bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital divide: Differences between digital access, preference, and use among parents of pediatric research participants
Authors: Smith Lauren , Koid Jia Shin Cassandra , Abdi Najma , Zhou Chuan , Brown Julie C. , Hartford Emily A. , Danai Mahtab , Lion K. Casey 
Published: December 2024

Objective Healthcare delivery and research are moving increasingly towards digital engagement, which could inequitably exclude some populations due to differential technology access and uptake. We sought to evaluate study-related digital access, preferences, and use among parents of patients with Medicaid insurance enrolled in research in a pediatric emergency department (ED). Methods We conducted a secondary analysis within a randomized trial at an academic pediatric ED. Children with public insurance and a language of English or Spanish who were treated for asthma symptoms were enrolled; parents completed surveys regarding digital access, preferences and demographics. Associations were tested using Fisher's exact test. Results We enrolled 80 families, of whom 18% had a language for care of Spanish; 31% of children identified as Hispanic, and 25% as Black. All baseline survey respondents (n = 79) endorsed having an internet-connected computer (73%) or smartphone (99%); 85% of smartphone holders reported unlimited data. When given the choice, 73% of participants requested a physical gift card instead of an electronic gift card. Only 31% had patient portal access 6 months after study end. Parents who spoke Spanish or with a child identified as Hispanic or Black more often requested physical gift cards and less often had patient portal access, but these differences were not statistically significant. Conclusion Despite ubiquitous access to internet-connected digital devices among this Medicaid-insured population, patient portal use was low and many families preferred non-digital reimbursement. Efforts to enhance research inclusion should consider digital preferences in addition to digital access when planning study procedures.
Multicomponent Workplace Tobacco Cessation Interventions: A Scoping Review
Authors: Baay Courtney , Jessiman-Perreault Geneviève , Toohey Ann M. , Allen Scott Lisa K. 
Published: December 2024

Introduction: Tobacco is the leading modifiable risk factor for cancer and other chronic diseases. The workplace provides an opportunity to advance tobacco cessation efforts. Combining tobacco cessation with complementary components addressing mental health, physical activity, and healthy eating has demonstrated effectiveness in non-workplace settings. This scoping review examines the literature on multicomponent workplace tobacco cessation interventions to identify core components and implementation facilitators and barriers to support uptake in the workplace setting. Methods: A scoping review was conducted following PRISMA guidelines for Scoping Reviews and Arksey and O’Malley’s five-step process. Peer-reviewed literature published in the past 20 years was searched across 9 databases. A search for relevant gray literature (i.e., conference papers/proceedings) was also completed. Articles were screened by two independent researchers for inclusion. Included studies evaluated workplace interventions recruiting individuals to participate in a tobacco cessation program alongside a complementary component (i.e., physical activity, mental health, healthy eating). Results: Most of the 12 included studies paired tobacco cessation with mental health or stress reduction interventions. Most complementary components targeted the individual versus organizational or policy levels. The synthesized facilitators indicated that multicomponent interventions should be incentivized and tailored to adequately meet the needs of different workplaces and employees. Discussion: This scoping review synthesizes studies integrating multiple complementary program components into workplace tobacco cessation efforts. Future interventions should implement tobacco cessation interventions at multiple levels, combining complementary components to maximize effectiveness and overcome barriers (e.g., weight gain and stress) to successful outcomes.
The Effects of Tranexamic Acid and Recombinant Activated Factor VII on Traumatic Bleeding and Mortality in Mice
Authors: Chumappumkal Joseph Bilgimol , De Pablo-Moreno Juan Andres , Falah Nicca , Wentzel Abraham , Frias-Anaya Eduardo , von Drygalski Annette 
Published: December 2024

