilibrar a tensão entre a presteza exigida pela emergência sanitária e o tempo necessário para avaliar em profundidade a segurança e a eficácia de novos produtos a fim de conter eventual ameaça à saúde pública. As principais agências regulatórias do mundo têm as suas próprias diretrizes. Este artigo teve como objetivo comparar as diretrizes de agências reguladoras do Brasil, China, Estados Unidos e União Europeia com àquelas da Organização Mundial da Saúde. Para isso, realizou-se uma busca sistemática das normas existentes sobre o tema nas páginas oficiais de cada agência. A elegibilidade para concessão da Autorização de Uso Emergencial, independentemente da agência estudada, requer a declaração da emergência sanitária; que não haja produtos licenciados eficazes e seguros ou satisfatórios para enfrentá-la; que as informações sobre segurança e eficácia do produto em desenvolvimento, embora incompletas, sejam indicativas de razão risco-benefício claramente favorável; e que o produto tenha qualidade satisfatória. Em contraste com o que ocorreu com as demais agências, a pandemia da covid-19 surpreendeu a Agência Nacional de Vigilância Sanitária, sem a previsão de concessão da Autorização de Uso Emergencial, e foi necessário elaborar normas transitórias, com a pandemia em curso. Emergências sanitárias se repetirão e o estudo comparativo entre as normas nacionais e as internacionais mostra-se uma contribuição para o aperfeiçoamento da regulação brasileira com vistas ao enfrentamento de futuras emergências sanitárias.
Quando Dr. Jekyll and Mr. Hyde encontram O Médico e o Monstro
Authors: Pisetta Lenita Maria Rimoli
Published: February 2025

O texto é uma resenha da tradução bilíngue e comentada feita por Ana Júlia Perrotti-Garcia, que analisa suas particularidades e seu potencial didático.
Evolution of Critical Care Cardiology: An Update on Structure, Care Delivery, Training, and Research Paradigms: A Scientific Statement From the American Heart Association
Authors: Sinha Shashank S. , Geller Bram J. , Katz Jason N. , Arslanian-Engoren Cynthia , Barnett Christopher F. , Bohula Erin A. , Damluji Abdulla A. , Menon Venu , Roswell Robert O. , Vallabhajosyula Saraschandra , Vest Amanda R. , van Diepen Sean , Morrow David A. ,   on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; and Council on Kidney in Cardiovascular Disease
Published: February 2025

Critical care cardiology refers to the practice focus of and subspecialty training for the comprehensive management of life-threatening cardiovascular diseases and comorbid conditions that require advanced critical care in an intensive care unit. The development of coronary care units is often credited for a dramatic decline in mortality rates after acute myocardial infarction throughout the 1960s. As the underlying patient population became progressively sicker, changes in organizational structure, staffing, care delivery, and training paradigms lagged. The coronary care unit gradually evolved from a focus on rapid resuscitation from ventricular arrhythmias in acute myocardial infarction into a comprehensive cardiac intensive care unit designed to care for the sickest patients with cardiovascular disease. Over the past decade, the cardiac intensive care unit has continued to transform with an aging population, increased clinical acuity, burgeoning cardiac and noncardiac comorbidities, technologic advances in cardiovascular interventions, and increased use of temporary mechanical circulatory support devices. Herein, we provide an update and contemporary expert perspective on the organizational structure, staffing, and care delivery in the cardiac intensive care unit; examine the challenges and opportunities present in the education and training of the next generation of physicians for critical care cardiology; and explore quality improvement initiatives and scientific investigation, including multicenter registry initiatives and randomized clinical trials, that may change clinical practice, care delivery, and the research landscape in this rapidly evolving discipline.
A Devotee of Abraham ibn Ezra Reads Rashi
Authors: Lawee Eric
Published: February 2025

