bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial predictors of health behavior adherence in heart-failure patients with comorbid depression: a secondary analysis of the Hopeful Heart trial
Authors: Carrillo Alba , Belnap Bea Herbeck , Rothenberger Scott D. , Feldman Robert , Rollman Bruce L. , Celano Christopher M. 
Published: June 2024

Abstract
Background
Depression affects 20–30% of individuals with heart failure (HF), and it is associated with worse health outcomes independent of disease severity. One potential explanation is the adverse impact of depression on HF patients’ adherence to the health behaviors needed to self-manage their condition. The aim of this study is to identify characteristics associated with lower adherence in this population, which could help to recognize individuals at higher risk and eventually tailor health behavior interventions to their needs.

Methods
Using data from a randomized, controlled, collaborative care treatment trial in 629 patients with HF and comorbid depression, we performed mixed effects logistic regression analyses to examine the cross-sectional and prospective relationships between medical and psychosocial variables and health behavior adherence, including adherence to medications, a low-sodium diet, and physician appointments.

Results
In cross-sectional analyses, married marital status and higher physical health-related quality of life (HRQoL) were associated with greater overall adherence (compared to married, single Odds Ratio [OR] = 0.46, 95% Confidence Interval [CI] = 0.26–0.80; other OR = 0.60, CI = 0.38–0.94; p = .012. Physical HRQoL OR = 1.02, CI = 1.00-1.04, p = .047). Prospectively, greater levels of social support were associated with improved overall adherence one year later (OR = 1.04, 95% CI = 1.00-1.08, p = .037). Social support, HF symptom severity, race and ethnicity, and age were predictors of specific types of adherence. Neither depression nor optimism was significantly associated with adherence outcomes.

Conclusions
These results provide important preliminary information about risk factors for poor adherence in patients with both HF and depression, which could, in turn, contribute to the development of interventions to promote adherence in this high-risk population.

Trial registration
https://clinicaltrials.gov/ct2/show/NCT02044211; registered 1/21/2014.
When income meets faith: the development and application of the Chinese generation Z unconventional religious orientation scale
Authors: Ziang Wang , Jindong Jiang , Xuan Cao , Yinglin Luo 
Published: June 2024

AbstractThis study seeks to analyze the psychological construction of Unconventional Religious Orientations and their association with individual income level satisfaction within Generation Z. Generation Z, individuals born between 1995 and 2010, grew up in a socio-cultural context marked by digitization and globalization. This study identifies three key dimensions of Unconventional Religious Orientations: religious spiritual dependence, religious instrumental tendencies, and religious uniqueness identity. By combining rootedness theory, semi-structured interviews, and literature review, we constructed and refined a set of relevant scales. Using exploratory and validation factor analyses (EFA and CFA), we verified the structural validity of the scale. The results of the analyses revealed significant negative correlations between satisfaction with income level and all dimensions of Unconventional Religious Orientation for Generation Z, suggesting that Unconventional Religious Orientation tends to diminish as income satisfaction increases. In addition, the significant positive correlations between these dimensions of religious inclination imply that they may share certain underlying factors in their psychological structure. This study not only successfully developed a set of psychometric instruments for Unconventional Religious Orientations, but also provided a new psychological perspective for understanding the dynamic interaction between economic satisfaction and religious psychological attitudes in Generation Z.
Spectroscopic and antibacterial activities of cobalt and nickel nanoparticles: a comparative analysis
Authors: Balogun Sheriff A. , Abolarinwa Tesleem O. , Adesanya Funmilola A. , Ateba Collins N. , Fayemi Omolola E. 
Published: June 2024

