bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying longitudinal medication adherence patterns of antipsychotic treatments: A real‐world cohort study in Catalonia, Spain
Authors: Fuente‐Moreno Marina , Cahir Caitriona , Passos Valéria Lima , Bennett Kathleen , Walsh Caroline , Hermida‐González Patricia , Peláez de Loño Jorge , Abella Maria Eugènia Rey , Baladon Luisa , Rubio‐Valera Maria , Serrano‐Blanco Antoni , Aznar‐Lou Ignacio 
Published: February 2025

AbstractAimsSuboptimal adherence to antipsychotics leads to poorer outcomes and relapse. Several factors, including the formulation and number of antipsychotics, may influence medication adherence. This study aimed to identify longitudinal adherence patterns to oral and long‐acting injectable (LAI) antipsychotics in monotherapy/polypharmacy through group‐based trajectory modelling (GBTM).MethodsThis was a retrospective cohort study that linked prescription and dispensing data of adult patients with a new antipsychotic prescribed between 2015 and 2019 in Catalonia (Spain). GBTM was used to classify patients following a similar longitudinal pattern of adherence. The response variable was adherence, estimated through the continuous medication availability measure (CMA), in each 30‐day period during 12 months of follow‐up. Baseline and treatment characteristics were used to characterize the trajectories identified.ResultsAmong the 7730 patients included in the study, we identified seven clinically distinct trajectory groups of adherence to antipsychotics: non‐initiation (19%), low implementation (9%), immediate discontinuation (6%), mid‐discontinuation (5%), late‐discontinuation (5%), high implementation (21%), and full implementation (35%). Trajectories with better adherence were more likely to receive the prescription from a psychiatrist, receive LAIs and have previous exposure to other antipsychotics. Intermittent medication use and high levels of polypharmacy were characteristics of the “low” and “high implementation” groups.ConclusionsTargeting newly prescribed patients by improving the clinician–patient relationship could be particularly valuable, as they seem more likely to not initiate or discontinue treatment immediately compared to patients in other groups. Patients on polypharmacy should have more regular adherence monitoring and LAIs should be considered, as they appear to be associated with better adherence.
The Impact of Digital Technology Innovation on Firm Performance: Based on the Corporate Digital Responsibility Perspective
Authors: Zhu Siwei , Lv Kangjuan , Cheng Yu 
Published: February 2025

ABSTRACTIn the era of the digital economy, the important issue for enterprises is how to achieve optimal performance by balancing the development of digital technology and undertaking digital responsibility. Based on optimal distinctiveness theory, we explore how enterprises balance the tension between political strategy and competitive strategy from the perspective of corporate digital responsibility to achieve optimal firm performance. Observing data such as annual reports, patent application information, and operating conditions of Chinese A‐share listed companies from 2009 to 2021 reveals the impact of corporate digital responsibility, substantive and symbolic digital technology on firm performance. The research results show that substantive digital technology innovation is superior to symbolic digital technology innovation in promoting firm performance. Mechanism analysis shows that symbolic digital technology innovation satisfies the firm's political strategy and positively impacts firm performance through management empowerment. In contrast, substantive digital technology innovation satisfies the firm's competitive strategy and improves performance by empowering the workforce. Further analysis find that corporate digital responsibility positively moderates the impact of substantive digital technology innovation on corporate performance and negatively moderates the relationship between symbolic digital technology innovation and corporate performance. This study incorporates digital technology innovation and digital responsibility into a unified research framework, which provides a new interpretative path for improving firm performance and contributes important practical references for firms to achieve a “win‐win” situation that improves competitiveness and social value.
Is more data always better? On alternative policies to mitigate bias in Artificial Intelligence health systems
Authors: Lazcoz Guillermo , de Miguel Iñigo 
Published: February 2025

