bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the value-added contributions of community health workers and communities to early child development: a longitudinal study in a low-income setting
Authors: Hemlock Caitlin , Dieci Maria , Fernald Lia C H , Galasso Emanuela , Ratsifandrihamanana Lisy , Weber Ann M 
Published: February 2025

BackgroundEarly child development (ECD) programs in low-resource settings can be effective when delivered through community health workers (CHWs), but there are significant challenges when moving to scale. This analysis aimed to determine the value-added, or relative effectiveness, of CHWs and communities on ECD outcomes within a home-visiting trial and examine associations between observable characteristics of the CHW or community and value-added.MethodsWe analysed data from the four treatment arms of a cluster-randomised trial conducted in 100 communities in rural Madagascar from 2014 to 2016. CHWs (one per cluster) and enrolled children (0–12 months) were surveyed at baseline and 2 years later. Child development scores were assessed using the Ages and Stages Questionnaire-Inventory (ASQ-I) and were internally age-standardised. We determined value-added by estimating CHW/community-level fixed effects on ASQ-I Z-score trajectories (change from baseline to endline), conditional on baseline ASQ-I Z-score and child and household characteristics. We also assessed associations between value-added and observable CHW and community-level characteristics.ResultsWe analysed data from 1456 children present at baseline and endline. CHW/community fixed effects explained 26% of ASQ-I trajectory variance and estimates ranged from −1.68 SD to 1.31 SD. CHWs who had another income-generating position were associated with a 0.54 SD (95% CI 0.22, 0.87) increase in ASQ-I Z-score from baseline to endline. Greater increases in children’s ASQ-I Z-scores were also associated with communities that had better healthcare, education and transportation infrastructure and were less geographically dispersed.ConclusionsChildren gained or lost over one standard deviation of ASQ-I Z-score depending on the community and CHW where they lived. Children’s development trajectories benefitted from CHWs involved in an external income-generating activity and communities with better access to healthcare, education, and transportation. Careful consideration of the contexts in which child development interventions are implemented and potential correlates of improved CHW performance are crucial for improved outcomes.
Efficacy of dynamic interpersonal therapy in improving mentalising in patients with major depressive disorder and the mediating effect of mentalising on changes in depressive symptoms
Authors: Jiang Wenhui , Yao Jiayu , Wang Yuan , Su Shanshan , Zheng Ziwei , Yang Yang , Qiu Jianyin 
Published: February 2025

BackgroundDynamic interpersonal therapy (DIT) is a short-term psychodynamic psychotherapy that has been shown to effectively reduce depressive symptoms in patients with major depressive disorder (MDD). In DIT, the depressive symptoms are formulated as responses to impaired mentalisation. DIT aims to alleviate depressive symptoms by improving mentalising.AimsThis study aimed to examine the effect of DIT on improving mentalising and the mediating effect of mentalising in changes in depressive symptoms.MethodsOutpatients received either DIT combined with antidepressant medication treatment (DIT group) or antidepressant medication treatment alone (ADM group) for 16 weeks. The Hamilton Depression Rating Scale (HAMD), Patient Health Questionnaire (PHQ) and Reflective Functioning Questionnaire (RFQ) were used. The intention-to-treat principle, mixed linear models, multiple imputation, Pearson’s correlation analysis and mediation analysis were conducted. The per-protocol principle was used as sensitivity analysis.ResultsThe DIT group had significantly lower HAMD (least-squares (LS) mean difference=−3.756, p<0.001), PHQ (LS mean difference=−4.188, p<0.001), uncertainty about mental states in the RFQ (RFQ-U, LS mean difference=−2.116, p<0.001) and higher certainty about mental states in the RFQ (RFQ-C, LS mean difference=2.214, p=0.028) scores than the ADM group at post-treatment. The change in RFQ-C was marginally significantly correlated with the change in HAMD (r=−0.218, pcorrected=0.09). The change in RFQ-U was significantly correlated with the change in HAMD (r=0.269, pcorrected=0.024) and the change in PHQ (r=0.343, pcorrected<0.001). When using RFQ-U as the mediating variable and PHQ as the dependent variable, a significant mediating effect was found (p=0.043, 95% confidence interval 0.024 to 1.453).ConclusionsThe DIT group yielded better outcomes compared with the ADM group in reducing depressive symptoms and improving mentalising. Improvements in mentalising were associated with reductions in depressive symptoms. These findings support that mentalising may contribute to the therapeutic effects of DIT in MDD.
Fall-related mortality in Spain: trends and disparities by age and gender
Authors: Cayuela Lucía , García-Muñoz Cristina , Achaval Victoria , Ortega Calvo Manuel , Cayuela Aurelio 
Published: February 2025

