bluuebunny/crossref_metadata_2025 huggingface dataset:
Centennial‐scale atmospheric CO2 rise increased photosynthetic efficiency in a tropical tree species
Authors: Zwartsenberg Sophie A. , Sterck Frank J. , Haddad Lenny , Schleucher Jürgen , Anten Niels P. R. , Morales Alejandro , Cernusak Lucas A. , Medina‐Vega José A. , Rahman Mizanur , Vlam Mart , Heinrich Ingo , Zuidema Pieter A.
Published: February 2025

Tropical forests substantially influence the terrestrial carbon sink. Their contributions to the forest carbon sink may increase due to the stimulation of photosynthesis by rising atmospheric CO2 (Ca); however, the magnitude of this effect is poorly quantified for tropical canopy trees.

We measured the ratio of two deuterium isotopomers of glucose derived from tree rings to estimate how photosynthetic efficiency (photorespiration‐to‐photosynthesis ratio) has responded to Ca rise at a centennial scale. Wood samples were obtained from Toona ciliata trees from three climatically distinct forests in Asia and Australia. We applied Bayesian mixed effect models to test how the isotopomer ratio changes with Ca, tree diameter (as a proxy for crown exposure), temperature, and precipitation.

Across all sites, long‐term Ca rise increased photosynthetic efficiency, likely due to increased photosynthesis and the concurrent suppression of photorespiration. Increasing tree size reduced photosynthetic efficiency, likely due to reduced leaf internal CO2 at higher irradiance and stronger hydraulic limitation. Associations of photosynthetic efficiency with temperature and precipitation were inconclusive.

Our study reveals a centennial‐scale association between photosynthetic efficiency and increasing Ca in canopy trees and provides a new and independent line of evidence for Ca‐induced stimulation of photosynthetic efficiency in tropical forests.
CONSUMPTION PATTERNS OF A VASSAL: THE CASE OF LACHISH AND JERUSALEM
Authors: Avisar Reli
Published: February 2025

This study analyzes the complex interplay of material culture, elite consumption and imperial power dynamics as they relate to the roles of Lachish and Jerusalem in the Iron IIA and to the formation of the Kingdom of Judah. Based on an analysis of luxury goods and social practices, it explores established interpretations of the geopolitical development of southern Canaan and challenges some of them.

Analysis of the elite consumption patterns at the two sites reveals imperial and local Levantine powers functioning in the background: Aram Damascus in the Iron IIA, which used Lachish as a central hub; and Assyria in the Iron IIB–C, when Judah emerged as a regional player, and Jerusalem functioned as the southern centre of imperial interests, generating a significant transformation in the region’s geopolitical landscape.
Whose public reason? Which reasonableness?
Authors: Tahzib Collis
Published: February 2025

Rawlsian public reason liberalism holds that laws must be justified in terms of reasons that all reasonable citizens can accept. But who counts as a “reasonable” citizen? Rawlsians typically answer that reasonableness is conditional on acceptance of liberal values. But they do not typically defend this answer by explaining why the Rawlsian definition is superior to alternative possible definitions of reasonableness—for instance, libertarian reasonableness, perfectionist reasonableness, communitarian reasonableness, and so on. Once this full range of possibilities is set out in plain view, it creates a novel challenge which I call the which‐reasonableness challenge. This is the challenge of showing that the Rawlsian definition of reasonableness is superior to all the alternatives. In this paper, I set out this challenge (Section 1) and consider potential ways to overcome it: namely, by arguing that the Rawlsian definition of reasonableness is superior to the alternatives on grounds of its free‐standingness and stability (Section 2), its implicitness in the public political culture (Section 3), its anti‐sectarianism (Section 4), its fidelity to the underlying motivations of the public reason project (Section 5), and its avoidance of triviality, ad‐hocness, shoehorning and related perils (Section 6). I argue that while these considerations narrow the range of possible definitions of reasonableness, they do not do so by enough to uniquely pick out the Rawlsian definition. Rawlsian public reason liberals thus face a pressing challenge stemming from the simple question: Whose public reason? Which reasonableness?
Identification of the Novel HLA‐DQB1*06:524 Allele by Sanger Dideoxy Nucleotide Sequencing
Authors: Zhang Dan , Wang Dongmei , Liu Na , Sun Tiecheng , Wang Lijun
Published: February 2025

The HLA‐DQB1*06:524 allele differs from HLA‐DQB1*06:02:43 by one nucleotide substitution in codon 57 in exon 2.
Common, Intermediate and Well‐Documented HLA Alleles in the Brazilian Population: An Analysis of the Brazilian Bone Marrow Donor Registry (REDOME)
Authors: da Silva Jose Samuel , Visentainer Jeane Eliete Laguila , Fabreti‐Oliveira Raquel Aparecida , de Souza Felipe Carlos Brito , Silva Marcio Nogueira Pereira , da Costa Sena Alexandre , Goldenstein Monica , Claudino Renata Esterque , de Souza Mendonça‐Mattos Patricia Jeanne , Motta Juliana Pessanha Rodrigues , Secco Danielle Angst , Oliveira Danielli , Porto Luís Cristóvão
Published: February 2025

