bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study
Authors: Liu Huiying , Zhang Mi , Zhang Xinyan , Zhao Xinyi 
Published: March 2024

ObjectivesThis study aimed to identify long-term distinct trajectories of multimorbidity with ageing from 50 to 85 years among Chinese older adults and examine the relationship between exposure to early-life adversity (ELA; including specific types of adversity and accumulation of different adversities) and these long-term multimorbidity trajectories.DesignThe group-based trajectory models identified long-term multimorbidity trajectories. Multinomial logistic regression models were used to examine the relationship between ELA and the identified multimorbidity trajectories.SettingThis study used data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018) and the 2014 Life History Survey.ParticipantsWe used data from 9112 respondents (aged 60 and above) of the 2018 wave of CHARLS.Outcome measuresEach respondent’s history of chronic conditions and experiences of ELA were collected from the 2011–2018 waves of CHARLS and the 2014 Life History Survey.ResultsFour heterogeneous long-term trajectories of multimorbidity development were identified: ‘maintaining-low’ (19.1%), ‘low onset-rapidly increasing’ (23.3%), ‘middle onset-moderately increasing’ (41.5%) and ‘chronically-high’ (16.2%). Our findings indicated that the heterogeneity can be explained by ELA experiences. Across various types of different ELA experiences, exposure to food insufficiency (relative risk ratios from 1.372 (95% CI 1.190 to 1.582) to 1.780 (95% CI 1.472 to 2.152)) and parental quarrel/divorce (relative risk ratios from 1.181 (95% CI 1.000 to 1.394) to 1.262 (95% CI 1.038 to 1.536)) had the most prominent associations with health deterioration. The accumulation of more different ELA experiences was associated with a higher relative risk of developing more severe multimorbidity trajectories (relative risk ratio for five to seven ELAs and chronically high trajectory: 7.555, 95% CI 4.993 to 11.431).ConclusionsThere are heterogeneous long-term trajectories of multimorbidity in Chinese older adults, and the risk of multimorbidity associated with ELA accumulates over the lifespan. Our findings highlight the role of a supportive early-life family environment in promoting health development across the lifespan, advocating for the integration of life-course approaches to implementing health disparity interventions.
Patient characteristics, surgery outcomes, presumed aetiology and other characteristics of fistula surgeries and related procedures supported by Fistula Foundation from 2019 to 2021: a multicentre, retrospective observational study
Authors: Pollaczek Lindsey , Rajagopal Keerthana , Chu Jesse 
Published: March 2024

ObjectivesObstetric fistula is a devastating childbirth injury primarily caused by prolonged, obstructed labour. It leaves women incontinent, severely stigmatised and isolated. Fistula repair surgery can restore a woman’s health and well-being. Fistula Foundation, a non-profit organisation, works in partnership with local hospitals and community organisations in Africa and Asia to address key barriers to treatment and to increase the number of women receiving surgical care. This paper presents data on fistula and fistula repair surgery across a large global network of hospitals supported by Fistula Foundation. The data were collected between 2019 and 2021.DesignMulticentre, retrospective, observational, descriptive study.Setting and participantsThe study analysed deidentified data from 24 568 surgical repairs supported by Fistula Foundation to treat women with obstetric fistula at 110 hospitals in 27 countries.ResultsThe data highlight patient characteristics and key trends and outcomes from obstetric fistula repair surgeries and related procedures. Of those surgeries, 87% resulted in a successful outcome (fistula dry and closed) at the time of discharge, highlighting the effectiveness of fistula repair in restoring continence and improving quality of life. Over the period studied, the number of supported surgeries increased by 14%, but there remains an urgent need to strengthen local surgical capacity and improve access to treatment. Women suffered an average of 5.7 years before they received surgery and only 4% of women sought care independently. This underscores the importance of enhancing community awareness and strengthening referral networks.ConclusionsThis research provides essential insight from a vast, global network of hospitals providing highly effective fistula repair surgery. Further investment is needed to strengthen surgical capacity, increase awareness of fistula and remove financial barriers to treatment if stakeholders are to make significant progress towards the United Nations’ ambitious vision of ending fistula by 2030.
Cross-sectional study to assess the impact of the COVID-19 pandemic on healthcare services and clinical admissions using statistical analysis and discovering hotspots in three regions of the Greater Toronto Area
Authors: Movahedi Nia Zahra , Prescod Cheryl , Westin Michelle , Perkins Patricia , Goitom Mary , Fevrier Kesha , Bawa Sylvia , Kong Jude 
Published: March 2024