BackgroundFalls are a significant public health concern, particularly among older adults. This study aimed to analyse trends in fall-related mortality in Spain from 1999 to 2022, focusing on age and gender disparities.MethodsUsing a longitudinal ecological study, we analysed trends in fall mortality. Using data from the Spanish National Institute of Statistics, age-standardised mortality rates (ASMRs) were calculated for different age groups and genders. Joinpoint regression analysis was employed to identify significant trends and calculate annual percentage changes in mortality rates.ResultsFall deaths in Spain surged from 1999 to 2022, with a significant increase in mortality rates. This increase was more pronounced among men than women, and the older adults aged 65 and older accounted for most fall-related deaths. Overall, ASMRs increased with age and were consistently higher for men across all age groups. Men experienced a 1.9% annual increase in ASMRs, with a significant rise starting in 2009. Women’s ASMRs increased by 1.8% per year, with a more pronounced increase from 2007 to 2013 before slowing. Among those aged 65 and over, rates increased significantly across most age groups, with the ASMR for men rising by 2.7% per year and for women by 2%.ConclusionsFall mortality in Spain has significantly increased, particularly among older adults and men. The findings underscore the need for targeted fall prevention strategies, especially for high-risk groups. Future interventions should address gender-specific risks and emerging issues in middle-aged adults to effectively reduce fall-related mortality across all age groups.
Human papillomavirus vaccination uptake among men who have sex with men living with HIV
Authors: Moran Conor , Garcia-Iglesias Jaime , Kerr Colm 
Published: February 2025

BackgroundHuman papillomavirus (HPV) is a very common sexually transmitted infection. Persistent infection with high-risk subtypes can lead to a variety of cancers. Men who have sex with men (MSM), particularly those who are living with HIV (MSMLWH), have a high prevalence of HPV infection and are at greatest risk of HPV-related diseases such as anal cancer. HPV vaccines are effective in preventing new infections, and many countries have implemented HPV vaccination for MSM.MethodsThis systematic review aimed to examine HPV vaccine uptake among MSM and MSMLWH. Quantitative studies published between 2010 and 2022 were screened and included if they detailed HPV vaccination uptake data for MSM and MSMLWH. Identified studies were screened using Covidence, data were extracted from the final included studies and narratively synthesised, and risk of bias of studies was assessed using the Joanna Briggs Institute Checklist tool for prevalence studies.ResultsThere were 19 studies all from high-income countries, included in the final review. This review showed a wide variety of HPV vaccine uptake, ranging from 2.7% to 91.5% for HIV-negative MSM and among MSMLWH ranging from 5.6% to 90%. Although limited by the heterogeneity of studies and settings, there was evidence of a consistent, steady increase in HPV vaccination particularly among younger men. MSMLWH generally had higher rates of HPV vaccination, but overall HPV vaccine uptake remained suboptimal.ConclusionMSMLWH are at high risk of HPV-related disease. Despite an available and efficacious vaccine in many countries, this review showed overall rates of HPV vaccination uptake remain inadequate. Further research and policy should aim to address and overcome barriers to HPV vaccination.PROSPERO registration numberCRD42023382251.
Speech perception: a model of word recognition
Authors: Luck Jean-Marc , Mehta Anita 
Published: February 2025

Abstract
We present a model of speech perception which takes into account effects o correlations between sounds. Words in this model correspond to the attractors of a suitably chosen descent dynamics. The resulting lexicon is rich in short words, and much less so in longer ones, as befits a reasonable word length distribution. We separately examine the decryption of short and long words in the presence of mishearings. In the regime of short words, the algorithm either quickly retrieves a word, or proposes another valid word. In the regime of longer words, the behaviour is markedly different. While the successful decryption of words continues to be relatively fast, there is a finite probability of getting lost permanently, as the algorithm wanders round the landscape of suitable words without ever settling on one.

