bluuebunny/crossref_metadata_2025 huggingface dataset:
Daily or near‐daily cannabis and alcohol use by adults in the United States: A comparison across age groups
Authors: Patrick Megan E.
Published: December 2024

Background and aims

Patterns of daily or near‐daily (DND) use of alcohol and cannabis among adults in the United States have been changing. The current study measured how these shifts have occurred across developmental periods of adulthood.

Design, Setting, and Participants

U.S. national data from the Monitoring the Future Panel Study include responses from approximately 20 000 adults aged 19 to 65 in 2023. In total, annual data from 1988 to 2023 include 389 649 responses.

Measurements

Self‐report measures of use of cannabis and alcohol DND (i.e., 20 + occasions in the last 30 days) were available for the full age ranges of 19–30 years from 1988 to 2023, of 35–50 years from 2008 to 2023, and of 55–65 years in 2023.

Findings

As of 2023, DND cannabis use was nearly three times as prevalent (10.4%) as DND alcohol use (3.6%) among young adults ages 19 to 30. Early midlife adults have had a convergence but not yet a crossover; there were similar prevalence levels of DND use of cannabis (7.5%) and alcohol (7.8%) among those ages 35 to 50 in 2023. Among late midlife adults ages 55 to 65, DND alcohol use remained more than twice as prevalent (11.4%) as DND cannabis use (5.2%) in 2023.

Conclusions

In the United States, daily or near‐daily (DND) alcohol use remains more prevalent than DND cannabis use among late midlife adults, but the opposite is true for young adults.
Impact of Tobacco, Marijuana, and Alcohol Use on Overall Survival in Recurrent Metastatic Head and Neck Cancer Patients Treated With Immune Checkpoint Inhibitors
Authors: Alsavaf Mohammad Bilal , Issa Majd , Klamer Brett G. , Husain Marium , Dibs Khaled , Pan Xueliang , Grecula John C. , Old Matthew O. , Konieczkowski David , Mitchell Darrion L. , Baliga Sujith , Carrau Ricardo L. , Rocco James W. , Bonomi Marcelo , Blakaj Dukagjin M. , Bhateja Priyanka
Published: December 2024

Aim

The response rates to immune checkpoint inhibitors (ICI) remain low (13%–20%) in metastatic head and neck cancer patients, indicating an urgent need to better understand factors predictive of response to these agents. This study explored the impact of smoking status, marijuana use, and alcohol consumption on treatment outcomes in recurrent‐metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients treated with ICI.

Methods

A retrospective analysis was performed on 201 R/M HNSCC patients treated with ICI between January 15th 2016 and April 9th 2020 at a single institution.

Results

Gender: 154 male (77%), 47 female (23%). Median age 61 (IQR: 55–68). ICI drug: pembrolizumab 100 (50%), nivolumab 91 (45%), nivolumab + ipilimumab 10 (5%). Line of therapy: first: 98 (49%), second and beyond: 103 (51%). Tumor site: oropharynx 84 (42%), oral cavity 45 (22%), larynx 26 (13%), other sites 46 (23%). p16 tumor status: negative 132 (66%), positive 69 (34%). Smoking status: former 111 (55%), never 54 (27%), current 36 (18%), median pack‐year 18 (IQR: 0–37). Alcohol use: yes 110 (55%), no 91 (54%). Marijuana use: yes 47 (23%), no 154 (77%). Overall response rate: 36 (18%). Median OS: 12 months (95% CI: 9.4–14.8). Tobacco: former (HR: 0.75, 95% CI: 0.50, 1.11), current (HR: 0.58, 95% CI: 0.33, 1.02). Marijuana: yes (HR: 0.93, 95% CI: 0.58, 1.49). Alcohol: yes (HR: 1.04, 95% CI: 0.72, 1.49).

Conclusion

In our cohort, smoking status, marijuana use, and alcohol consumption did not have a statistically significant impact on OS in patients with R/M HNSCC treated with ICI.
How budget trade‐offs undermine electoral incentives to build public housing
Authors: Hilbig Hanno , Wiedemann Andreas
Published: December 2024

Housing shortages and rising rents have increased demands for affordable housing. In this paper, we examine whether electoral constraints can undermine local politicians' incentives to build public housing. Empirically, we draw on the full‐count census of all housing built in Germany, data on 19,685 local elections between 1989 and 2011, and an original survey. Using a difference‐in‐differences design, we demonstrate that incumbents are not rewarded, but rather experience moderate electoral losses after constructing new public housing. We then show that these losses are not primarily driven by homeowner opposition or native–foreigner competition. Instead, electoral punishment is largest in economically disadvantaged municipalities with relatively affordable housing, as voters prioritize spending in other local policy areas that are crowded out by public housing. Survey evidence demonstrates that electoral constraints emerge when voters' short‐term spending preferences conflict with municipalities' long‐term goals to provide affordable housing.
A systematic review and meta‐analysis of interventions to delabel low‐risk penicillin allergies with consideration for sex and gender
Authors: Maximos Mira , Pelletier Ryan , Elsayed Sameer , Maxwell Colleen J. , Houle Sherilyn K. D. , McConnell Brie , Gamble John‐Michael
Published: December 2024

Aims

Sex and gender may influence penicillin allergy label (PAL) prevalence and outcomes. This review evaluates the effectiveness and safety of direct delabelling (DD) and oral challenge (OC) for low‐risk patients and examines sex and gender differences in reporting and outcomes.