ObjectivesThe COVID-19 pandemic disrupted healthcare services, leading to the cancellation of non-urgent tests, screenings and procedures, a shift towards remote consultations, stalled childhood immunisations and clinic closures which had detrimental effects across the healthcare system. This study investigates the impact of the COVID-19 pandemic on clinical admissions and healthcare quality in the Peel, York and Toronto regions within the Greater Toronto Area (GTA).DesignIn a cross-sectional study, the negative impact of the pandemic on various healthcare sectors, including preventive and primary care (PPC), the emergency department (ED), alternative level of care (ALC) and imaging, procedures and surgeries is investigated. Study questions include assessing impairments caused by the COVID-19 pandemic and discovering hotspots and critical subregions that require special attention to recover. The measuring technique involves comparing the number of cases during the COVID-19 pandemic with before that, and determining the difference in percentage. Statistical analyses (Mann-Whitney U test, analysis of variance, Dunn’s test) is used to evaluate sector-specific changes and inter-relationships.SettingThis work uses primary data which were collected by the Black Creek Community Health Centre. The study population was from three regions of GTA, namely, the city of Toronto, York and Peel. For all health sectors, the sample size was large enough to have a statistical power of 0.95 to capture 1% variation in the number of cases during the COVID-19 pandemic compared with before that.ResultsAll sectors experienced a significant decline in patient volume during the pandemic. ALC admissions surged in some areas, while IPS patients faced delays. Surgery waitlists increased by an average of 9.75%, and completed IPS procedures decreased in several subregions.ConclusionsThe COVID-19 pandemic had a universally negative impact on healthcare sectors across various subregions. Identification of the hardest-hit subregions in each sector can assist health officials in crafting recovery policies.
Improving availability and accuracy of the junior doctors’ on-call handover through digitalisation
Authors: Haysom Alexia , Loveday William Harry , Ratneswaran Kajanesh , Nerantzis Georgios , Hakim Nahid , Dineva Darena , Richards Adam 
Published: March 2024

Clinical handovers from out-of-hours activity are essential for relaying information about events such as new admissions, outstanding or complete investigations, physical health reviews, ward jobs and risk. This information enables the day team to effectively prioritise and follow-up any necessary tasks.Junior doctors at a hospital site in the London Borough of Newham were aware that the existing handover system, constituted of a word document circulated via email, was lacking robustness and that the handover was not sent out reliably on a daily basis.Quality improvement (QI) methods including process mapping, PDSA ('Plan, Do, Study, Act') cycles, driver diagrams and run charts were used to understand the issue, create a more robust process and measure the improvements made, all supported by regular QI project meetings. The change ideas included moving from an informal Microsoft (MS) Word document, which was emailed out, to an Excel spreadsheet stored centrally on MS Teams. Column headers were added for admissions, ward jobs, seclusion reviews, matters relating to mental health law and Accident and Emergency (A&E) assessments, as well as defined columns for outstanding jobs and standard tasks that need to be completed for all admissions. Responsibility for circulating the handover list was given to the incoming day duty doctor if the night doctor was too busy, with admin support to chase the circulation of the handover. Results were studied for the following 18 months.The percentage of handovers being appropriately sent out increased from a median of 80% to 100% during the project period, and the availability of handover data where the data were visible to doctors on MS Teams but had not been sent out also increased from a median of 80% to 100%. The system was deemed safe, effective and easy to use, and has already been replicated at neighbouring hospitals.
Socioeconomic disparity in stage at cancer diagnosis among patients with type 2 diabetes in Dutch primary care: a cross-sectional study
Authors: de Haan-Du Jing , Groenier Klaas H , Kleefstra Nanne , van der Vegt Bert , Siesling Sabine , Landman Gijs W D , de Bock Geertruida H 
Published: March 2024