AbstractThis study aimed to compare the spectroscopy, morphological, electrocatalytic properties, and antibacterial activities of cobalt nanoparticles (CoNPs) with nickel nanoparticles (NiNPs). Cobalt nanoparticles and NiNPs were prepared via a chemical reduction approach and characterized utilizing transmission electron microscopy (TEM), energy-dispersive X-ray (EDX), and X-ray diffraction (XRD) techniques. The result from XRD and TEM analysis revealed that the synthesized nanoparticles exhibit face-centered cubic with smooth spherical shape, having average particles size of 12 nm (NiNPs) and 18 nm (CoNPs). The electrochemical properties of the nanoparticles were examined via cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) techniques. The CV results showed that GCE-Ni (35.6 μA) has a higher current response compared to GCE-Co (10.5 μA). The EIS analysis revealed that GCE-Ni (1.39 KΩ) has faster electron transport capability compared to GCE-Co (2.99 KΩ) as indicated in their Rct values. The power density of the synthesized nanoparticles was obtained from their "knee" frequency (f°) values, with GCE-Ni (3.16 Hz) having higher f° values compared to GCE-Co (2.00 Hz). The antibacterial activity of the nanoparticles was evaluated against multidrug-resistant Escherichia coli O157, Escherichia coli O177, Salmonella enterica, Staphylococcus aureus, and Vibrio cholerae. The result from the antibacterial study revealed that at low concentrations both CoNPs and NiNPs have significant antibacterial activities against E. coli O157, E. coli O177, S. enterica, S. aureus, and V. cholerae. NiNPs showed better antibacterial activities at low concentrations of 61.5, 61.5, 125, 61.5, and 125 µg/mL compared to CoNPs with minimum inhibitory concentrations of 125, 125, 250, 61.5, and 125 µg/mL against E. coli O157, E. coli O177, S. enterica, S. aureus, and V. cholerae, respectively. These promising antibacterial activities emphasize the potential of CoNPs and NiNPs as effective antibacterial agents, which could aid in the development of novel antibacterial medicines.
An embodied perspective on an augmented reality game in school: pupil's bodily experience toward learning
Authors: Stalheim Odd Rune , Somby Hege Merete 
Published: June 2024

AbstractThere has long been an increased focus on and investment in digital technology in schools to improve the quality of education. While digital tools have gained access to pedagogical spheres, physical activity has been overlooked, as pupils often engage in activities that require minimal bodily movement. In this article, we discuss pupils’ experiences with learning through an augmented reality (AR)-based game application and explain how the application supports embodied learning. Digital tools, including gaming, can supplement traditional activities, motivate children to become physically active and enhance their learning experiences. Integrating technology and physical activity can create a more varied, meaningful, and dynamic school day, positively supporting pupils’ learning processes. The AR game associated with this study facilitated physical activity and learning experiences through a mobile device application. The empirical material for the study includes interviews with pupils participating in an AR game in mathematics. The findings show that participating in an AR game promoted embodied learning and positively impacted pupils’ motivation, engagement and learning processes. More specifically, AR facilitated learners’ engagement in the learning process by fostering their active involvement through physical and social collaboration and by enhancing the pupils’ joy of learning. Additionally, the pupils expressed that they enjoyed the application’s variations and the experiences that followed working collaboratively with the tasks. Moreover, they commonly found the physical and collaborative components of the AR game exciting and academically motivating. Studies on AR games and technology focusing on the opportunities and pedagogical foundations for their use in education are relevant in these precarious times. Indeed, more knowledge is needed on the ways creative and flexible learning processes that transpire within a technological learning environment influence embodied learning, knowledge that is essential for designing teaching and learning in the technical future.
Does a higher hashrate strengthen Bitcoin network security?
Authors: Kim Daehan , Ryu Doojin , Webb Robert I. 
Published: June 2024

