bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of lumbar disc herniation and its associated factors: A cross-sectional study in Gansu
Authors: Chen Zhiwei , Zhao Jirong , Wang Li , Shao Hong , Cao Liangjia , He Xueyun , Yang Zhenghan , Ma Junfei , Chen Qianwen , Jiang Peng , Zhang Licun , Hu Jihong
Published: December 2024

Background and objective

The prevalence rate of LDH and its influencing factors in Gansu is unclear. This study aims to analyze the prevalence of LDH and influencing factors in Gansu.

Methods

A stratified multi-stage random sampling method was used to obtain representative samples of residents more than 18 years old from <1500m, 1500-3500m, and >3500m altitude sites in Gansu, China, in June 2022 to August 2022. A unified questionnaire was used for the investigation.

Results

The total number of people surveyed was 4545, with a prevalence rate of 22.77% for LDH. LDH prevalence differed by latitude, city, age, sex, nationality, education, marital status, income, drinking habits, residence duration, physical activity, exercise intensity, health status (including hypertension, diabetes, CHD, chronic infection, and tumors) (all P <0.05). Logistic regression showed higher LDH risk at high (OR = 2.250) and middle latitudes (OR = 2.551), among males (OR = 0.808), ages 35-49 (OR = 1.530) and 50-64 (OR = 1.991), Tibetans (OR = 1.533) and Hui (OR = 0.557), alcohol consumers (OR = 0.696), those with moderate (OR = 0.742) and mild physical activity (OR = 0.840), cadres (OR = 0.46), workers (OR = 1.568), farmers/herdsmen (OR = 1.840), married individuals (OR = 2.239), residents for ≥36 months (OR = 0.618), annual income ≥50,000 yuan (OR = 1.246), central obesity (OR = 1.399), and those with tumors (OR = 3.953), hypertension (unknown, OR = 1.817), diabetes (yes, OR = 0.529, unknown, OR = 0.565), CHD (unknown, OR = 1.404), and osteoporosis (unknown, OR = 1.404).

Conclusion

The prevalence of LDH was high, varying significantly with latitude, gender, and nationality, indicating potential lifestyle and demographic influences in Gansu.
Behavioural and social drivers of human papillomavirus vaccination in eThekwini District of KwaZulu-Natal Province, South Africa
Authors: Bhengu P. , Ndwandwe D. , Cooper S. , Katoto P. D. M. C. , Wiysonge C. S. , Shey M.
Published: December 2024

Background

Cervical cancer is the second most common cancer in women in South Africa. Infection with high-risk types of human papillomavirus (HPV) is the cause of cervical cancer, which can be prevented by HPV vaccination. However, there is wide variation in HPV vaccination coverage among the urban districts of South Africa; with the lowest coverage being 40% in eThekwini, KwaZulu-Natal. There could be many factors which affect HPV vaccine uptake in eThekwini District. Thus, this research aims to investigate the behaviourial and social drivers of HPV vaccination in this district.

Methods

The study will consist of two phases. We will apply a convergent parallel mixed methods approach, including a quantitative survey (phase 1) and in-depth interviews (phase 2) among caregivers and frontline healthcare workers to determine the drivers of HPV vaccination uptake.

Discussion

The study will provide knowledge on the main barriers facing HPV vaccination and provide contextually-tailored solutions for how these barriers might be addressed. A policy brief will be formulated from this study aimed at government policymakers and other stakeholders who formulate or influence policy, respectively. In addition, we will disseminate the findings through peer-reviewed publications in scientific journals.
Perceptions of sexual assault perpetrators, victims, and event depend on system justification beliefs and perpetrator atonement
Authors: Delker Brianna C. , Means Kira K. , Schwam Allison , Patterson Aubrie L. , Fogel Camille A. , Brown Amelita , Czopp Alex M. , McLean Kate C.
Published: December 2024

When accused of wrongdoing, a sexual assault perpetrator may express atonement, i.e., he may acknowledge harm done, take responsibility, and make amends. Anecdotal observations suggest that mainstream U.S. audiences respond favorably when high-status perpetrators express less atonement, such as telling stories that minimize harm, or place responsibility on the victim. However, empirically, little is known about how perpetrator status and atonement influence audience responses. Informed by system justification theory, this vignette-based experiment tested the hypothesis that the more audiences are psychologically invested in an unequal status quo (i.e., the greater their system justification beliefs), the more they will favor perpetrators (vs. victims), especially when high-status perpetrators atone less, and low-status perpetrators atone more. In a pre-registered 2(perpetrator status: low, high) x 3(perpetrator narrative atonement: low, medium, high) x continuous(participant system justification) between-subjects design, U.S. adults (N = 895) were randomly assigned to read 1 of 6 first-person stories by a white male who has been accused of sexual assault by a female acquaintance. Dependent measures included perceived severity of and relative responsibility for the assault, empathy toward perpetrator and victim, and ratings of their likeability and positive personality traits. Hierarchical regression analysis revealed that, instead of the hypothesized interactive effects, there were consistent main effects of system justification and atonement across perpetrator status levels. The greater their system justification beliefs, the more participants favored perpetrators, the less severe they rated the assault, and the less they favored victims. Greater perpetrator atonement boosted favorability ratings for him and the victim. Conversely, less perpetrator atonement diminished his favorability ratings, but also made the assault appear less severe and less his (vs. the victim’s) responsibility. Findings underscore the strong influences that perpetrator stories and psychological investment in an unequal status quo have on perceptions of sexual violence.
What drives repurchase retention in music training institutions? examining the roles of customer satisfaction, perceived value, and service quality
Authors: Long Li , Lijia Liu
Published: December 2024

