Response Efficacy Research Articles

Prostate-specific membrane antigen (PSMA)-targeted radiopharmaceutical therapy (RPT) is a safe and well-tolerated treatment option for metastatic, castration-resistant prostate cancer (mCRPC). A new radioligand, comprising ibuprofen as an albumin-binding entity, [177Lu]Lu-SibuDAB, demonstrated an increased tumour-absorbed dose and efficacy in preclinical studies while tumour-to-organ absorbed dose coefficient ratios were similar to conventional PSMA radiopharmaceuticals. We conducted a translational study to evaluate response rate, safety and efficacy, and quality of life of [177Lu]Lu-Sibu-DAB in progressive mCRPC patients. From July 2021 to January 2023 a total of seventeen eligible patients, sixteen (median age 71 years, range 63-83) were selected to receive up to four cycles of [177Lu]Lu-SibuDAB at an activity of 4.3 to 5.9 GBq (median 5.3 GBq). The response rate was assessed by serum prostate specific antigen (PSA) and by PET/CT using [18F]PSMA-1007, at baseline and post-therapeutic up to eight weeks, using RECIP 1.0 criteria. Safety and adverse events were investigated clinically by analyzing serial blood biomarkers and the recording of adverse events according to CTCAE v5.0. Quality of life was assessed by the European Organization for Research and Treatment of Cancer Core Quality of Life (EORTC) questionnaires QLQ-C30 and QLQ-PR25. Seven participants received 4 cycles of [177Lu]Lu-SibuDAB, 3 participants received 3 cycles and 6 participants received ≤ 2 cycles because of disease progression or advanced stage of the disease. A maximum PSA decline (median baseline PSA value: 49.1 ng/ml (min 0,84 ng/ml max 145,1 ng/ml) by at least ≥ 50%, was observed in four participants, while stable serum PSA was observed in five further participants. Longitudinal PET/CT was performed with 10 participants, showing partial remission in five, stable disease in two and progressive disease in three patients. We observed an association between the changes in PSA levels and PET/CT-image-based assessment of the response. Two participants experienced grade three anaemia, one of them also a grade four thrombocytopenia. Two patients, heavily pre-treated with chemotherapy, experienced grade 3 thrombocytopenia. Impairment of renal or liver function was not observed. Importantly, no xerostomia was recorded for any of the participants. No significant changes in the quality of life were reported. Median overall survival was 13.9 months in this cohort. Overall survival and response rates of patients are consistent with previous reports on PSMA-targeted RPT while the absence of xerostomia can be considered an improvement. Up to four cycles of [177Lu]Lu-SibuDAB were well tolerated and [177Lu]Lu-SibuDAB appears to be a valid option for effective treatment of patients with progressive mCRPC. Randomized clinical trials to assess efficacy compared to established RPT are warranted.

Purpose The purpose of this study is to evaluate the effectiveness of government-mandated anti-smoking cinema advertisements in shaping smoking cessation intentions among Indian youth. Grounded in protection motivation theory (PMT), it examines the cognitive mechanisms underlying quit intention, captures the temporal decay of motivation over four weeks and assesses gender-based differences in threat and coping appraisals. Design/methodology/approach A quasi-experimental, two-wave longitudinal survey design was used. A sample of 1,600 smokers aged 18–24 was surveyed immediately after exposure to an anti-smoking cinema public service advertisement (Time 1) and a subsample of 600 participants was followed up four weeks later (Time 2). Structural equation modeling (SEM) and Wilcoxon signed-rank tests were used to assess predictive pathways and motivational decay. Gender-based moderation was tested using multi-group SEM. Findings Self-efficacy and response efficacy were the strongest predictors of quit intention, while threat appraisals (perceived severity and vulnerability) also contributed significantly. A counterintuitive positive relationship was found between perceived rewards and quit intention, possibly reflecting cognitive dissonance. At Time 2, all PMT constructs and quit intention declined significantly, while perceived rewards and response costs increased. Gender moderated several pathways, with males responding more to efficacy and vulnerability and females to severity and rewards. Research limitations/implications The study focuses on intention rather than actual cessation behavior. All data were self-reported and follow-up SEM was limited due to sample constraints. Future studies should incorporate behavioral outcome measures and explore participatory approaches in campaign design. Practical implications The findings underscore the short-lived nature of fear-based appeals and the need for reinforcement strategies such as Short Message Service (SMS) boosters or peer-based engagement. Tailored messaging based on gender-specific cognitive pathways and inclusion of target audience voices through co-design can enhance campaign impact. The study also supports Sustainable Development Goal 3.5, aimed at reducing tobacco use among youth. Social implications This research offers actionable insights for public health practitioners and policymakers by evaluating a widely implemented but under-researched tobacco control intervention in a real-world setting. It contributes to evidence-based social marketing practice in low- and middle-income countries, especially India, where youth smoking remains a persistent concern. Originality/value To the best of the authors’ knowledge, this study is one of the first to evaluate the cognitive and temporal effects of real-world anti-smoking cinema public service advertisements using PMT in an Indian context. It advances theory by integrating a systems-thinking lens and identifying demographic variation in protective motivation processes.