AbstractIn the blockchain world, proof-of-work is the dominant protocol mechanism that determines the consensus of the ledger. The hashrate, a measure of the computational power directed toward securing a blockchain through proof-of-work consensus, is a fundamental measure of preventing various attacks. This study tests the causal relationship between the hashrate and the security outcome of the Bitcoin blockchain. We use vector error correction modeling to analyze the endogenous relationships between the hashrate, Bitcoin price, and transaction fee, revealing the need for an additional variable to achieve our aim. Employing a measure summarizing the growth of demand factors in the Bitcoin ecosystem indicates that hashrate fluctuations significantly influence security level changes. This result underscores the importance of the hashrate in ensuring the security of the Bitcoin blockchain.
Can women empowerment boost dietary diversity among children aged 6–23 months in sub-Saharan Africa?
Authors: Aboagye Richard Gyan , Donkoh Irene Esi , Okyere Joshua , Seidu Abdul-Aziz , Ahinkorah Bright Opoku , Yaya Sanni 
Published: June 2024

Abstract
Background
The empowerment of women has implications on the health and dietary needs of children. Using the survey-based women’s empowerment index (SWPER), we examined the association between women’s empowerment and dietary diversity among children aged 6–23 months in sub-Saharan Africa.

Methods
Data from the Demographic and Health Surveys of 21 countries were utilized. Descriptive spatial map was used to present the proportions of dietary diversity among the children. Multilevel binary logistic regression was used to examine the association between SWPER and dietary diversity.

Results
Overall, 22.35% of children aged 6–23 months had adequate minimum dietary diversity (MDD) in sub-Saharan Africa. The countries with the highest proportions of adequate MDD were Angola, Benin, Madagascar, Rwanda, Sierra Leone, and South Africa. South Africa had the highest proportion of MDD (61.00%), while Liberia reported the least (9.12%). Children born to mothers who had high social independence were more likely to have adequate MDD compared to those with low social independence [aOR = 1.31, 95% CI 1.21, 1.41]. In addition, children born to women with medium [aOR = 1.12; 95% CI 1.03, 1.21] and high decision-making [aOR = 1.25, 95% CI 1.14, 1.37] were more likely to receive MDD than those with low decision-making.

Conclusions
Insufficient dietary diversity is evident among children aged 6–23 months in sub-Saharan Africa. MDD in children is influenced by women's empowerment. Policies and interventions promoting women's empowerment can enhance MDD, especially for vulnerable groups in rural and poorer households. It is crucial to leverage media and poverty reduction strategies to improve MDD among children in sub-Saharan African countries.
Genomic and tumor microenvironment dynamics of brain metastases in breast cancer.
Authors: Manogna Dharmini , Wu Sharon , Deshmukh Sachin Kumar , Xiu Joanne , Ehsani Sima , Gopalakrishnan Ragisha , Sandoval-Leon Ana Cristina , Sammons Sarah L , Sledge George W. , Graff Stephanie L. 
Published: June 2024