While there is increased interest in the supercommentary tradition that came to surround Abraham ibn Ezra’s Torah commentary, Oṣar Neḥmad by Moses ben Jacob of Kiev (1448–1520), an unusually comprehensive entry in this field, remains mostly terra incognita. This article explores interactions in Moses’s pages with the commentator often seen as Ibn Ezra’s Ashkenazic counterpoint, Rashi. Patterns include Moses’s designation of Rashi as the unnamed negative stimulus spurring Ibn Ezra’s comments and appeals to him as a purveyor of correct interpretation of biblical law when Ibn Ezra has lapsed on this score. Further study of Moses should spark insight into the Ibn Ezra supercommentary tradition and the receptions of Rashi’s biblical scholarship in the East. It will also throw light on broader topics, including early phases of Rabbanite-Qaraite communion and dispute in Eastern Europe and Crimea, and the interplay of science and Kabbalah in late medieval times.
The Right to Life, and Death: A Health Equity Approach to Canada’s Expansion of Medical Assistance in Dying for Individuals With Mental Disorder(s)
Authors: Bojkovic Katarina , Jupudi Rithvic , Bojkovic Michael , Bossarte Robert
Published: February 2025

Canadian medical assistance in dying (MAID) is positioned to expand to allow voluntary euthanasia for individuals with mental disorders as their sole underlying condition(s) (MAID-MD-SUMC) by 2027. As governments consider this type of legislation, thoughtful critique of proposed eligibility criteria is imperative in order to consider potential consequences that may follow expansion of current policies guiding end-of-life care. As MAID-MD-SUMC enters another phase of revision, we propose two critical consideration: (1) the need to define a comprehensive, empirical basis for the “irremediability” of psychiatric disorders and (2) a more comprehensive consideration of the inextricable links between an individual’s surrounding environment, socioeconomic factors, access to healthcare and outcomes resulting from treatment of mental health disorders.
The dose-response relationship and gender differences of serum uric acid with total cholesterol: a cross-sectional study
Authors: Guo Leilei , Cai Lina , Hu Li , Zhou Yueshan
Published: February 2025

Objective

To explore the dose-response relationship and gender differences between serum uric acid (SUA) and total cholesterol (TC) in Chinese individuals.

Methods

This cross-sectional study included secondary data of Chinese adults, collected between 2010 and 2018. The exposure variable was SUA, the outcome variable was TC, and participants were split into five quantiles by SUA levels (Q1 [men, ≤283; women, ≤223] to Q5 [men, ≥416; women, ≥332]). Covariates included age, gender, laboratory and examination information. Multivariable linear regression and subgroup analysis were performed to examine the independent association between SUA and TC. Smooth curve fitting and threshold effect analysis was employed to assess potential non-linear relationships. Additionally, a sensitivity analysis was conducted to validate the robustness of the findings.

Results

The analysis included 6119 participants, of whom, 4078 (66.6%) were female, with a mean age of 63.7 years. After adjusting for potential confounders, SUA showed a significant association with TC in both men (β = 0.09; 95% confidence interval [CI] 0.05, 0.14) and women (β = 0.13; 95% CI 0.10, 0.17). The Q5 group exhibited higher TC levels than the Q1 group in both men (β = 0.26; 95% CI 0.16, 0.37) and women (β = 0.25, 95% CI 0.17, 0.32). In women, there was an inverted L-shaped relationship between SUA and TC with an inflection point at 359.962 μmol/L, whereas a linear relationship was exhibited in men. Subgroup analysis showed no significant interactions in men. Sensitivity analyses confirmed the robustness of the findings.

Conclusions

Significant sex differences and dose-response relationships exist between SUA and TC in the Chinese population. The study may provide new insights into cholesterol management.
Immature Platelets and Platelet Reactivity in Patients with COVID-19
Authors: Balmakov Yulia , Mark Tomer , Barnett Itzik , Cipok Michal , Lev Eli I. , Cohen Amir , Aviram Eliad , Mayo Ami
Published: February 2025

Coronavirus disease 2019 (COVID-19) is associated with a high incidence of thromboembolic events, both venous and arterial. There are currently no specific clinical or laboratory markers to guide antithrombotic therapy for COVID-19 patients. Immature platelets represent a population of hyper-reactive platelets associated with arterial thrombotic events. This prospective study compared consecutive severe COVID-19 patients (n = 53, median age = 73 years) versus patients with sepsis from another origin (n = 41, median age = 69 years). Total platelet counts, immature platelet fraction (IPF) and immature platelet count (IPC) were determined by the Sysmex XN-3000 auto-analyzer on admission and at subsequent time-points. IPC levels three days after admission were significantly higher in the COVID-19 group compared to the sepsis group (13.4 × 109/ L [IQR 9.1–18.5] in the COVID-19 group vs 9 × 109/ L [5.5–14.7] in the sepsis group, P = 0.007). COVID-19 patients with respiratory disease show increased platelet turnover and reactivity, as seen in higher levels of immature platelet indices, especially IPC, compared to the sepsis control group. While these platelet indices remained high, CRP levels decreased, particularly in patients treated with tocilizumab. This reduction in CRP was not accompanied by any apparent clinical improvement. These findings suggest that immature platelets may serve as a biomarker for disease severity in COVID-19 patients and their CRP may not be a reliable marker for disease severity.
EXPRESS: Human Is Gold: Why Premium Customers Hate Chatbots and What to Do about It
Authors: Tatavarthy Aruna Divya , Martuza Jareef , Thorbjørnsen Helge
Published: February 2025