Methods

We searched PubMed, Database of Abstracts of Reviews and Effects, ClinicalTrials.gov, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, medRxiv, Ovid MEDLINE, and Ovid EMBASE until February 2024 for studies including DD or OC compared to no intervention, skin testing or other methods. Two reviewers assessed quality. Meta‐analyses were conducted, and subgroup analyses were carried out if I2 >   75%. Descriptive data was analysed using NVivo 14 and reported narratively.

Results

From 1046 screened studies, 28 met inclusion criteria (two RCTs, 26 quasi‐experimental studies). Sex at baseline was reported in 86% of studies, with 61% females: 18% disaggregated outcomes by sex with a female mean delabelling rate of 66%. Gender variables were not reported. OC was not found to be more or less as effective comparaed to skin testing in RCTs (risk ratio [RR] 1.04; 95% confidence interval [CI] 0.95, 1.13, I2 = 74%). DD interventions had a 27% delabelling rate (95% CI 10%, 50%, I2 = 96%), with nursing staff achieving 29% (95% CI 15%, 47%, I2 = 63%) and allergists/immunologists 6% (95% CI 0.00, 0.00, I2 = 20%). Quasi‐experimental studies reported 90% delabelling for OC, with 59% by allergists/immunologists and 90% by pharmacists. Adverse events averaged 4% and were non‐severe.

Conclusions

DD and OC are effective for delabelling low‐risk penicillin allergies. Comprehensive data is lacking on sex and gender differences, indicating a need for further research.
Landscape of somatic mutations and clonal evolution in NUP98‐rearranged adult acute myeloid leukaemia
Authors: Frerich Candace , Li Peng , Raess Philipp W. , Dunlap Jennifer , Lachowiez Curtis , Solis‐Ruiz Jose , Press Richard , Long Nicola , Swords Ronan T. , Wiszniewska Joanna , Fan Guang , Xie Wei
Published: December 2024

Acute myeloid leukaemia with NUP98 rearrangement (AML‐NUP98) has been previously described in paediatric patients, and the clinical significance in adult AML patients remains largely unexplored. In this study, we identified specific partner fusion genes and examined somatic co‐mutations and clonal evolution longitudinally in adult AML‐NUP98 patients. Our comprehensive analysis provides an understanding of NUP98 rearrangement and co‐mutations influencing clonal evolution and disease progression and offers valuable insights into potential therapeutic strategies. Further multiple centre studies are needed to investigate this entity in adult patients and improve treatment strategy.
“It's not being ‘on‐the‐land,’ it's like we are a part of the Land”: Indigenous youth share visual stories at “on‐the‐land” camps in the Dehcho
Authors: Woodworth Steph , Tanche Kristen , Nadli Britney , Wesche Sonia D. , Spring Andrew
Published: December 2024

In northern Canada, Indigenous Peoples face rapid environmental and sociocultural changes that disrupt access to traditional places and practices. This disruption limits cross‐generational knowledge transfer and decreases opportunities for youth to connect with the Land. Land‐based education programs aim to provide Indigenous youth with spaces to learn about and connect with the Land, their language, and culture. However, there is limited research on what youth experience, enjoy, and learn during these programs. Our paper explores this through a study with Dene and Métis youth in the Dehcho region of the Northwest Territories. We investigate what youth experience and learn during “on‐the‐land” camps and how these camps provide spaces for youth to connect with the Land. Using a community‐based, Indigenous research methodology, we employed photovoice, allowing youth to share visual stories of their camp experiences and their (re)connection with the Land. Our results are categorized into three themes: (1) connections with the Land; (2) enjoyment of the camp environment; and (3) land‐based learning. We argue that land‐based education programs, such as on‐the‐land camps, are effective for fostering relationships between Indigenous youth and the Land. These camps teach youth various ways to connect with and protect the Land for future generations.
Building Capacity for Digital Innovation—A Game‐Study
Authors: Madsen Kristina Maria , Brix Jacob
Published: December 2024

Organizations are facing a constant stream of emerging technologies that require management and staff to be more flexible, open and critical in exploring new potential. In supporting new digital innovation, an organization will inevitably be affected on the level of strategy, business design and operation. In this paper, we explore games' potential as one approach for building digital innovation capacity in an organization since games have been proven beneficial in early innovation and learning processes. Theoretically, we focus on ‘building digital innovation capacity.’ This is understood as a process where the knowledge about digitalization and digital transformation is used to strengthen individuals' skills, abilities and opportunities—knowledge that can be used as a source for organizational learning and development. In this paper, we explore and discuss the role of games in building capacity for digital innovation in established organizations through an empirical study consisting of four game sessions with the game Cards for IoT. Overall, this game study implies three important themes concerning games' role in building capacity for digital innovation in established organizations: gameplay & facilitation, player mindset and contextualization. The perspectives, nuances and insights of the themes are discussed with the literature on capacity building.
Information Governance: Paving the Way to Digital Institutions and Organizations
Authors: Caron Daniel J.
Published: December 2024