The rise of quality education has led to increased attention on music training as a vital means of enhancing personal qualities. However, with numerous music training institutions competing in the market, distinguishing oneself has become an urgent challenge. This study explores the key factors influencing customers’ willingness to renew their enrollment at music training institutions through a questionnaire survey. The questionnaire addresses various aspects, including customer expectations, perceived value, customer satisfaction, repurchase intention, teacher expectations, peer influence, service quality, and brand image. The findings reveal a significant positive correlation between customer satisfaction and repurchase intention, suggesting that enhancing customer satisfaction is crucial for promoting repurchase intention. Additionally, perceived value positively impacts both customer satisfaction and repurchase intention, indicating that customers are more inclined to repurchase when they believe the course’s value justifies the investment. Customer expectations also play a vital role, positively affecting perceived value and overall customer satisfaction. Furthermore, service quality and brand image significantly influence both customer satisfaction and repurchase intention, emphasizing the importance of high-quality service and a positive brand image in customer decision-making. Although the direct impact of teacher expectations on customer satisfaction is relatively weak, improving interactions between teachers and students, along with providing personalized guidance, can indirectly enhance satisfaction. Lastly, the anticipated positive correlation between peer influence and perceived value was not supported, suggesting that the impact of classmates may be less direct compared to that of teacher expectations and service quality.
Comparative analysis of bone healing in subcritical defects with air turbine and electric handpiece in a rat model
Authors: Sol Izabella , Hadad Henrique , Kano Tatsuya Henrique , Tonini Karen Rawen , Lage Nunes Martina Andreia , Ponzoni Daniela
Published: December 2024

Rotatory devices are essential in clinical surgical practice, however, depending on the different systems available, their function can impact bone repair and postoperative responses on varying scales. This impact underscores the need to explore new techniques aiming to enhance bone repair. This study aimed to assess the immediate and delayed effects on bone healing in subcritical bone defects using both air turbine and an electric handpiece. For this purpose, 40 male Wistar rats were allocated into two groups. The Control Group (CG) had bone defect made using an air turbine device, while the Experimental Group (EG) had defects made using an electric handpiece. Ten animals were sacrificed for each time of evaluation. Bone neoformation, microstructure, and collagen organization were assessed ate 7, 15 and 30 days postoperative. Inflammatory profiling was conducted at 7 and 15 days. Immediate thermal osteonecrosis were evaluated after the use of rotary systems. Multivariate analysis was used to access statistical differences. The EG exhibited enhanced parameters of bone neoformation in all analyses, with statistical difference between 15 and 30 days (P = .0002) and in comparison with CG in 30 days (P = .0009). A reduced number of inflammatory cells and increased angiogenesis in the initial periods was seen in EG, corroborating the consistent values of collagen type 1 and a decrease of collagen type 3 over times. Immediate thermal osteonecrosis was statistically higher for the CG (P < .05), which showed adequate neoformation of subcritical defects but consistently lower values than those found in the EG. These data suggest that the electric handpiece demonstrated more bone repair area, proving to be an excellent alternative to surgical practice.
Sleep problems and chronic conditions in single parents in Ghana: Serial mediating roles of health-related quality of life and functional limitations
Authors: Owusu-Sarpong Obed Jones , Abass Kabila , Buor Daniel , Tutu Solomon Osei , Gyasi Razak M.
Published: December 2024

Objectives

Data on the association between sleep problems and chronic conditions among single parents in low- and middle-income countries (LMICs) are limited, and no study has, to date, reported the serial mediation effects of functional limitations and poor health-related quality of life (HRQoL) in this association. This study examines the extent to which functional limitations and poor HRQoL serially explain the link between sleep problems and chronic conditions among single parents in Ghana.

Methods

Data on 627 single mothers and fathers were obtained through a multi-stage stratified sampling technique. Sleep duration, nocturnal sleep problems, and daytime sleep problems were used to assess sleep problems. The EQ-5D-3L questionnaire was used to measure HRQoL. Multivariable OLS models and bootstrapping serial mediation analyses were performed to evaluate the hypothesized associations.

Results

The mean age (SD) was 45.0 (14.66) years; 67.3% females. After full adjustment, sleep problems were significantly associated with increases in chronic conditions (β = .238, 95%CI = .100-.377), poor HRQoL (β = .604, 95%CI = .450-.757), and functional limitations (β = .234, 95%CI = .159-.307). Chronic conditions were positively influenced by poor HRQoL (β = .352, 95%CI = .284-.421) and functional limitations (β = .272, 95%CI = .112-.433). Sleep problems were indirectly related to chronic conditions via poor HRQoL (β = .213, BootSE = .039, 95%CI = .143-.295), functional limitations (β = .063, BootSE = .029, 95%CI = .013-.130) and functional limitations → HRQoL (β = .099, BootSE = .025, 95%CI = .054-.152), mediating 34.70%, 10.31% and 16.15% of the total effect, respectively.

