bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Discussing High Blood Pressure Readings in Clinical Notes
Authors: Chapman Cole G , Polgreen Philip M , Suneja Manish , Carter Barry L , Polgreen Linnea A 
Published: December 2024

Abstract

BACKGROUND
Blood pressure (BP) is routinely measured and recorded at healthcare visits, but high BP (HBP) measurements are not always discussed in clinical notes. Our objective was to identify patient- and visit-level factors associated with discussion of HBP measurements in clinical notes, among patients without prior diagnosis of hypertension.

METHODS
Data from 2016 to 2022 for all patients with any BP record of 140/90 mmHg or greater were obtained from University of Iowa Hospitals and Clinics electronic medical records. Patients with any prior hypertension diagnosis were excluded. We used a multi-level regression model to evaluate differences in the rates of discussing HBP. The model included varying intercepts for visit specialty and non-varying slopes and intercepts for patient- and visit-level features.

RESULTS
The final sample included 278,766 outpatient visits for 27,423 patients, of which 61,739 visits had HBP. Only 31% of visits with HBP had associated clinical notes with a discussion of HBP. Even in primary-care-related clinics, HBP measurements were discussed in only 70% of visits. Factors associated with decreased odds of HBP being discussed in clinical notes included fever (OR: 0.46; 95%CI: 0.24–0.86) or external injury or pain (0.84; 0.79–0.90), and a larger number of comorbidities (6+: 0.27; 0.22–0.32). Discussion of HBP in clinical notes was more likely among visits of patients with prior visits where HBP was discussed in clinical notes (12.36; 11.75–13.01).

CONCLUSIONS
We found that discussion of HBP is relatively uncommon. Increasing discussion of hypertension in clinical notes could decrease hypertension-related diagnostic inertia.
Augmenting small biomedical datasets using generative AI methods based on self-organizing neural networks
Authors: Ultsch Alfred , Lötsch Jörn 
Published: December 2024

Abstract
Small sample sizes in biomedical research often led to poor reproducibility and challenges in translating findings into clinical applications. This problem stems from limited study resources, rare diseases, ethical considerations in animal studies, costly expert diagnosis, and others. As a contribution to the problem, we propose a novel generative algorithm based on self-organizing maps (SOMs) to computationally increase sample sizes. The proposed unsupervised generative algorithm uses neural networks to detect inherent structure even in small multivariate datasets, distinguishing between sparse “void” and dense “cloud” regions. Using emergent SOMs (ESOMs), the algorithm adapts to high-dimensional data structures and generates for each original data point k new points by randomly selecting positions within an adapted hypersphere with distances based on valid neighborhood probabilities. Experiments on artificial and biomedical (omics) datasets show that the generated data preserve the original structure without introducing artifacts. Random forests and support vector machines cannot distinguish between generated and original data, and the variables of original and generated data sets are not statistically different. The method successfully augments small group sizes, such as transcriptomics data from a rare form of leukemia and lipidomics data from arthritis research. The novel ESOM-based generative algorithm presents a promising solution for enhancing sample sizes in small or rare case datasets, even when limited training data are available. This approach can address challenges associated with small sample sizes in biomedical research, offering a tool for improving the reliability and robustness of scientific findings in this field. Availability: R library “Umatrix” (https://cran.r-project.org/package=Umatrix).
Theoretical study on aromatic characters in π-stacked multimers composed of antiaromatic molecules
Authors: Sugimori Ryota , Ikeuchi Masato , Kishi Ryohei , Kitagawa Yasutaka 
Published: December 2024

Abstract
Corminboeuf et al. theoretically predicted that closely π-stacked dimers of antiaromatic molecules tend to exhibit aromatic characters in the sense of magnetic and structural criteria due to the strong intermolecular orbital interactions. This phenomenon is usually called stacked-ring aromaticity. Several experimental and theoretical studies have been conducted to elucidate the aromaticity switching mechanism in the π-stacked dimers and proposed molecular systems realizing this type of phenomenon. So far, most of these studies focused on the aromatic characters of dimers. This paper aims to examine aromatic characters of π-stacked multimers of antiaromatic molecules where the number of monomers, N, is more than 2. We constructed theoretical and calculation models of π-stacked N-mers consisting of cyclobutadienes with different stacking distances d. Applying the theoretical analyses based on the Hückel theory, we clarified the mechanisms of N-, d-, and monomer position dependences of aromatic characters that are evaluated from the density functional theory calculations of these models. It is found that the terminal monomers in the π-stacked N-mer (N &gt; 2) exhibit the most significant antiaromatic character, whereas the second terminal monomers show the most reduced antiaromatic characters at small d. These results demonstrate that, in addition to the stacking distance and configuration, the number and the positions of monomers can be useful factors in controlling the aromaticity switching in π-stacked assemblies of antiaromatic molecules.
Refractory benign familial pemphigus successfully treated with dupilumab: a case series
Authors: Simon Gozalbo Ana , Mauleon Fernandez Cristina , Carrascosa de Lome Raquel , Martin Diaz Maria A , de la Cueva Dobao Pablo 
Published: December 2024

