Search Results (1,190)

Digital transformation (DT) reshapes supply chain ecosystems and promotes inter-firm synergistic development. Using a sample of 2417 focal firm–partner dyads of Chinese A-share listed firms from 2013 to 2023, we employ regressions with industry and year fixed effects and mediation analysis to examine how focal firms’ DT affects partners’ internal control (IC) quality. We find that focal firms’ DT enhances partners’ IC quality, robust to various tests (e.g., IV, PSM). Mechanism analysis reveals two distinct pathways: transformation contagion (focal firms’ DT drives partners’ synchronized DT) and management spillover (focal firms’ DT-driven control activities exported to partners). Heterogeneity analysis shows that the positive transmission effect is stronger in geographically distant or low-concentration supply chain relationships, as well as for focal firms with greater market power. This study extends research on IC determinants beyond firm boundaries and shifts DT externality research from operational to governance outcomes, providing a governance-level synergistic pathway to supply chain sustainability. Full article

Background: Preterm infants remain vulnerable after discharge from the neonatal intensive care unit (NICU), yet the key components of effective hospital-to-home transitional care remain unclear. Objectives: This systematic review synthesized evidence on hospital-to-home transitional care models for preterm infants and identified intervention characteristics associated with post-discharge infant and parental outcomes. Methods: This PRISMA 2020-guided systematic review was registered in PROSPERO (CRD420251011887). The protocol was amended to remove the planned meta-analysis because of substantial heterogeneity. Searches were conducted in EBSCO-MEDLINE, Scopus, PubMed, and the Cochrane Library in March 2025 and updated in March 2026. Quantitative and mixed-method studies evaluating hospital-to-home transitional care for preterm infants were included. Findings were synthesized narratively using a SWiM-based approach. Results: Twenty-one studies were included, comprising 4142 study units across infants, parents/caregivers, or infant–parent dyads. Interventions were initiated during NICU admission, at discharge, or after discharge and commonly included discharge preparation, parental education, telehealth support, and care coordination. Several studies reported favorable outcomes related to infant growth, feeding, length of stay, readmission, healthcare utilization, and parental readiness or caregiving competence, although findings varied across intervention types, study designs, and outcome measures. Three non-comparative studies provided additional evidence on feasibility and acceptability. Conclusions: Hospital-to-home transitional care may benefit preterm infants and their families when delivered as a multicomponent, family-centered pathway extending beyond discharge. However, the evidence remains heterogeneous, and practice implications should be interpreted cautiously. Larger comparative studies using standardized infant-centered outcomes are needed, particularly in low- and middle-income settings. Full article

Objective: To review the literature on palliative care protocols and models of care for pregnant women and their fetuses with life-limiting conditions. Methods: A narrative literature review was conducted in the PubMed/MEDLINE and Virtual Health Library (VHL)—BIREME/SciELO/LILACS, using the descriptors “palliative care” and “prenatal care”. Studies of all designs published between February 2015 and May 2025 were considered for inclusion. Articles in languages other than Portuguese, English, and Spanish, duplicates, and those that did not discuss care protocols or experiences in perinatal palliative care for life-limiting fetal conditions starting from prenatal care were excluded. Articles were selected through title, abstract, and full-text screening. Results: Twenty-one studies focused on prenatal care were selected, presenting protocols and experiences of care in palliative fetal medicine. Most addressed the diagnosis of life-limiting fetal malformations, prenatal care, birth and delivery plan, perinatal grief and the puerperium. Across the included studies, a recurring emphasis on individualized, patient and family-centered approaches was identified, reflecting core principles of personalized medicine. Tailoring communication, care planning, and bereavement support to the specific clinical, genetic, cultural, and psychosocial profile of each dyad emerged as a structural characteristic of effective perinatal palliative care models. Conclusions: There is a scarcity of specific palliative care protocols for pregnancy, indicating a need to expand studies. The reviewed literature can contribute to the creation and adaptation of palliative care protocols and models for pregnant women and their fetuses with life-limiting conditions, may support more consistent care planning, improved communication, and better alignment with parental values. Full article

