Search Results (54)

Background: Oral cavity cancer is a clinically relevant subgroup of head and neck malignancies and is associated with substantial treatment burden and healthcare utilization. Hospital length of stay (LOS) is an important indicator of inpatient resource use and complexity of care, yet large multicenter data from Germany are limited. Methods: This retrospective multicenter analysis used anonymized inpatient administrative data from 49 German hospitals; eligible oral cavity cancer hospitalizations were contributed by 34 of these hospitals. Adult inpatient hospitalizations (≥18 years) with malignant neoplasms of the oral cavity, defined using ICD-10-GM codes C00–C06, recorded between January 1 2019 and 31 December 2024 were included. The primary outcome was hospital LOS in days. Multimorbidity was quantified using the van Walraven-weighted Elixhauser Comorbidity Score. Prolonged hospitalization was defined as LOS ≥ 7 days and LOS ≥ 14 days. Associations between demographic, clinical, and treatment-related variables and LOS were examined using multivariable Poisson regression models. Because overdispersion was present, a negative binomial mixed model was additionally fitted as a sensitivity analysis. To account for inter-hospital variability, hospital was included as a random intercept in all multivariable models. Associations with prolonged LOS were analyzed using multivariable logistic regression models. All analyses were performed at the hospitalization level. Results: A total of 3957 inpatient hospitalizations for oral cavity cancer were included. Mean age was 65.6 years, and 66.2% of hospitalizations involved male patients. The median LOS was 6 days (interquartile range [IQR] 3–13; mean 10.2 days, standard deviation 11.8). Overall, 49.4% of hospitalizations had an LOS ≥ 7 days and 23.5% had an LOS ≥ 14 days. Older age, particularly >80 years, and higher comorbidity burden were associated with longer LOS (adjusted Poisson rate ratio [RR] for age > 80 years 1.17, 95% CI 1.13–1.21; high comorbidity burden RR 1.58, 95% CI 1.54–1.63). Several treatment-related variables, including surgical procedures in the oral and facial region, lymphatic system operations, blood transfusions, and complex intensive care treatment, were associated with prolonged hospitalization (e.g., blood transfusion RR 1.80, 95% CI 1.76–1.85; complex intensive care RR 1.70, 95% CI 1.65–1.75). Chemotherapy-related hospitalizations were associated with shorter LOS. Conclusions: LOS varied substantially across inpatient hospitalizations for oral cavity cancer in Germany. Older age, higher comorbidity burden, and markers of more complex inpatient treatment were associated with extended hospital stay. These findings may help identify hospitalizations at increased risk of prolonged LOS and inform inpatient planning and resource allocation. Full article