Abstract
Benign familial pemphigus (BFP) is a chronic autosomal dominant genodermatosis characterized by the appearance of flaccid blisters that progress to painful erythematous macerated plaques and erosions in intertriginous areas. Although various treatments for BFP exist, current treatments are not consistently effective, and BFP symptoms often cause a decreased quality of life. We report a case series of three patients with refractory moderate-to-severe BFP who were successfully treated with dupilumab. We also describe their clinical evolution over a follow-up period of 18 months. All patients reported a decrease in pruritus and improved skin findings, with no adverse side-effects. However, increased dosing was required in one patient to achieve optimal control of the disease. We also discuss previously reported cases of BFP treated with biologics. Dupilumab appears to be a useful and safe treatment option for patients with refractory BFP.
An integrated pathway for influenza vaccination across primary and secondary care using a clinical decision support system: model definition and predictive impact analysis
Authors: Specchia Maria Lucia , Beccia Flavia , Cacciuttolo Maria Gabriella , Tona Diego Maria , Di Pumpo Matteo , Porcelli Martina , Lontano Alberto , Corona Valerio Flavio , Laurenti Patrizia , Boccia Stefania , Pastorino Roberta 
Published: December 2024

Abstract
Influenza is an important public health issue given its significant burden of disease. In Italy, the unsatisfactory coverage rate in people ≥65 years underlines the need to improve the current vaccination pathway. This study aims to define an integrated pathway across primary and secondary care, facilitated by a digital clinical decision support system (CDSS), to enhance vaccination coverage in people ≥65 years by actively recruiting patients in hospitals and administering vaccination. Moreover, the study seeks to gauge the potential epidemiological and economic impact of this approach. The methodology consisted of two main phases: definition of the integrated pathway and CDSS and estimation of the potential epidemiological and economic impact resulting from the implementation of the pathway in the whole Lazio region. Assuming an increase of influenza vaccination coverage from the current rate of 60% to 65% in ≥65 years old population in the Lazio region thanks to the pathway implementation, an increase of 8% in avoided influenza cases, avoided influenza- or pneumonia-related hospitalizations and avoided influenza-related outpatient visits was estimated with a relative increase in savings for hospitalizations and outpatient visits of up to 11.85%. Setting the vaccination coverage at 70%, the impact is doubled. Alongside offering a predictive estimate of the pathway’s potential impact, both epidemiological and economic, this project, with its robust methodology, may serve as a scalable and transferable model for enhancing vaccination coverage at national and international level.
Tuning out tenderness: the influence of gender and friends on U.S. adolescents’ emotional self-socialization via film selection and avoidance
Authors: Meier Matthew L , Mares Marie-Louise 
Published: December 2024

Abstract
Teen boys often face peer pressures to avoid “feminine” emotions, such as tenderness. Media selections may reflect such pressures and constitute emotional self-socialization into traditional gender roles. An online experiment with 402 13- and 14-year-olds, based on Knobloch-Westerwick’s SESAM model, tested hypotheses about gendered selections/avoidance of hostile and tender content. Randomized to imagine watching a film alone or with friends, teens rated their interest in different film emotions and their likelihood of viewing eight films (pre-tested hostile or tender), then selected and viewed four trailers. Boys (vs. girls and nonbinary youths) gave higher ratings to hostile films and lower ratings to tender films. Baseline tender affect (lower in boys vs. girls and nonbinary youths) negatively predicted number of hostile trailers viewed which in turn negatively predicted post-test tenderness, consistent with emotional self-socialization. Imagined viewing condition did not moderate gender differences except in post hoc interactions with gender mix of friends.
Trauma-informed healthcare systems: an evaluation of trauma-informed care training for hospital-based healthcare professionals in the aftermath of the 2023 earthquakes in Türkiye
Authors: Şimşek Zeynep , Uğur Büşra 
Published: December 2024