Advances in ITCs features have been putting our institutions and organizations under sustained pressure for several years. Based on concrete examples, this article first recalls the nature of the issues at stake and raises the importance of reconsidering our ways of organizing our bureaucracies based on the central role of information. The main responses provided so far are analyzed in the light of this shortcoming in the processing of information, which is often overlooked. Then, democratic principles and values are discussed as guidelines to be respected to avoid a techno‐centric drift. Finally, the importance of understanding the meaning and implications of the digital transformation, the need to consider the organization from the perspective of information processing, and the implementation of information governance are addressed as the three cornerstones of the digital transformation. The text concludes with a series of proposals to be considered to achieve this.
In Silico‐Designed G‐Quadruplex Targeting Peptide Attenuates VEGF‐A Expression, Preventing Angiogenesis in Cancer Cells
Authors: Banerjee Nilanjan , Roy Laboni , Panda Suman , Roychowdhury Tanaya , Chatterjee Subhrangsu
Published: December 2024

Vascular endothelial growth factor‐A (VEGF‐A) is a growth factor and pluripotent cytokine that promotes angiogenesis in cancer cells, transitioning to an angiogenic phenotype. The binding of VEGF‐A protein to VEGF receptors (VEGFR‐1 and VEGFR‐2) initiates a cascade of events that stimulates angiogenesis by facilitating the migration and enhancing the permeability of endothelial cells. The proximal promoter of the VEGF gene encompasses a 36‐base pair region (from −85 to −50) that can form a stable G‐quadruplex (G4) structure in specific conditions. The activity of the VEGF promoter is reliant on this structure. During cancer progression, the VEGF‐A G4 succumbs to cellular pressure and fails to maintain a stable structure. This shifts the balance to form a duplex structure, increasing the transcription rate. Earlier research has tried to develop small‐molecule ligands to target and stabilise G4, demonstrating the possibility of suppressing VEGF expression. However, they either lack specificity or toxic. Peptides, on the other hand, are significantly less studied as G4 binders. Here, we designed a peptide that successfully binds and stabilises the VEGF‐A G4 while reducing its gene expression. This further alters the expression fate of the VEGF‐A signalling cascade and blocks angiogenesis in cancer cells. We employed high‐resolution nuclear magnetic resonance (NMR) spectroscopy and molecular dynamics simulation to elucidate the chemical details of G4‐peptide interaction. In addition, we used qPCR and western blot techniques to investigate the expression pattern of the molecules implicated in the VEGF‐A signalling cascade. The study explores the intricate relationship between peptides and quadruplex structures, revealing valuable insights that can improve the design of pharmacophores targeting the dynamic quadruplex structure. The results of our study are encouraging, opening possibilities for advancements in, the characterisation and optimisation of peptides as G‐quadruplex ligands in view of their potential therapeutic uses.
Enhancing lymphoscintigraphic specificity of lymphoedema diagnosis in patients with lipoedema
Authors: Amiel Hadrien , Coulie Julien , Georis Raphaël , van la Parra Raquel , Pirson Genevieve , Deconinck Christine
Published: December 2024

This study addresses the diagnostic challenges of identifying lymphoedema in patients with lipoedema using lymphoscintigraphy. Overdiagnosis of lymphoedema in this patient population is frequent and may result in reduced proposed surgical interventions. We retrospectively analyzed clinical data from patients followed for lipoedema, lymphoedema or lipolymphoedema and who underwent lymphoscintigraphy. All patients were assigned a clinical or lymphoscintigraphic diagnosis of lymphoedema and concordance between clinical and lymphoscintigraphic diagnosis was assessed. A modification of lymphoscintigraphic criteria interpretation was proposed to enhance the diagnosis specificity. We included 94 female patients (188 lower limbs). One hundred and thirty‐seven limbs presented with signs of lipoedema (137/188; 72.9%) and 42 with clinical signs of lymphoedema (42/188; 22.3%). Overall, 125 limbs presented with a diagnosis of lymphoedema on lymphoscintigraphy (125/188; 66.5%). Using lymphoscintigraphy to diagnose lymphoedema in patients with lipoedema resulted in low specificity (38.3%). By adjusting the interpretation criteria of the lymphoscintigraphic anomalies, we could achieve a specificity of 80.85%, reducing the risk of overdiagnosing lymphoedema in patients with lipoedema. This study contributes to the ongoing efforts to optimize the assessment and management of patients with lipoedema and potential lymphatic involvement, by modifying the interpretation of lymphoscintigraphic criteria.
Effect of the SGLT2 inhibitor ipragliflozin on the expression of genes that regulate skin function
Authors: Ikarashi Nobutomo , Tabata Keito , Shinozaki Yui , Kon Risako , Sakai Hiroyasu , Hosoe Tomoo
Published: December 2024

Aims

Skin disorders occur more frequently with sodium‐dependent glucose cotransporter type 2 (SGLT2) inhibitors than with other antidiabetic drugs. We conducted basic research using ipragliflozin, with the aim of identifying new measures to prevent skin disorders caused by SGLT2 inhibitors.

Methods

db/db type 2 diabetes model mice were orally administered ipragliflozin (10 mg/kg or 30 mg/kg) once a day for 28 days and skin function genes were analysed by real‐time RT‐PCR or Western blotting.

Results

No difference in the expression level of collagen (Col1a1 and Col1a2) in the skin was detected between the ipragliflozin treatment group and the control group. On the other hand, the expression levels of enzymes involved in the synthesis and decomposition of hyaluronic acid (Has2 and Hayl1) and enzymes involved in the synthesis and decomposition of ceramide (Sptlc1, Sptlc2, Asah1, and Acer1) were significantly decreased by the administration of ipragliflozin. Furthermore, the expression levels of filaggrin (Flg), loricrin (Lor), elastin (Eln), and aquaporin‐3 (Aqp3) in the skin were lower in the ipragliflozin treatment group than in the control group.