Background: The COVID-19 pandemic simultaneously affected vascular risk and healthcare utilization. We evaluated whether monthly trajectories of Brazilian Unified Health System (Sistema Único de Saúde; SUS)-financed hospitalizations for different cerebrovascular categories changed differently during the pandemic in the municipality of São Paulo. Methods: We conducted an ecological time-series study using monthly Hospital Information System of the Brazilian Unified Health System (SIH-SUS), Department of Informatics of the Unified Health System (DATASUS) data from January 2017 through December 2021. Nontraumatic intracranial hemorrhage (I60–I62), cerebral infarction (I63), unspecified stroke (I64), and other cerebrovascular diseases (I65–I69) were included. The analytical dataset comprised 240 monthly observations. Annual IBGE population estimates were used as denominators. The primary analysis used segmented negative-binomial regression with log(population) offset, temporal trend, an immediate level change from March 2020, post-intervention slope change, and annual harmonic terms for seasonality. Poisson and negative-binomial models were compared using overdispersion diagnostics and Akaike information criterion (AIC). Residual autocorrelation, category-by-intervention interactions, alternative intervention dates, and leave-one-month-out influence were assessed. Results: A total of 60,756 hospitalizations were identified. Descriptive differences in mean annual counts between the pre-pandemic and pandemic periods were +3.7% for intracranial hemorrhage, +15.2% for cerebral infarction, −16.2% for unspecified stroke, and −27.2% for other cerebrovascular diseases. All categories were overdispersed (Pearson ratios 2.16–5.05), and AIC was consistently lower for negative-binomial models. In the primary segmented model, March 2020 was associated with an immediate 39.3% decrease in other cerebrovascular diseases (incidence rate ratio [IRR] 0.607; 95% confidence interval [CI] 0.512–0.720; p < 0.001) and a 10.0% decrease in unspecified stroke (IRR 0.900; 95% CI 0.817–0.991; p = 0.032). No statistically significant immediate level change was found for intracranial hemorrhage (IRR 1.018; p = 0.760) or cerebral infarction (IRR 0.868; p = 0.086). No category showed a significant post-intervention slope change. The formal category-by-level-change interaction was significant (Wald p = 0.004), indicating heterogeneity among categories. LjungBox tests at 12 lags showed no significant residual autocorrelation. Conclusions: SUS-financed cerebrovascular hospitalizations showed heterogeneous temporal changes during the pandemic, particularly immediate decreases in I64 and I65–I69. The findings support differences in trajectories across diagnostic categories but do not demonstrate diagnostic migration, individual biological mechanisms, or causality. Changes in care-seeking, referral, coding, diagnostic availability, and healthcare organization remain plausible but untested explanations. Full article

Order-0 enumerative coding represents a fixed-length block not as a self-delimiting bitstream but as a short tuple of integer fields over known finite ranges: each value’s positions form a bitset, reduced to its colexicographic rank, leaving per-symbol counts and ranks. We study this representation, not a particular codec: one structural fact—finite-range integer fields—affords what a self-delimiting bitstream cannot. It is order-0-optimal, reaching the entropy bound up to an $O(AlogN)$ per-block overhead; at matched block sizes it is the most compact block-resetting order-0 coder (Huffman, range, asymmetric numeral systems (ANS)) on narrow alphabets, though a globally modeled coder wins at small blocks. Because every field is an integer over a known range, it also yields an exact compressed size known before encoding, independent random access, and an in-place size-preserving cipher (addition modulo each range) reducing to a standard keystream. Leaving the counts in clear exposes only a block’s count spectrum—an adjustable leakage equal to its entropy, small on the homogeneous streams it best suits. Slower than streaming coders at equal ratio—35–199 MB/s compressing; 9–38 MB/s decompressing—it is not a general-purpose compressor but a structurally transparent design point, suited to record stores and constrained-alphabet data. Full article

Professional online communities increasingly function as digital social infrastructures during societal disruption, yet less is known about how their support practices reorganize during prolonged crises. This study examined how social support, engagement patterns, and support-seeking behavior changed in a large Hebrew-language professional Facebook group for Israeli educators across routine and crisis periods. Quantitative content analysis was conducted on an analytic sample of 1008 posts published between January 2022 and July 2025, covering the pre-war period and the wartime period following October 2023. Posts were coded for informational, emotional, and instrumental support and for support-seeking, and negative binomial and logistic regression models examined engagement and predictors of support-seeking. Informational support was dominant (69.3%), followed by support-seeking (30.7%), emotional support (12.8%), and instrumental support (4.4%). During wartime, support-seeking and instrumental support were less frequent, whereas informational and emotional support were more frequent. Informational posts received approximately three times more likes, while support-seeking posts received fewer likes but sustained comment activity. Anonymous authors were more likely to seek support, but posts by anonymous authors received fewer comments. The findings suggest an aggregate pattern of support flexibility in the analytic sample, reflected in a relative shift from reactive support-seeking toward proactive informational sharing and emotional processing as part of collective resilience-building during sustained societal crisis. Full article