Introduction
Trauma-associated bleeding and coagulopathy are often lethal. Early administration of tranexamic acid (TXA) is included in massive transfusion protocols since it somewhat reduces mortality. Recombinant activated factor VIIa (rFVIIa) is used variably during exsanguination when its procoagulant effects may outweigh potential prothrombotic risks. Since a comprehensive understanding of the effects of TXA and rFVIIa on bleeding, coagulopathy, and mortality is lacking, we investigated those in a murine trauma model.
Materials and Methods
C57BL/6J mice (8-10 weeks old, ~20 per group) were pretreated (within 5 minutes of trauma) intravenously with saline, TXA (10mg/kg), or rFVIIa (3mg/kg) and subjected to liver laceration. Blood loss (weighing blood-soaked sponges from the abdomen), coagulopathy [APTT, Factor (F)II, FV, FVIII, FX, and fibrinogen), thrombin-antithrombin (TAT), plasmin-antiplasmin (PAP) complexes, and D-dimer] were analyzed at 60 minutes after trauma. Data were expressed as median and compared by Mann-Whitney test. Seven-day survival was analyzed using Kaplan-Meier curves and pulmonary fibrin burden was determined by Orcein and Martius Scarlet Blue staining.
Results
Blood loss in saline-treated mice (21 µL/g) was reduced significantly by both agents, TXA or rFVIIa (~16 µL/g). Saline-treated mice developed acute traumatic coagulopathy (ATC), characterized by elevated APTT (35 seconds vs 23 seconds baseline [BL]), TAT-complex formation (334 ng/mL vs 7 ng/mL BL), and reductions of FV (14% vs 94% BL) FVIII (4% vs 101% BL)), and fibrinogen (47% vs 99% BL). Consistent with ATC, FII, and FX remained unaffected. Whereas TXA normalized the ATC, rFVIIa over-corrected the APTT, and increased TAT complexes and FVIII levels. While both agents reduced PAP complex formation similarly, suggestive of fibrinolysis control, rFVIIa was unable to suppress D-dimer formation, suggestive of persistent clot turnover. Seven-day survival was ~80% for mice treated with saline or TXA, but only ~50% for mice treated with rFVIIa. Pronounced pulmonary fibrin depositions (luminal thrombi) were noted in the surviving mice treated with rFVIIa, but were absent in TXA-treated mice
Conclusion
Peri-traumatic TXA and rFVIIa resulted in similar bleed reduction. However, while TXA normalized ATC, rFVIIa promoted prothrombotic coagulation abnormalities associated with increased mortality and thromboembolic complications. Since TXA mitigates but does not abolish bleeding and death in humans, our findings highlight the urgent need for alternative, targeted interventions to reduce ATC, traumatic bleeding, and death in humans.
Repolarisation of M2 Macrophages Via Cgas-Sting Activation Enhances Phagocytosis of Acute Myeloid Leukaemia
Authors: Markham Matthew , Maynard Rebecca S , Bell George , Hampton Katherine , Fowler-Shorten Dominic James , Polski-Delve Alyssa Nicole , Altera Annalisa , Taylor Rosie , Hellmich Charlotte , Bowles Kristian , Rushworth Stuart A 
Published: December 2024