Graphic abstract
Reimagining Entrepreneurial Ecosystems through Novel University-Driven Collaborative Formats
Authors: Vujovic Pavlina , Baloutsos Stratos 
Published: February 2025

Abstract
Entrepreneurial Ecosystems (EE s) constitute complex systems with various interacting elements that are central in the process of generating innovation. While there is significant research on mature ecosystems, our understanding of the mechanisms that affect EE s is still limited when discussing early-stage EE s. In this context, universities are known to play an important role in orchestrating ecosystems. This article reimagines EE s as Activity Systems using Activity Theory and explores a university-driven cross-European EE collaborative format. The “Start For Future” ecosystem is used as a testbed to understand how the implementation of a holistic, inclusive entrepreneurial transformation model, can create a set of “congruencies” which enable ecosystem actors to collaborate and co-create despite inherent problems. Hence, this work identifies factors that facilitate the innovation process, the collaboration between ecosystem actors, and showcases the importance of universities in EE s as a trusted intermediary and a focal point for collaborative formats.
How Thomas Bartholin the Younger Read his Rudbeck: A Forgotten Debate on Historical Method in Seventeenth-Century Scandinavia
Authors: Norris Matthew 
Published: February 2025

Abstract
In 1689 the Danish royal antiquary Thomas Bartholin the Younger (1659–1690) published a celebrated antiquarian work on the attitudes, customs, and rituals of the pagan inhabitants of Scandinavia. It has been deemed significant both for influencing the development of the historical conception of the ‘Viking Age’ in the eighteenth and nineteenth centuries, and for introducing a rigorous source-critical methodology to Scandinavian historiography, inspired by the French Benedictine scholar Jean Mabillon, and foreshadowing the scientific history of the coming centuries. Yet modern assessments of the work have rarely questioned the consistency with which Bartholin applied his principles to solve historical problems, and have never made note of the fact that he framed his methodological reform as a bitter critique of contemporary Swedish scholarship. Exploring the overlooked debate generated by Bartholin’s book, this article shows that it accentuated an internal friction in late seventeenth-century historiography between opposing views concerning historical evidence.
The Amplified Glacial Arctic Tide Regime – Sensitivities and Feedback on the Atlantic Ocean
Authors: Sulzbach Roman , Bagge Meike , Schindelegger Michael , Klemann Volker 
Published: February 2025

Abstract
Numerical tide simulations for the Arctic Ocean under glacial conditions imply a macro- to megatidal regime in contrast to its present-day microtidal regime. Applying a barotropic ocean tide model, we study the sensitivity of this regime change driven by the semidiurnal M2 tide to a set of modeling parameters. We find that the near-resonant tidal oscillation system is sensitive to changes in the paleo bathymetry due to glacial isostatic adjustment, as well as to the effect of ocean self-attraction and loading, resulting in an amplification of the dominantM2 tide by a factor of up to four. Furthermore, the modeling framework is used to investigate the back-effect of the Arctic resonance on the world oceans. This feedback contributes +289 GWof internal wave dissipation (13% of the global figure). The results are contextualized by an analytical model of cylindrical symmetry. This model illustrates the driving mechanism for the amplified glacial Arctic tide regime as an interplay of shelf- and deep-ocean-resonance at semidiurnal frequencies.
Level of sedation in patients with COVID-19 supported with ECMO: A comparative analysis of the critical care consortium international database
Authors: Heinsar Silver , Labib Ahmed , Cespedes Marcela , Riera Jordi , White Nicole , Zaaqoq Akram , Jacobs Jeffrey P , Buscher Hergen , Alexander Peta M. A. , Ciullo Anna , Aftab Muhammad , Suen Jacky Y , Bassi Gianluigi Li , Lorusso Roberto , Fraser John F , Peek Giles ,   On behalf of the COVID-19 Critical Care Consortium (COVID Critical)
Published: February 2025