Geographic variation (GV) in screening patterns for breast cancer exists among Zip Code Tabulation Areas (ZCTAs) in Florida, but most spatial analyses are based on frequentist point estimates which do not formally represent uncertainty. This study used a three-stage analytical approach to the breast cancer screening data at the zip code tract (ZCTA) level in Hillsborough County, Florida (n = 55 ZCTAs): first, a frequentist Poisson regression was applied with diagnostics for multicollinearity; second, global spatial autocorrelation (GSA) analysis was conducted using Moran’s I; and third, a Bayesian Poisson and a Bayesian negative binomial regression were performed, both estimated via the No-U-Turn Sampler in the brms/Stan framework. In ArcGIS Pro 3.6, spatial analyses were carried out. The dependent variable was the number of breast cancer screening exams conducted at the ZCTA level over the study period. Across all racial/ethnic subgroups, the observed number of screenings was correlated with the number of females in the household, while no independent correlation was found for median household income, insurance status or age by stratum variables after adjustment. There was no significant and strong spatial autocorrelation across the study area (Moran’s I = 0.003, z = 0.326, p = 0.745). The Poisson model did best among the Bayesian models with a Bayesian R² of 0.91, RMSE of 5.40, and MBE of 0.02. The results show the usefulness of Bayesian uncertainty quantification in small area public health surveillance and offer a framework for quantifying geographic variation in screening activity in a probabilistic manner. The results only compare screening examination (not population-standardized screening rates) and should be considered to reflect screening volume rather than screening participation. Full article

Background: The D-Health Trial, by far the largest trial investigating the impact of vitamin D supplementation on infection-related hospitalizations, did not find any protective effects. However, this trial was conducted in a mostly vitamin D-replete population of older adults from Australia. Objectives: We aimed to derive trial results that would have been expected if the trial had been conducted in a vitamin D-insufficient or -deficient population. Methods: Our analyses are based on data from the UK Biobank cohort. Participants meeting the D-Health Trial eligibility criteria (n = 185,809) were either weighted to match the trial’s baseline 25-hydroxy-vitamin D (25(OH)D) distribution (mean 77 nmol/L [30.8 ng/mL]) or restricted to those with insufficiency or deficiency (25(OH)D < 50 nmol/L [<20 ng/mL] or <30 nmol/L [<12 ng/mL], respectively). A 38 nmol/L (15.2 ng/mL) increase in 25(OH)D was assumed, as observed in the trial. Infection-related hospitalizations were identified via International Classification of Diseases, 10th Revision (ICD-10) codes. Incidence rate ratios (IRRs), adjusted for a comprehensive list of potential confounders, were estimated using negative binomial models over a follow-up period of 5.7 years, corresponding to the median follow-up time of the D-Health Trial. Results: In analyses reflecting the vitamin D-replete trial population, no protective association was observed (IRR 1.08, 95% CI 0.99–1.17), consistent with the reported trial results. In contrast, among participants with baseline 25(OH)D < 50 nmol/L, a 38-nmol/L increase in 25(OH)D was associated with lower risks of hospitalization for any infection (IRR 0.85, 95% CI 0.80–0.90), with even stronger associations for participants with baseline 25(OH)D < 30 nmol/L (IRR 0.79, 95% CI 0.73–0.86). Findings were consistent across infection types, sex, and body mass index (BMI). Conclusions: Null findings in the vitamin D-replete D-Health trial population were to be expected. Substantial protective effects might have been expected in vitamin D-insufficient or -deficient populations. Full article