IntroductionDisparities in cancer stage appear to exist by socioeconomic status (SES) in the Netherlands. We evaluated the association of SES and cancer stage among patients with type 2 diabetes (T2DM) treated in primary care.Research design and methodsThis cross-sectional study linked data from the primary care Zwolle Outpatient Diabetes Project Integrating Available Care database for T2DM (n=71 648, 1998–2019) to a cancer registry and personal records database in the Netherlands. Only cancers (excluding all skin cancers) diagnosed after the onset of diabetes were included and grouped by stages (III–IV or 0–II). SES was estimated as low, intermediate or high based on postal codes and Dutch social research status scores. Logistic regression was performed, with stratification by sex and correction for age, body mass index, smoking, diabetes duration, glycaemic control and metformin use. ORs and 95% CI are reported.ResultsOf the 5087 males and 4021 females with any cancer, 50.1% and 53.7% had low SES, respectively. Compared with patients with high SES, the ORs for diagnosing cancer at stages III–IV in patients with low SES were 1.00 (95% CI 0.84 to 1.19) for males and 1.32 (95% CI 1.06 to 1.67) for females. However, the ORs varied by cancer type: breast, 1.46 (95% CI 0.90 to 2.39); male colorectal, 1.00 (95% CI 0.70 to 1.43); female colorectal, 1.72 (95% CI 1.06 to 2.77); prostate, 0.81 (95% CI 0.57 to 1.15); male lung, 1.06 (95% CI 0.62 to 1.80) and female lung, 2.56 (95% CI 1.32 to 4.95).ConclusionsAmong patients treated for T2DM in Dutch primary care, our data suggest the need to target females with low SES to decrease inequalities in the early detection of colorectal and lung cancer.
Oral nicotine product marketing expenditures in the USA from 2016 to 2023: trends over time by brand and targeted media outlets
Authors: Ozga Jenny E , Cornacchione Ross Jennifer , Hrywna Mary , Sharma Akshika , Ling Pamela M , Stanton Cassandra A 
Published: March 2024

BackgroundOral nicotine products (ONPs) are increasing in sales, availability and flavours. In April 2022, the US Food and Drug Administration (FDA) obtained regulatory authority over non-tobacco nicotine products, which include many ONPs. Advertising practices for ONPs need monitoring to understand marketing strategies and inform FDA marketing authorisation decisions.MethodsONP advertisement (ad) expenditure data (January 2016–June 2023) were purchased (print, TV, radio, online video, online display and mobile; N=125 236) and adjusted to 2023 dollars. Descriptive statistics examined expenditures by ONP brand and media outlet over time.ResultsVelo spent the most on ONP advertising (89.8%), followed by Zyn (5.7%) and Black Buffalo (1.2%). Velo encompassed the majority of TV (98.1%), radio (99.9%) and mobile ad spend (87.3%); Zyn was the leader for online display (46.2%) and online video (71.1%); and Black Buffalo accounted for 100% of print ads. In 2023, (January–June), Zyn accounted for 88.0% of ad expenditures and Velo spent $0, though the total amount spent by Zyn was far less than Velo in prior years. TV ads (98.1% Velo) aired primarily on prime time/late night or 09:00–17:00 on weekends. Radio ads (99.9% Velo) aired primarily from 06:00 to 10:00, 12:00 to 14:00 and 15:00 to 19:00 on weekdays. Overall, expenditures focused on reaching a national audience, though print ads indicated potential male-targeted marketing.ConclusionsFollowing FDA’s regulatory authority over non-tobacco nicotine products, ad expenditures for Velo dropped to $0. Ongoing surveillance of ONP ad trends can inform FDA marketing authorisation decisions by revealing brand-specific marketing strategies that may be targeted toward populations at increased risk of tobacco use.
Trajectories of photons around a rotating black hole with unusual asymptotics
Authors: Li Yong-Zhuang , Kuang Xiao-Mei 
Published: March 2024