Conclusions

It was revealed that ipragliflozin reduces the expression of genes involved in skin barrier and moisturizing functions, which this may be one of the mechanisms through which this drug causes skin disorders.
Exploring the interplay between inflammation and male fertility
Authors: Fomichova Oleksandra , Oliveira Pedro F. , Bernardino Raquel L.
Published: December 2024

Male fertility results from a complex interplay of physiological, environmental, and genetic factors. It is conditioned by the properly developed anatomy of the reproductive system, hormonal regulation balance, and the interplay between different cell populations that sustain an appropriate and functional environment in the testes. Unfortunately, the mechanisms sustaining male fertility are not flawless and their perturbation can lead to infertility. Inflammation is one of the factors that contribute to male infertility. In the testes, it can be brought on by varicocele, obesity, gonadal infections, leukocytospermia, physical obstructions or traumas, and consumption of toxic substances. As a result of prolonged or untreated inflammation, the testicular resident cells that sustain spermatogenesis can suffer DNA damage, lipid and protein oxidation, and mitochondrial dysfunction consequently leading to loss of function in affected Sertoli cells (SCs) and Leydig cells (LCs), and the formation of morphologically abnormal dysfunctional sperm cells that lay in the basis of male infertility and subfertility. This is due mainly to the production and secretion of pro‐inflammatory mediators, including cytokines, chemokines, and reactive oxygen species (ROS) by local immune cells (macrophages, lymphocytes T, mast cells) and tissue‐specific cells [SCs, LCs, peritubular myoid cells (PMCs) and germ cells (GCs)]. Depending on the location, duration, and intensity of inflammation, these mediators can exert their toxic effect on different elements of the testes. In this review, we discuss the most prevalent inflammatory factors that negatively affect male fertility and describe the different ways inflammation can impair male reproductive function.
Applying the Quadrant Method for Pumping‐Trace Metal Correlations in Variable Time, Low‐Data Systems
Authors: Tomlinson Zachary D. , Dee Kato T. , Madden Megan E. Elwood , Madden Andrew S. Elwood
Published: December 2024

Due to increasing global demand for fresh water, it is increasingly necessary to understand how aquifer pumping affects groundwater chemistry. However, comprehensive predictive relationships between pumping and groundwater quality have yet to be developed, as the available data, which are often collected over inconsistent time intervals, are poorly suited for long‐term historical correlation studies. For example, we needed an adequate statistical method to better understand relationships between pumping rate and water quality in the City of Norman (OK, USA). Here we used the interval‐scaled change in mean pumping rate combined with the Quadrant method to examine correlations between pumping rates and changes in trace metal concentrations. We found that correlations vary across the study area and are likely dependent on a variety of factors specific to each well. Comparing the Quadrant method to the commonly used Kendall's tau correlation, which requires different assumptions about aquifer behavior, the methods produced similar correlations when sample sizes were large and the time interval between samples was relatively short. Sample sizes were then artificially restricted to determine correlation reproducibility. Despite being less reproducible overall, the Quadrant method was more reproducible when there were large time intervals between samples and very small sample sizes (n ~ 4), but not as reproducible as significant (p ≤ 0.1) Kendall's tau correlations. Therefore, the Quadrant method may be useful for further investigating the effects of pumping in cases where Kendall's tau does not produce significant correlations.
Ossifying fibromyxoid tumours with lipomatous and cartilaginous differentiation: A diagnostic pitfall
Authors: Klubíčková Natálie , Billings Steven , Dermawan Josephine K T , Molligan Jeremy F , Fritchie Karen
Published: December 2024

Aims

Ossifying fibromyxoid tumour is a rare mesenchymal neoplasm predominantly affecting adults characterised by a multinodular growth pattern and the presence of a fibrous pseudocapsule with areas of ossification. Prompted by the recognition of a non‐ossifying ossifying fibromyxoid tumour with lipomatous differentiation which caused diagnostic difficulty, we sought to further explore cases of ossifying fibromyxoid tumour with non‐osseous heterologous elements.

Methods and Results

A search of our institutional and consultation archives revealed three additional cases that demonstrated lipomatous components and two cases with cartilaginous differentiation. RNA‐sequencing revealed fusions involving PHF1 (n = 4) or EPC1 (n = 1) in all (five of five) cases tested, including EPC1::PHC1 and JAZF1::PHF1 fusions, which have not been reported before in ossifying fibromyxoid tumour.

Conclusion

These six cases expand the histomorphological spectrum of ossifying fibromyxoid tumour, introducing lipomatous differentiation as a hitherto undocumented feature. Awareness of these rare variants will ensure appropriate diagnosis and clinical management.
Immunogenicity and Safety of AS03‐Adjuvanted H7N9 Influenza Vaccine in Adults (18–64 and ≥65 Years): A Phase 1/2, Randomized, Placebo‐Controlled Trial
Authors: Hastie Andrew , Clarke Tanya , Germain Sophie , Ollinger Thierry , Lese Patricia , Gupta Vinay
Published: December 2024

Background

Influenza A/Hong Kong/125/2017 (H7N9) virus poses a pandemic risk owing to its evolving nature. This study evaluated the immunogenicity and safety of an AS03‐adjuvanted H7N9 vaccine in adults (18–64 years [younger] and ≥65 years [older]).