Individuals are often biased in their judgments about AI, especially when it comes to customer-support-oriented service interactions. With three preregistered experiments (and three supplementary studies), the current research examines how marketplace status creates systematic differences in customer biases against chatbot-delivered services, and what firms can do to mitigate the impact of those biases on their evaluations. In Study 1 (N = 1,019), we show that high-tier (vs. basic) customers react more negatively to chatbot-delivered services, even when the objective service delivered is the same. We also demonstrate that greater perceptions of uniqueness neglect and entitlement among high-tier (vs. basic-tier) customers are possible explanations for this tier-based bias against chatbots. In Study 2 (N = 1,196), we demonstrate the effectiveness of three “framing interventions” that significantly reduced high-tier customers’ bias against chatbots. Finally, Study 3 (N = 899) examines different ways of acquiring a high marketplace status— earned vs. unearned— as a boundary condition for our main effect, while experimentally demonstrating the mediational role of entitlement in addition to uniqueness neglect. Together, our research advances the understanding of human-robot interactions from a marketplace status lens and provides concrete managerial strategies for communicating about automated customer support services.
Mindful escapes: Unveiling the transformative wellness journeys of generation Z
Authors: Rana Krishma , Gangotia Amit , Bhatt Ketan
Published: February 2025

Wellness tourism has emerged as a prominent source of healing and stress relief, significantly enhancing the tourist experience. This present study aims to analyze the mindfulness journey of Generation Z (Gen Z) during their visits to wellness centers. Semi-structured interviews were conducted with eligible participants who had spent a week or stayed longer at wellness centers or retreat spots, and data was collected using purposive sampling techniques. Data analysis was performed using NVivo (14), employing thematic and content analysis methods to achieve research objectives. The study identifies five key factors influencing the mindfulness experience at wellness centers: spirituality, nature connectedness, focus mind, self-awareness and thoughts regulation. The findings contribute to understanding the emerging market segment, i.e., Gen Z, and their mindfulness experience during visits to wellness centers. Furthermore, the study offers theoretical insights into the factors that shape Gen Z's experiences while visiting wellness centers, enabling service providers to enhance their offerings and ensure better tourist experiences according to the preferences of Gen Z tourists.
Ethical Funding and Good Governance: Does the Design of Funding Matter?
Authors: Hudon Marek , Nyarko Samuel Anokye , Szafarz Ariane
Published: February 2025

Purpose: This paper examines the relationship between corporate governance and subsidies received by hybrid organizations. It is hypothesized that good governance enhances the subsidies embedded in soft loans because lenders are incentivized to care about governance and want their capital back. Conversely, it is hypothesized that there is no correlation between governance factors and grants, as grant providers mainly prioritize the social mission. Study design: To assess our theoretical predictions, we use audited data about 250 microfinance organizations operating in the global South. First, an exploratory analysis identifies the five main factors of effective corporate governance. Second, we estimate a fixed-effect generalized least squares model and test whether these five factors affect the subsidies received by the organizations. Findings: The results confirm that soft loans are positively correlated with good governance, while grants are not. Contributions: Grant and soft loan providers exhibit different levels of appreciation for corporate governance, possibly based on mission segmentation. These findings demonstrate that charitable funders of hybrid organizations have developed a distinct approach to managing the unique challenges posed by the double bottom line of these entities. Implications: Microfinance managers should align their corporate governance systems with their specific financing needs to optimize their access to different forms of subsidies.
Material hardship, forced displacement, and negative health outcomes among unhoused people who use drugs in Los Angeles, California and Denver, Colorado: a latent class analysis
Authors: Goldshear Jesse Lloyd , Ganesh Siddhi S. , Borquez Annick , Gelberg Lillian , Corsi Karen F. , Bluthenthal Ricky N.
Published: February 2025

Background

Homelessness is a growing concern in the United States, especially among people who use drugs (PWUD). The degree of material hardship among this population may be linked to worse health outcomes. PWUD experiencing homelessness in urban areas are increasingly subjected to policies and social treatment, such as forced displacement, which may worsen material hardship. It is critical to describe hardship among PWUD and examine if it is linked to health outcomes.