Background/Objectives: Asthma-coded hospital admissions in very young children represent a clinically relevant but diagnostically complex marker of severe wheezing/asthma-like morbidity. Methods: We conducted a nationwide ecological municipality-year study of children aged 0–3 years in Spain during 2020–2022 using hospital discharge records from the Spanish Minimum Basic Data Set (MBDS/RAE-CMBD). Exposure and outcome were analyzed at the municipality-year level: the exposure metric was the contemporaneous annual mean municipality-level concentration of PM_2.5, PM₁₀, NO₂, SO₂, O₃, and CO, and the outcome was the annual number of asthma-coded admissions, with the population aged 0–3 years as offset. Results: The regression panel comprised 20,746 municipality-year observations, 7251 municipalities, and 3231 admissions; 93.7% of municipality-years had zero admissions. In unipollutant Poisson models adjusted for calendar year, rural–urban status, temperature, and relative humidity, incidence rate ratios per interquartile-range increase were 1.54 (95% CI 1.28–1.85) for PM_2.5 and 1.89 (95% CI 1.59–2.26) for PM₁₀. Negative-binomial and province-fixed-effect sensitivity models attenuated but did not remove the particulate-matter signal. The multipollutant model was unstable because of strong collinearity between particulate fractions and was interpreted only as an exploratory sensitivity analysis. Conclusions: These findings should be interpreted as ecological, population-level associations between annual ambient particulate pollution and pediatric respiratory hospital burden, not as individual-level causal risk estimates. Full article

Background and Objectives: The SARS-CoV-2 pandemic disrupted oral and maxillofacial surgery (OMS) services worldwide because of the high aerosol-generating nature of head-and-neck procedures, restricted access to elective dental care, and systemic reallocation of hospital resources. Continuous longitudinal multi-year data covering both the pandemic and the post-pandemic phases from regional Romanian (and more broadly central and southeastern European) emergency centers remain scarce. We aimed to quantify the impact of the pandemic on OMS activity in a large Romanian regional referral center and to evaluate post-pandemic resilience. Materials and Methods: We conducted a retrospective single-center study of all inpatient admissions to the OMS Clinic of a tertiary emergency hospital in western Romania between 1 January 2018 and 31 December 2024. Three periods were pre-specified: pre-pandemic (2018–2019), pandemic (2020–2022) and post-pandemic (2023–2024). A Newey–West segmented interrupted-time-series (ITS) regression and a negative-binomial monthly count model with Fourier seasonality were fitted; length of hospital stay was further analyzed with a multivariable gamma-log generalized linear model adjusted for age, sex, county, primary ICD-10 chapter and total ICD-10 codes. Variables analyzed included case volume, demographics, primary and secondary ICD-10 diagnoses, length of hospital stay (LOS), case complexity (total ICD-10 codes per admission) and in-hospital mortality. Results: A total of 11,628 inpatient admissions corresponding to 8084 unique patients (56.5% male; mean age 52.2 ± 19.2 years) were analyzed. Compared with the pre-pandemic baseline (mean 2037 admissions/year), annual volume dropped by 45.1% in 2020, 44.0% in 2021 and 32.3% in 2022, with a nadir of −76% during the first state of emergency (April 2020; n = 34 admissions). Recovery was rapid; 2024 exceeded the pre-pandemic baseline by +10.1% on raw counts and by +16.2% on admissions per 100,000 catchment population using year-specific INS denominators. The segmented ITS regression confirmed an immediate level drop of −114.2 admissions/month in March 2020 (95% CI −133.1 to −95.3; p < 0.001) and a positive post-intervention slope of +2.06 admissions/month (95% CI 1.23–2.88; p < 0.001), with observed monthly volume returning to the counterfactual projection by October 2023. The case mix shifted significantly (χ² = 406.9, p < 0.0001); elective benign neoplasm admissions were reduced from 7.2% to 2.0%, while neoplasms of uncertain behavior nearly doubled from 15.7% to 27.5%. Case complexity increased during the pandemic (mean ICD codes 4.08 ± 2.42 vs. 3.44 ± 2.30; p < 0.001); after exclusion of administrative codes (whole Z chapter and U07.x), the difference attenuated to 3.34 vs. 3.17 codes (still p < 0.001 by Kruskal–Wallis), indicating that the largest portion of the unadjusted increase was driven by the new mandatory pre-admission SARS-CoV-2 screening code Z11.5 rather than true clinical complexity. Notably, the clinically interpretable proxy R63.3 (feeding difficulty) independently rose from 41.5% to 53.1%. The crude median LOS did not differ between the pre-pandemic and pandemic periods (3.07 vs. 3.06 d; p = 0.19) and dropped significantly post-pandemic (2.22 d; p < 0.001); however, after multivariable adjustment for case mix, age, sex, county and code count, the LOS was 15.7% shorter during the pandemic (adjusted ratio 0.84, 95% CI 0.82–0.87; p < 0.001) and 22.8% shorter post-pandemic (adjusted ratio 0.77, 95% CI 0.75–0.80; p < 0.001) relative to baseline. Conclusions: The pandemic caused a severe but transient contraction of OMS activity accompanied by increased case complexity and a marked shift away from elective surgery. Inpatient volume returned to and exceeded the pre-pandemic baseline by 2024. These results support the value of standing pandemic-preparedness protocols, sustained access to preventive dental care, and integrated tele-triage pathways for future public-health crises. Full article