AbstractMost black hole solutions are characterized with asymptotically flat, or asymptotically (anti) de-Sitter behaviors, but some black holes with unusual asymptotics have also been constructed, which is believed to provide remarkable insights into our understanding of the nature of gravity. In this paper, focusing on a rotating black hole with unusual asymptotics in Einstein–Maxwell-dilaton (EMD) theory, we innovatively analyze the photons’ trajectories around this black hole background, showing that the unusual asymptotics has significant influences on the photons’ trajectories. We expect that our analysis could give more insights in the scenario of black holes’ shadow and image.
Repolarization of Immunosuppressive Macrophages by Targeting SLAMF7-Regulated CCL2 Signaling Sensitizes Hepatocellular Carcinoma to Immunotherapy
Authors: Weng Jialei , Wang Zheng , Hu Zhiqiu , Xu Wenxin , Sun Jia-Lei , Wang Fu , Zhou Qiang , Liu Shaoqing , Xu Min , Xu Minghao , Gao Dongmei , Shen Ying-Hao , Yi Yong , Shi Yi , Dong Qiongzhu , Zhou Chenhao , Ren Ning 
Published: March 2024

Abstract

Immune checkpoint inhibitors have limited efficacy in hepatocellular carcinoma (HCC). Macrophages are the most abundant immune cells in HCC, suggesting that a better understanding of the intrinsic processes by which tumor cells regulate macrophages could help identify strategies to improve response to immunotherapy. As signaling lymphocytic activation molecule (SLAM) family members regulate various immune functions, we investigated the role of specific SLAM receptors in the immunobiology of HCC. Comparison of the transcriptomic landscapes of immunotherapy-responsive and nonresponsive patients with advanced HCC identified SLAMF7 upregulation in immunotherapy-responsive HCC, and patients with HCC who responded to immunotherapy also displayed higher serum levels of SLAMF7. Loss of Slamf7 in liver-specific knockout mice led to increased hepatocarcinogenesis and metastasis, elevated immunosuppressive macrophage infiltration, and upregulated PD-1 expression in CD8+ T cells. HCC cell-intrinsic SLAMF7 suppressed MAPK/ATF2-mediated CCL2 expression to regulate macrophage migration and polarization in vitro. Mechanistically, SLAMF7 associated with SH2 domain-containing adaptor protein B (SHB) through its cytoplasmic 304 tyrosine site to facilitate the recruitment of SHIP1 to SLAMF7 and inhibit the ubiquitination of TRAF6, thereby attenuating MAPK pathway activation and CCL2 transcription. Pharmacological antagonism of the CCL2/CCR2 axis potentiated the therapeutic effect of anti–PD-1 antibody in orthotopic HCC mouse models with low SLAMF7 expression. In conclusion, this study highlights SLAMF7 as a regulator of macrophage function and a potential predictive biomarker of immunotherapy response in HCC. Strategies targeting CCL2 signaling to induce macrophage repolarization in HCC with low SLAMF7 might enhance the efficacy of immunotherapy.

Significance:
CCL2 upregulation caused by SLAMF7 deficiency in hepatocellular carcinoma cells induces immunosuppressive macrophage polarization and confers resistance to immune checkpoint blockade, providing potential biomarkers and targets to improve immunotherapy response in patients.
Social Memory Theory and the Enigmatic Mediated Past in Historical Jesus Research
Authors: Hatina Thomas R. 
Published: March 2024

Abstract
The recent appropriation of social memory theory in Jesus studies has brought us to a fork in the road in relation to what is meant by a continuity of remembrances about Jesus. Currently, the common claim among many Jesus scholars is that the past of Jesus is knowable through or is contained within the memory process, not behind it or apart from it. Mnemonic processes and their text-products are regarded as a means to an historical end as opposed to being an end in and of themselves. The main problem presented in this article is that the pervading references to, and assumptions about, the mediated past as a potential link between the evangelists’ present and the actual past of Jesus lack the clarification and critical support that is needed for advancing historical Jesus research.
Making a Home, Keeping God Close
Authors: Groskamp Nienke , Ivanescu Carolina 
Published: March 2024

Abstract
In Evangelical Christian communities, the responsibility for maintaining the home is taken up primarily by women (Bartkowski, 1999; Gallagher & Smith, 1999). The discursive construction of the home as a sacred space free from toxic influences emerged during the Cold War, when the global turmoil seemed to demand the delineation of a matriarchal safe space (Shively, 2017; Neumann, 2019; Anagnost 2013). More recently, restrictions concerning covid-19 have initiated a further shift from the public to the private sphere. Women who were accustomed to conducting housework while their husbands were at work have abruptly come to the foreground as life primarily took place at home. This article explores the intersection of daily activities with religious beliefs as reflected in the practice of blogging. Central to this study is the assumption that ordinary, daily activities provide a unique lens into the way people ‘in the pews’ live their lives.
Shiʿa Smartphone Communities: Trends of Continuity and Change
Authors: Mirshahvalad Minoo 
Published: March 2024