1018 Background: Brain metastases (BM) in breast cancer (BC) have a poor prognosis, with median survival at 7.2-13 months. Interplay between genomic evolution of cancer cells and development of BM is obscure. We sought to identify genomic aberrations associated with BM. Methods: We included 14095 BC samples: 429 BM, 7858 extra-cerebral metastases (ECM) and 5808 primary tumors (PT) were analyzed by next generation sequencing of DNA (NextSeq, 592 genes and NovaSeq, WES) and RNA (NovaSeq, WTS) (Caris Life Sciences, AZ). Tumor mutational burden-high (TMB-H) was defined as ≥10 mt/MB. Cut-off for PD-L1 immunohistochemistry positivity was ≥2 intensity and >5% staining (SP142). Global loss of heterozygosity (gLOH) used a cut-off of ≥ 16%. PAM50 was evaluable for a subset (n=9724, 69%) with WTS data. Statistical significance determined using chi-square and Mann-Whitney U test and adjusted for multiple comparisons (q<0.05). Results: Median age was lower in BM than ECM and PT (55 vs 62 vs 59 years, q<0.05). BM subtype was triple negative (TNBC, 40.1%), HR+/HER2- (30.5%), or HER2+ (29.4%) vs. ECM primarily HR+/HER2- (65.4%) and PT HER2+ (52.5%). BM were Basal-like (35.3%) or HER2-enriched (35.3%), whereas ECM were Luminal B (47.2%) and PT were Basal-like (34.4%) or Luminal B (34.6%). The Table summarizes molecular findings. In HR+/HER2- BC, BM were associated with TMB-H vs. ECM and PT (q<0.05). BM had higher GATA3-mt and ESR1-mt compared to PT (q<0.05). In HER2+ BC, BM had lower PD-L1+ (11.8% vs 39.3%) and higher ESR1-mt than PT. BM had higher ERBB2-amp (93.5% vs 75.2%) and RARA-amp (27.3% vs 6.7%) than PT (q<0.05). TNBC BM had higher proportion of TMB-H tumors but lower PD-L1+ (20.8% vs 50.7%) than PT. BM had increased gLOH than ECM (59.2% vs 36.2%). PIK3CA was lower in BM vs. ECM. In all subtypes, BM, when compared to ECM and PT respectively, were associated with decreased AR+ (HR+/HER2-: 57.7% vs 80.8% vs 85.7%; HER2+: 54.4% vs 77.1% vs 81%; TNBC: 15.1% vs 27.7% vs 23.1%), increased dendritic cell infiltration (HR+/HER2-: 3.2% vs 2.6% vs 2.5%; HER2+: 3.85% vs 2.41% vs 2.36%; TNBC: 3.96% vs 2.89% vs 3.05%) but lower IFN score (HR+/HER2-: -0.56 vs -0.41 vs-0.35; HER2+: -0.53 vs -0.39 vs -0.30; TNBC: -0.55 vs -0.30 vs -0.28). Conclusions: BM in BC are more frequently associated with TNBC and Basal-like BC phenotypes than ECM or PTs. BM have a higher proportion of ESR1-mut than PTs, highlighting a possible association between endocrine resistance and development of BM. BM had lower IFN score and PDL-1 expression highlighting an immunosuppressed tumor microenvironment. [Table: see text]
Imlunestrant, an oral selective estrogen receptor degrader (SERD), in combination with human epidermal growth factor receptor 2 (HER2) directed therapy, with or without abemaciclib, in estrogen receptor (ER) positive, HER2 positive advanced breast cancer (aBC): EMBER phase 1a/1b study.
Authors: Bhave Manali A. , Jhaveri Komal L. , Kaufman Peter A. , Aftimos Philippe Georges , Lombard Janine Margaret , Sideras Kostandinos , Im Seock-Ah , Ma Cynthia X. , Lee Kuo-Ting , Kim Sung-Bae , Li Yujia , Yuen Eunice , Estrem Shawn T. , Nguyen Bastien , Bacchion Francesca , Ismail-Khan Roohi , Beeram Muralidhar , Sohn Joohyuk 
Published: June 2024