This study investigates the HLA allele diversity in Brazil, a reflection of the country's unique history of population admixture. The international comparison of findings emphasises the importance of incorporating underrepresented populations into global HLA databases. We present a comprehensive analysis of HLA alleles within the Brazilian population, utilising high‐resolution sequencing data from 298,000 unrelated haematopoietic stem cell volunteer donors registered with the Brazilian Bone Marrow Donor Registry (REDOME). Our research encompasses donors from all regions of Brazil, identifying HLA alleles that are catalogued as common, intermediate or well‐documented (CIWD Version 3.0). We evaluated the alleles of HLA‐A, HLA‐B, HLA‐C, HLA‐DRB1, HLA‐DQA1, HLA‐DQB1, HLA‐DPA1 and HLA‐DPB1. At a two‐field resolution, we identified 1969 alleles: 418 were classified as common, 358 as intermediate and 1193 as non‐CIWD in Brazil. Notably, we report HLA alleles that, while not classified as common or intermediate in the CIWD 3.0 catalogue, are prevalent within the Brazilian population. A detailed list of alleles from the registry, presented at a two‐field resolution and supplemented with grouped ARD levels, including three‐ or four‐field resolution when available, serves as an essential reference for HLA typing frequencies specific to the Brazilian population.
Characterisation of the Novel HLA‐DRB1*13:01:44 Allele by Sequencing‐Based Typing
Authors: Pajot Thibault , Elsermans Vincent , Top Isabelle , Labalette Myriam
Published: February 2025

HLA‐DRB1*13:01:44 differs from HLA‐DRB1*13:01:01:01 by one nucleotide substitution in codon 180 in exon 3.
Effectiveness of a Brief Mindfulness‐Based Intervention on Compassion Fatigue and Compassion Satisfaction in Pediatric Nurses
Authors: AL‐Jdeetawey Nid'a A. , Al‐Hammouri Mohammed Munther , Rababah Jehad A. , Ta'an Wafa'a F. , Suliman Mohammad
Published: February 2025

Background

Unlike other medical practitioners, nurses working in pediatric intensive care units face uniquely challenging workplace conditions because they care for preterm newborns and critically ill patients. These workplace challenges led to increased compassion fatigue (i.e., burnout and secondary traumatic stress) and decreased compassion satisfaction. Compassion fatigue and compassion satisfaction strongly influence the quality of care and patient outcomes, and these need to be addressed through effective interventions such as mindfulness‐based interventions.

Aim

This study aimed to examine the impact of a brief mindfulness‐based intervention on compassion fatigue and compassion satisfaction among pediatric intensive care nurses.

Methods

A quasi experimental study with a pretest posttest design was used to recruit 204 nurses: 102 in the intervention group and 102 in the control group with randomization by hospital (n = 4). The brief mindfulness‐based intervention was delivered over 6 weeks. Data were collected using a demographics questionnaire and the Professional Quality of Life Scale, Version 5.

Results

The intervention group's mean scores of burnout and secondary traumatic stress were significantly lower postinterventions compared with the control group. Similarly, the mean compassion satisfaction score for the intervention group indicated a significant improvement post‐intervention compared with the control group. Additional evidence for the effectiveness of the intervention was the disappearance of low compassion satisfaction, high burnout, and high secondary traumatic stress categorizations postintervention in the intervention group, contrary to the control group.

Linking Evidence to Action

Implementing brief mindfulness‐based interventions can improve pediatric intensive care nurses' well‐being by reducing burnout and secondary traumatic stress while enhancing compassion satisfaction. By using the study's findings, nurse managers can make these practices essential for high‐quality care and effective workforce management.

Trial Registration

ClinicalTrials.gov identifier: ACTRN12622000389707
Agenda setting of Chinese Traditional Festivals in Chinese English-language Newspaper: A Content analysis of China Daily, 2011-2023
Authors: Wang Wensui , Adnan Hamedi Mohd , Choong Pui Yee
Published: February 2025

China Daily, as the leading English-language newspaper in China, plays an important role in promoting Chinese traditional festival culture to the world. The main objective of this study is to analyze the agenda setting of the articles about Chinese traditional festivals in China Daily from 2011 to 2023, and examine whether there are significant differences between different time periods in agenda setting. Based on the agenda setting theory, content analysis was used to study articles in China Daily. The coverage from 2011 to 2023 is divided into three time periods, and they were compared to examine whether there are significant differences between them in issue agenda setting and attribute agenda setting. The research results show that in issue agenda setting, with the development of time, the topics of politics and technology, as well as the reports on foreign regions and the world show an increasing trend. In attribute agenda setting, the proportions of the front page, long articles with more than 1,000 words, the types of news, and the presentation form of words and pictures coexisting all show an obvious increasing trend. Articles of Chinese traditional festivals in China Daily show significant differences in three different time periods at both issue agenda setting and attribute agenda setting levels, indicating China Daily has paid increasing attention to Chinese traditional festivals and made more and more efforts to promote Chinese traditional festivals to the world.
Ética en la creación: hacia una práctica íntegra y responsable
Authors:   Pontificia Universidad Javeriana, Delgado Barón Tania Catalina , Díaz Amado Eduardo , Beltrán Luengas Elsa María , Campion Minerva , Contreras Jaramillo Juan Camilo , Uribe Piedrahita Carlos Andrés , Gómez Torres Nicolás , Ballesteros Mejía Melissa
Published: February 2025