Methods

Participants (younger, n = 418; older, n = 420) were randomized to receive one of six adjuvanted vaccines (hemagglutinin [1.9 μg, 3.75 μg, and 7.5 μg] with AS03A or AS03B) or placebo. The co‐primary objectives were to determine whether the adjuvanted vaccines elicit an immune response against the vaccine‐homologous virus 21 days after the second vaccine dose and to evaluate the safety of the vaccines.

Results

H7N9 AS03‐adjuvanted vaccines at various doses showed a humoral immune response but failed to meet CBER immunogenicity criteria. However, a trend of increased immune responses was observed with the AS03A adjuvant versus the AS03B adjuvant, particularly in older adults. In both age groups, injection site pain and fatigue occurred more frequently with adjuvanted vaccines. No reported serious adverse events were vaccine‐related.

Conclusions

This study did not achieve its primary objective at any dose level. The modest immune response to AS03‐adjuvanted vaccines, consistent with other studies using similar antigens, highlights the need for continued research for H7N9 pandemic preparedness.

Trial Registration: NCT04789577 [ClinicalTrials.gov]
Programme Recipient and Facilitator Experiences of Positive Family Connections for Families of Children With Intellectual Disabilities and/or Who Are Autistic
Authors: Sutherland Daniel , Flynn Samantha , Griffin Joanna , Hastings Richard P.
Published: December 2024

Background

Family members of children with developmental disabilities on average report poorer family functioning and mental health. Positive Family Connections is a co‐produced, positively‐oriented, family‐systems support programme for families of children with developmental disabilities aged 8–13. We investigated experiences of Positive Family Connections, and the processes involved in change.

Method

We conducted semi‐structured interviews with eight family carers who took part in Positive Family Connections and nine facilitators. Data were analysed using framework analysis.

Results

Programme recipients' and facilitators generally reported positive experiences of Positive Family Connections and described beneficial effects on wellbeing and family relationships. We developed a model showing how the lived experience of facilitators and positive approach led to reductions in isolation and perceived changes in mindset that were described as improving family carers' wellbeing and family relationships.

Conclusions

Positive Family Connections appears to be an acceptable programme which programme recipients and facilitators perceive to be beneficial.
Cadê o Kauê? Co‐design and acceptability testing of a chat‐story aimed at enhancing youth participation in the promotion of mental health in Brazil
Authors: Pavarini Gabriela , Murta Sheila Giardini , Mendes Josimar Antônio de Alcântara , Siston Felipe Rodrigues , de Souza Rafa Ribeiro Alves , de Oliveira da Cunha Rafaela , Alves Ferreira Julyana , de Santos Victor Hugo de Lima , Seabra Brenda Thallys Rocha ,   Talk2U, Singh Ilina
Published: December 2024

Background

Adolescent mental health is vital for public health, yet many interventions fail to recognise adolescents as proactive community contributors. This paper discusses the co‐design and acceptability testing of a chat‐story intervention to enhance Brazilian adolescents' participation in the promotion of mental health in their peer communities. We specifically highlight the iterative process of co‐creating this intervention with community stakeholders.

Methods

The co‐design was led by researchers, a youth collaborative group, and health‐tech experts. Part 1 included quantitative (n = 1,768) and qualitative (n = 46) studies with Brazilian adolescents aged 15–18 for priority‐setting. Part 2 involved co‐creation and technical production, with input from youth advisors (n = 24), school staff (n = 11), and policy experts (n = 3). In Part 3, the chat‐story was user tested (n = 32). Parts 4 and 5 assessed acceptability through a qualitative study in schools (n = 138) and initial efficacy during an online campaign (n = 795).

Results

Participants aspired to support their peers' mental health in schools, both one‐to‐one and collectively, but felt unprepared. This informed the chat‐story's goal of enhancing peer support and collective action skills. Themes identified during Part 1, such as prejudice and academic pressure, were woven into the narrative to raise awareness of the social determinants of mental health, drawing from real‐life stories. In the final story, players search for their missing best friend at school, uncovering his anxiety struggles and practicing skills such as empathic listening and partnership building. A manual for teachers was collaboratively designed for use within school settings, supplementing direct‐to‐user online applications. Acceptability testing showed participants found the tool authentic and user‐friendly. Online users perceived the tool as preparing and motivating them to offer peer support and engage in collective action.

Conclusions

The immersive co‐creation model, enriched by input from key stakeholders, yielded a relevant and well‐received intervention for Brazilian adolescents. Co‐designed creative tools like chat‐stories hold promise as digital mental health tools, fostering awareness, critical reflection, and inspiring adolescents to drive positive social change.
Association between endogenous estradiol, testosterone, and long‐term mortality in adults with prediabetes and diabetes: Evidence from NHANES database
Authors: Feng Ye , Jin Xi , Zhu Jing , Yuan Meng , Zhu Liang , Ye Dan , Shen Yuqing
Published: December 2024

Aim and Introduction

Diabetes and prediabetes pose significant global public health challenges. Sex steroids, particularly testosterone and estradiol, play crucial roles in various metabolic processes. This study investigates the relationship between sex hormone levels and long‐term mortality in adults with prediabetes and diabetes, as well as those without glucose intolerance.