1027 Background: Imlunestrant is a next-generation, oral SERD designed to deliver continuous ER-target inhibition. In the first-in-human Phase 1a/b EMBER study (NCT04188548), imlunestrant demonstrated favourable safety, PK, and clinical benefit when administered as monotherapy or with targeted therapy in ER+, HER2- aBC. Here we present clinical data of imlunestrant with HER2 targeted therapy, in patients (pts) with ER+, HER2+ aBC enrolled in EMBER. Methods: Pts were randomized to imlunestrant (400mg po daily) + trastuzumab (H), with or without (±) abemaciclib (Part C) or received maintenance treatment with imlunestrant + H + pertuzumab (P) (Part E), at standard doses in 21-day cycles. Key eligibility (Part C): ≥ 2 prior HER2 directed regimens, no prior CDK4/6i or fulvestrant; (Part E): received 1st line induction taxane chemotherapy (any duration) + H + P, without disease progression and ≤1 prior therapy for aBC. Key endpoints included safety, PK, ORR, CBR and PFS. Results: Overall, 45 pts with ER+/HER2+ aBC received the following combinations: imlunestrant + H (n=18), imlunestrant + H + abemaciclib (n=21; 1 pt received 800 mg imlunestrant), and imlunestrant + H + P (n=6). Baseline characteristics, safety, and preliminary efficacy are presented below (Table). Most TEAEs were grade 1-2. Common TEAEs with imlunestrant + H were fatigue (33%) and nausea (28%); with imlunestrant + H + abemaciclib were diarrhea (100%), neutropenia (57%), fatigue (52%) and nausea (48%); and with imlunestrant + H + P were diarrhea (50%) and arthralgia (50%). Imlunestrant PK was consistent with those previously reported with no drug-drug interactions observed with the combinations. From Part C, sequencing of baseline plasma ctDNA samples (n=37) identified prevalent mutations in TP53 (49%), PIK3CA (30%), ESR1 (24%), and GATA3 (14%). Clinical activity of imlunestrant in this ER+/HER2+ population, while based on small numbers, is promising. Conclusions: Imlunestrant in combination with trastuzumab ± abemaciclib or pertuzumab was well tolerated, showed no drug-drug interactions, and demonstrated preliminary antitumor activity in pts with ER+/HER2+ aBC. Clinical trial information: NCT04188548 . [Table: see text]
Immune checkpoint inhibition for the treatment of metastatic breast cancer with high tumor mutational burden: Real world clinical and genomic correlates of response.
Authors: Mai Nicholas , Safonov Anton , Marra Antonio , Chen Yuan , Chandarlapaty Sarat , Razavi Pedram , Plitas George 
Published: June 2024

1078 Background: Pembrolizumab has received tumor-agnostic approval for the treatment of unresectable/metastatic solid tumors carrying a tumor mutational burden (TMB) >10 mut/Mb. The registrational KEYNOTE-158 study, however, did not include any patients with metastatic breast cancer (MBC). Here we present a retrospective study of patients with TMB-high MBC treated with immune checkpoint inhibition (ICI) and report real-world efficacy endpoints, including progression free survival as well as clinical and genomic characteristics that may be associated with duration of response. Methods: All patients with MBC treated with an ICI at MSK and with TMB-high tumors (>10 mut/Mb) assessed by tumor-normal targeted sequencing (MSK-IMPACT) were included. Clinicopathological and demographic data were obtained via the MSK Breast Cancer Translational Program. Mutational signatures were determined using the Signature Multivariate Analysis (SigMA) algorithm. Real world progression free survival (PFS) was determined clinically and analyzed using Kaplan-Meier estimates. Univariate and multivariate analyses were performed using Cox-proportional hazards models. Results: Of 688 patients with TMB-high breast cancer at MSKCC, 87 had received ICI-based therapy for estrogen receptor positive (ER+), triple negative breast cancer (TNBC), and HER2+ MBC. Of those, 45 patients were treated with ICI monotherapy (29 ER+, 11 TNBC, 5 HER2), 31 were treated with ICI + chemotherapy (12 ER+, 19 TNBC), and 11 were treated with combinations of ICI and targeted therapy (8 ER+, 1 TNBC, 2 HER2). Median age at time of ICI treatment across all patients was 60. ICI was the median 5th line therapy for all patients (range 1-16). Median PFS of ICI for all patients was 3.17 months (95%CI 2.27-5.5). Multivariable analysis did not show statistically significant differences in PFS based upon treatment regimen (monotherapy vs. chemoIO HR 1.03, 95%CI 0.54-1.96, p= 0.92, monotherapy vs combination IO HR 1.66, 95%CI 0.69-4.02, p=0.26), ER status (ER- vs ER+, HR 1.20, 95%CI 0.63-2.28, p=0.57), or HER2 status (HER2- vs HER2+, HR 1.63, 95%CI 0.51-5.20, p=0.41. However, longer PFS was significantly associated with TMB>30 (HR 0.35, 95%CI 0.13-0.92, p=0.03) and dominant APOBEC signature score (APOBEC- vs APOBEC+, HR 0.49, 95%CI 0.25-0.98, p=0.04). Shorter PFS was significantly associated with later treatment line at the time of ICI exposure (continuous, HR 1.22, 95%CI 1.11-1.36, p=0.0001). Conclusions: In this heavily pretreated real-world cohort, ICI in TMB high MBC shows modest clinical activity. Our analysis suggests that ICI may be more effective in MBC patients that are less heavily pre-treated, have TMB>30, and have a predominantly APOBEC mutational signature. Further translational work is necessary to explore the mechanisms of these findings.
Multicenter retrospective cohort study of the sequential use of the antibody-drug conjugates (ADCs) trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG) in patients with HER2-low metastatic breast cancer (MBC): Updated data and subgroup analyses by age, sites of disease, and use of intervening therapies.
Authors: Huppert Laura Ann , Mahtani Reshma L. , Fisch Samantha Catherine , Dempsey Naomi , Premji Sarah , Taylor Angelina , Jacob Saya , Quintal Laura , Melisko Michelle E. , Chien Amy Jo , Sandoval-Leon Ana Cristina , Carcas Lauren , Ahluwalia Manmeet Singh , Harpalani Natasha , Hoppenworth Jenna , Idossa Dame , Rao Ruta D. , Giridhar Karthik , Rugo Hope S. 
Published: June 2024