BackgroundWild mushroom poisoning represents a significant public health challenge in China, with the highest mortality rate globally. Despite extensive prevention campaigns, consumption behaviors persist, particularly among university students who may be influenced by social media and peer pressure.ObjectiveThis study applied Protection Motivation Theory (PMT) to investigate psychological factors influencing wild mushroom consumption intentions among Chinese university students and identify key predictors for targeted intervention development.MethodsA cross-sectional survey was conducted among 216 Chinese university students. The PMT model included threat appraisal (perceived severity, susceptibility, benefits, costs) and coping appraisal (response efficacy, self-efficacy, response costs). Behavioral intention was assessed through scenario-based consumption likelihood measures. Structural equation modeling was used to test the theoretical model.ResultsThe PMT model demonstrated good fit (χ²/df = 2.14, CFI = 0.94, TLI = 0.92, RMSEA = 0.073, SRMR = 0.065) and explained 42.3% of the variance in wild mushroom consumption intentions (R² = 0.423, 95% CI [0.35, 0.49]). Perceived benefits emerged as the strongest positive predictor (β = 0.385, 95% CI [0.27, 0.50], p < 0.001), while self-efficacy was the strongest negative predictor (β = −0.298, 95% CI [−0.42, −0.18], p < 0.001). Traditional threat appraisal components (severity and susceptibility) showed minimal predictive effects. Response costs also significantly predicted consumption intentions (β = 0.156, 95% CI [0.04, 0.27], p < 0.01).ConclusionsPMT provides a valuable framework for understanding wild mushroom consumption behavior among Chinese university students. The dominance of perceived benefits and self-efficacy as predictors suggests that effective interventions should address positive outcome expectations while building confidence in avoidance behaviors. These findings indicate that effective interventions must move beyond traditional risk communication to address the complex interplay of perceived benefits, self-efficacy, and social factors driving consumption decisions, with implications for developing culturally-tailored, multi-component prevention strategies.

Microplastics pose serious threats to both the environment and human health. Although governments have introduced various policies and promoted international cooperation to address this issue, the effectiveness of these efforts is closely linked to the importance of individuals&amp;rsquo; engagement, which is shaped by their perceptions. However, limited research has examined how such perceptions interact with perceived policy effectiveness in shaping pro-environmental behavioral intentions. To address this gap, this study aims to examine how risk perceptions (perceived severity and perceived vulnerability) and efficacy beliefs (self-efficacy and response efficacy) influence behavioral intentions to reduce microplastic emissions within the framework of protection motivation theory, and whether perceived policy effectiveness moderates these relationships. We conducted a nationwide survey of South Korean adults and analyzed the data using hierarchical regression to test the proposed hypotheses. The results revealed that both risk perception and efficacy had significant positive effects on behavioral intentions, with response efficacy emerging as the strongest predictor, followed by perceived severity, self-efficacy, and perceived vulnerability. Perceived policy effectiveness did not directly affect behavioral intentions but moderated the relationship between self-efficacy and behavioral intentions. The moderation effect indicated that higher perceived policy effectiveness attenuated the positive relationship between self-efficacy and pro-environmental behavioral intentions, suggesting a potential motivation crowding-out effect. These findings highlight the importance of integrating psychological factors and perceptions of policy effectiveness into policy design. They offer valuable insights for environmental campaigns, communication strategies, and governance efforts aimed at promoting sustainable behaviors to mitigate microplastic emissions.