La Asistencia para la Creación Artística de la Pontificia Universidad Javeriana ha sido pionera en establecer directrices y fomentar la reflexión sobre las prácticas creativas. Este libro aborda el impacto ético de la producción creativa, destacando la relación entre investigadores y su entorno. A lo largo de seis capítulos, se examinan cuestiones éticas fundamentales en la creación e investigación, promoviendo un enfoque plural y la formulación de políticas públicas que apoyen a los creadores.
Association of Gait Speed With Cognitive Outcomes in Older Adults With Hypertension: A Secondary SPRINT MIND Analysis
Authors: Mirzai Saeid , Volk Maximilian C. , Kazibwe Richard , Gabani Mohanad , Schaich Christopher L. , Hammonds Racquel , Seals Austin , Singleton Matthew J. , Yeboah Joseph , Shapiro Michael D. , Herrington David , Kitzman Dalane W. , Hughes Timothy M. , Williamson Jeff D. , Kritchevsky Stephen B.
Published: February 2025

Background/Objectives: Hypertension is linked to slower walking pace and cognitive decline, but the ability of slow gait to predict dementia in older adults with hypertension is unclear. This study examined whether slow baseline gait predicts future cognitive impairment in older adults with hypertension enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (MIND) study. Methods: SPRINTMIND randomized adults ≥50 years of age with hypertension to intensive (target systolic blood pressure <120 mmHg) or standard (<140 mmHg) blood pressure control. Baseline gait speed was measured in participants ≥75 years of age. We defined slow gait as speed ≤0.8 m/s. Outcomes were probable dementia (pD), mild cognitive impairment (MCI), and composite pD or MCI. Results: Among 2,351 participants, 33.3% had slow baseline gait. Over median 4-year follow-up, the slow gait group had higher rates of incident pD (13.5% vs 6.4%), MCI (19.4% vs 11.9%), and pD or MCI (29.2% vs 16.3%) compared with normal gait. Adjusted Cox regression models revealed that slow gait was associated with a 1.85-fold higher risk of pD (95% confidence interval [1.37, 2.50], p < .001), 1.52-fold higher risk of MCI (95% confidence interval [1.20, 1.93], p = .001), and 1.61-fold higher risk of pD or MCI (95% confidence interval [1.32, 1.97], p < .001). Intensive blood pressure control did not significantly affect cognitive outcomes in either gait group. Conclusion: Slow gait speed predicts increased cognitive decline risk among older adults with hypertension. Significance/Implications: Gait speed assessment can identify older adults with hypertension at higher risk of cognitive decline, allowing earlier intervention to potentially delay progression.
Continued permafrost ecosystem carbon loss under net-zero and negative emissions
Authors: Park So-Won , Mun Jin-Hyuk , Lee Hanna , Steinert Norman J. , An Soon-Il , Shin Jongsoo , Kug Jong-Seong
Published: February 2025

The loss of ecosystem carbon (the sum of vegetation, litter, and soil carbon) may occur in a permafrost region under mitigation pathways, which could reduce the efficiency of carbon dioxide removal. Here, we investigate changes in permafrost under net-zero and negative emissions, based on idealized emission-driven simulations using a state-of-the-art Earth system model. While acting as a net ecosystem carbon sink during most of the positive emission phase, permafrost becomes a net ecosystem carbon source just before reaching net-zero and negative emissions. Permafrost slowly recovers, especially in regions with high organic carbon content, and net ecosystem carbon loss persists until the end of simulations, resulting in a cumulative net ecosystem carbon loss of approximately 14 petagrams of carbon (PgC) in both scenarios. In addition, methane emissions increase under net-zero and negative emissions, due to the irreversibility of the inundated areas. We conclude that the permafrost ecosystem carbon loss may continue under net-zero and negative emissions, which could hinder climate change mitigation efforts.
Human camouflage and expression via soft mask from reprogrammable chemical fluid skin
Authors: Zhong Yiding , Tang Wei , Gui He , Sheng Qincheng , Xu Huxiu , Qin Kecheng , Guo Xinyu , Yang Huayong , Zou Jun
Published: February 2025

Developing a wearable, active, dynamic face-changing mask for human camouflage and expression is a substantial challenge. Many organisms achieve camouflage and expression through skin deformation and color change. Inspired by this, we report a reprogrammable chemical fluid skin, which achieves deformation through fluids like the skin of a pufferfish and achieves color change function like the skin of a chameleon. Based on the skin, we design a soft mask that allows switching between at least eight human faces at a time. The soft mask is lightweight, thin, and fits the wearer’s head. Its actuation is silent and safe, and can realize facial switching, including facial color and shape. By wearing the soft mask, robots can show facial changes and expression modulation, and humans can change their faces as needed. Our work enables the implementation of transforming a human into other humans in the real world to achieve camouflage and expression, which, to date, exists only in people’s imagination.
Fully analog iteration for solving matrix equations with in-memory computing
Authors: Li Jiancong , Xue Yibai , Li Yi , Jia Han , Zhou Zhiwei , Yang Ling , Ren Shengguang , Chen Jia , He Yuhui , Xue Kanhao , Xu Ming , Miao Xiangshui
Published: February 2025