AbstractThe development and implementation of Artificial Intelligence (AI) health systems represent a great power that comes with great responsibility. Their capacity to improve and transform healthcare involves inevitable risks. A major risk in this regard is the propagation of bias throughout the life cycle of the AI system, leading to harmful or discriminatory outcomes. This paper argues that the European medical device regulations may prove inadequate to address this—not only technical but also social challenge. With the advent of new regulatory remedies, it seems that the European policymakers also want to reinforce the current medical device legal framework. In this paper, we analyse different policies to mitigate bias in AI health systems included in the Artificial Intelligence Act and in the proposed European Health Data Space. As we shall see, the different remedies based on processing sensitive data for such purpose devised by the European policymakers may have very different effects both on privacy and on protection against discrimination. We find the focus on mitigation during the pre‐commercialisation stages rather weak, and believe that bias control once the system has been implemented in the real world would have merited greater ambition.
Nucleoside reverse transcriptase inhibition enhances platelet production and megakaryocyte maturation in patients with COVID‐19
Authors: Li Yubin , Wang Juan , Huang Bingqian , Wang Ruixue , Xu Yitong , Zhang Ping , Wang Ruting , Wang Wanru , Cao Junying , Hou Ming , Hou Yu 
Published: February 2025

SummaryCoronavirus disease 2019 (COVID‐19) is a systemic infection frequently involving the haematopoietic system. Thrombocytopenia is associated with increased risks of severe disease progression and mortality. Antiviral agents have shown much promise in decreasing viral load and shortening the time to the resolution of symptoms. However, their effect on platelet counts in patients with COVID‐19 remains unexplored. Therefore, we first performed a retrospective study to evaluate the variation in platelet mass of hospitalized patients with high‐risk COVID‐19 who were given either SARS‐CoV‐2 main protease inhibitor, nucleoside reverse transcriptase inhibitor or no antiviral agents. A total of 177 patients were included, among which 64 received azvudine, 12 received nirmatrelvir–ritonavir and 101 patients received none. Compared to those without antiviral treatment, significantly higher platelet counts' increments were observed in patients receiving azvudine or nirmatrelvir–ritonavir (p = 0.001). Of note, this elevation was significantly more profound in the azvudine group than that in the control group (p < 0.001) or the nirmatrelvir–ritonavir group (p = 0.042). Subsequently, in vitro experiments were conducted to investigate the mechanism of platelet elevation underlying the activity of azvudine. Results showed that azvudine promoted the polyploidization and platelet production of the MEG‐01 cell line. Although azvudine had minimal effect on megakaryopoiesis, it could significantly trigger platelet release of megakaryocytes in the presence of SARS‐CoV‐2 spike‐membrane recombinant fusion protein or not. Finally, RNA‐sequencing demonstrated that azvudine‐treated MEG‐01 exhibited a marked increase in VWF, TUBB1 and GP1BA, and upregulated genes associated with the PI3K/AKT and JAK/STAT signalling pathways. In conclusion, our findings indicated that nucleoside reverse transcriptase inhibition potentially enhances platelet production and megakaryocyte maturation in patients with COVID‐19, suggesting a new therapeutic option for thrombocytopenia.
Urinary Estrogens in Girls Throughout Puberty as a Marker of Metabolic Risk and Their Relationship With Premature Adrenarche
Authors: Zepeda Diego , Pereira Ana , Iñiguez German , Mericq Veronica 
Published: February 2025

ABSTRACTObjectiveThe relationship between biochemical premature adrenarche (PA) in girls and metabolic alterations during puberty it is well described. A part of these circulating androgens undergoes aromatization in peripheral tissues to estrogens. This raises the question whether the metabolic effects are due to the action of androgens or estrogens. Our aim was to assess whether levels of urinary estrogens are associated with metabolic risk at late stages of puberty in girls with and without PA.MethodsThis prospective observational study included 321 girls from the Growth and Obesity Chilean Cohort Study (GOCS). Anthropometric and biochemical variables included in metabolic syndrome score (MetS) were measured along with urinary estrogens at Tanner stage B4, 1‐year (M1) and 4‐years after menarche (M4). Relationships between urinary estrogens and metabolic syndrome were analyzed during these periods. Furthermore, we analyzed whether metabolic disturbances in patients with biochemical PA (based on DHEA‐S levels at age ~7) were mediated by androgens or estrogens.ResultsIn multilevel analysis urinary estrone correlated positively with anthropometric variables (BMI, WC and fat percentage) and MetS score in adolescent girls. In contrast, urinary estradiol was not associated with metabolic risk. Interestingly, urinary estrogens were not associated with metabolic score in patients with biochemical PA.DiscussionOur investigation suggests that metabolic risk in patients without biochemical PA are mostly associated with estrone levels. In contrast, in patients with biochemical PA, androgens are associated with MetS. Therefore, metabolic disturbances throughout puberty might be generated by different pathways in girls with and without biochemical PA.
Understanding Drug Interactions in Antiplatelet Therapy for Atherosclerotic Vascular Disease: A Systematic Review
Authors: Huang Xiangqian , Song Jiahao , Zhang Xiaoming , Wang Mengqi , Ding Yuchuan , Ji Xunming , Zhou Da , Meng Ran 
Published: February 2025