1083 Background: T-DXd and SG are both FDA-approved treatments for patients (pts) with HER2-low MBC, but little data exists on the sequential use of these ADCs. Methods: In this multicenter retrospective cohort study, we identified pts with HER2-low MBC treated sequentially with both T-DXd and SG in either order, with or without intervening therapies (IntTx), at 5 academic centers between 2020-2023. We previously reported real-world progression free survival (rwPFS) and real-world overall survival (rwOS) by HR-status and ADC sequence order. Here we provide updated rwPFS and rwOS data, as well as new subgroup analyses by age, sites of disease, and use of IntTx between ADCs for HR- and HR+ disease. Results: 84 pts with HER2-low MBC treated with both T-DXd and SG were included, including 56 pts with HR+/HER2-low MBC (66.7%) and 28 pts with HR-/HER2-low MBC (33.3%). Prior to the start of ADC1, median age was 58 yrs and 22 pts were >65 yrs (26.2%), 65 pts (77.4%) had visceral disease, and 14 pts (16.7%) had central nervous system (CNS) disease. 36 pts (42.9%) had an IntTx between ADCs. Table 1 shows updated rwPFS and rwOS data by HR-status and ADC sequence order. For pts with HR+ and HR- MBC, there was no difference in ADC1 rwPFS or ADC2 rwPFS by age ≤65 vs. >65 yr or by presence vs. absence of visceral disease. For pts with HR- MBC, ADC1 rwPFS and rwOS was shorter for pts with CNS disease vs. pts without CNS disease (rwPFS 5.4 mo (n=6) vs. 8.5 mo (n=22), p=0.03; rwOS 11.6 mo vs. 21.1 mo, p<0.01 respectively). For pts with HR+ and HR- MBC, there was no difference in ADC2 rwPFS with or without receipt of IntTx. There was no difference in time to treatment failure for first IntTx vs. ADC2 if no InTx was given. Conclusions: This is one of the largest multicenter cohorts of pts treated with sequential ADCs for HER2-low MBC. Median rwPFS was longer for ADC1 than ADC2 in all subgroups, regardless of HR-status, ADC sequence order, age ≤65 or >65 yr, presence of visceral disease, or use of IntTx. Among pts with HR-/HER2-low MBC, pts with CNS disease had shorter ADC1 rwPFS and rwOS than pts without CNS disease. [Table: see text]