Conclusions

Sleep problems and poor HRQoL were positively associated with chronic conditions. Functional limitations and poor HRQoL partially and serially explained this association. Efforts to address chronic conditions among single parents should consider interventions for sleep problems and physiological health outcomes, particularly in LMICs.
When do science recommendations stop being effective? The case of the sprawl of diesel electricity generators in Beirut
Authors: Al Hallak Mohammad , Kurdieh Abdul Aziz , Yassine Amira , El Hage Rachel , Saliba Najat
Published: December 2024

Lebanon, plagued by political and economic crises, experienced a government collapse in early 2020, leading to an electrical nationwide blackout by 2023. Diesel generators were used to compensate for the absence of power production from the national provider, Electricité du Liban (EDL). To investigate the effect of the crisis on the levels of 16 EPA particle bound polycyclic aromatic hydrocarbons (PPAHs), an annual comparative analysis of three locations within Beirut started in 2022 and ended in 2023. The locations are: American University of Beirut (AUB), Beirut Central District (BCD) and Nursing School Makassed University (NSMU). Sampling took place and the PPAHs samples were extracted, quantified using Gas Chromatography-Mass spectrometry (GC-MS) and source apportioned using Positive Matrix Factorization (PMF). Particulate Matter 2.5μm (PM2.5) mean levels at AUB, BCD and NSMU, which was found to be 14.3 μg/m3, 18.3 μg/m3 and 22.6 μg/m3 respectively, beside the high annual PM2.5 mean level (17.19 μg/m3) exceeded the World Health Organization (WHO) standard levels. The factors identified in the three sites are diesel, incineration, and gasoline emissions. The dominant factor in three sites was the diesel emissions, specifically from generators, with 56% in BCD, 42% in AUB and 43% in NSMU. The contribution of diesel emission in AUB has increased by 100% since the last study in 2016–2017. Similarly, the excess cancer risk (ESR) in the three sites was above the EPA threshold with an increase of 53% compared to the one calculated previously in AUB. This situation, where law of enforcement is absent, need for international action to curb emissions and for funding agencies to adopt sustainable, "carbon-free" funding strategies to support urban development in low- and middle-income countries (LMICs). Yet, EDL’s failure to fulfill Lebanon’s populace electricity requirements infringes upon their electricity entitlements.
Barriers and facilitators for cardiopulmonary resuscitation discussions with people with heart failure
Authors: Barnes-Harris Matilda M. M. , Datla Sushma , Abel Alexandra , Clark Andrew L. , Johnson Miriam J.
Published: December 2024

Background

Care planning with people with advanced heart failure enables appropriate care, and prevents futile interventions, such as cardio-pulmonary resuscitation (CPR).

Aim

To explore what motivates clinicians to conduct, and people with heart failure and their carers, to engage in well-conducted CPR discussions.

Methods

In-depth remote interviews with i) people with heart failure and self-reported daily symptoms (≥ 3 months), ii) informal carers and, iii) clinicians recruited through social media and professional groups, team contacts and snowballing. Interviews were audio-recorded, transcribed, anonymised and subjected to framework analysis. Findings were mapped to the Capabilities, Opportunities, Motivation-Behaviour change model.

Results

Two themes were generated from 23 interviews: a) the cardio-pulmonary resuscitation discussion: preparation; who should conduct discussions; what should happen during discussions; impact on future discussions; b) Understanding of the: patient’s health status; and purpose and likely outcome of cardio-pulmonary resuscitation. For clinicians, ensuring preparation time, education, and support provided physical and psychological capability. For all, constructive experiences and a realistic understanding of health status and likely cardio-pulmonary resuscitation outcome motivated engagement in cardio-pulmonary resuscitation discussions providing opportunity for patient involvement in decision-making.

Conclusions

For all, constructive past experiences of important conversations motivates engagement with CPR discussions. A realistic understanding of health status and likely cardio-pulmonary resuscitation outcome (all stakeholders), and training, skills, preparation and multidisciplinary support (clinicians) provide physical and psychological capability. Findings should inform organisational structures and training to ensure opportunity for this important clinical practice to take place.
Enhancing generalization in a Kawasaki Disease prediction model using data augmentation: Cross-validation of patients from two major hospitals in Taiwan
Authors: Hung Chuan-Sheng , Lin Chun-Hung Richard , Liu Jain-Shing , Chen Shi-Huang , Hung Tsung-Chi , Tsai Chih-Min
Published: December 2024