The tumour microenvironment is composed of extracellular matrix and non-mutated cells supporting tumour growth and development. Tumour-associated macrophages are among the most abundant immune cells in the microenvironment. Studies of the innate immune compartment in the bone marrow of patients with acute myeloid leukaemia (AML) reveal a shift toward a tumour-supportive M2-polarised macrophage (Weinhäuser et al., 2023). Furthermore, previous work by our group has shown that AML drives activation of the stimulator of interferon genes (STING) pathway in macrophages in the AML bone marrow microenvironment (Moore et al., 2022). We found that AML-derived mitochondrial damage-associated molecular patterns were processed by bone marrow macrophages via LC3-associated phagocytosis. This activation of STING resulted in a suppression of AML growth.
To fully characterise the role of STING pathway in AML-associated macrophages we have combined RNA sequencing, flow cytometry and in vivo characterisation to reveal a shift of M2 tumour supportive macrophages towards an M1 phenotype in response to STING activation. We used various STING agonists including DMXAA, 2'3'-cGAMP, and CpG oligonucleotides to model STING activation of bone marrow derived macrophages (BMDM) in vitro. Functionally, STING activation of BMDM induced an anti-tumour response by increasing phagocytosis of AML blasts which was also established in an in vivo model of AML in C57Bl/6 mice. Using the well-established syngeneic AML murine model (MN1), STING activation in vivo slowed tumour progression and prolonged survival. RNA sequencing of STING activation in macrophages revealed a M1 proinflammatory polarisation phenotype. Moreover, AML-induced M2 macrophage polarisation was reversed in response to STING activation.
Additionally, we show that STING activation upregulates genes involved with cell-cell adhesion, and we used blocking antibodies to assess their involvement in the increased phagocytic clearance of AML blasts. We observed that inhibiting the ICAM1/LFA1 interaction blocked STING-induced phagocytosis of AML blasts, therefore demonstrating the role this interaction plays in mediating the anti-tumour response of STING activation. Finally, we show that AML cells have higher levels of LFA1 cell surface expression than non-AML cells within the bone marrow. This is further supported by the BloodSpot database which demonstrates a higher level of LFA1 expression in human AML subtypes compared to haematopoietic stem and progenitor cells (Bagger, F.O. et al., 2016).
Our study provides insight into mechanisms by which AML-associated macrophages can be reprogrammed through STING activation towards an anti-tumour, pro-phagocytic phenotype, thus providing an alternative strategy for targeting leukaemia progression.
Hospital-Acquired Venous Thromboembolism (HA-VTE) Epidemiology and Risk Factors Among Critically Ill Children and Young Adults with Diabetic Ketoacidosis
Authors: DeMayo Kristin , Havlicek Elizabeth , Root Maya , Betensky Marisol , Goldman Zachary , Goldenberg Neil , Sochet Anthony A 
Published: December 2024

Introduction: Children hospitalized for diabetic ketoacidosis (DKA) experience hyperglycemic hyperosmolarity and severe dehydration that are considered prothrombotic, heightening the risk of hospital-acquired venous thromboembolism (HA-VTE). Yet, the occurrence rate and risk factors for HA-VTE among cases of pediatric DKA remain ill-defined.
Methods: We performed a retrospective, single center cohort study including children and young adults 0 - 21 years of age hospitalized in the pediatric intensive care unit for DKA from Oct 2020 - December 2023. The primary outcome was radiographically confirmed HA-VTE (i.e., pulmonary embolism, limb/neck deep venous thrombosis, and cerebral sinovenous thromboembolism). Detailed data were collected on HA-VTE (timing, location, central venous catheterization [CVC]-relatedness), DKA (degrees of acidosis and hyperglycemia, β-hydroxybutyrate levels, clinical cerebral edema), thromboprophylaxis (TP) modalities, and putative HA-VTE risk factors (age, inherited coagulopathy, acute and chronic immobility, mechanical ventilation [IMV], infectious comorbidity). Descriptive and comparative (e.g., chi-square, student's t, and Wilcoxon rank sum tests) statistics were performed.
Results: During the study period, 386 children and young adults were hospitalized for DKA of which 2 (0.5%) developed a HA-VTE (both were CVC-related). The children who developed HA-VTE were 13 and 14 years of age, prescribed mechanical TP without pharmacologic TP, treated for acute cerebral edema, profoundly acidotic (β-hydroxybutyrate: 8.5 and 9.6 mmol/L, respectively), acutely immobilized (per Braden QD values), and exhibited plasma hyperosmolarity (339 and 342 mOsm/kg, respectively). Rates of HA-VTE were more common among subpopulations with CVC (40% vs 0%), symptomatic cerebral edema (12.5% vs 0%), undergoing IMV (20% vs 0.2%), and COVID-19 infection (5.6% vs 0.3%) as compared to those without these clinical features.
Conclusion: The observed HA-VTE rate among critically ill children with DKA over a three-year period was 0.5%. Putative risk factors for HA-VTE in this population, including comorbid conditions and markers of disease severity at presentation such as symptomatic cerebral edema, degree of acidosis, CVC, and IMV, should be prospectively investigated.
Management of Upper Extremity Superficial Vein Thrombosis in Patients with Cancer: A Retrospective Observational Cohort Study
Authors: Tokessy Lauren , Brown Cameron , Wang Tzu-Fei , Kimpton Miriam , Carrier Marc 
Published: December 2024