Background/Objectives: Heart failure (HF) imposes a significant healthcare burden in aging populations. The COVID-19 pandemic disrupted care, raising concerns about chronic disease management. We analyzed temporal trends in HF hospitalizations in Italy (2008–2022), assessing the influence of demographics, clinical complexity, seasonality, and the pandemic. Methods: Using national discharge records, we strictly identified hospitalizations with a primary HF diagnosis via ICD-9-CM codes. Admissions were stratified by age, sex, season, and clinical severity according to the Elixhauser Comorbidity Index. Temporal trends were analyzed using a Negative Binomial Generalized Linear Mixed Model with the time component modeled through a segmented regression to account for pre-pandemic, pandemic (2020), and late-pandemic dynamics. Results: We identified 3,162,075 primary HF admissions, yielding a crude hospitalization rate of 35.11 per 10,000 person-years. Patients with an intermediate comorbidity burden (Elixhauser 13–20) accounted for 59.3% of the total volume. Multivariable analysis identified male sex (RR = 2.24, p < 0.001 ***), age ≥ 75 years (RR = 95.04 vs. 25–44, p < 0.001 ***), and winter seasonality as strong independent predictors. Trend analysis revealed a structural long-term decline across all severity tiers, driven by a sharp drop in 2020 (RR = 0.80, p < 0.001 ***) coincident with a spike in in-hospital mortality. While patients with low-to-intermediate comorbidity exhibited a partial rebound in 2021–2022 (overall RR = 1.06, p < 0.001 ***), admissions for highly complex patients (score > 20) showed an accelerated late-pandemic decline. Conclusions: HF hospitalizations in Italy remain a substantial burden driven by advanced age and clinical comorbidity. Our 15-year population-level data indicate no sustained, structural late-pandemic surge in HF admissions. The observed fluctuations were likely driven by severe healthcare disruptions and patient care avoidance rather than a true epidemiological shift, highlighting the urgent need for resilient chronic care systems during emergencies. Full article

Background: Short-form video platforms have become important channels for vaccine science communication, yet whether professionally produced vaccine content aligns with audience demand remains underexplored. Methods: We conducted a cross-sectional quantitative content analysis of 3752 publicly available vaccine-related videos retrieved from three major Chinese short-form video platforms between 21 November and 13 December 2024. A coding framework based on the Health Belief Model (HBM) and the World Health Organization (WHO) Behavioral and Social Drivers (BeSD) framework was used to identify key content themes. Multivariate Bayesian negative binomial regression and demand–avoidance analysis were used to examine engagement patterns and supply–demand alignment across account types. Results: Individual users produced the majority of videos (53.17%), whereas medical professionals received the highest level of engagement. Engagement was positively associated with themes related to disease severity (β ≈ 0.19–0.25) and side effects and management (β ≈ 0.31–0.67), but negatively associated with vaccine effectiveness (β ≈ −0.28 to −0.14) and vaccination precautions (β ≈ −0.28 to −0.27). Professional sources showed broader thematic coverage but also the greatest supply–demand mismatch, with mismatch indices of 0.377 for medical institution official media and 0.304 for medical professionals, primarily driven by overrepresentation of themes associated with audience avoidance. Conclusions: Significant structural mismatch exists between professionally produced vaccine content and audience engagement-based demand on short-form video platforms. Optimizing vaccine communication may require prioritizing audience-concerned risk-related information and dynamically adjusting content strategies based on engagement feedback to enhance the effectiveness of vaccine education. Full article