Memristive in-memory computing has demonstrated potential for solving matrix equations in scientific computing. However, the inherent inaccuracies of analog mechanisms create challenges in achieving high-precision solutions while maintaining low-energy consumption. This study introduces a memristive matrix equation solver that considerably accelerates solutions by performing mathematical iterations directly within an analog domain. Our approach facilitates rapid approximate solutions with a scalable circuit topology and expedites the high-precision refinement process by substantially reducing the digital-to-analog conversion overhead. We experimentally validated this methodology using a heterogeneous computing system. We performed simulations of multiple scientific problems on these circuits, including solving the diffusion equation and modeling equilibration in silicon P-N junctions. Notably, our memristive solver, combined with digital refinement, achieved software-equivalent precision (with an error of 10
−12
). Compared to conventional digital processing units, this approach offered a 128-fold improvement in solution speed and a 160-fold reduction in energy consumption. This work establishes a foundation for future scientific computing using imprecise analog devices.
VARP binds SNX27 to promote endosomal supercomplex formation on membranes
Authors: Chandra Mintu , Kendall Amy K. , Ford Marijn G. J. , Jackson Lauren P.
Published: February 2025

Endosomes are vital cellular hubs for sorting protein cargoes. Retromer (VPS26/VPS35/VPS29) binds multiple sorting nexin (SNX) proteins on endosomal membranes, but assembly mechanisms of metazoan SNX/Retromer complexes remain elusive. We combine biochemical and biophysical approaches with AlphaFold modeling to identify a previously unidentified direct interaction between SNX27 and VARP. A full biochemical reconstitution system using purified proteins systematically tests how and when coats are recruited to membranes to generate tubules. We demonstrate and measure how specific combinations of Retromer with SNX27, ESCPE-1 (SNX2/SNX6), or both complexes, remodel membranes containing physiological cargo and phospholipids. SNX27, alone and with Retromer, remodels membranes with PI(3)P and PDZbm cargo. ESCPE-1 deforms membranes with bis-phosphoinositides and CI-MPR cargo but surprisingly does not recruit Retromer. VARP co-immunoprecipitates all coat components in cells and is required to reconstitute a proposed endosomal “supercomplex” (SNX27, ESCPE-1, and Retromer) in vitro. These data suggest VARP regulates metazoan endosomal coat assembly to promote cargo sorting out of endosomes.
Phase separation of the poplar microtubule-associated protein PagPCaP1a aids microtubule depolymerization in response to high salt
Authors: Lian Na , Zhang Xinyuan , Wang Xinwei , Zhang Yu , Wu Xinyuan , Qian Hongping , He Qizouhong , Jing Yanping , Mao Tonglin , Lin Jinxing
Published: February 2025

Woody plants must acclimate to environmental stresses, including soil salinity, for proper growth and development. Microtubule reorganization supports plant survival in saline-rich soils, but the underlying molecular mechanism in tree species remains unclear. In this study, we identified a salinity stress response mechanism in hybrid poplar seedlings. This mechanism involves regulation of microtubule dynamics by the microtubule-associated protein PLASMA MEMBRANE–ASSOCIATED CATION BINDING PROTEIN 1a (PagPCaP1a). Salinity stress induced
PagPCaP1a
expression and phase separation of PagPCaP1a protein to form PagPCaP1a condensates in a calcium-dependent manner. The formation of PagPCaP1a condensates was partially driven by the VEEEKK motif within the carboxyl terminus of the protein, which rapidly depolymerizes microtubules under salinity stress. Our study reveals that the liquid-liquid phase separation of PagPCaP1a represents an additional regulatory layer for microtubule depolymerization, and we propose an effective strategy to manipulate the phase separation of PagPCaP1a to improve plant stress tolerance.
Quantifying CO
2
forcing effects on lightning, wildfires, and climate interactions
Authors: Verjans Vincent , Franzke Christian L. E. , Lee Sun-Seon , Kim In-Won , Tilmes Simone , Lawrence David M. , Vitt Francis , Li Fang
Published: February 2025

Climate change affects lightning frequency and wildfire intensity globally. To date, model limitations have prevented quantifying climate-lightning-wildfire interactions comprehensively. We exploit advances in Earth System modeling to examine these three-way interactions and their sensitivities to idealized CO
2
forcing in 140-year simulations. Lightning sensitivity to global temperature change (+1.6 ± 0.1% per kelvin) is mitigated by compensating atmospheric effects. Global burned area sensitivity to temperature (+13.8 ± 0.3% per kelvin) is largely driven by intensified fire weather and increased biomass but marginally by lightning changes. We find a universal law characterizing regional-scale modeled fire activity and its CO
2
sensitivity, consistent with basic principles of statistical mechanics. Last, a negative climate feedback through intensified aerosol direct effect from fire emissions reaches an equivalent decrease of 0.91 ± 0.01% in CO
2
radiative forcing. However, this feedback contributes to polar amplification. Our analysis shows that climate-lightning-wildfire interactions involve multiple compensating and amplifying feedbacks, which are sensitive to anthropogenic CO
2
forcing.
Anti-NMDA receptor encephalitis following Murray Valley encephalitis: a case report
Authors: Yerramilli Arvind , Ramachandran Prashanth , Burston John , Howard-Jones Annaleise R. , Lim Chuan Kok , Kok Jen , Fitzpatrick Leigh , Hingston Peter , Jackson Justin
Published: February 2025

Background

Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune condition that is increasingly being recognized as a complication of central nervous system infections. While association with herpes simplex virus encephalitis is well established, the condition has also been reported to occur following Japanese encephalitis virus infection and yellow fever vaccination.

Case Summary

Here, we report a case of anti-NMDA receptor encephalitis following infection with Murray Valley encephalitis virus (MVEV), another virus of the family Flaviviridae. Following initial recovery, and 34 days after the onset of illness, our patient developed autonomic instability, orofacial dyskinesia, and decreased level of consciousness. Diagnosis was established with the detection of anti-NMDA receptor antibodies in cerebrospinal fluid. Immunosuppressive therapy with rituximab and corticosteroids resulted in a favorable outcome.