Biomimetics often treats convergent evolution as the strongest sign that a biological solution is general. That inference is safest when the constraint does not counter-adapt. Hosts do. In coevolved host-interface systems, recurrence alone cannot tell us whether a solution is translatable. Biomimetic transferability depends first on two axes: conservation of the host target and versatility of the attacking lineage. A conserved target behaves, for translational purposes, like a biochemical constraint, a broad-host parasite has already tested its mechanism across biological variation. The window narrows when the target is taxonomically local, or when the mechanism has become a private molecular conversation inside a narrow dyad. Haematophagous feeders, intracellular protozoans, specialist helminths, and polydnavirus-bearing parasitoid wasps therefore do not offer the same kind of biomimetic object. Some yield molecules, some vulnerability maps, some contextual principles, and some only architecture or analogy. The point is not to mine coevolved systems less, but to stop mistaking coevolutionary success for biomimetic portability. Full article

Background: Physical exercise is known to promote positive psychological functioning among college students; however, its relationship with meaning in life within naturally occurring friendship dyads remains underexplored. This study examined both actor and partner associations between physical exercise, social support, and meaning in life. Methods: A cross-sectional dyadic survey was conducted among 415 friendship dyads (830 Chinese college students, aged 17–23 years). Participants completed validated measures of physical exercise, perceived social support, and meaning in life. Intraclass correlations, Pearson correlations, actor–partner interdependence models (APIMs), and an indistinguishable APIM mediation model were applied to assess within-dyad nonindependence, actor and partner effects, and indirect pathways through social support. Results: Intraclass correlations revealed within-dyad similarities in physical exercise, social support, and meaning in life, with ICCs of 0.101, 0.188, and 0.253, respectively. The constrained indistinguishable mediation model demonstrated acceptable fit: χ²(6) = 12.81, p = 0.046; CFI = 0.973; TLI = 0.933; RMSEA = 0.052; SRMR = 0.028. Physical exercise was positively associated with social support at both the actor level (B = 0.150, p < 0.001) and partner level (B = 0.095, p < 0.001). Social support, in turn, was positively linked to meaning in life at both actor (B = 0.174, p < 0.001) and partner levels (B = 0.206, p < 0.001). Direct effects of physical exercise on meaning in life remained significant for both actor (B = 0.055, p = 0.001) and partner pathways (B = 0.067, p < 0.001). Bootstrap analyses confirmed significant total indirect effects for actors (B = 0.046, 95% CI [0.030, 0.063]) and partners (B = 0.047, 95% CI [0.032, 0.065]). Conclusions: Physical exercise is associated with meaning in life not only via intrapersonal pathways but also through interpersonal pathways within friendship dyads. Social support serves as a key mediating factor in this relationship. Full article

Background: Antiretroviral resistance-associated mutations, within the broader context of HIV-1 genetic variability, represent a growing challenge for HIV-1 control, highlighting the need for continuous molecular surveillance and mechanistic understanding of drug resistance. This study aimed to characterize mutations in the pol gene associated with resistance to protease inhibitors and to explore their structural implications. Methods: Viral RNA was extracted from plasma samples of HIV-positive patients, and a 266 bp fragment of the HIV-1 pol gene was amplified by RT-PCR and sequenced using the Sanger method. Sequences showing ≥98% homology were aligned and analyzed using MEGA v11 and the Stanford HIV Drug Resistance Database to identify resistance-associated mutations, while viral subtypes were determined using COMET, jpHMM-HIV, and STAR tools. Amino acid sequences were used for structural modeling with AlphaFold, followed by molecular docking with Nelfinavir using the CB-Dock2 server. Results: Four samples exhibited resistance-associated profiles, including high-level, intermediate, and low-level resistance, with one isolate showing high-level resistance to multiple protease inhibitors. Structural analyses revealed that Nelfinavir preferentially binds to alternative hydrophobic cavities rather than the canonical catalytic site, lacking direct interactions with the Asp25/Asp25′ dyad. Conclusions: These findings suggest a structural mechanism of resistance based on non-canonical ligand binding that may impair effective protease inhibition. Full article