Lichen planus (LP) is a chronic immune-mediated inflammatory disease of unknown etiology affecting the skin and mucous membranes and is frequently associated with comorbid conditions, although data from Swedish populations remain limited. This retrospective population-based case–control study included all registered citizens in Region Jönköping, Sweden, between 2013 and 2022, to examine comorbidities, estimate prevalence and incidence, assess diagnostic validity of ICD-10 coding (L43), and evaluate treatment patterns. Incidence and prevalence were calculated, demographic and treatment characteristics were described, and diagnostic validity was assessed through independent medical record review of 70 randomly selected cases to determine positive predictive value (PPV). Associations between LP and predefined comorbidities were analyzed using binomial logistic regression adjusted for age and sex. Among 361,812 individuals, prevalence was 235.5 and incidence 19.6 per 100,000 inhabitants. The PPV of the LP diagnosis was 78.6%, yielding an adjusted prevalence of 184.9 per 100,000 inhabitants. Over one third of prevalent patients received topical therapy, primarily corticosteroids. LP was significantly associated with thyroid, malignant, metabolic, and autoimmune conditions. LP is relatively uncommon, ICD-10 coding shows acceptable validity, and its association with clinically relevant comorbidities highlights the need for comprehensive patient assessment. Full article

Background: Respiratory syncytial virus (RSV) is a leading cause of hospitalization in early infancy, with the greatest burden occurring in the first months of life. Following the COVID-19 pandemic, many countries experienced intensified RSV circulation. Nirsevimab, a long-acting monoclonal antibody providing season-long protection after a single dose, was introduced in Italy for the 2024–2025 RSV season and recommended for infants born during the period of RSV circulation. We evaluated the population-level impact of this seasonal nirsevimab strategy on RSV-related hospitalizations among young infants. Methods: We conducted a population-based observational study using regional hospital discharge records from Emilia-Romagna, Northern Italy, spanning January 2017 to April 2025. Analyses were restricted to RSV seasons (October–March) and infants aged ≤180 days. RSV-related hospitalizations were identified using ICD-9-CM codes. Hospitalization rates were calculated per 100,000 person-days. Incidence rate ratios (IRRs) were estimated using negative binomial regression models adjusted for season, age group, and sex, with clustering at the hospital level. The post-nirsevimab season (2024–2025) was compared with the immediate pre-nirsevimab season (2023–2024) and a pre-COVID reference season (2018–2019). Results: A total of 551 RSV hospitalizations occurred in the pre-COVID season, 753 in the pre-nirsevimab season, and 252 in the post-nirsevimab season. The post-nirsevimab season was associated with a substantial reduction in RSV-related hospitalization rates compared with both the pre-COVID season (IRR 0.52; 95% CI 0.41–0.66) and the pre-nirsevimab season (IRR 0.36; 95% CI 0.29–0.44). Reductions were observed consistently across epidemic months and were most pronounced during the first three to four months of life. Conclusions: Seasonal administration of nirsevimab to infants born during the RSV circulation period was associated with a marked and sustained reduction in RSV-related hospitalizations in early infancy. These findings support the effectiveness of targeted, seasonally timed infant immunoprophylaxis as a population-level RSV prevention strategy. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are a heterogeneous subset of orthodontic conditions with persistent diagnostic and reporting variability. This review compared transparency, reporting quality, and spin prevalence in TMD/TMJ (temporomandibular joint)-focused orthodontic randomized controlled trials (RCTs) versus general orthodontic RCTs. Methods: The review followed PRISMA 2020 and was registered in PROSPERO (4201024184). Searches were performed in PubMed/MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest available records in each database up to 15 October 2025. Eligible studies were peer-reviewed human orthodontic RCTs. Five transparency indicators (funding disclosure, bias discussion, confounder consideration, protocol registration, reporting-guideline adherence) and five spin indicators (selective focus, unsupported efficacy claims, emphasis on benefits, recommendations despite nonsignificance, “trend toward significance” language) were coded dichotomously. Beta–binomial mixed-effects models compared composite scores between groups, adjusting for publication era, impact factor, and journal clustering. Results: Among 874 included trials (840 general, 34 TMD/TMJ-focused), TMD/TMJ-focused studies showed lower adjusted transparency (odds ratio (OR) = 0.58; 95% confidence interval (CI) 0.34–0.99; p = 0.047), mainly due to limited registration and incomplete guideline adherence. Predicted transparency proportions were 0.82 for general and 0.73 for TMD/TMJ-focused studies. Composite spin did not differ (OR = 1.05; 95% CI 0.68–1.62; p = 0.821), though TMD/TMJ-focused abstracts more often emphasized benefits (OR = 4.62) and recommended interventions despite nonsignificant primary outcomes (OR = 2.83). Conclusions: TMD-focused orthodontic trials exhibited lower transparency and a distinct pattern of interpretive spin, particularly a greater tendency to emphasize benefits or recommend interventions despite non-significant results, compared with general orthodontic research. Full article