Background Liberation from sedation may be beneficial for patients with acute respiratory distress syndrome supported by veno-venous (VV) extracorporeal membrane oxygenation (ECMO). Currently, there is limited evidence to support this approach. Therefore, this study aimed to compare the 90-day patient mortality of different sedation strategies in COVID-19 patients supported with VV ECMO. Methods Retrospective, observational sub-study of the COVID-19 Critical Care Consortium database including COVID-19 patients supported with VV ECMO. Two cohorts were compared: high sedation patients who received neuromuscular blocking agents (NMBAs) throughout ECMO and low sedation patients who did not receive NMBA consistently. Patients’ level of sedation during ECMO was also considered. The primary outcome was 90-day in-hospital mortality and was assessed using cause-specific Cox proportional hazard models. Results 224 low and 104 high sedation patients were included. Pre-ECMO respiratory condition prior was similar between groups, except for the ratio of partial pressure of oxygen to inspired fraction of oxygen, which was lower in the high sedation group at 93 [61–130] than the low sedation group at 106 [69–140]. No difference was observed in disease severity scores between cohorts. Low sedation patients had longer ECMO runs, more circuit changes, but lower infectious and hemorrhagic complications. Higher sedation was associated with a hazard ratio for death of 3.23 (95% CI 2.16–4.83) compared to low sedation. Conclusions Reduced sedation in COVID-19 ECMO patients is feasible and may be associated with improved survival and reduced complications compared to continuous paralysis, albeit with longer ECMO runs.
Cognitive Authority Theory: Reframing health inequity, disadvantage and privilege in palliative and end-of-life care
Authors: Hunt Katherine J , May Carl R 
Published: February 2025

Background: There persist disparities in access to quality palliative and end-of-life care, often based on avoidable injustice. Research and theory to explain this health inequity focuses on structural or individual-based factors, overlooking important relational factors between health professionals, patients and families. Aim: To apply Cognitive Authority Theory in palliative and end-of-life care to explain neglected relational drivers of inequity in access and experience. Methods: Cognitive Authority Theory, a middle-range theory of power relations between individuals and authority over knowledge, was developed from empirical and review data. This paper demonstrates its utility in explaining an overlooked component of inequity in palliative care: interactions between health professionals and patients/caregivers. Results: Using examples from the palliative care literature, we characterise how people who are socially disadvantaged have fewer resources to exploit during consultations with health professionals which makes it difficult for them to have their voices heard, their choices prioritised by others, and to express their expertise. We examine the implications of health professionals’ judgements of expertise for care access, experience, involvement and appropriateness. We offer a fresh perspective on the mechanisms by which stereotypes, bias and power imbalances between health professionals and patients reinforce existing health inequities, drawing on the role of social privilege in shaping inequity in palliative care. Conclusion: This paper provides a new language to articulate relational drivers of inequity in palliative care. It explains how to use Cognitive Authority Theory to design and interpret research to determine how healthcare interactions reinforce both social privilege and social disadvantage at end-of-life.
Activation of SIRT3/AMPK/mTOR-mediated autophagy promotes quercetin-induced ferroptosis in oral squamous cell carcinoma
Authors: Wang Jin , Yang Jia-Hui , Xiong Di , Chen Ling 
Published: February 2025