ABSTRACTBackgroundAntiplatelet drugs are a cornerstone in managing atherosclerotic vascular disease (ASVD). However, their interactions with other medications present significant challenges to treatment efficacy and safety. Patients with ASVD often require multiple treatment regimens due to complex comorbidities, which increases the risk of drug–drug interactions (DDIs). These interactions can lead to drug resistance, reduced therapeutic outcomes, or adverse effects. A thorough understanding of DDIs is crucial for optimizing patient care.AimsThis review aims to explore the clinical significance. mechanisms, and implications of DDIs in antiplatelet therapy Additionally, it seeks to identify future research directions to advance personalized treatment strategies and improve therapeutic outcomes.Materials and MethodsA systematic literature review was conducted using key databases, focusing on clinical studies, mechanistic research, and guidelines related to antiplatelet therapy and DDIs. Findings were analyzed to identify common interaction patterns, associated risks, and management strategies.ResultsThe review identifies common DDIs involving antiplatelet drugs, particularly with anticoagulants, nonsteroidal anti‐inflammatory drugs, and proton pump inhibitors. These interactions primarily occur through pharmacokinetic mechanisms, such as alterations in drug metabolism via cytochrome P450 enzymes, and pharmacodynamic mechanisms, including synergistic or antagonistic effects on platelet inhibition. Clinically, DDIs can increase bleeding risk, reduce antiplatelet efficacy, and contribute to adverse cardiovascular outcomes. Strategies to mitigate these risks include individualized drug selection, dose adjustments, genetic testing, and therapeutic drug monitoring.DiscussionEffective management of DDIs in antiplatelet therapy is essential to improve clinical outcomes. A patient‐specific approach, considering comorbidities, genetic predispositions, and concurrent medications, is crucial. The review categorizes DDIs based on clinical settings and underscores the need for further research on predictive biomarkers, pharmacogenomics, and advanced monitoring techniques.ConclusionDDIs significantly impact the effectiveness and safety of antiplatelet therapy, necessitating a comprehensive understanding of their mechanisms and clinical implications. Future research should focus on developing personalized treatment approaches, integrating genetic testing, and optimizing pharmacological monitoring to minimize risks and improve therapeutic outcomes. This review provides a foundation for advancing clinical practice and enhancing the management of patients with ASVD.
Neurodevelopmental Implications Underpinning Hereditary Spastic Paraplegia
Authors: Zhi Yiqiang , Shi Yan , Lu Danping , Xu Dan 
Published: February 2025

ABSTRACTBackgroundHereditary spastic paraplegia (HSP) is a group of rare genetic neurodegenerative disorders characterized by corticospinal tract abnormalities. But frequently, abnormalities of proteins implicated in HSP have been identified in brain disorders of childhood, raising the possibility that early brain developmental mechanism underlying HSP.Results and ConclusionsHere we summarized the clinical features of 89 HSP subtypes and found most have onset of symptoms earliest reported in infancy or early childhood. Importantly, HSP patients showed early brain developmental related phenotypes such as microcephaly, ventricular enlargement, and corpus callosum dysplasia. In addition, the expression trajectories analysis showed HSP genes were diffusely expressed across all human prenatal cortical regions and most genes enriched from post‐conception weeks 8–24, periods characterized by neuro progenitor proliferation and neurogenesis. Furthermore, studies utilizing patient derived induced pluripotent stem cells (iPSCs)/organoids and mouse models have suggested that most HSP proteins play either direct or indirect roles in the development of the central nervous system. Therefore, HSP possesses a neurodevelopmental aspect and is not merely a degenerative disease, which may aid in better understanding the pathogenesis of this disease.
Integrating GPS‐Tracked Sentinel Species Into the Fight Against Wildlife Poisoning
Authors: Rodríguez‐Pérez Jorge , Bravo‐Chaparro Elena , Fernández‐García María , González José Carlos , Báguena Gerardo , González‐Quirós Pablo , López‐Bao José Vicente , Mateo‐Tomás Patricia 
Published: February 2025