Kawasaki Disease (KD) is a rare febrile illness affecting infants and young children, potentially leading to coronary artery complications and, in severe cases, mortality if untreated. However, KD is frequently misdiagnosed as a common fever in clinical settings, and the inherent data imbalance further complicates accurate prediction when using traditional machine learning and statistical methods. This paper introduces two advanced approaches to address these challenges, enhancing prediction accuracy and generalizability. The first approach proposes a stacking model termed the Disease Classifier (DC), specifically designed to recognize minority class samples within imbalanced datasets, thereby mitigating the bias commonly observed in traditional models toward the majority class. Secondly, we introduce a combined model, the Disease Classifier with CTGAN (CTGAN-DC), which integrates DC with Conditional Tabular Generative Adversarial Network (CTGAN) technology to improve data balance and predictive performance further. Utilizing CTGAN-based oversampling techniques, this model retains the original data characteristics of KD while expanding data diversity. This effectively balances positive and negative KD samples, significantly reducing model bias toward the majority class and enhancing both predictive accuracy and generalizability. Experimental evaluations indicate substantial performance gains, with the DC and CTGAN-DC models achieving notably higher predictive accuracy than individual machine learning models. Specifically, the DC model achieves sensitivity and specificity rates of 95%, while the CTGAN-DC model achieves 95% sensitivity and 97% specificity, demonstrating superior recognition capability. Furthermore, both models exhibit strong generalizability across diverse KD datasets, particularly the CTGAN-DC model, which surpasses the JAMA model with a 3% increase in sensitivity and a 95% improvement in generalization sensitivity and specificity, effectively resolving the model collapse issue observed in the JAMA model. In sum, the proposed DC and CTGAN-DC architectures demonstrate robust generalizability across multiple KD datasets from various healthcare institutions and significantly outperform other models, including XGBoost. These findings lay a solid foundation for advancing disease prediction in the context of imbalanced medical data.
(Mis)estimation of the modal number of desired sexual partners
Authors: Shapiro Arthur G. , Peters Rubie M. , Ahrens Anthony H.
Published: December 2024

Misperceptions of the social world can lead to actions and social policy that are detrimental to an individual’s or group’s well-being. Here we investigate whether misperceptions arise when participants make predictions of the modal number of ideal future sexual partners reported by heterosexual cohorts (younger cohort: 18–23 years; older cohort: 24–29 years). For both men and women and in both cohorts, the modal number of reported partners equaled 1.0, but men’s averages were higher than women’s averages due to a subgroup of men who reported desiring large numbers of partners (that is, the distributions had the same shape, but men’s distributions had a longer tail). Study 1: When asked to estimate the mode directly, participants performed poorly and, in some conditions, dramatically so (e.g., 40% of younger men reported wanting one sexual partner, but 0% of younger men predicted 1 to be the most frequent response). Study 2: When asked to estimate the shape of the whole distribution, participants underestimated the number of respondents who would desire the mode and thus replicated patterns in the literature for misestimations of skewed distributions. Study 3: When provided information about others’ actual modal desired number of partners, the number of male participants who reported desiring one sexual partner increased, suggesting that misperceptions of social norms may influence preferences. We discuss how the mean and mode can lead to two accurate but different interpretations of the data (mean: men report desiring more sexual partners than women; mode: the most frequent response reported by both men and women is 1.0). Discrepancies of this sort can lead to mischaracterizations that may not be uncommon in the research literature. These discrepancies cannot be differentiated by significance tests that seek to find differences in the mean but can be resolved with attention to other methods of analyses.
The effect of different anesthetics on the incidence of AKI and AKD after neurosurgical procedures
Authors: Premuzic Vedran , Stambolija Vasilije , Lozic Marin , Kovacevic Josip , Prelevic Vladimir , Peklic Marina , Scap Miroslav , Sekulic Ante , Basic-Jukic Nikolina , Mihaljevic Slobodan , Kashani Kianoush B.
Published: December 2024

Acute kidney injury (AKI) incidence after neurosurgical operations has been reported as 10–14%. The literature regarding the incidence of nosocomial acute kidney disease (AKD) following neurosurgery is scarce. This retrospective, single-center, observational study aimed to assess the impact of different anaesthetics on development of postoperative AKI and persistent AKD in neurosurgical patients. We have categorized patients depending by the type of total intravenous anaestesia with propofol or sevoflurane. Most patients (74%) were on total intravenous anesthesia with propofol, while the rest (26%) were on sevoflurane. Patients were divided into subgroups with and without AKD depending on glomerular filtration rate  60 ml/min regarding kidney function at the end of intensive care unit stay. AKI was diagnosed in 341 (5.39%) patients. Significantly higher number of patients developed AKD in the sevoflurane group (16.9% vs. 6.3%). There was a significantly higher number of patients with both high and low AKI stages on sevoflurane and with hypotension during operation. Anaesthesia with sevoflurane had increased OR of 5.09 and ROC value of 0.681 for development of AKI. Anesthesia with sevoflurane had an increased OR of 4.98 and ROC value of 0.781 for development of AKD. Mortality was independently associated with anesthesia with sevoflurane, AKI development, hypotension during operation and AKD. Anesthesia with sevoflurane, hypotension during operation, and the development of AKD at the end of ICU stay were associated with higher mortality in the whole group (HR 6.996, HR 1.924 and HR 4.969, respectively). Patients treated with balanced anesthesia with sevoflurane had more frequent AKI and AKD with shorter survival. Renal toxicity of sevoflurane is pronounced in hypotension during operation and with a history of diabetes and coronary disease.
Knowledge regarding human monkeypox among a sample of undergraduate and post-graduate students from selected tertiary institutions in Bangladesh: An online-based cross-sectional study
Authors: Banna Md. Hasan Al , Seidu Abdul-Aziz , Mallick Trisha , Rahman Nahidur , Sultana Mst. Sadia , Mouly Humayra Alam , Alshahrani Najim Z. , Akter Nargees , Mahmud Tareq , Hossain Susmita , Sheikh Anannya , Biswas Ashish , Sahrin Sumaia , Hassan Md. Nazmul , Khan Md. Shafiqul Islam
Published: December 2024