Abstract
Disasters are complex global problems with an increasing impact with rising prevalence of associated illness, mortality, and intensifying health inequities. In recent years, there has been an emphasis on integrating trauma-informed care approaches into health policies and protocols. The purpose of the current study was to investigate the benefits of a trauma-informed healthcare training program for hospital-based healthcare providers with a focus on knowledge acquisition, empowerment of professional practice, and personal well-being. The program was implemented in the aftermath of the 2023 earthquakes in southeastern Türkiye. The training consisted of four modules, developed based on psychological trauma theories and behavior change theories, and was evaluated using a mixed-methods approach. Assessments were conducted at the end of the training program, at baseline, and at a 6-month follow-up. A structured questionnaire including items covering the content of the training, trainer effectiveness, and program suitability was administered at the end of the training program. At 6 months, participants completed an 18-item follow-up questionnaire which assessed their understanding of the principles of the trauma-informed care approach. The Maslach Burnout Inventory (MTI) was also administered, and themes regarding the impact of the training program were extracted through in-depth individual qualitative interviews. Data were obtained from 501 program participants. The intervention program was found to improve healthcare workers’ understanding of trauma, professional practices, and interpersonal relationships, and significantly reduced symptoms of burnout. These results demonstrate the critical role of trauma-informed training programs in hospitals in disaster-affected regions, especially when assistance to survivors will be enhanced by strengthening healthcare workers’ resilience and improving their perceptions of service efficacy and value. The study highlights the need for more widespread adoption of these training initiatives and emphasizes that they may play significant future roles in transforming trauma-informed healthcare systems in disaster-prone countries and regions.
The transcription factor ClWRKY61 interacts with ClLEA55 to enhance salt tolerance in watermelon
Authors: Lan Guangpu , Xuan Changqing , Guo Yidong , Huang Xin , Feng Mengjiao , Yuan Li , Li Hao , Ma Jianxiang , Zhang Yong , Wang Zhongyuan , Yang Jianqiang , Yu Rong , Luan Feishi , Zhang Xian , Wei Chunhua 
Published: December 2024

Abstract
High salinity can severely inhibit the growth and development of watermelon (Citrullus lanatus L.). WRKY proteins are believed to mediate the adaptation of plants to abiotic stresses. Here, we identified the ClWRKY61 gene, which positively regulates the tolerance of watermelon to salt stress. Knockout of the ClWRKY61 reduced salt tolerance, while overexpression of the ClWRKY61 enhanced salt tolerance in watermelon according to phenotypic and physiological analyses. Yeast two-hybrid assays revealed that ClWRKY61 interacts with the ClLEA55 protein, and this interaction was further confirmed by luciferase complementation imaging, transient bimolecular fluorescence complementation, and GST pull-down assays. Knockout of the ClLEA55 resulted in lower salt tolerance compared to the wild-type plants. RNA-seq analysis indicated 421 up-regulated and 133 down-regulated genes in the ClWRKY61 knockout line under salt stress, containing 293 differentially expressed genes with W-box in their promoters. After salt treatment of watermelon seedlings, qRT-PCR assays evidenced that the expression of genes encoding phytoene synthase, MYB transcription factor, sucrose synthase, alpha/beta-hydrolases superfamily protein, glutathione reductase, and sugar transporter were significantly increased; while the expression of genes encoding LEA protein, WRKY transcription factor, ERF transcription factor, alpha-glucan water dikinase, and calcium-dependent protein kinase were significantly decreased in ClWRKY61 knockout lines. These results provide an opportunity to mediate the regulation of salt stress in watermelon with WRKY proteins.
Elaborating the Role of Narrative and Self-Determination Theory in Video Game Design Research
Authors: Lu Amy Shirong , Moller Arlen C 
Published: December 2024

Abstract
Narratives, defined as stories involving two or more events arranged in a chronological or causal sequence, are fundamental and ubiquitous characteristics of human communication and serve as an integral feature of many video games. Moreover, narratives can be understood in nuanced ways through the lens of Self-Determination Theory (SDT). Yet, the intersection of SDT and video game narratives has been surprisingly underexplored. This article reviews research on narrative media and examines how narratives can be integrated into games from the perspective of SDT and potential boundary conditions. We then explore how concepts from narrative theories and SDT can be integrated. The goal of this integration is to help guide future game design and identify new questions for future research related to: (1) the integration of parable narratives in video games, specifically parable narratives featuring characters’ personal transformation and growth and (2) predicting which video games people choose and prefer. We argue that scholars working with narrative theories and SDT can collaborate to advance video game research.
Investigation on the reversal effect of closantel on colistin resistance in MCR-1 positive Escherichia coli based on dose–response relationship
Authors: Cui Xiao-Die , Liu Shuo-Bo , Wang Rui-Yun , He Dan-Dan , Pan Yu-Shan , Yuan Li , Zhai Ya-Jun , Hu Gong-Zheng 
Published: December 2024

Abstract

Background
The lack of research on the dose–response relationship of adjuvants in reversing colistin resistance will lead to a lack of scientific theoretical basis for determining the dosage of adjuvants in clinical combination therapy plans or their compound formulations.

Objectives
This study investigates the dose–response relationship of the deworming drug closantel (CST) on the reversal of colistin resistance in mcr-1-positive Escherichia coli (E. coli).