Conclusion

This case report raises awareness of post-viral autoimmune encephalitis which should be considered in patients with a biphasic pattern of illness following viral encephalitis or a compatible clinical syndrome. Given the initial diagnosis of Murray Valley encephalitis, clinicians should be alert to the possibility of MVEV as an infectious trigger associated with the development of anti-NMDA receptor encephalitis. We also highlight the challenges inherent in the diagnosis of flavivirus infections, which may require a combination of clinical, epidemiological, and laboratory evidence.
Severe accidental poisonings in children: a British Paediatric Surveillance Unit nationwide prospective study
Authors: King Charlotte , Anderson Mark , Agarwal Abhishek , Fakis Apostolos , Parry Christopher M , Lynn Richard Michael , Hawcutt Daniel B , Starkey Elizabeth Sarah
Published: February 2025

Background

Poisoning in children and young people is common. Understanding the incidence, causes and circumstances of severe accidental poisonings, requiring admission and medical intervention, may help healthcare professionals and shape public health interventions.

Methods

A prospective, population-based surveillance study using the British Paediatric Surveillance Unit (BPSU)’s active surveillance methodology (July 2018–July 2019) in the UK and Ireland. Inclusion criteria were as follows: all children aged <15 years; accidental poisoning requiring intervention; Poisoning Severity Score (PSS) score ≥2 (moderate or severe). Intentional poisonings were excluded.

Results

116 cases of poisoning were reported, and 31 cases met the inclusion criteria. The overall incidence of reported severe accidental poisoning was 2.4 cases per million children (3.2 per million in male, 1.6 per million in female), with 7.3 cases per million in children under 2 years. On PSS scoring, 14 (45%) cases were classified as moderate, 16 (52%) cases severe and 1 (3%) case fatal. The frequency of fatal poisonings reported was 0.08 per million children. Prescription medications were the most common substance implicated (n=13, 42%), with opioids (n=6, 19%) being the most common medication group. Common non-medication causes were illicit drugs or alcohol (n=12, 39%), household or industrial products (n=5, 16%), and carbon monoxide (n=1, 3%). The most cited circumstance was ‘the substance being left unattended’ (n=8, 26%).

Conclusion

Severe accidental poisoning remains a significant problem for children, but the most common causes have changed, underscoring the importance of updating public health initiatives.
Challenges of diagnosing and managing Addison’s disease in a resource-limited setting
Authors: Mwakyula Issakwisa Habakkuk , Kishimbo Peter Anael , Nzota Mary , Nsojo Anthony
Published: February 2025

This case from Tanzania involving a black woman in her 60s with Addison’s disease (AD) highlights the diagnostic and management challenges of this condition in a resource-limited setting. It underscores the need for increased awareness, better diagnostic facilities and more accessible treatment options for AD in Tanzania and other developing countries. The case also highlights the role of junior, inexperienced medical staff, which is common in Africa, in contributing to delays in diagnosis and treatment. This context is crucial for understanding the complexities involved in diagnosing and managing AD in such regions, where the disease can often go unrecognised due to overlapping symptoms with other common conditions and limited healthcare resources.
Feasibility, acceptability and preliminary effectiveness of the Hospital to Home discharge and follow-up programme in rural Uganda: a mixed-methods intervention study
Authors: Niyonshaba Beatrice , Kabugo Daniel , Nakiganda Cornety , Otai Christine , Seela Margret , Nankabala Joyce , Nyonyintono James , Nakakande Josephine , Kigozi Tadeo , Vaughan Madeline , Nakamura Heidi , Paudel Mohan , Haddix-McKay Kimber , al-Haddad Benjamin J S , Tann Cally J , Mubiri Paul , Waiswa Peter , Magnusson Brooke
Published: February 2025

Introduction

Over 60% of premature infants are born in Africa or South Asia. Infants born early, small or who become sick after birth have a higher risk of death, poor growth and developmental impairments. Innovative interventions tailored for low- and middle-income countries are essential to help these newborns survive and develop optimally. This study evaluated the feasibility, acceptability and preliminary effectiveness of Hospital to Home (H2H), a discharge and follow-up programme for small and sick newborns in rural Uganda.

Methods

We compared two cohorts of high-risk hospitalised neonates in Uganda: a historical-comparison cohort receiving standard facility-based care and an intervention cohort that received the H2H programme, a hospital and community spanning package of interventions designed to improve neurodevelopmental outcomes. We compared 6-month corrected neurodevelopmental, growth, nutritional and vaccination outcomes between the cohorts complemented by qualitative interviews of caregivers, community health workers and health facility staff.

Results

We recruited 191 participants: 91 historical-comparison cohort (born between July and September 2018), and 100 intervention cohort (born July 2019 to February 2020). No statistically significant difference was seen in neurodevelopmental outcomes (adjusted OR 0.68; 95% CI: 0.32 to 1.46). Improved vaccination completion (88.5% intervention vs 76.9% comparison, p=0.041), and exclusive breastfeeding rates (42% vs 6.6%, p<0.001) were seen. Caregivers and healthcare workers reported the intervention to be acceptable and feasible in this rural Ugandan setting.