Methods

Data were collected as part of a prospective cohort study of PWUD in Los Angeles, California and Denver, Colorado (n = 476). Analysis sample size was smaller (N = 395) after selecting for people experiencing homelessness and for whom data were complete. Five indicators assessing hardship (difficulty finding food, clothing, restrooms, places to wash/shower, and shelter) in the past three months were obtained from participants at baseline and were used in latent class analysis (LCA). We chose a base latent class model after examination of global fit statistics. We then built three auxiliary models using the three-step Bolck–Croon–Hagenaars (BCH) method to test the relationship of latent class membership to several hypothesized social and health variables in this same three month time period.

Results

Fit statistics, minimum classification probabilities, and ease of interpretation indicated a three-class solution for level of material difficulty. We termed these classes “High Difficulty” (n = 82), “Mixed Difficulty” (n = 215), and “Low Difficulty” (n = 98). Average classification probabilities indicated good class separability. “High Difficulty” participants had high probabilities of usually having difficulty accessing all five resources. “Mixed Difficulty” participants indicated a range of difficulty accessing all resources, with restrooms and bathing facilities being the most difficult. “Low Difficulty” participants were defined by high probabilities of never having access difficulty. In auxiliary analyses, there were significant (p < 0.05) differences in experiences of displacement, opioid withdrawal symptoms, nonfatal overdose, and violent victimization between classes.

Conclusions

This LCA indicates that among PWUD experiencing homelessness there exist distinct differences in resource access and material hardship, and that these differences are linked with political, social, substance use, and other health outcomes. We add to the literature on the relationship between poverty and health among PWUD. Policies which increase difficulty accessing necessary material resources may negatively impact health in this population.
Pelvic pain & endometriosis: the development of a patient-centred e-health resource for those affected by endometriosis-associated dyspareunia
Authors: Parmar Gurkiran , Howard A. Fuchsia , Noga Heather , Tannock Leah , Abdulai Abdul-Fatawu , Allaire Catherine , Lett Sarah , Sutherland Jessica , de Arbina Edurne Lopez , Hummelshoj Lone , Bridge-Cook Phillipa , Yong Paul J.
Published: February 2025

Background

We recognized a paucity of accessible, evidence-based, empowering patient-centred resources for those with endometriosis-associated dyspareunia. Affecting more than 50% of people with endometriosis, dyspareunia can significantly impact relationships, chronic pain and the ability to have a family. We aimed to develop a patient-centred educational website for those affected by endometriosis-associated dyspareunia.

Methods

To develop a functional and meaningful website for endometriosis-associated dyspareunia, we utilized a Knowledge to Action framework, supplemented with a patient-centred research design and technology-enabled knowledge translation. Our patient partners influenced the direction and scope of the project, provided critical feedback throughout the development process, and approved website revisions prior to launch. The website was developed in five phases; (1) needs assessment interviews and focus groups with key stakeholders, (2) landscape analysis of pre-existing websites, (3) development, (4) usability testing and qualitative interviews, and (5) revisions and launch.

Results

Phase 1 and 2 emphasized a need for comprehensive yet plain language explanations of pain mechanisms and strategies for pain management. Rigorous consultation with key stakeholders informed the creation of the preliminary website in phase 3. Usability testing in phase 4 identified five main categories of usability problems, most of which were considered minor. Phase 4 qualitative interviews identified users’ overall impressions of the preliminary website, including that the website could help people understand their pain and describe their pain to partners and healthcare providers, as well as feel empowered to seek healthcare and validated in their experiences. User suggestions, combined with usability testing, informed revisions in phase 5.