Objective: In the digital age, short-video platforms are key channels for adolescents’ sex education, yet content strategies and their effects remain unclear. This study analyzes Douyin using an integrated source–content–effect framework, identifies infotainment strategies by creator type, and examines their impact on interaction and topic engagement. Methods: Quantitative content analysis of 465 sex-education videos. Content was coded on informational and entertainment value. Four information–entertainment combinations were tested. Engagement outcomes (likes, comments, favorites, shares) were modeled with negative binomial regression; the likelihood that comments were sex-education–related was modeled with logistic regression. Creator type (medical professionals vs. individual creators) entered as a covariate. Results: A functional-infotainment pattern emerged. High information–high entertainment performed best across all interaction metrics. Low information–high entertainment (pure entertainment) performed worst, significantly suppressing deeper engagement and topical discussion. Medical professionals emphasized medicalized, low-risk knowledge; individual creators covered more diverse topics yet likewise avoided sensitive issues. Conclusions: Under algorithmic incentives and cultural norms, Douyin’s sex-education content is not entertainment-first. Dissemination is driven by information-rich content delivered through a functional-infotainment model. Findings refine infotainment theory and offer data-driven guidance: prioritize informational value while pairing it with engaging forms (creators), support high-information content and proactive governance (platforms), and inform education policy. Full article

This research analyzes the impact of crime news on users’ digital engagement on social networks. Specifically, this study reviews the influence of presentation format, crime details, and news or discursive values on people’s interaction with media content. To achieve the study’s objective, 1000 posts from the social network Instagram about crimes in the main media outlets of Colombia, Mexico, Paraguay, and Ecuador were reviewed. Content analysis was employed to code the variables, while negative binomial regression models were used to assess their impact on engagement, measured through likes and comments received on the posts. The findings show that shorter videos and image collections generate more engagement than other formats, while the type of crime did not show significant differences in interaction, suggesting a possible normalization of violence among the analyzed viewers. Among the news values, inseparability had a positive effect on engagement, while consonance and references to elite figures demonstrated negative effects. The original value of this research lies in empirically verifying how the characteristics of crime news influence engagement, providing relevant information for understanding the interaction between electronic media and the perception of criminality among Latin American viewers. Full article