Conclusion

The H2H programme was feasible and acceptable to caregivers and healthcare providers. Improved vaccination and exclusive breastfeeding rates were seen in the intervention group when compared with a historical comparison cohort in this rural Ugandan setting. Further investigation on the short and long-term effectiveness of the H2H programme in a government health services setting is warranted.

Trial registration number

ISRCTN51636372.
Trends in the prevalence and factors associated with indoor smoking in 24 countries Party to the WHO FCTC: implications for equitable policy implementation
Authors: Odo Daniel Bogale , Ayo-Yusuf Olalekan , Dinku Yonatan , Mekonnen Alemayehu Gonie , Maddox Raglan
Published: February 2025

Introduction

The health consequences of secondhand smoke (SHS) are a long-standing concern. The WHO Framework Convention on Tobacco Control (FCTC) is an evidence-based treaty that aims to protect people from health and environmental harms of commercial tobacco use and exposure to SHS. This study quantified the prevalence of daily smoking inside the house (indoor smoking) and change over time and examined the determinants of indoor smoking in 24 WHO FCTC Parties.

Methods

We used data from the 2 most recent Demographic and Health Surveys (DHS) from 24 countries. Counties were selected if they submitted at least one FCTC implementation report and had two DHS surveys conducted after 2010. The weighted prevalence and percentage changes in daily indoor smoking in the two consecutive surveys were calculated, including rate of change, and a two-sample test of proportions was used to assess changes. Multinomial logistic regression model was employed to examine the association between socioeconomic characteristics and indoor smoking. All results were presented by country.

Results

A significant decline in the prevalence of daily indoor smoking was detected in 16/24 countries, with the rate of decline ranging from −45.8% in Liberia to −15.2% in India. Jordan reported a significant increase in daily indoor smoking from 57% to 60%; p=0.002. The meta-analytical estimate showed that overall, the relative risk ratio (RRR) of daily indoor smoking was significantly lower for households in the 5th wealth quintile compared with counterparts in the 1st quintile (RRR=0.40; 95% CI: 0.30 to 0.52), and in households where head of the household attended higher education compared with no formal education (RRR=0.60; 95% CI: 0.53 to 0.69).

Conclusions

This study demonstrated that prevalence of daily indoor smoking was associated with low socioeconomic status. Reducing SHS exposure is critical, including addressing inequities to help improve health outcomes. Currently, over 2.8 billion people in low-income countries are not protected by smoke-free environment laws, and only 18% of the world’s population is covered by strong restrictions on tobacco marketing.
Association between high-sensitivity C-reactive protein and bleeding in dual antiplatelet therapy age: a retrospective observational study
Authors: He Wen-fei , Zeng Li-huan , Lin Zi-jing , Chen Peng-yuan , Liu Yuan-hui , Duan Chongyang , Jiang Lei , Guo Zhi-qiang , He Peng-cheng
Published: February 2025

Objectives

The aim of the present study was to investigate the association of high-sensitivity C-reactive protein (hs-CRP) with bleeding events among patients with acute coronary syndrome (ACS) received dual antiplatelet therapy (DAPT) after percutaneous coronary intervention.

Design

An observational and multicentre study was conducted among non-ST-segment elevation ACS (NSTE-ACS).

Setting

The study was conducted at five medical centres in China.

Participants

This study retrospectively included 2583 adults with NSTE-ACS between 1 January 2010 and 31 December 2014.

Primary and secondary outcome measures

The primary outcome was major bleeding, defined by the Bleeding Academic Research Consortium definition (grades 3–5). The second outcome was death and any bleeding.

Results

53 (2.1%) patients experienced major bleeding in the hospital. Patients with hs-CRP levels greater than 8.20 mg/L had the highest incidence of in-hospital major bleeding (25 (3.9%), p<0.001) compared with the other groups. Multivariable analysis indicated that hs-CRP was an independent factor associated with in-hospital major bleeding (continuous: adjusted OR=1.01, 95% CI: 1.01 to 1.02, p<0.001; quartiles: adjusted OR for quartile 4 (referring to quartile 1) =3.71, 95% CI: 1.35~10.23, p=0.011), which was further confirmed by subgroup analysis and receiver operating characteristic curves. The restricted cubic spline analysis demonstrated an S-shaped association between hs-CRP and major bleeding. During the 5-year follow-up, there was a significantly high risk of bleeding in patients with higher hs-CRP levels.

Conclusions

Systemic inflammation marker hs-CRP in patients with NSTE-ACS who received DAPT is associated with a high risk of in-hospital major bleeding. An S-shaped association was found between hs-CRP and bleeding events. Further studies are warranted to optimise antithrombotic drug therapy in high bleeding risk patients during follow-up.
Development and validation of a questionnaire on parental health literacy in the context of promoting healthy lifestyles during childhood: a study protocol
Authors: Flügel Verena , Hering Thomas , Dadaczynski Kevin
Published: February 2025

Introduction

Becoming a parent presents profound changes and numerous challenges, notably the necessity for reliable information regarding their child’s health. Given the overabundance of information available today, it is important for parents to acquire the skills necessary to find, understand, evaluate and apply health information. Research demonstrates that this ability, known as parental health literacy (PHL), is crucial for developing and maintaining a healthy lifestyle during childhood. However, there is currently no reliable instrument for measuring PHL in the field of prevention and health promotion. This paper presents the development and validation of a new questionnaire designed to assess parents’ ability to process health-related information to support the healthy development of their children aged 3–6 years.