Background/objectives: To describe and compare Korean AYAs’ and parental perspectives on the family environment in terms of agreement and significant differences and examine which variables were associated with AYAs’ symptom distress. Sample and setting: Self-report data were collected from a total sample of 113 AYAs, recruited from a pediatric-oncology outpatient clinic at a university-affiliated hospital and community group in South Korea. Because each study aim required different data sources, different analytic samples were used. Specifically, 54 AYA–parent dyads were included for Aim 1, whereas self-report data from 111 AYAs with complete data were used for Aim 2. Methods and variables: This subgroup analysis used a quantitative–descriptive, cross-sectional design. AYAs’ and parent perceptions of the family environment (family cohesion and adaptability, family strength, and social support from family) and AYAs’ symptom distress were collected using reliable and validated self-report questionnaires and analyzed using descriptive and inferential statistics. Results: AYAs and their parents showed low (family support) to moderate agreement (family strength, family cohesion, and adaptability) on perceptions of family environment (ICC = 0.374–0.612). AYAs reported significantly lower perceptions of family support than their parents, with a small to moderate effect (p < 0.001, d = 0.48). All family environment variables were correlated with AYAs’ symptom distress (p < 0.05). Among these variables, AYAs’ perceived family strength emerged as the only family environment variable significantly associated with their symptom distress (F = 14.309, p < 0.001, R² = 0.359, R²adj = 0.334), which was stronger during treatment. Conclusions: AYAs’ perceived family strength should be routinely assessed, especially during cancer treatment. Additional nursing interventions focusing on enhancing AYAs’ families as a support group are needed. Full article

Background/Objectives: Persons living with dementia (PLwD) receive informal care services from loved ones, commonly referred to as care partners (CPs). While the symptoms (e.g., depressive affect, cognitive impairment) experienced by PLwD are recognized to influence CP wellbeing, longitudinal investigations into the association of CP QoL and PLwD symptoms have yet to be fully explored. The present study sought to address this gap and highlight how CP QoL and PLwD symptoms systematically covary over time. Methods: Participants were composed of 33 dyads (PLwD and their CP) who partook in the Voices in Motion project, a social-cognitive intervention for dementia. CP QoL (WHOQOL-BREF), PLwD depressive symptomology (Patient Health Questionnaire-9) and PLwD global cognitive functioning (Mini-Mental State Examination) were assessed every three to four weeks in an intensive repeated-measures design. Time-varying covariation models using multilevel modeling examined systematic covariation between CP QoL and PLwD symptoms between and within dyads. Results: Increased CP psychological and social QoL were both associated with increased PLwD global cognitive functioning between dyads and vice versa (p < 0.05). Within dyads, increased CP social QoL was associated with improved PLwD depressive symptoms (p < 0.05), while increased CP environmental QoL was associated with increased depressive symptoms (p < 0.05). Conclusions: Significant coupling associations were observed both between and within dyads. Such results highlight the association between CP QoL and the symptoms experienced by their care recipient and provide important, novel longitudinal contributions to the literature. Full article

Ventricular remodeling occurring in heart failure (HF) involves structural disarray of the sarcolemma T-tubule (TT)–sarcoplasmic reticulum (SR) dyad junctions, thereby disrupting the close apposition of L-type Ca²⁺ channels (Ca_V1.2) with ryanodine receptors (RyR2) that trigger SR Ca²⁺ release and myofilament contraction. In a rat ischemic heart failure model expressing low thyroid hormone (TH) function, we used 3D stochastic optical reconstruction microscopy (STORM) to image RyR2 clusters with Ca_V1.2 channels, and the associated protein junctophilin-2 (Jph2). We tested whether treatment with T3, the biologically active form of TH, throughout progression of the disease would preserve T-tubule structure and dyadic ion channel organization. Confocal microscopy of isolated cardiomyocytes (CMs) stained with ANEPPS membrane dye showed significantly decreased TT density in diseased CMs while T3 treatment attenuated TT disorganization. 3D STORM images of dyadic ion channels labeled with fluorescent-tagged antibodies to RyR-Dylight550, Jph-CF647 and Ca_V1.2/IgG-Dylight488 were captured. A density-based algorithm defined RyR2 clusters, and a 400 nm spherical 3D volume of interest around each RyR2 cluster’s centroid determined the number of Ca_V1.2 and Jph2 localizations associated with each RyR2 cluster. Analysis revealed significant reduction in RyR2 cluster size and number with reduced co-localized Jph2 in failing CMs. T3 treatment increased RyR2 cluster numbers and cluster volumes albeit non-significantly, with increased co-clustering of Jph2. The number of Ca_V1.2 co-localized with RyR2 clusters trended lower in the failing CMs. These results support maintaining TH homeostasis in optimizing the nanoscale organization of Ca²⁺ ion channels in triggering Ca²⁺ release and myofibrillar contraction in patients with heart disease. Full article