Introduction:
Venous thromboembolism (VTE) including superficial vein thromboses are common in patients with cancer. Although clinical studies have reported that anticoagulant therapy may be beneficial in some patients with lower extremity superficial vein thrombosis, the management of upper extremity superficial vein thrombosis (UESVT), especially in patient with cancer, remains unclear. Patients with cancer are at higher risk of both recurrent VTE and bleeding complications while receiving anticoagulant therapy. Hence, the risks and benefits of anticoagulant therapy are unknown in this patient population. We sought to assess the efficacy and safety of anticoagulant therapy in patients with cancer and UESVT.
Methods:
A single center retrospective observational cohort study which included consecutive patients with cancer and UESVT assessed between 2019 and 2023 was conducted. The primary outcome was the extension of the UESVT or recurrence of VTE during a 90-day follow-up period. Secondary outcomes included major bleeding and clinically relevant non-major bleeding (CRNMB), and overall mortality. Major bleeding and CRNMB were defined according to the International Society on Thrombosis and Haemostasis criteria. Outcomes were reported as proportions along with their 95% confidence intervals (CI) during the follow-up period.
Results:
Overall, 86 patients were included in the analyses. The median age was 79±48 years, and 47.7% were female. The most common locations for cancer types were lung (16.3%) and breast (11.6%), and 57.0% in stage 3 or 4. A majority of patients had a central venous catheter in place. A total of 64 (74.4%) patients received anticoagulant therapy, including 27 patients (31.4%) at a therapeutic dosage. The overall rate of UESVT or VTE recurrence was 17.4% (95% CI: 10.1-27.1) over the 90-day follow-up period. There were 2 major bleeding events (2.3%, 95% CI: 0.2-8.2) and 5 CRNMB (5.8%, 95% CI: 1.9-13.1) during the follow-up period. The overall mortality rate was 24.4%.
Conclusion:
In patients with cancer and UESVT, the risk of superficial vein thrombosis extension or recurrent VTE is high despite anticoagulant therapy. Future prospective studies are needed to derive the optima management strategy for this patient population.
Barriers and opportunities for developing, implementing and operating inclusive digital mobility services
Authors: Delaere Hannes , Basu Samyajit , Macharis Cathy , Keseru Imre 
Published: December 2024

AbstractAs digital mobility services increasingly reshape the transportation landscape, offering a multitude of choices for users, a significant lack of equality emerges: vulnerable-to-exclusion groups are often left behind, unable to equally access digital transport services. This study investigates the opportunities to create inclusive and accessible digital mobility services, based on the viewpoints of developers, operators, and policy makers. Through 32 semi-structured interviews with stakeholders, we look into the existing regulatory frameworks, the extent of user involvement in service (re-)development, considerations for data protection and privacy for vulnerable groups, and the financial aspects supporting the development and operation of inclusive digital transport services. A thematic content analysis reveals a complex challenge: a lack of effective communication, collaboration, and co-creation across the majority of services, in combination with a widespread failure to disseminate insights among stakeholders, resulting in a lack of knowledge about vulnerable-to-exclusion groups. Despite a general awareness of the importance of inclusive design, actionable steps to achieve inclusive digital services remain scarce, with only a handful of services actively pursuing these goals. Our findings push for a comprehensive approach that enhances clear communication, stakeholder collaboration, and promotes the co-creation of services, while also protecting vulnerable users' data and thereby bridging the accessibility gap to ensure that the benefits of digital mobility extend to all users, including those most at risk of exclusion.
The complexity of addressing equity in COVID-19-related global health governance and population health research priorities in Canada: a multilevel qualitative study
Authors: Mac-Seing Muriel , Di Ruggiero Erica 
Published: December 2024

Abstract
Background
Since COVID-19 emerged in 2020, the promotion of health equity, including in research, has further been challenged worldwide by both global health governance (GHG) processes and decisions, and national public health control measures. These global and national decisions have also led to the ‘covidization’ of health research agendas where resources have been massively channelled to address COVID-19, especially during the first years of the pandemic. This situation could potentially result in current and future population health research priorities not explicitly tackling equity as a central tenet. The study objective examined how and to what extent the COVID-19-related GHG architecture is affecting population health research priorities in Canada.