Methods and analysis

The development of the item pool is based on Sørensenet al’s conceptualisation of general health literacy (finding, understanding, evaluating and applying health information). Empirical findings suggest that communication with healthcare providers and the social network represents another important skill area for parents and is therefore included as an additional subscale. The questionnaire will be developed in four stages, including a literature search and analysis, expert consultations via Delphi study, cognitive interviews with parents and a validation study. The validation study uses exploratory (EFA) and confirmatory factor analysis (CFA) for construct validity, first identifying test dimensions through EFA, then confirming these dimensions with CFA to ensure the factor structure aligns with theoretical expectations. This methodology, alongside reliability and correlational analyses, seeks to assess the questionnaire’s validity and reliability, expecting strong correlations with existing related constructs.

Ethics and dissemination

Ethical approval was obtained from the Ethics Committee of Fulda University of Applied Sciences. All participants receive a consent form together with the study information, in which they give their written consent to the storage, processing and linking of all data collected. The results of the study will be presented at national and international conferences and published in specialist journals.

Trial registration number

DRKS00033482.
Capacity assessment for EHR-based medical device post-market surveillance for synthetic mid-urethral slings among women with stress urinary incontinence: a NEST consortium study
Authors: Matheny Michael E , Perkins Amy M , Rieger-Christ Kimberly , Ross Joseph S , Mao Jialin , Sedrakyan Art , Shah Nilay D , Winter Robert , Reynolds W Stuart , Mourtzinos Arthur , Schulz Wade L , Bartlett Victoria , Solotke Michael , Pandya Sameer , Aryal Suvekshya , Cho Ahra , Frankenberger Edward A , Park Daniel , Bostrom Danielle , Robbins Susan , Yustein Aron , Chughtai Bilal , Trabuco Emanuel C
Published: February 2025

Objectives

To evaluate the feasibility for use of electronic health record (EHR) data in conducting adverse event surveillance among women who received mid-urethral slings (MUS) to treat stress urinary incontinence (SUI) in five health systems.

Design

Retrospective observational study using EHR data from 2010 through 2021. Women with a history of MUS were identified using common data models; a common analytic code was executed at each site. A manual chart review was conducted in a per-site random patient subset to establish a reference standard. Automated text processing (Text Processed Integrated (TPI)) was developed and evaluated at each site to determine the surgical approach and synthetic mesh implantation. Patients were characterized and surgical outcomes were ascertained over 730 subsequent days.

Setting

Five large tertiary care academic medical centers.

Participants

Across five health systems, 9,906 eligible patients (mean age 57–60 per site) were identified.

Main outcome measures

Determination of surgical approach, synthetic mesh implantation, and assessment of the duration of surveillance for mortality and reoperation rates following MUS implantation.

Results

In the TPI cohort analysis, 3,331 patients were identified. Surgical approach per site was retropubic (42% to 77%), transobturator (6% to 44%), single incision (0% to 24%), and adjustable sling (0% to <4%). Concordance rates for TPI using chart review were 71%–90% at each site for the surgical approach and 28%–85% for synthetic mesh implantation. Patient follow-up observation rates for mortality and reoperation ranged from 22% to 36% at 90 days, 15% to 30% at 365 days, and 8% to 19% at 730 days.

Conclusion

Using EHR data alone, identification of medical devices and surgical approaches was feasible among women with MUS surgery for SUI, but long-term follow-up ascertainment rates were low. Medical device surveillance using EHR data should be evaluated in the context of the clinical use case, as applicability may vary.
Long-term safety and efficacy of the combination of belimumab and rituximab in the treatment of severe and refractory SLE: a preliminary report
Authors: van Schaik Mieke , Arends Eline J , Wetzels Marjolein J A L , Kraaij Tineke , Verbruggen Stéphanie H , van der Kooij Sandra W , Kamerling Sylvia W A , Huizinga Tom , Goekoop Robbert J , van Kooten Cees , Rabelink Ton , Teng Y K Onno
Published: February 2025

Objective

Combination therapy with rituximab and belimumab is a novel treatment strategy for severe SLE and lupus nephritis. Phase II studies have shown promising results, although long-term data are currently lacking. To address this, we analysed outcomes of patients with severe treatment-refractory SLE who previously participated in the phase II Synbiose Study, with a particular focus on immunological parameters.

Methods

Eight patients continued belimumab treatment beyond the 2-year duration of the original trial. We conducted a descriptive study to evaluate the course of treatment and immunological parameters over an extended follow-up. Our analyses include blood cell counts, immunoglobulins, autoantibodies, complement markers and clinical disease activity parameters. Additionally, we examined long-term effects on the B cell compartment employing high-sensitivity flow cytometry.

Results

Over a median follow-up period of 6.8 years, six out of eight previously treatment-refractory patients maintained long-term clinical remission, while two experienced a major flare. Among those in remission, two patients achieved immunosuppression-free remission, and four continued belimumab. Long-term effects on humoral (auto-)immunity were a persistent decrease in IgM levels, while IgG normalised. Most patients maintained low autoantibody titres, and complement markers remained normal. On the cellular level, belimumab treatment after rituximab prevented B cell repopulation. Notably, patients exhibited a stable reduction of double-negative (DN) B cells, irrespective of continuing or stopping belimumab.