Material and Methods

This retrospective cohort study utilized data from the NHANES 2013–2016, including adults aged 50–79 across prediabetic, diabetic, and non‐diabetic groups. Serum testosterone, estradiol, and their ratios (T/E) were analyzed. The primary outcomes were all‐cause mortality and CVD mortality tracked until December 2019. Cox regression models estimated the associations between hormone levels and mortality risks.

Results

The study included 3,665 participants (male: 2,140; female: 1,775). In males with prediabetes, higher estradiol (adjusted hazard ratio [aHR] = 0.17, 95% confidence interval [CI]: 0.07–0.43) or testosterone (aHR = 0.39, 95% CI: 0.31–0.50) was significantly associated with lower risk of all‐cause mortality. Higher estradiol (aHR = 0.12, 95% CI: 0.04–0.32) or testosterone (aHR = 0.36, 95% CI: 0.27–0.48) was significantly associated with lower CVD mortality risk. In females with diabetes, there was a significant association between higher estradiol levels (aHR = 0.22, 95% CI: 0.06–0.83) or T/E ratio (aHR = 0.18, 95% CI: 0.04–0.73) with a reduced all‐cause mortality risk.

Conclusions

This study identifies some novel associations between estradiol, testosterone, and their ratios with long‐term mortality in men and women across different glycemic statuses. These findings suggest a potential protective role of sex hormones in individuals with altered glucose metabolism, with gender difference, warranting further investigation.
A Novel Swirling Flow Fluidized Bed Microwave Drying Process
Authors: Köse Mert , Küçük Haydar , Midilli Adnan
Published: December 2024

This study aims to develop a novel microwave integrated‐swirling flow‐fluidized bed drying system. In this regard, for better understanding the drying performance and energy consumption of this novel system and its effect on the product quality parameters, the experiments were performed by using green tea leaves. Also, mathematical modeling and energy analysis was performed for this novel system. Drying experiments were carried out for 100, 300, 600, and 800 W microwave powers and some critical drying parameters such as dimensionless moisture ratio, moisture content, and drying rate were computed. Moreover, specific energy consumption (SEC), specific moisture extraction rate, and thermal efficiency of the system were estimated. Accordingly, the best drying curve equation was obtained as Improved Midilli‐Kucuk model for all microwave powers. Moreover, the highest water extract, the maximum caffeine, and the minimum total ash of the product were determined to be 43.83%, 2.2%, and 5.94%, respectively, at 800 W power. Minimum SEC, maximum specific moisture extraction rate, and maximum energy efficiency of the system were estimated as 11.4 KWh kg−1, 0.088 kg KWh−1, and 23.7% at 800 W, respectively.
Effect of Nursing Practice Environment, Nurse Staffing, Overtime and Hand Hygiene on Hospital‐Acquired Infections in a Tertiary Teaching Hospital
Authors: Al‐Ghraiybah Tamer , Lago Luise , Fernandez Ritin , Molloy Luke , Sim Jenny
Published: December 2024

Aims

To investigate the impact of the nursing practice environment, nurse staffing, working overtime and compliance with hand hygiene standards on hospital‐acquired infections.

Design

A multi‐source quantitative study.

Methods

Nursing data were collected from selected wards in one hospital between 18 January 2021 and 15 March 2021. Hand hygiene compliance data were obtained retrospectively from Hand Hygiene Australia Audits between July 2018 and June 2021. Patient data were gathered from July 2018 to June 2021. Data from the three sources were linked together at the episode of care level. Descriptive statistics were used to summarise participant characteristics, and multiple logistic regression was employed to assess associations between the nursing practice environment, nurse staffing, overtime and hand hygiene with hospital‐acquired infections.

Results

A total of 361 nurses participated in the nursing survey. There were 13,440 hand hygiene moments assessed, and 10,924 (81.3%) correct practices were observed. There were 71,257 patient care episodes, including 2037 with hospital‐acquired infections. The odds of hospital‐acquired infections decreased by 19% for every 10% increase in nurses' compliance with hand hygiene and decreased by 7% for each one standard deviation increase in the nursing practice environment scale. Each additional patient per nurse was associated with a 42% increase in the odds of a hospital‐acquired infection.

Conclusion

This study found evidence that a favourable nursing practice environment, reduced nurse workload and compliance with hand hygiene are linked to a lower risk of hospital‐acquired infections.

Impact

A favourable nursing practice environment contributes to fewer hospital‐acquired infections.

Monitoring of hand hygiene compliance provides important local information to support improvements in practice.

Findings from this study can be used to support the implementation of safe nurse staffing policies that guide implementation of nurse‐to‐patient ratios.

Reporting Method

RECORD Checklist.

Patient or Public Contribution

No Patient/Public Contribution.
Development and Validation of a Nomogram for Predicting Frailty Risk Among Older Patients With Ischaemic Stroke
Authors: Shen Dongdong , Li Jingjie , Teng Shuang , Li Mei , Tang Xianping
Published: December 2024

Aim

To investigate the risk factors associated with frailty in older patients with ischaemic stroke, develop a nomogram and apply it clinically.

Design

A cross‐sectional study.

Methods

Altogether, 567 patients who experienced ischaemic strokes between March and December 2023 were temporally divided into training (n = 452) and validation (n = 115) sets and dichotomised into frail and non‐frail groups using the Tilburg Frailty Indicator scale. In the training set, feature selection was performed using least absolute shrinkage and selection operator regression and random forest recursive feature elimination, followed by nomogram construction using binary logistic regression. Internal validation was performed through bootstrap re‐sampling and the validation set was used to assess model generalisability. The receiver operating characteristic curve, Hosmer–Lemeshow test, Brier score, calibration curve, decision curve analysis and clinical impact curve were used to evaluate nomogram performance.