Background

The recent human monkeypox (mpox) outbreak in 2022 has become a serious concern due to its rapid expansion to various non-endemic countries. There is limited information about the knowledge regarding mpox among the Bangladeshi population. Therefore, this study’s objectives were to: (i) determine the level of knowledge regarding mpox among undergraduate and post-graduate students in Bangladesh, and (ii) assess the determinants of knowledge regarding mpox among the study sample.

Methods

An online-based cross-sectional study was conducted among 879 tertiary-level students from selected tertiary institutions (n = 13) in Bangladesh. The structured questionnaire consisted of two parts: (i) socio-demographic information and (ii) an assessment of knowledge regarding mpox. The Kruskal-Wallis test, Mann-Whitney test, and multivariable quantile regression model were employed.

Results

The median age of the study participants was 23 years (IQR: 25–22). Low knowledge of mpox was found among study participants (20.7%, 23.2% and 56.1% had good, moderate and poor knowledge, respectively). The overall median knowledge score for mpox was 11 (IQR: 16–6). The median knowledge score of mpox significantly differed by participants’ gender, study major, and academic education about mpox. In the quantile regression analysis, the association between gender and mpox knowledge was observed at the 25th (β = 1.343), 50th (β = 2.00) and 75th (β = 1.59) quantiles with females having more knowledge compared to males. The effects of study group were significant at 25th (β = 1.746), 50th (β = 1.5), 75th (β = 1.361) and 90th (β = 1.248) quantiles. Thus, those in medical or public health programs were likely to have more knowledge about mpox relative to those who were in non-medical related study groups. Students who received information about mpox during their education were more knowledgeable compared to those who had not, with statistical significance occurring at 10th (β = 3.711), 25th (β = 6.656), 50th (β = 5.75), 75th (β = 3.404) and 90th (β = 2.592) quantiles.

Conclusion

These findings imply that educational interventions about mpox should consider the gender dynamics and program of study among the students in Bangladesh.
Developing and validating an Interdisciplinary Teaching Readiness Scale (ITRS) for pre-service teachers in China
Authors: Wang Xin , Yuan Lei , Li Shuang , Yu Haoyuan , Tuo Pan , Du Yongxiang , Zhang Baohui
Published: December 2024

Assisting pre-service teachers in developing readiness for interdisciplinary teaching has been recognized as a crucial direction in teacher education in China. However, there is currently a lack of reliable instrument to measure the readiness. We developed and validated an Interdisciplinary Teaching Readiness Scale (ITRS) for pre-service teachers to fill the gap. We utilized literature review and interdisciplinary teaching competence framework to develop the initial item pool for the ITRS. Data were collected from 234 pre-service teachers at S Normal University (Sample A) for item analysis and exploratory factor analysis (EFA), followed by data collection from 543 pre-service teachers in China (Sample B) for confirmatory factor analysis(CFA), convergent validity, discriminant validity, and reliability testing. Item analysis on Sample A data using the critical ratio method revealed discriminative items, indicating no need for item deletion. PCA showed that the ITRS has a three-factor structure, explaining 77.282% of the total variance. CFA on Sample B demonstrated a good model fit (GMIN/DF = 4.189, RMSEA = 0.077, GFI = 0.852, AGFI = 0.821, NFI = 0.939, RFI = 0.932, CFI = 0.953, IFI = 0.953). Analysis of the AVE for each dimension indicated good convergent and discriminant validity. Reliability testing revealed a high overall Cronbach’s α coefficient of 0.972 for the ITRS, indicating good internal consistency. Ultimately, we confirmed that the ITRS consists of three factors(including interdisciplinary teaching knowledge structure readiness, interdisciplinary teaching skills readiness, interdisciplinary teaching attitudes readiness) and 24 items. In conclusion, the ITRS that has been developed shows great potential for promoting the professional development of pre-service teachers, evaluating the effectiveness of teacher education programs, and supporting the development of educational policy. The extensive utilization of this instrument will help to comprehensively assess the overall level of pre-service teachers’ readiness for interdisciplinary teaching and to promote the professional growth of pre-service teachers in China. Furthermore, the ITRS, through the implementation of culturally adaptable modifications, can offers invaluable instrumental support and insightful guidance to pre-service teacher education programs globally.
Policy effects of reduced pension contribution rate on innovation input——Empirical evidence from Zhejiang and Shandong provinces
Authors: He Zimian , Xu Jianwei
Published: December 2024