Fungal iterative non-reducing polyketide synthases (NR-PKS) contain a unique product template (PT) domain for aromatic cyclization. Among them, some NR-PKSs, such as the sorbicillin NR-PKS (SorB), have an apparently inactive PT. It is unknown what role such PT plays in NR-PKS programming. In this study, the PT domain of SorB was first dissected and engineered. Removal of the PT domain from SorB did not change the product profile, but the yield decreased. Meanwhile, a significantly lower transcriptional level of the ketoacyl synthase (KS) domain was observed in the knockout mutant (UvSorB∆PT). Phylogenetic tree analysis and multiple sequence alignments revealed this PT belongs to group I (C2–C7, monocyclic ring), and mutations were found at catalytic dyad sites when compared with functional fungal PTs. However, mutating these residues back to the conserved ones did not give rise to products corresponding to a functional PT, but rendered the NR-PKS unproductive. Likewise, removal of the C-methyltransferase (CMT) domain from SorB destroyed the polyketide production. Furthermore, in an attempt to alter the methylation pattern, mutations of the key substrate-binding sites of the CMT domain were made. Site-directed mutations of the C-MT led to cessation of the polyketide production. This reveals CMT is vulnerable to engineering in a collaborating NR-PKS (SorB). These results provide additional insights for catalytic reprogramming in fungal NR-PKS. Full article

Background/Objectives: Early postpartum milk expression is common, but its relationship with later breastfeeding outcomes depends on the clinical context in which expression is used. This systematic review examined distinct exposure domains, including expression method, timing and intensity of expression, expressed-milk feeding modality, composite in-hospital feeding patterns, and clinically indicated expression in pump-dependent populations. Methods: Following PRISMA 2020 guidance, primary studies of postpartum milk expression, breast pump use, or expressed breast-milk feeding were identified and synthesized using a PECO framework. Because included studies differed substantially in population, exposure definition, comparator structure, and outcome measurement, meta-analysis was not undertaken. Instead, studies were grouped a priori into exposure families, and conclusions were derived within each domain while explicitly considering risk of bias was assessed using RoB 2, version of 22 August 2019, for randomized trials and the original 2016 version of ROBINS-I for non-randomized studies. Results: Seventeen studies met the eligibility criteria. In healthy term dyads, routine early pumping or exclusive/predominant expressed-milk feeding was generally associated with less favorable breastfeeding continuation than direct feeding at the breast, although these associations were mainly derived from observational studies at serious risk of confounding by indication. In preterm, separated, or otherwise pump-dependent dyads, earlier and more frequent milk expression was associated with improved early lactation outcomes, including lactogenesis, milk yield, or achievement of full lactation; evidence for longer-term breastfeeding continuation was more limited. Broad population-level definitions of any pump use produced less consistent findings and were not directly comparable with studies of exclusive expressed-milk feeding. Conclusions: Early postpartum milk expression should be interpreted as a context-dependent practice rather than as a uniform exposure. The strongest clinical inference is that direct breastfeeding should be supported when feasible in healthy term dyads, whereas early and frequent expression remains necessary and potentially beneficial when direct breastfeeding is not immediately possible. Full article

Adolescent depression and anxiety are prevalent, yet brief and scalable parent–child digital interventions remain understudied. This study evaluated the effects of a digital parent–child single-session growth mindset intervention targeting beliefs about intelligence, failure, and emotion on adolescent internalizing of symptoms. In a three-arm waitlist cluster randomized controlled trial, 390 parent–child dyads from seven secondary schools in Hong Kong were assigned to a parent–child intervention group, a child-only intervention group, or a waitlist control group. Students were assessed at baseline, 2 weeks, and 3 months, and parents at baseline and 3 months. Cluster-adjusted generalized estimating equations were used for intention-to-treat analyses. A significant time-by-group interaction was observed for child-reported depression, whereas the interaction effects for other outcomes were non-significant. However, cluster-adjusted baseline differences across groups limited attribution of changes in depression to intervention effects. Relative to controls, the parent–child intervention descriptively showed short-term improvement in hopelessness and sustained gains in child-reported parent–child relationships over 3 months. Moderation analyses suggested clearer short-term benefits among adolescents with higher baseline symptoms and among girls. Overall, the PC-SMILE intervention in this study did not show statistically significant effect on reducing internalizing symptoms. Improvement on intervention design and implementation would benefit further refinement of brief, scalable parent–child digital interventions. Trial registration: ClinicalTrials.gov NCT05493865. Full article