ABSTRACTThe cryptic nature of wildlife crimes challenges the detection and implementation of effective prevention and prosecution measures. Allocating often limited resources will benefit from increasing detectability through evidence‐informed integration of sentinel GPS‐tracked species. We illustrate this by analyzing the spatial use of 25 GPS‐tracked griffons and 26 reintroduced bearded vultures with anti‐poison canine unit patrols and a wildlife poisoning risk map in NW Spain. Vultures’ spatial use greatly correlated with high‐risk areas, highlighting their role in detecting poisoning events and guiding preventive anti‐poison patrolling, allowing us to approach a zonation scheme to optimize efforts in this regard. We identified poisoning hotspots where sentinel and anti‐poison canine units should be reinforced and high‐risk areas with low sentinel monitoring where on‐ground efforts should be increased. While emphasizing the potential of GPS‐tracked vultures as sentinels, our results offer an example of strategic integration to prioritize interventions and enhance their effectiveness against wildlife crimes.
Reconciling Different Forms of Ecological Integrity to Aid the Kunming‐Montreal Global Biodiversity Framework
Authors: Mendez Angarita Valeria Y. , Larsen Peter Bille , Marcolin Lara , Di Marco Moreno 
Published: February 2025

ABSTRACTWith the Kunming‐Montreal Global Biodiversity Framework (GBF), the international community has committed to retaining ecosystems of high ecological integrity. Monitoring progress toward this target requires the identification of suitable indicators, but these are not universally recognized. In this study, we analyze available global maps of terrestrial ecological integrity and evaluate their representation of different dimensions of integrity (structure, composition, and function). Although 73% of terrestrial surface holds conservation value according to at least one map, less than 1% of land attains high integrity according to all of them. Solely relying on one indicator map risks overlooking the integrity value of at least 41 million km2 of land, with some key areas for biodiversity conservation inadequately represented by these indicators of integrity. However, when used in combination, complementary dimensions of integrity help identify an area covering 41.1% of the terrestrial surface, two‐thirds requiring urgent conservation action. The synergistic use of existing measures offers considerable potential to guide the implementation of Target 1 of the GBF while supporting more equitable conservation paradigms. Developing robust indicators and understanding the link among different ecological dimensions is essential to protect ecosystems of high ecological integrity in the long term.
Psychoactive substance use among Russian migrants relocated in Georgia following the 2022 invasion of Ukraine: Qualitative study
Authors: Otiashvili David , Mgebrishvili Tamar , Sherozia Mariam , Alania Marika , Kirtadze Irma 
Published: February 2025

AbstractIntroductionStudy aimed at exploring the experience of migrants from Russia who use psychoactive substances, who arrived in Georgia in the wake of the invasion of Ukraine.MethodsQualitative individual interviews and focus group discussions. The data collection took place from May to August 2023.ResultsThe final sample consisted of 23 respondents, who were mostly young and employed. Participants left Russia because of the war in Ukraine and the threat of conscription in Russia, but also due to political dissent. Participants experienced depressive symptoms and a worsening of mental health conditions. The increased consumption of sedatives and alcohol was closely associated with the efforts to manage stress and depression, acting as a means to cope with adverse effects on mental health. The absence of leisure alternatives emerged as a significant factor, with drug use becoming a feature of socialising in circumstances where such behaviour was not typical in their Russian lives. Participants exhibited low awareness of available relevant health services (including drug‐related) and typically addressed recurrent health needs by consulting Russian specialists online or Russian‐speaking professionals within Georgia's migrant community.Discussion and ConclusionsMigration was associated with a deterioration in mental health status and substance use often manifested as a maladaptive strategy to cope with mental health problems. The difficulties encountered in the process of assimilation contributed to behaviours related to drug consumption. Immigration policies need to be inclusive of the health needs of migrants and provide opportunity to integrate effectively into society.
Reproducibility of the Motor Optimality Score–Revised in infants with an increased risk of adverse neurodevelopmental outcomes
Authors: Luke Carly , Bos Arend F. , Jackman Michelle , Ware Robert S. , Gordon Anya , Finn Christine , Baptist Dyvonne H. , Benfer Katherine A. , Bosanquet Margot , Boyd Roslyn N. 
Published: February 2025