Methods
We conducted a multilevel qualitative study informed by the intersectionality-based policy analysis and multiple streams frameworks. We collected and thematically analysed data from four groups of respondents (n = 35: researchers, research funders and global and public health research institutes in Canada, and WHO/international actors) and an interactive feedback workshop (n = 40 participants).

Results
Study findings generated four main themes. First, both global and national COVID-19 responses failed to address equity considerations, especially among populations in situations of vulnerability and marginalisation. Second, the integrated examination of funding, equity, and accountability was judged as necessary determinants of GHG and population health research priorities in Canada. Third, contrary to common beliefs about COVID-19, the consequences were not all negative, but they were also positive and unintended, and lessons can be learned. Fourth, study respondents proposed multiple recommendations to address inequities in the complex intersection between COVID-19-related GHG and population health research in Canada.

Conclusion
This study provides substantial evidence of the multilayered and complex intersection between COVID-19-related GHG and population health research priorities in Canada. Although the window of opportunity was slim according to study respondents, there was still a unique collective effort to address COVID-19-related socioeconomic and health inequities by considering the numerous recommendations proposed by the four groups of study respondents. These recommendations can directly contribute to improving knowledge of global and national population health and equity research strategies in the context of an evolving pandemic and for policy- and decision-makers to adjust and rectify the course of global and public health governance.
The effect of life skills training on reducing domestic violence and improving treatment adherence in women with diabetes experiencing intimate partner violence: a randomized clinical trial based on the theory of self-efficacy
Authors: Rezaee Shahrbanoo , Bagherzadeh Razieh , Reisi Mahnoush , Fotovat Leila , Vahedparast Hakimeh 
Published: December 2024

Abstract
Background
Intimate partner violence (IPV) is a global health problem and the cause of chronic diseases, such as diabetes. It has a negative effect on adherence to treatment, decreases self-efficacy beliefs, and intensifies stress in women. Therefore, this study aimed to investigate the effect of life skills training based on the self-efficacy theory on IPV and adherence to treatment in women with type 2 diabetes.

Methods
This trial was conducted using a pretest-posttest design and follow-up after one month. The samples included 100 women selected by convenience sampling with random block allocation with type 2 diabetes and IPV. The intervention consisted of 8 sessions over one month of life skills training based on self-efficacy theory. Participants completed questionnaires at pre-test, post-test and follow-up, including a demographic information form and questionnaires on IPV and treatment adherence. Considered statistically significant at P < 0. 05.

Results
The mean changes in IPV scores from the pre-test to the post-test were − 8.38 ± 4.06 and − 0.06 ± 3.09 in the intervention and control groups, respectively. Also, the reduction in the intervention group was significantly more than in the control group (P < 0.001; 95%CI=-9.75; -6.89). The mean changes in IPV scores from post-test to follow-up were − 1.36 ± 3.47 and 1.50 ± 4.14 in intervention and control groups, respectively, indicating a statistically significant difference between the two groups (P < 0.001; 95%CI=-4.38; -1.34). The mean changes in adherence scores from the pre-test to the post-test were 11.40 ± 4.23 and 0.68 ± 3.49 in the intervention and control groups, respectively. The increase was significantly higher in the intervention group than in the control group (P < 0.001; 95%CI = 9.18; 12.26). The mean changes in adherence scores from post-test to follow-up were 2.68 ± 5.06 and − 0.86 ± 2.43 in the intervention and control groups, respectively. The difference between the two groups was statistically significant (P < 0.001; 95%CI = 1.95; 5.12).

Conclusion
Life skills training based on self-efficacy theory reduced IPV and improved treatment compliance in women with diabetes under IPV. It is recommended that this training be taught to other patients with chronic conditions as a means of violence prevention and treatment adherence.

Trial registration
The trial was registered with the Iranian Registry of Clinical Trials (IRCT) on 13 October 2022 and can be found on the Iranian Registry of Clinical Trials platform. IRCT registration number: IRCT20090522001930N6.