Conclusion

We developed an educational website for endometriosis-associated painful sex where people can find evidence-based etiologies for pain, pain management options, and actionable resources. Based on the data collected through qualitative interviews with patients, this website can potentially empower people to seek health care. The strength of the website development approach used was the inclusion of qualitative user insights in addition to the commonly completed user tests. The patient interviews provided insights into the potential impact of the website and, thus, ensured that we not only created a functional website that meets end users’ needs, but a website that is also meaningful to those affected by this condition.
"We need time, a great know-how and security for patients to always be there in time”: a qualitative study on factors distinguishing General from Specialized Palliative Home Care
Authors: Joshi Melanie , Dillen Kim , Krumm Norbert , Hesse Michaela , Brunsch Holger , Strupp Julia , Radbruch Lukas , Rolke Roman , Voltz Raymond ,   on behalf of the APVEL Consortium, Pfaff Holger , Scholten Nadine , Hellmich Martin , Rietz Christian , Meyer Ingo , Fink Robin
Published: February 2025

Background

An increasing number of patients in the palliative phase of their disease are cared for at home by palliative home care services. A sense of security, normality of everyday life and symptom control are found to be active factors of quality of care in Specialized Palliative Home Care. Whether this also applies to General Palliative Home Care has not yet been systematically investigated. The aim of this study was to identify distinctions between General and Specialized Palliative Home Care from a healthcare professional’s perspective concerning those factors.

Methods

With a qualitative approach, we conducted 11 semi-structured interviews with healthcare professionals from different professional backgrounds in General and/or Specialized Palliative Home Care.

Results

In both General and Specialized Palliative Home Care, healthcare-professionals (HCP) found a sense of security (through availability) to be most relevant for the patients. The majority saw aspects of normality of everyday life as a key component for high-quality palliative home care, especially having time for the patient and the family caregiver(s). However, statements about symptom control are mainly related to Specialized Palliative Home Care. The subcodes availability, having time and competence, symptom burden and financial resources were the main distinguishing factors between General and Specialized Palliative Home Care in sense of security, normality of everyday life and symptom control, respectively.

Conclusions

Our results provide the basis for a clearer definition of GPHC and SPHC and contribute to identifying factors for a transferal between the two services to provide best care for the patient. Distinguishing (sub)factors revealed challenges and short-term solutions. Providing (financial) incentives to guarantee time and availability in General Palliative Home Care would lead to more effective care.
Health Alliances: a new way of working internationally
Authors: Allen Omolade , Ewusie Ketsina , Waghorne Amy , Byrne Ged , Byrne-Davis Lucie , Hart Jo
Published: February 2025

Background

International collaborations have been pivotal in global health delivery, particularly in addressing challenges like tuberculosis. Recently, there has been a shift towards more focused alliances designed for targeted collaboration. This study examines health alliances as a distinct model of international partnership in global health, exploring their operational approaches, key activities, encountered challenges, and potential contributions.

Methods

A qualitative approach was utilised, in which ten semi-structured interviews were conducted with individuals involved in various health alliances. These were transcribed, anonymised, and analysed to identify common themes.

Results

Four main themes were generated, revealing that health alliances operate through collaborative efforts pooled from diverse stakeholders, including governments, and academic institutions. Serving as platforms for open communication, these alliances facilitate the exchange of expertise, resources, and best practices.

The study highlights key activities undertaken by health alliances, including research, capacity building, policy engagement, and resource mobilisation. These activities strengthen health systems, generate new knowledge, and mobilise financial and technical resources.

Conclusion

This research demonstrates the potential of health alliances as effective models for future collaborations in global health. By addressing the challenges of fragmentation, lack of coordination, and limited focus on capacity building and evaluation, health alliances enhance the impact of global health initiatives. The findings contribute to a better understanding of health alliances and could inform the development of future alliances.
HIF1α controls steroidogenesis under acute hypoxic stress
Authors: Ariyeloye Stephen , Watts Deepika , Jaykar Mangesh T. , Ermis Cagdas , Krüger Anja , Kaden Denise , Stepien Barbara K. , Alexaki Vasileia Ismini , Peitzsch Mirko , Bechmann Nicole , Mirtschink Peter , El-Armouche Ali , Wielockx Ben
Published: February 2025

Background

Hypoxia is a critical physiological and pathological condition known to influence various cellular processes, including steroidogenesis. While previous studies, including our own, have highlighted the regulatory effects of Hypoxia-Inducible Factor 1α (HIF1α) on steroid production, the specific molecular mechanisms remain poorly understood. This study investigates the role of hypoxia and HIF1α in steroid biosynthesis across multiple experimental models during acute exposure to low oxygen levels.