Conclusions

Long-lasting remission was observed in patients with SLE following combination treatment with rituximab and belimumab. We observed no significant hypogammaglobulinaemia and, notably, persistent reduction of DN B cells.
Words-to-Letters Valuations for Language Kleene Algebras with Variable and Constant Complements
Authors: Nakamura Yoshiki , Sin’ya Ryoma
Published: February 2025

We investigate the equational theory for Kleene algebra terms with variable complements and constant complements — (language) complement where it applies only to variables or constants — w.r.t. languages. While the equational theory w.r.t. languages coincides with the language equivalence (under the standard language valuation) for Kleene algebra terms, this coincidence is broken if we extend the terms with complements. In this paper, we prove the decidability of some fragments of the equational theory: the universality problem is coNP-complete, and the inequational theory [Formula: see text] is coNP-complete when [Formula: see text] does not contain Kleene-star. To this end, we introduce words-to-letters valuations; they are sufficient valuations for the equational theory and ease us in investigating the equational theory w.r.t. languages. Additionally, we show a completeness theorem of the equational theory for words with variable complements and the non-empty constant.
Operations on Boolean and Alternating Finite Automata
Authors: Hospodár Michal , Jirásková Galina , Krajňáková Ivana
Published: February 2025

We investigate the complexity of basic regular operations on languages represented by Boolean and alternating finite automata. We get tight upper bounds [Formula: see text] and [Formula: see text] for union, intersection, and difference, [Formula: see text] and [Formula: see text] for concatenation, [Formula: see text] and [Formula: see text] for square, [Formula: see text] and [Formula: see text] for left quotient, [Formula: see text] and [Formula: see text] for right quotient. We also show that in both models, the complexity of complementation and symmetric difference is [Formula: see text] and [Formula: see text], respectively, while the complexity of star and reversal is [Formula: see text]. All our witnesses are described over a unary or binary alphabets, and whenever we use a binary alphabet, it is always optimal. We also show that the tight upper bound for the conversion of alternating finite automata into nondeterministic finite automata with a unique initial state is [Formula: see text]. Some of our results provide answers to open problems stated by Fellah et al. [5].
Research on Multi-Feature Fusion Music Emotion Classification Method Under Cognitive Psychology
Authors: Liu Aizhen
Published: February 2025

Music is one of the most essential forms of human communication, capable of conveying a wealth of emotional information. This paper proposes a novel multi-feature fusion algorithm for music emotion classification, combining features such as timbre, dynamics, melody, rhythm, pitch, range and time domain to capture the complexity of emotional expression in music. Grounded in cognitive psychology, the proposed method employs a Backpropagation (BP) neural network for classification, leveraging multi-feature data to improve accuracy. Experimental results demonstrate the effectiveness of the proposed approach, achieving a classification accuracy of 89.5%, which is significantly higher than traditional methods such as Random Forest (81.2%) and Support Vector Machine (84.7%). Furthermore, the proposed model shows consistent improvements in recall and precision across various emotion categories. These findings validate the algorithm’s robustness and practicality, offering a valuable contribution to the field of music emotion recognition.
Charged wormholes with a quintessence dark-energy field in the galactic halo
Authors: Manna Rounak , Debnath Ujjal
Published: February 2025

Based on the widely recognized Karmarkar condition, or embedding class 1 technique, this work searches for charged wormhole solutions with spherical symmetry for the Einstein field equations. With charged traversable wormhole geometry, we use the Karmarkar condition to derive a wormhole shape function. The obtained shape function satisfies the necessary traversability conditions. In addition, we discuss the embedding diagram in Euclidean space, in both two and three dimensions, and verify the proper radial distance to display the wormhole configurations. Next, we examine a model with a quintessence field and a second field that represents regular matter and has an anisotropic pressure, providing energy for developing wormhole spacetime. Then, we obtain the Einstein field equations to verify the energy conditions. After that, we take three density profiles, which are the pseudo-isothermal density profile, the Navarro–Frenk–White density profile, and the density profile of Einasto Dark Matter of the galactic halo, and observe that for all of these density profiles, the NEC is violated. Hence, wormhole structures are firmly maintained by the composition of exotic matter within them. Furthermore, we use the volume integral quantifier to determine the necessary quantity of exotic matter near the wormhole throat.
Acceleration of the Universe without the Hubble tension with Kaniadakis holographic dark energy using the Hubble horizon as the IR cut-off
Authors: Fang Wei , Chen Guo , Feng Chao-Jun , Du Wei , Shu Chenggang
Published: February 2025

In this paper, we introduce a holographic dark energy model that incorporates the first-order approximate Kaniadakis entropy, utilizing the Hubble horizon, [Formula: see text], as the infrared cutoff. We investigate the cosmological evolution within this framework. The model introduces an extra parameter relative to the [Formula: see text]CDM model. It posits a Universe that is initially dominated by dark matter, which then evolves to a phase where dark energy becomes the predominant component, with this transition occurring at a redshift of approximately [Formula: see text]. The energy density of dark energy is ultimately expected to become constant, thereby circumventing the potential issue of a “big rip”. Employing the most recent Type Ia supernova and Hubble parameter data, we constrain the model’s parameters and find a Hubble constant of [Formula: see text] km/s/Mpc, thereby resolving the Hubble tension issue. The estimated age of the Universe, based on the best-fit parameter values, is [Formula: see text] Gyr. Furthermore, we predict the number of strong gravitational lenses and conduct statefinder and [Formula: see text] diagnostic analyses to validate and characterize the model.