Reducing pension insurance rates is an important measure for lowering the burden on enterprises. Does this measure encourage enterprises to invest in innovation? This study uses provincial panel data of China during 2000–2017 to analyze the reduction in the proportion of enterprise contributions to pension insurance in Zhejiang and Shandong provinces as a quasi-natural experiment. Specifically, it uses the synthetic control method to construct a counterfactual state of the treatment group, and analyzes the effect of fee reduction policy on enterprise innovation input. Taking R&D intensity as a proxy for innovation input, the study finds that the cost reduction policy has a significant promoting effect on innovation input. Although the reduction of pension insurance rate in Shandong is smaller than that in Zhejiang, the net effect of policy on R&D intensity is higher than that in Zhejiang. This study uses a placebo test, permutation test, and difference-in-differences method to carry out robustness checks, and confirms that the results are reliable, showing that the reduction of pension premium is conducive to the increase in enterprises’ R&D intensity. However, owing to different economic development cycles in different regions, the net effect of pension premium reduction on enterprise innovation shows heterogeneity.
Analyzing HIV/AIDS dynamics with a novel Caputo-Fabrizio fractional order model and optimal control measures
Authors: Butt Azhar Iqbal Kashif , Imran Muhammad , Azeem Komal , Ismaeel Tariq , McKinney Brett Allen
Published: December 2024

In this manuscript, we present a novel mathematical model for understanding the dynamics of HIV/AIDS and analyzing optimal control strategies. To capture the disease dynamics, we propose a new Caputo-Fabrizio fractional-order mathematical model denoted as SEIEUPIATR, where the exposed class is subdivided into two categories: exposed-identified EI and exposed-unidentified EU individuals. Exposed-identified individuals become aware of the disease within three days, while exposed-unidentified individuals remain unaware for more than three days. Simultaneously, we introduce a treatment compartment with post-exposure prophylaxis (PEP), represented as P, designed for individuals of the exposed identified class. These individuals initiate treatment upon identification and continue for 28 days, resulting in full recovery from HIV. Additionally, we categorize infectious individuals into two groups: under-treatment individuals, denoted as T, and those with fully developed AIDS not receiving antiretroviral therapy (ART) treatment, denoted as A. We establish that the proposed model has a unique, bounded, and positive solution, along with other fundamental characteristics. Disease-free and endemic equilibrium points and their associated properties (such as the reproduction number R 0 and stability analysis) are determined. Sensitivity analysis is performed to assess the impact of parameters on R 0 and hence on the disease dynamics. Finally, we formulate a fractional optimal control problem to examine strategies for minimizing HIV/AIDS infection while keeping costs at a minimum. We adopt the use of condoms and changes in sexual habits as optimal controls. The numerical results are presented and discussed through graphs.
Anderson-Darling and Watson tests for the geometric distribution with estimated probability of success
Authors: Coronel-Brizio Héctor Francisco , Hernández-Montoya Alejandro Raúl , Rodríguez-Achach Manuel Enrique , Tapia-McClung Horacio , Trinidad-Segovia Juan Evangelista
Published: December 2024

This paper introduces two new goodness-of-fit tests for the geometric distribution based on discrete adaptations of the Watson W2 and Anderson-Darling A2 statistics, where the probability of success is unknown. Although these tests are widely applied to continuous distributions, their application in discrete models has been relatively unexplored. Our study addresses this need by developing a robust statistical framework specifically for discrete distributions, particularly the geometric distribution. We provide extensive tables of asymptotic critical values for these tests and demonstrate their practical relevance through a financial case study. Specifically, we apply these tests to analyze price runs derived from daily time series of NASDAQ, DJIA, Nikkei 225, and the Mexican IPC indices, covering the period from January 1, 2015, to December 31, 2022. This work broadens the range of available tools for assessing goodness-of-fit in discrete models, which are essential for applications in finance and beyond. The Python programs developed for this paper are available to the academic community.
Prediction of neonatal survival among Pacific Islander preterm births in the US
Authors: Wu Bohao , Taylor Sarah , Shabanova Veronika , Hawley Nicola L.
Published: December 2024

Objective

Predicting neonatal survival is essential for targeting interventions to reduce neonatal mortality. Pacific Islanders have been underrepresented in existing prediction tools and have unique, maternal obesity-related risk factors for both preterm birth and neonatal mortality. Using neonatal sex, birth weight, and gestational age, we developed a graphical tool for neonatal survival among Pacific Islander singletons in the United States.

Methods

Birth-infant death data files from the United States National Center for Health Statistics were used (2014–2018). Pacific Islander mothers and singletons without congenital anomalies born between 22–36 gestational weeks were included. Poisson regression models were used to predict neonatal mortality (<28 days of life) rate including neonatal sex, birth weight, and gestational age in weeks as predictors. Predicted survival rates in the graphical tool were calculated as "1 minus mortality rate”.

Results

Of the 5192 included neonates, the neonatal mortality rate was 2.0%; 43.5% of mothers had pre-pregnancy obesity, and 16.5% of neonates were born large-for-gestational age. Birth weight and gestational age had a non-linear association with neonatal death, and their interaction was included in the model. Retaining neonatal sex, models with gestational age at birth or both birth weight and gestational age at birth performed better than the model with birth weight only.