Methods

To assess the extent to which acute hypoxia modulates steroidogenesis, we employed several approaches, including the Y1 adrenocortical cell line, and a conditional HIF1α-deficient mouse line in the adrenal cortex. We focused on various regulatory patterns that may critically suppress steroidogenesis.

Results

In Y1 cells, hypoxia upregulated specific microRNAs in a HIF1α-dependent manner, resulting in the suppression of mRNA levels of critical steroidogenic enzymes and a subsequent reduction in steroid hormone production. The hypoxia/HIF1α-dependent induction of these microRNAs and the consequent modulation of steroid production were confirmed in vivo. Notably, using our adrenocortical-specific HIF1α-deficient mouse line, we demonstrated that the increase in miRNA expression in vivo is also directly HIF1α-dependent, while the regulation of steroidogenic enzymes (e.g., StAR and Cyp11a1) and steroid production occurs at the level of protein translation, revealing an unexpected layer of control under hypoxic/HIF1 α conditions in vivo.

Conclusions

These findings elucidate the molecular mechanisms underlying acute hypoxia/HIF1α-induced changes in steroid biosynthesis and may also be useful in developing new strategies for various steroid hormone pathologies.
Copper-enriched automotive brake wear particles perturb human alveolar cellular homeostasis
Authors: Parkin James G. H. , Dean Lareb S. N. , Bell Joseph A. , Easton Natasha H. C. , Edgeway Liam J. , Cooper Matthew J. , Ridley Robert , Conforti Franco , Wang Siyuan , Yao Liudi , Li Juanjuan , Raj Helen Vethakan , Downward Julian , Gerlofs-Nijland Miriam , Cassee Flemming R. , Wang Yihua , Cook Richard B. , Jones Mark G. , Davies Donna E. , Loxham Matthew
Published: February 2025

Background

Airborne fine particulate matter with diameter < 2.5 μm (PM2.5), can reach the alveolar regions of the lungs, and is associated with over 4 million premature deaths per year worldwide. However, the source-specific consequences of PM2.5 exposure remain poorly understood. A major, but unregulated source is car brake wear, which exhaust emission reduction measures have not diminished.

Methods

We used an interdisciplinary approach to investigate the consequences of brake-wear PM2.5 exposure upon lung alveolar cellular homeostasis using diesel exhaust PM as a comparator. This involved RNA-Seq to analyse global transcriptomic changes, metabolic analyses to investigate glycolytic reprogramming, mass spectrometry to determine PM composition, and reporter assays to provide mechanistic insight into differential effects.

Results

We identified brake-wear PM from copper-enriched non-asbestos organic, and ceramic brake pads as inducing the greatest oxidative stress, inflammation, and pseudohypoxic HIF activation (a pathway implicated in diseases associated with air pollution exposure, including cancer, and pulmonary fibrosis), as well as perturbation of metabolism, and metal homeostasis compared with brake wear PM from low- or semi-metallic pads, and also, importantly, diesel exhaust PM. Compositional and metal chelator analyses identified that differential effects were driven by copper.

Conclusions

We demonstrate here that brake-wear PM may perturb cellular homeostasis more than diesel exhaust PM. Our findings demonstrate the potential differences in effects, not only for non-exhaust vs exhaust PM, but also amongst different sources of non-exhaust PM. This has implications for our understanding of the potential health effects of road vehicle-associated PM. More broadly, our findings illustrate the importance of PM composition on potential health effects, highlighting the need for targeted legislation to protect public health.
How does a preference-based generic health-related quality of life measure perform in patients with a rare disease? Measurement properties of the EQ-5D-Y proxy version among underage patients with neurofibromatosis type 1
Authors: Liang Wanxian , Cao Shihuan , Suo Yusi , Zhang Lining , Yang Lujia , Wang Hanfei , Wang Han , Jin Xuejing
Published: February 2025

Background

EQ-5D-Y is a pediatric preference-based health-related quality of life (HRQL) measure that is recommended in health economic evaluation according to China’s guidelines. However, there is limited evidence regarding how the EQ-5D-Y perform in patients with rare diseases in the country. Neurofibromatosis type 1 (NF1) is a rare disease that affects the growth and development of underage patients. This study aimed to examine the performance of EQ-5D-Y proxy version among underage NF1 patients in China.