Methods
Firstly, the reversal effect of different concentrations of CST on colistin resistance in mcr-1-positive E. coli was analysed using broth microdilution method, checkerboard method and time-killing curves. Then, the inhibitory effect of CST on the development of colistin resistance, as well as the haemolytic and cytotoxic properties of CST, was analysed. Finally, the in vivo efficacy of the combination of CST and colistin was evaluated.

Results
Both the checkerboard assays and the time-killing curves indicate that there is a special dose–response relationship between CST and its reversal effect on colistin resistance, which is not concentration-dependent. High reversal efficiency can be achieved within a low concentration range. However, as the CST concentration increases, the ability to reverse colistin resistance remains unchanged or decreases, which resulted in a gradual decrease in reversal efficiency. Additionally, CST can inhibit the development of colistin resistance and reduce the cytotoxicity of colistin. Importantly, in a mouse model of E. coli infection, the combination of CST and colistin showed a significant therapeutic effect.

Conclusions
This study indicates a special dose–response relationship between CST and its reversal effect on colistin resistance, which was not concentration-dependent.
Choice of the Type of School and Outcomes for Youth in the Labour Market in Togo
Authors: Koudjom Etayibtalnam , Ngoko Eric Hubert , Limazie Mazignada Sika , Mafang Lionie 
Published: December 2024

Abstract
The objective of this research is to analyse the impact of the choice of a type of school by parents on the wage of young individuals in the labour market in Togo. To do this, the multinomial endogenous switching model has been specified and estimated. The empirical analysis is based on the Harmonised Survey on Household Living Conditions (EHCVM, 2018–2019) conducted by the National Institute of Statistics and Economic and Demographic Studies in Togo (INSEED) on 16,821 young people aged between 15 and 35 years. The results reveal that the variables relating to the distances that separate the schools from the homes of the young individual's parents (distance to public school and distance to private school), male gender, age, level of secondary and higher education, the Maritime and Kara regions of residence and socio-professional category (employed father, employed mother) are the main determinants of parents' choice to enrol their children in a type of school. In addition, the results indicate that young people in the age group considered with access to private-type training have advantages in the labour market in terms of wage increases compared to young individuals with access to other types of training or who have not chosen any training. These results provide useful information for public policies in Togo. They imply that policies aimed at reducing inequalities amongst young people in the labour market should consider the type of school attended by the young people as an effective tool to achieve these objectives.
Asymmetric Response of Poverty to Growth and Inequality in South Africa: Implications for Current and Future Shocks
Authors: Ngepah Nicholas 
Published: December 2024

Abstract
This study investigates the effect of economic growth on poverty reduction, given inequality in South Africa. It focuses on whether the poor suffer more losses of welfare during economic recessions and depressions than they gain during expansions. It further explores the factors that can assist the poor to stay afloat during times of economic shocks. Individuals in micro-datasets are matched with municipality-level data and in binary, truncated, panel, instrumental variables and quantile regression techniques to estimate poverty and welfare effects of positive and negative economic growth rates. The study finds that, whilst economic growth reduces poverty, it is not enough to compensate for the poverty-raising effects of inequality. Moreover, economic decline raises poverty, but economic prosperity more than compensates by a higher magnitude. The study also reveals that social grants, free health care and free basic education policies have limited effects on poverty reduction during economic downturns. Additionally, the provision of good education up to tertiary level and access to the labour market are crucial for sustaining poverty reduction efforts in South Africa. The findings call for policy measures that reduce inequality and promote economic growth to help cushion the poor during times of significant economic decline.
Examining Poverty Dynamics in Ghana: Evidence from Longitudinal and Repeated Cross-Sectional Data
Authors: Gafa Dede Woade , Hodey Louis Sitsofe , Senadza Bernardin 
Published: December 2024

Abstract
This article examines poverty dynamics in Ghana using the Ghana Socioeconomic Panel Surveys and a synthetic panel based on the Ghana Living Standards Surveys. It provides insight into the extent of poverty mobility and persistence in Ghana, and the factors that explain poverty transitions. The results show that upward mobility has been a key feature of Ghana's poverty transitions between 2006 and 2019. However, there are still high probabilities of poverty persistence and downward mobility among initially poor and non-poor households, respectively. Furthermore, notable heterogeneities exist in poverty transitions across socioeconomic groups. Poverty is more chronic in rural areas and the northern parts of Ghana compared with urban and southern regions, respectively, and among households headed by persons from opportunity-deprived backgrounds. Other characteristics such as the number of dependants, sex, occupation and level of education of the household head are important correlates of poverty persistence and downward mobility in Ghana. Hence, addressing chronic poverty requires targeted policies that foster more inclusive and sustainable growth in rural areas and northern parts of Ghana, and improved access to opportunities for people from disadvantaged backgrounds, the unemployed, and those in vulnerable employment.