Abstract
This article investigates trends of continuity and differentiability between primarily Italian Shiʿa communities online and offline. Here, “online community” is adopted for groups formed on WhatsApp, Telegram, and Zoom, both before and after the outbreak of covid-19. The similarity and differences between Shiʿa activities in the online and offline spheres are investigated in three main areas: interreligious relations, gender roles, and relations with religious authorities. These fields have been selected because they are where Shiʿas face significant life challenges in a non-Islamic context. Online ethnography and interviews with members of Shiʿa communities were employed to gather data. The results confirm that women’s issues remain resistant to change, even in the online sphere, whereas relations with out-groups, as well as relations with Shiʿa religious authorities, reveal elements of novelty.
Quality Management and Animal Welfare as Culture of Care for Animal Experiments under Biosafety Level-3, taking COVID-19 as a Practical Example
Authors: Richter Armina , Wirz Katrin , Pilchová Veronika , Schulz Claudia , Volz Asisa , von Köckritz-Blickwede Maren 
Published: March 2024

Abstract
Since the start of the COVID‐19 pandemic, a tremendous amount of work has been done by scientists to understand the pathogenesis of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Several animal models have been reported to be useful for the development and testing of vaccines, antivirals, or therapeutics. These in vivo experiments have to be performed at high containment biosafety level (BSL)-3. Thus, an appropriate biosafety, facility and data management as well as high standard of animal welfare, thorough study design, and staff training combined with an overall research transparency and open communication need to be implemented to achieve high quality reproducible research. Such an approach combined with the well-known 3R principle (Replacement, Reduction, and Refinement) and the 3S principle (Good Science, Good Sense, and Good Sensibilities) can contribute to culture of care in scientific research. The perspective reviews the key points of optimized biosafety, data, quality and animal welfare management in high risk biosafety-settings to conduct animal experiments with infectious pathogens in the context of a culture of care.
A Data-Driven Probabilistic Network Approach to Assess Model Similarity in CMIP Ensembles
Authors: Graafland Catharina Elisabeth , Brands Swen , Gutiérrez José Manuel 
Published: March 2024

Abstract
The different phases of the Coupled Model Intercomparison Project (CMIP) provide ensembles of past, present, and future climate simulations crucial for climate change impact and adaptation activities. These ensembles are produced using multiple global climate models (GCMs) from different modeling centers with some shared building blocks and interdependencies. Applications typically follow the “model democracy” approach which might have significant implications in the resulting products (e.g., large bias and low spread). Thus, quantifying model similarity within ensembles is crucial for interpreting model agreement and multimodel uncertainty in climate change studies. The classical methods used for assessing GCM similarity can be classified into two groups. The a priori approach relies on expert knowledge about the components of these models, while the a posteriori approach seeks similarity in the GCMs’ output variables and is thus data-driven. In this study, we apply probabilistic network models (PNMs), a well-established machine learning technique, as a new a posteriori method to measure intermodel similarities. The proposed methodology is applied to surface temperature fields of the historical experiments from the CMIP5 multimodel ensemble and different reanalysis gridded datasets. PNMs are able to learn the complex spatial dependency structures present in climate data, including teleconnections operating on multiple spatial scales, characteristic of the underlying GCM. A distance metric building on the resulting PNMs is applied to characterize GCM model dependencies. The results of this approach are in line with those obtained with more traditional methods but have further explanatory potential building on probabilistic model querying.

Significance Statement
The present study proposes the use of probabilistic network models (PNMs) to quantify model similarity within ensembles of global climate models (GCMs). This is crucial for interpreting model agreement and multimodel uncertainty in climate change studies. When applied to climate data (gridded global surface temperature in this study), PNMs encode the relevant spatial dependencies (local and remote connections). Similarities among the PNMs resulting from different GCMs can be quantified and are shown to capture similar GCM formulations reported in previous studies. Differently to other machine learning methods previously applied to this problem, PNMs are fully explainable (allowing probabilistic querying) and are applicable to high-dimensional gridded raw data.