Methods

Data from a nationwide cross-sectional survey from Nov 2022 to Jan 2023 was used. A total of 154 caregivers for underage NF1 patients who completed the EQ-5D-Y proxy version, PedsQL 4.0 Generic Core Scales (PedsQL GCS) proxy version, and Zarit Burden Interview (ZBI-22) were included. The performance of the EQ-5D-Y was assessed by response pattern (ceiling and floor effects), convergent validity against the PedsQL GCS, known-groups validity, and Shannon (H’) and Shannon evenness (J’) indices.

Result

Data from 154 caregivers were analyzed. The mean age of caregivers was 38.23 (6.02) years, and 78.57% of them were mothers of NF1 patients. The mean age of NF1 patients was 8.38 (3.34) years, with 51.30% being females. The ceiling effect of EQ-5D-Y was 30.52%, and floor effect was 0%. Moderate to strong correlations were found between EQ-5D-Y and PedsQL GCS dimensions that share similar constructs (rho − 0.42 to -0.60, all p values < 0.001). The hypotheses of known-groups defined by different PedsQL GCS and ZBI scores were validated. The EQ-5D-Y exhibited the strongest informativity and discriminatory power of the “feeling worried, sad or unhappy” dimension and weakest for the “mobility” dimension (H’(mobility) = 0.60, J’(mobility) = 0.38; H’(feeling worried, sad or unhappy) = 1.23, J’(feeling worried, sad or unhappy) = 0.78).

Conclusions

EQ-5D-Y is acceptable for measuring HRQL of underage NF1 patients in China. More evidence for using EQ-5D-Y in rare diseases is awaited.
The relationship between students’ personality traits, attention state, and use of regulatory strategies during emergent distance learning
Authors: Emara Mona , Schwab Susanne , Alnahdi Ghaleb , Gerdenitsch Cornelia
Published: February 2025

Background

Attention issues are increasingly prevalent among students in higher education. While existing research has primarily focused on external distractions and their relationship with personality traits, internal distractions remain underexplored, particularly in the context of specific learning scenarios like distance education. This study addresses this gap by investigating the correlations between personality traits, attention distraction, and attentional regulation in the context of distance learning.

Method

This study adopted a combined person- and variable-oriented approach to examine the extent to which students’ personalities relate to attentional state and regulation strategies during emergent distance learning under COVID-19 lockdown conditions. 400 higher education students completed an online survey for this cross-sectional study.

Results

The integrated approaches revealed three distinct groups: (1) the “Self-Attention Regulated” group, characterized by the lowest attention problems, the highest use of attention regulation strategies, and higher levels of conscientiousness and openness; (2) the “Hanging-On” group, marked by high attention discontinuity, moderate attention regulation strategies, and average levels across all personality traits; and (3) the “Social Media-Distracted” group, exhibiting the highest levels of distraction caused by social media and higher levels of neuroticism. Older students, who tended to belong to the self-attention-regulated group, spent considerably more time studying online than younger students, who were more likely to be social media-distracted.

Conclusion

This study enhances our understanding of attention regulation in distance learning by identifying personality traits associated with students at risk for distracted attention issues. The results could help universities to design and implement effective distance learning programs that cater to a wide range of student personalities.
Individualized Cognitive Effort to Failure Does Not Impact Subsequent Strenuous Physical Performance
Authors: Holgado Darías , Cailleux Alice , Ruggeri Paolo , Martarelli Corinna , Bekinschtein Tristan A. , Sanabria Daniel , Place Nicolas
Published: February 2025

Introduction

The relationship between cognitive tasks and physical performance has garnered significant attention, with evidence suggesting that cognitive effort before exercise may impair physical performance. However, recent findings challenge the robustness of this effect, necessitating a reassessment of the mechanisms linking cognitive load to physical performance. This study introduces a novel approach to address methodological limitations, emphasizing individualized cognitive task difficulty and duration. Using techniques such as Temporal Experience Tracing (TET) and psychophysiological monitoring, we explore the dynamics between cognitive effort, subjective states, and physical performance.

Methods

In a pre-registered, randomized, within-participant design experiment, 21 recreational athletes completed a running time to exhaustion test at 90% of their maximal aerobic speed after performing a cognitive task until failure or watching a self-selected documentary. Pupillometry and six subjective dimensions were measured with the TET during task performance.

Results

We found that 1) subjective changes during effortful tasks are not limited to a single experience, such as mental fatigue or boredom, but can be grouped into distinct patterns; 2) the individualized and demanding cognitive task, completed before exercise did not impair subsequent physical performance; 3) pupil size reliably reflected cognitive load and is partially related to changes in subjective states, while fixation on the stimulus decreased over time, especially during high-demand periods.