Conclusion

This is the first graphical tool for neonatal survival prediction among preterm-born Pacific Islander singletons in the United States. Using only neonatal sex, birth weight, and gestational age, this graphical tool is a straightforward reference for survival among groups of neonates with similar characteristics.
Voluntary Medical Male Circumcision’s (VMMC) strategy for HIV prevention in Sub-Saharan Africa, prevalence, risks, costs, benefits and best practice: A scoping review study protocol of progress and unfolding insights
Authors: Maibvise Charles , Munangatire Takaedza , Tomas Nestor , Ashipala Daniel O. , Dlamini Priscilla S.
Published: December 2024

Campaigns to scale up Voluntary Medical Male Circumcision (VMMC) for the prevention of HIV transmission has been going on for years in selected Southern African countries, following recommendations from the World Health Organisations. Despite significant strides made in the initiative and its proven benefits, controversies surrounding the strategy have never ceased, and its future remains uncertain especially as some countries near their initial targets. Over the years, as the campaigns unfolded, a lot of insights have been generated in favour of continuing the VMMC campaigns, although some insights portray the impression that the strategy is not worthy of the risks and effort required, or that enough has been done, as the targets have now been achieved. This article proposes a scoping review that aims at synthesizing and consolidating that evidence into a baseline for a further systematic review aimed at developing sound recommendations for the future of the VMMC strategy for HIV prevention. The scoping review will target all scientific literature published on the Web of Science, Cochrane Library, Scopus, Science Direct, PubMed as well as grey literature from Google Scholar and WHO Institutional Repository for Information Sharing (IRIS) from the inception of the campaigns. The review shall be guided by Arksey and O’Malley’s (2005) framework for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist shall be followed. Discussion of the findings is envisioned to yield evidence that can be further analysed to give insights about risk/cost-benefits ratios of the strategy at this point in time as well as best clinical practices for the VMMC procedure, to inform the future of the strategy. This protocol is registered with the Open Science Framework, registration ID https://doi.org/10.17605/OSF.IO/SFZC9.
Care for post-COVID-19 condition in Germany from the perspectives of patients, informal caregivers and general practitioners: Study protocol for a mixed methods study
Authors: Brinkmann Melanie , Stolz Maike , Herr Annika , Herrmann-Lingen Christoph , Koch Imke , Müller Christiane , Müller Frank , Sekanina Uta , Stahmeyer Jona Theodor , de Zwaan Martina , Krauth Christian , Schneider Nils
Published: December 2024

Background

A large number of individuals suffer from post-COVID-19 condition (PCC), characterised by persistent symptoms following a SARS-CoV-2 infection with an impact on daily personal and professional activities. This study aims at examining which (health) care services are used by PCC patients in the German federal state of Lower Saxony, and how these patients manage their condition. The perspectives of patients, informal caregivers and general practitioners (GPs) will be considered.

Methods

The study will employ a mixed methods design. Patients’ perspective will be evaluated through an online survey of: (1) 21,000 adult individuals with a PCC diagnosis (ICD10 U09.9!) in their statutory health insurance claims data in 2022 (“AOK survey”) and (2) a self-selected sample of adult individuals with a proven SARS-CoV-2 infection in 2023 and persistent symptoms (“public survey”). Additional data sources will be claims data (n = 27,275) and 25–30 semi-structured interviews. Informal caregivers’ perspective will be collected through an online survey and semi-structured interviews. GPs’ perspective will be evaluated through four focus groups involving six to eight participants each and an online survey of all registered and practicing GPs in Lower Saxony (approximately 5,000). All survey data will be descriptively analysed. In addition, correlation analyses and multivariable regression analyses will be conducted, for example on factors influencing affected individuals’ use of medical services. Interview and focus group data will be subjected to qualitative content analysis. A health economic analysis will be used to determine the costs of PCC to health care payers, patients and society. The project will conclude with an expert workshop to discuss the results and derive recommendations.

Discussion

The results of the study will provide a multidimensional description of the (health) care situation and needs of patients with PCC, and derive recommendations for improving health care.

Trial registration

The VePoKaP study is registered at the German Clinical Trials Register (DRKS00032846).
Moderating effect of cultural differences on the association between social media use and mental health outcomes in adolescents: A cross-cultural comparison study
Authors: Gordesli Betul Keles , Leamy Mary , Murrells Trevor , Grealish Annmarie
Published: December 2024

The influence of social media on the mental health of adolescents has been controversial and the findings in the literature are inconclusive. Although prior studies have identified several factors that may cause or trigger the proposed relationship, little is known about the culture-related factors as an underlying mechanism that could explain the complexity of this association. This study addressed this gap by examining the associations between the two domains of social media (i.e., time spent on weekdays and weekends) and two mental health outcomes (anxiety and depression) in adolescents via the moderating effect of horizontal-vertical individualism and collectivism. 299 secondary school students (Mage = 15.21 years; 61% girls) from Türkiye (N = 176), Ireland (N = 70), and England (N = 53) completed self-report surveys. Spending more than four hours on weekdays and weekends was positively associated with anxiety and depression whereas spending more than two hours on social media during weekends was positively associated with anxiety in the entire sample. Horizontal and vertical individualism moderated the association between time spent on social media and depression in the entire sample. The study’s strengths and limitations, along with the implications of the findings for future research, are thoroughly discussed.
Mapping employment dynamics in public agencies with payroll data: A methodological framework with an application to Chile
Authors: Herrera Mauricio , Brieba Daniel
Published: December 2024