Introduction Quercetin has been reported to inhibit the growth of oral squamous cell carcinoma (OSCC), but the mechanism remains unclear. Therefore, our study aimed to investigate the involvement of sirtuin 3 (SIRT3) and the autophagy-dependent form of cell death, ferroptosis, in the pathogenesis of OSCC, and observe the impacts of quercetin on ferroptosis and SIRT3/AMPK/mTOR-mediated autophagy. Methods SIRT3 knock out or overexpressing SCC15 cell line was generated, treated with indicated drugs, and malondialdehyde (MDA) and ROS levels were measured. Roles of SIRT3 in regulating autophagy-mediated ferroptosis were assessed by immunoprecipitation and Western blotting. Results SIRT3 overexpression increased levels of MDA and ROS, reducing cell viability, and SIRT3 knockout produced the opposing effect. SIRT3 overexpression upregulated ATG16L1 expression and the conversion of LC3-Ⅰ to LC3-Ⅱ, triggering autophagy. Suppression of autophagy by ATG16L1 knockout impaired SIRT3-triggered ferroptosis. Use of an AMPK inhibitor antagonized the induction of ferroptosis by SIRT3 in SCC15 cells, indicating the involvement of the AMPK/mTOR pathway. Additionally, quercetin significantly increased the levels of SIRT3, p-AMPK, ATG16L1, and the ratio of LC3-Ⅱ/Ⅰ, but reduced cell viability and p-mTOR in SCC15 cells. Autophagy and AMPK inhibitors, or SIRT3 deletion significantly antagonized the impacts of quercetin on the autophagy-mediated ferroptosis in cancer cells. Discussion SIRT3 overexpression activated the AMPK/mTOR pathway and triggered ATG16L1-mediated autophagy, promoting ferroptosis in SCC15 cells, and we proposed that quercetin may be a promising therapeutic drug for OSCC.
The brain-boosting power of exergames in neurological disabilities
Authors: Prosperini Luca , Pezzella Francesca Romana , Quartuccio Maria Esmeralda , Alcamisi Irene , Cruciani Alessandro , Ruggieri Serena 
Published: February 2025

Purpose of the research We propose a framework on how to implement exergames in the rehabilitation process. Major findings An increasing body of research is showing that exergames improve balance, motor dexterity, and cognitive functions. People suffering from stroke, Parkinson’s disease, multiple sclerosis, dementia, and many other neurological conditions may benefit from exergames. Similar to other rehabilitation strategies, playing exergames enhances neuroplasticity and facilitates functional recovery in individuals with neurological disabilities. Alongside pharmacological treatments, rehabilitation interventions, including exergames, are essential in neurological diseases to achieve functional restoration, promote independence, enhance quality of life, and prevent secondary complications. Conclusions Exergames are an emerging tool in the field of digital rehabilitation. They provide fun, engaging, and effective interventions for adaptive physical and cognitive training. The integration of exergames into a comprehensive neurorehabilitation program has stepped up considerably following the first COVID-19 pandemic wave that led to widespread disruptions in healthcare systems.
Linguistic cues for automatic assessment of Alzheimer’s disease across languages
Authors: Rentoumi Vassiliki , Vassiliou Evangelos , Pittaras Nikiforos , Demiraj Admir , Papageorgiou Manolis , Sali Dimitra , Papatriantafyllou Athina , Griziotis Panagiotis , Chardouveli Artemis , Pattakos Konstantinos , Paliouras George 
Published: February 2025

Background Most common forms of dementia, including Alzheimer's disease, are associated with alterations in spoken language. Objective This study explores the potential of a speech-based machine learning (ML) approach in estimating cognitive impairment, using inputs of speech audio recordings. Methods We develop an automatic ML pipeline that ingests multimodal inputs of audio and transcribed text, mapping speech and language to domain-specific biomarkers optimized for high explainability and predictive ability. The resulting features are fed through a multi-stage pipeline to determine efficient classification configurations. Results We evaluated the system on large real-world datasets, achieving above 90% and 70% weighted average F1 scores for two-class (AD versus normal controls) and three-class (AD versus mild cognitive impairment versus normal controls) classification tasks, respectively. Model performance remains stable across different population characteristics. Conclusions The study introduces a robust, non-invasive method for gauging the cognitive status of AD and MCI patients from speech samples, with the potential of generalizing effectively to multiple types of diseases/disorders which may burden language.