Conclusions

These results do not support the effect of performing a highly demanding cognitive task on subsequent strenuous physical performance. Instead, they reveal the richness of the subjective experience linked to cognitive performance that goes beyond mere mental fatigue. Overall, we show a novel way to understand the interplay between cognitive and physical performance.
Administrative Burdens in the Social Safety Net
Authors: Herd Pamela , Moynihan Donald
Published: February 2025

Administrative burdens shape people’s experiences of, and access to, social safety net programs. They can undermine the goals these programs are trying to achieve. Such burdens are the experience of policy implementation as onerous, and arise via learning costs (knowing about the existence of and requirements of public services), compliance costs (time and effort spent dealing with bureaucratic demands, such as paperwork and documentation), and psychological costs (emotional responses to citizen-state interactions). Such frictions can substantially limit eligible peoples’ access to public services they want, would benefit from, and are legally entitled to receive. Those with the fewest resources, and the greatest needs, may struggle more to overcome burdens; the frictions thereby reinforcing existing inequality. As a research approach, administrative burden offers an intuitive and accessible way for policy actors and researchers to improve state capacity and the delivery of public services.
The 2023 Merger Guidelines and the Arc of Antitrust History
Authors: Francis Daniel
Published: February 2025

In 2023, the federal antitrust agencies rewrote the nation's flagship merger policy document, as part of a broader “Neo-Brandeisian” effort to bring about a deep reform of the antitrust system. The result—the 2023 Merger Guidelines—has been highly controversial: celebrated by some as a revolutionary advance, and criticized by others as a step back toward a benighted past. This article evaluates the 2023 guidance against the arc of antitrust's modern history. It argues that the new guidance breaks a long trend of migration from structure toward welfare as the primary orientation of merger enforcement, but that it does so cautiously, by achieving a fraught ambiguity between welfarist and nonwelfarist policies. In inviting both revolutionary and evolutionary readings, the agencies have sacrificed clarity and discouraged beneficial deals, but they have also deferred—at least for now—a sharp conflict between those who would preserve antitrust's governing paradigm and those who would remake it.
Genetic technology in the targeted therapy of Alport Syndrome
Authors: Kłusek Magdalena , Pawłowski Bartosz , Sienkiewicz Michał , Mandziuk Anna
Published: February 2025

Introduction and aim of the study: Alport syndrome is the most common inherited chronic kidney disease, with three distinct patterns of inheritance: X-linked, autosomal, and digenic. Currently, there is no curative treatment for Alport syndrome. This review aims to provide updated knowledge about Alport syndrome, including its clinical and genetic characteristics and therapies that slow disease progression. 
Material and Methods: A systematic literature search was conducted using PubMed and Google Scholar, with the following keywords: "gene," "therapy," "Alport," and "syndrome."
Description of the state of knowledge: Gene therapy, which uses genetic material to prevent or treat diseases, offers promising prospects for Alport syndrome.  The results of the metaanalysis suggest that gene editing by CRISPR/Cas9, exon-skipping using an antisense-oligonucleotide, premature termination codon readthrough, anti-miRNA-21 oligonucleotides, protein replacement, pharmacological chaperones and X-chromosome reactivation therapies are a feasible approach for some patients with Alport syndrome.
Summary: Targeting defective collagen chains early in the disease through gene therapy may have the greatest potential to reverse this disorder. Therefore, we strongly believe Alport syndrome will become a treatable condition in the near future using gene editing techniques.
Tirzepatide - role in obesity, health and physical wellness. Information overview
Authors: Hanslik Anna , Mendak Magdalena , Białek Agata , Walczak Agnieszka , Hovagimyan Adrian , Olszanecka Monika , Olszanecki Tomasz
Published: February 2025

Nowadays there is an increasing number of people with overweight and obesity all around the world. Unhealthy food, sweets and fast foods are available everywhere, that causes self-perpetuating problem. Food restriction is an obvious treatment, but it is difficult to achieve. A certain solution are GLP-1 agonists using to treat type 2 diabetes. Last studies shown that that medicaments may be effective in promoting weight loss. Tirzepatide as a novelty and is a long-acting dual agonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. It can be very supportive in the fight against obesity.