This study introduces a novel, replicable methodology for analyzing employment dynamics within public sector agencies, focusing on turnover and staff longevity. The methodology is designed to be generalizable and applicable to diverse national contexts where detailed administrative data is available. Using payroll data from over 325,000 Chilean civil servants (2006—2020), we apply mixed-effects Cox survival models and linear mixed models to examine patterns of employment stability across state agencies. By incorporating Propensity Score Matching, we further enhance the causal interpretation of turnover changes, especially in post-election years. Finally, we introduce two key metrics—Service Frailty and Relative Turnover Difference—to quantify long-term stability and short-term, post-electoral disruptions. Our findings highlight substantial differences in turnover patterns between regular and post-election years, as well as significant inter-agency heterogeneity in turnover and employee longevity, largely driven by latent agency characteristics. While major covariates like contract type and staff rank account for some variation, much of the disparity stems from agency-specific factors. This framework offers precise, cross-nationally comparable benchmarks for understanding public sector employment dynamics. Additionally, the methodology contributes to the literature by providing transparent and scalable tools for analyzing workforce stability across different contexts.
NATE: Non-pArameTric approach for Explainable credit scoring on imbalanced class
Authors: Han Seongil , Jung Haemin
Published: December 2024

Credit scoring models play a crucial role for financial institutions in evaluating borrower risk and sustaining profitability. Logistic regression is widely used in credit scoring due to its robustness, interpretability, and computational efficiency; however, its predictive power decreases when applied to complex or non-linear datasets, resulting in reduced accuracy. In contrast, tree-based machine learning models often provide enhanced predictive performance but struggle with interpretability. Furthermore, imbalanced class distributions, which are prevalent in credit scoring, can adversely impact model accuracy and robustness, as the majority class tends to dominate. Despite these challenges, research that comprehensively addresses both the predictive performance and explainability aspects within the credit scoring domain remains limited. This paper introduces the Non-pArameTric oversampling approach for Explainable credit scoring (NATE), a framework designed to address these challenges by combining oversampling techniques with tree-based classifiers to enhance model performance and interpretability. NATE incorporates class balancing methods to mitigate the impact of imbalanced data distributions and integrates interpretability features to elucidate the model’s decision-making process. Experimental results show that NATE substantially outperforms traditional logistic regression in credit risk classification, with improvements of 19.33% in AUC, 71.56% in MCC, and 85.33% in F1 Score. Oversampling approaches, particularly when used with gradient boosting, demonstrated superior effectiveness compared to undersampling, achieving optimal metrics of AUC: 0.9649, MCC: 0.8104, and F1 Score: 0.9072. Moreover, NATE enhances interpretability by providing detailed insights into feature contributions, aiding in understanding individual predictions. These findings highlight NATE’s capability in managing class imbalance, improving predictive performance, and enhancing model interpretability, demonstrating its potential as a reliable and transparent tool for credit scoring applications.
Obesity-induced activation of NADPH oxidase 2 prolongs cardiac repolarization via inhibiting K+ currents
Authors: Li Bin , Chen Yating , Zhao Maoxiang , Chen Zhijie , Lin Zhuhui , Liu Jie , Wang Xueping , Zhang Jiancheng , Li Yang
Published: December 2024

Obesity is associated with abnormal repolarization manifested by QT interval prolongation, and oxidative stress is an important link between obesity and arrhythmias. However, the underlying electrophysiological and molecular mechanisms remain unclear. The aim of this study is to evaluate the role of obesity in potassium current in ventricular myocytes and the potential mechanism of NADPH oxidase 2 (Nox2). We investigated the effect of Nox2 on cardiac repolarization without compromising its expression and function in other systems using mice with conditional cardiac-specific deletions of Nox2 (knockout [KO]). Wild-type, KO, and Flox littermate mice were randomized to either the control or high-fat diet (HFD) groups. Surface electrocardiograms were recorded to analyze repolarization in vivo. Whole-cell patch-clamp techniques were used to evaluate the electrophysiological phenotype of isolated myocytes in vitro. Western blotting was performed to assess protein expression levels. Compared with the control mice, the HFD group had a prolonged QTc. The consequences of an HFD were not attributed to delayed rectifier K+ and inward-rectifier K+ currents but were associated with reduced peak outward KV and fast transient outward K+ currents. Downregulated expression of KV4.2 and KChIP2, comprising functional Ito channel pore-forming (α) and accessory (β) subunits, was detected in HFD mice. Nox2-KO reversed the effect of obesity on Ipeak and Ito amplitude. Our data demonstrate that obesity mediates impaired cardiac repolarization in mice, manifested by QTc at the whole organism level and action potential duration at the cellular level, and correlated with Nox2. The electrophysiological and molecular aspects of this phenomenon were mediated by repolarizing outward K+ currents.