Results

The prevalence of frailty was 58.6%. Marital status, smoking, history of falls (in the preceding year), physical exercise, polypharmacy, albumin levels, activities of daily living, dysphagia and cognitive impairment were predictors in the nomogram. Receiver operating characteristic curve analysis indicated outstanding discrimination of the nomogram. The Hosmer–Lemeshow test, calibration curve and Brier score results confirmed good model consistency and predictive accuracy. The clinical decision and impact curve demonstrated notable clinical utility. This free, dynamic nomogram, created for interactive use and promotion, is available at: https://dongdongshen.shinyapps.io/DynNomapp/.

Conclusion

This nomogram may serve as an effective tool for assessing frailty risk in older patients with ischaemic stroke.

Relevance to Clinical Practice

The nomogram in this study may assist healthcare professionals in identifying high‐risk patients with frailty and understanding related factors, thereby providing more personalised risk management.

Reporting Method

TRIPOD checklist.

Patient or Public Contribution

No patient or public contribution.
COVID‐19: An unplanned experiment to assess the effect of tourism on ungulates in a world heritage site
Authors: Ontiveros Y. , Cappa F. M. , Borghi C. E. , Andino N. , Campos C. M. , Giannoni S. M.
Published: December 2024

Nature‐based tourism in protected areas can benefit millions of people, generating significant economic income. However, tourism can also have negative impacts on the environment and wildlife. The emergence of the COVID‐19 pandemic led to the closure of cities and towns, bringing substantial disruption to various human activities and providing an opportunity to assess the impact of reduced tourism activity from the general level. In this study, we assessed the association between tourism and guanaco (Lama guanicoe) activity patterns in Ischigualasto Provincial Park across two contrasting periods: pre‐pandemic and pandemic during the COVID‐19 outbreak. The different roads in the area were used as a proxy of tourism activity, and comparisons of activity patterns of guanaco between the roads were made, taking into account both periods. Based on camera‐trapping data, we analyzed the daily activity patterns of the species, as well as whether there was a change in activity toward night hours. We found that guanacos changed their activity patterns in response to human tourism activities and increased their nocturnal activity in places with high tourist activity in pre‐pandemic periods; however, we found no such effects during the pandemic when tourist pressure was low. These results are vital for the area's management aimed at conserving the species since, currently, after the pandemic, tourism activities have been resumed, and the number of visitors to Ischigualasto Provincial Park has grown exponentially.
Family Policies in Low Fertility Countries: Evidence and Reflections
Authors: Gauthier Anne H. , Gietel‐Basten Stuart
Published: December 2024

Family policies, defined as measures designed to support families with children, are part of modern welfare states. They range from punctual measures provided at the birth of a child to measures aimed at making it easier for parents to combine work and family responsibilities. The actual goal of these measures varies largely, being explicitly pronatalist in some cases while embracing a more equalitarian principle in others. Despite the variations in the nature of these policies and their stated goal, they are nonetheless all generally assumed to have a positive effect on fertility. The aim of this paper is threefold. First, the aim is to summarize the main findings from the literature on the impact of family policies on fertility. This is done by adopting a historical perspective, including the review of the early studies in this field of research and by distinguishing different methodologies. Second, the aim is to reflect on these findings, including the role of national context and the framing of policies. Third, the aim is also to reflect on the limited impact of policy interventions on fertility, stressing that their “success” should instead be measured in terms of their ability to support families holistically including their work‐life balance.
Antioxidant activity and comparative RNA‐seq analysis support mitigating effects of an algae‐based biostimulant on drought stress in tomato plants
Authors: Cerruti Paolo , Campobenedetto Cristina , Montrucchio Elisa , Agliassa Chiara , Contartese Valeria , Acquadro Alberto , Bertea Cinzia Margherita
Published: December 2024

Drought is a significant global environmental stress. Biostimulants offer a sustainable solution to enhance crop tolerance and mitigate productivity losses. This study assessed the impact of foliar application of ERANTHIS®, a biostimulant derived from the algae Ascophyllum nodosum and Laminaria digitata and yeast extracts, on tomato plants under mild water stress. Evaluations were conducted at 5 and 24 hours after the third treatment. Under optimal water conditions, the biostimulant showed a priming effect, with an early increase of stress markers and a timing‐specific modulation of ROS non enzymatic and enzymatic ROS scavenging activities. Under drought stress, the biostimulant later decreased stress markers, by aligning the majority of analyzed ROS scavengers closer to levels in well‐irrigated plants. Transcriptome analysis using RNA‐seq data revealed differentially expressed genes (DEGs) and multivariate data highlighted groups of co‐regulated genes (k‐means clustering). Genes involved in water channel activity, transcription regulator activity, and oxidoreductase activity were significantly modulated. Cluster analysis identified distinct gene clusters influenced by the biostimulant under optimal conditions, including early responses (cell wall modification, hormone signaling) and late responses (RNA modification, nutrient uptake process). Under water stress, early responses involved actin filament organization and MAPK signaling, while late responses were related to plasma membrane components and cell wall organization. This study, integrating biochemical and transcriptomic data, provides a comprehensive understanding of how a biostimulant primes plants under optimal conditions and mitigates water stress effects, offering valuable insights for sustainable agriculture.
Metabolomic analysis of plant‐derived nanovesicles and extracellular vesicles from Pinellia ternata: insights into a temporary immersion bioreactor system
Authors: Shu Fuxing , Sarsaiya Surendra , Ren Lili , Jin Leilei , Hu Yuhe , Qiao Ling , Xu Xiaoqing , Chen Guoguang , Chen Jishuang
Published: December 2024