AbstractAimTo determine reproducibility of the Motor Optimality Score–Revised (MOS‐R) to assess infants at high risk of adverse neurodevelopmental outcomes, including cerebral palsy (CP), autism, and developmental delays.MethodThirty infants (18 males, 12 females, gestational age mean [range] = 32.5 [23–41] weeks) were randomly selected, according to 2‐year outcome (typically developing; CP; or adverse neurodevelopmental outcome [ad‐NDO]) from a prospective cohort. Participants had two General Movements videos between 12 weeks and 15 + 6 weeks corrected age. Six assessors, masked to history and outcomes, independently scored the MOS‐R from videos. Assessors scored either one (Group 1; n = 3) or two videos for each infant (Group 2; n = 3). Intraclass correlation coefficient (ICC), Gwet's agreement coefficient, and limits of agreement were calculated.ResultsCombined interassessor reliability (IRR) over six assessors for total MOS‐R was ‘fair’ (ICC = 0.56, 95% confidence interval [CI] 0.41–0.72), and ‘excellent’ with consensus agreement (ICC = 0.99, 95% CI 0.98–0.99). Analyses demonstrated a mean interrater difference of 0.316 (95% limits of agreement −11.51, 12.14) over 450 comparisons (15 pairs). IRR was ‘moderate’ to ‘almost perfect’ across subcategories, with the highest reliability ‘movement patterns’ (Gwet's agreement coefficient = 0.73–1.00) and the lowest ‘postural patterns’ (0.45–0.73). Assessors who scored two videos (Group 2) demonstrated higher reproducibility. IRR for total MOS‐R was ‘excellent’ when infants were typically developing (ICC = 0.90), and ‘good’ for CP (0.74) and ad‐NDO (0.68).InterpretationThe MOS‐R is a highly reproducible tool for assessing infants at high risk of ad‐NDOs and is feasible for implementation in clinical settings. Reproducibility is best when the tool is used by experienced assessors to gain consensus agreement.
Does Corruption Impede the Accumulation of Human Capital in Developing Countries?
Authors: Dianda Issa 
Published: February 2025

ABSTRACTWe investigate the heterogeneous effect of various types of corruption on human capital accumulation in a sample of 88 developing countries from 2000 to 2018. Quantiles via moments regression is used for our empirical investigation. We find that corruption exerts an adverse effect on human capital accumulation. Moreover, the harmful effect of corruption on human capital accumulation is higher in countries with low stock of human capital and lower in countries with high stock of human capital. In addition, both public sector corruption and regime corruption are detrimental to human capital accumulation, although public sector corruption is the most detrimental. Furthermore, corruption disproportionately affects female human capital compared to male human capital. These results imply that anti‐corruption strategies should be taken into account in the formulation and implementation of policies to improve human capital in developing countries.
Third Mission and Digital Transformation: An Opportunity to Take Advantage
Authors: Proietti Emanuela 
Published: February 2025

ABSTRACTDigital technologies transformed people's life, business and society. Higher education systems are particularly affected by digital transformation, which can enable new learning and teaching processes, innovative organisational dimensions and services, providing new opportunities for the development of the Third Mission. Digital technologies at the service of HEIs can permit them to reinforce their role of drivers of growth and development for their own ecosystems; represent an opportunity to foster education participation; to develop lifelong and lifewide learning initiatives; to share new cooperation paths with different stakeholders; to promote digital culture as a means for innovation and entrepreneurship; to help actors in their ecosystems adopt and use digital technologies to become more innovative. This paper introduces concepts and definitions on how the digital transformation is affecting HEIs, with reference to the Third Mission and presents the main results of a field research conducted in an international research project.