Play is a universal activity. Yet there are cultural and linguistic differences in how families engage in adult–child play. In the present study, Thai–English bilingual mother–child dyads completed a toy play task in both languages. The results revealed cross-linguistic differences in bilingual mothers’ and children’s conversation styles. When speaking Thai, the nature of bilinguals’ dyadic play was more adult-centered, characterized by the use of directives by the mothers and use of repetitions by the children, which was congruent with parent–child interpersonal dynamics in high-power-distance Asian cultures. When speaking English, the play session was more child-centered, evidenced by children’s use of directives and encouragements, which was congruent with behavioral norms in low-power-distance Western cultures. Bilingual mothers and children exhibited positive associations in their narrative styles during both the Thai and English sessions. Additionally, the preliminary results provided evidence that cross-linguistic differences in mother–child speech patterns may be moderated by child gender. These findings suggest that the communicative and interactional patterns that bilingual caregivers modeled for bilingual children varied across languages and that preschoolers aligned their behaviors with those exemplified by their mothers. We conclude that bilingualism influences early social communication, with theoretical and applied implications for researchers, educators, and clinicians. Full article

Background: In increasingly dynamic and uncertain organizational environments, employees’ proactive behavior—characterized by self-initiation, future orientation, and change orientation—is critical for organizational adaptability and long-term competitiveness. Prior research has primarily examined how externally provided job resources stimulate proactive behavior. More recent work has begun to consider employees’ personal resources, but it largely adopts a capability level-based view, conceptualizing them as self-evaluations of individuals’ ability to control and influence their environment. This focus overlooks capability malleability-based personal resources that shape more fundamental beliefs about the malleability of human capability. Objective: Drawing on the job demands–resources (JD–R) model, this study investigates how employees’ growth mindset—reflecting beliefs that human capability can be developed—promotes proactive behavior by alleviating workplace anxiety, an anticipatory emotional state rooted in concerns about future work-related threats. We further examine time pressure as a key boundary condition. Method: A three-wave, multisource survey design was employed, collecting data from 326 employee–supervisor dyads. Results: The results show that employees’ growth mindset is negatively associated with workplace anxiety, which in turn positively predicts proactive behavior. Moreover, time pressure strengthens both the anxiety-buffering effect of growth mindset and the indirect effect of growth mindset on proactive behavior via workplace anxiety. Conclusions: By incorporating capability malleability-based personal resources into the JD–R model, this study advances understanding of the antecedents of proactive behavior beyond capability level-based self-evaluations toward deeper beliefs about the malleability of human capability. Applications: This study offers practical implications for managers seeking to cultivate employee proactivity. Full article

This study develops a game-theoretic framework to analyze collaborative advertising decisions between manufacturers and retailers in seasonal product supply chains characterized by competitive–cooperative channel relationships. We formulate a mathematical programming model to jointly optimize advertising efforts, the manufacturer’s advertising cost-sharing rate, order quantities, and inventory decisions across distinct channel configurations—including a single manufacturer–retailer dyad and a competitive multi-channel market. Numerical experiments and sensitivity analyses are conducted to investigate how key structural parameters—particularly demand elasticity and channel power asymmetry—influence overall system performance and equilibrium decision outcomes. Results indicate that well-designed collaborative advertising mechanisms enhance total channel profitability and, under specific conditions, yield Pareto-improving outcomes for both parties. This study makes three primary contributions: (i) it integrates inter-firm competition with intra-channel cooperation within a unified strategic framework; (ii) it jointly coordinates advertising and inventory decisions—two critical operational levers—rather than treating them in isolation; and (iii) it embeds financial arrangements (e.g., cost sharing) endogenously into the analytical model, thereby offering a novel, theoretically grounded, and practically implementable decision-support framework for distribution systems operating in complex, dynamic market environments. Full article