Plant‐derived nanovesicles (PDNVs) and extracellular vesicles (EVs) represent a promising area of research due to their unique properties and potential therapeutic applications. Pinellia ternata (P. ternata) is well‐known for its pharmacological properties but the PDNVs and EVs derived from it have been largely understudied. Previous studies have shown that a Temporary Immersion Bioreactor System (TIBS) plays an important role in controlling plant growth in order to obtain reproducible EVs and PDNVs. PDNVs were isolated from P. ternata plants and EVs were collected in the TIBS medium via ultra‐high‐speed differential centrifugation. Particle size, Zeta potentials and particle concentrations were assessed for PDNVs and EVs. Furthermore, non‐targeted metabolomics was used to assess metabolic compositional differences between EVs and PDNVs, enabling the evaluation of the TIBS's quality control efficacy. Metabolomic profiling revealed 1072 metabolites in PDNVs and EVs, including 426 differential metabolites (DMs) distinguishing PDNVs from EVs: 362 DMs were positively correlated with PDNVs and 64 DMs were positively correlated with EVs; they were enriched across 17 KEGG pathways. PCA, PLS‐DA, and metabolite sample correlation analyses showed high consistency between the replicates (PDNVs >0.87, EVs >0.93). This study demonstrated that TIBS is a performant system allowing consistency in generating PDNVs and EVs from P. ternata. We also highlighted the metabolic differences between PDNVs and EVs, guiding researchers in finding the bet system to produce efficient nanodrugs containing P. ternata pharmacological compounds.
Jewish Divination in the Greco–Roman Era
Authors: Tervanotko Hanna
Published: December 2024

This article analyzes the divinatory methods the Jews used to address their questions in the Greco–Roman era. Scholars have previously examined how authors of the Hebrew Bible are aware of numerous divinatory techniques. The texts of the Greco–Roman era, especially the Dead Sea Scrolls, preserve even more references illuminating the ancients' interest in divination. In this article, I first address how the texts of the Greco–Roman era present people inquiring about the divine will through inspiration, the lot oracle, astrology, physiognomy, and death oracle. I argue that it was not indifferent which method an individual chose for their inquiry but that each technique served purposes that the ancients knew. As people could typically not access all methods, both the technique and its accessibility were considered when individuals decided how to inquire about their questions.
A risk‐based unmanned aerial vehicle path planning scheme for complex air–ground environments
Authors: Zhou Kai , Wang Kai , Wang Yuhao , Qu Xiaobo
Published: December 2024

Multifarious applications of unmanned aerial vehicles (UAVs) are thriving in extensive fields and facilitating our lives. However, the potential third‐party risks (TPRs) on the ground are neglected by developers and companies, which limits large‐scale commercialization. Risk assessment is an efficacious method for mitigating TPRs before undertaking flight tasks. This article incorporates the probability of UAV crashing into the TPR assessment model and employs an A* path‐planning algorithm to optimize the trade‐off between operational TPR cost and economic cost, thereby maximizing overall benefits. Experiments demonstrate the algorithm outperforms both the best‐first‐search algorithm and Dijkstra's algorithm. In comparison with the path with the least distance, initially, the trade‐off results in a increase in distance while achieving an reduction in TPR. As the trade‐off progresses, this relationship shifts, leading to a reduction in the distance with only a negligible increase in TPR by 0.0001, matching the TPR‐cost‐based algorithm. Furthermore, we conduct simulations on the configuration of UAV path networks in five major cities in China based on real‐world travel data and building data. Results reveal that the networks consist of one‐way paths that are staggered in height. Moreover, in coastal cities particularly, the networks tend to extend over the sea, where the TPR cost is trivial.
A measure of information value for risk
Authors: Targoutzidis Antonis
Published: December 2024

Information is crucial for risk management; however, no quantified measure to evaluate risk information exists to date. The standard measure of value of factual information is information entropy—that is, the negative logarithm of probability. Despite its applications in various fields, this measure is insufficient for the evaluation of risk information; there are three reasons. First, it requires precise probabilities, which are generally absent in the context of risks. Second, it does not consider the effect of the consequences, which is essential for risks. Third, it does not account for human preferences and subjectivity. This study proposes a quantified measure for the evaluation of factual risk information—that is, observations of occurrence, particularly for binary, unambiguous, and rare phenomena. To develop such a measure, precise probabilities are replaced with updated probabilities, based on the Prospective Reference Theory. Additionally, utility is included as a proxy for the size of consequences. The third challenge—human preferences and subjectivity—is partly addressed by the application of updated perceived probabilities and utility as a measure of human preferences. Such a conventional, quantified measure facilitates the comparison of the potential impact of different messages for a new observation of occurrence for a risk, as well as of messages for different risks. Moreover, it clarifies the factors that systematically affect this impact. More particularly, it indicates the major effects of the perceived number of past occurrences.