Abstract Methane is the third most significant anthropogenic driver of climate change after carbon dioxide and aerosols, contributing about one-fourth of carbon dioxide’s effective radiative forcing in the industrial era. Given the role of methane in observed and future climate changes, this study compares the slow climate responses to carbon dioxide (CO2) and methane (CH4) radiative forcings by estimating individual climate feedbacks using radiative kernels. We use the National Center for Atmospheric Research (NCAR) Community Atmosphere Model, version 5 (CAM5), in two configurations (prescribed sea surface temperature and slab ocean) to estimate radiative forcing and climate response, respectively. These experiments show that for comparable radiative forcing, methane forcing’s efficacy in the 10xCH4 experiment (0.90) is smaller than the efficacy of 1.35xCO2 (unity), consistent with previous studies. This lower efficacy of the slow response for CH4 owing to its more negative feedback (−1.08 W m−2 K−1) compared to CO2 (−0.97 W m−2 K−1) is attributed to differences in lapse rate, water vapor, shortwave cloud, and albedo feedbacks. Despite the broadly similar meridional distributions of radiative forcing, methane’s larger longwave and shortwave forcing in tropical latitudes gives rise to significant differences in lapse rate and cloud feedbacks, resulting in smaller climate sensitivity than CO2 forcing. CH4 also has a smaller albedo feedback, owing to its atmospheric absorption of shortwave radiation. Significance Statement In this study, we compare the climate responses to increases in two different greenhouse gases, carbon dioxide (CO2) and methane (CH4), and show how differences in their meridional patterns of radiative forcing affect the magnitude of global-mean surface warming. Using a climate model and the forcing-feedback framework, we show that CH4 produces smaller global-mean surface warming than CO2 for similar magnitudes of global-mean radiative forcing, mainly due to larger warming caused by the net effect of temperature, water vapor, cloud, and surface albedo feedbacks in the case of CO2 forcing compared to the CH4 case. Consequently, although the climate response from the same magnitude of radiative forcing is similar to within 10%, there are systematic differences in climate feedbacks and warming patterns between forcing due to CH4 and CO2.

Dynamic response and protective efficacy evaluation of Multi-airbag/PU composite structures under external explosion

How self-efficacy and response efficacy change with risk and adaptation behaviors during tropical cyclones

The digital wave has reshaped the construction industry’s organizational ecosystem, driving the continuous evolution of project organizational capabilities. As environmental turbulence increases, these capabilities exhibit new evolutionary traits.The study combined the forward-looking logic of how organizational capabilities affect project performance with the retrospective evolutionary logic based on performance analysis, and proposed a comprehensive framework for the evolution of organizational capabilities. A hybrid method combining structural equation model and system dynamics is employed to explore the mechanism of organizational capabilities evolution. The findings show that, all five dimensions of project organizational capabilities show significant fluctuating growth, with information technology capability and innovation capability as primary drivers in adapting to environmental change; A 25% increase in environmental turbulence can effectively facilitate the evolution of organizational capabilities. However, if environmental turbulence surpasses the threshold prematurely, it may impair the organization’s response efficacy and interfere with the progression of organizational capabilities evolution. The study reveals the evolution mechanism of project organizational capabilities under the digital construction mode, providing theoretical support and practical references for construction project organizations to effectively respond to increasingly turbulent environment. Simultaneously, it provides reference and reflection for the research on organizational change.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-21981-9.

Purpose Online-to-offline (O2O) delivery represents an innovative e-commerce paradigm that bridges the Internet with physical commercial activities, including, but not limited to, food delivery. Although frequent engagement with the O2O delivery application (O2ODA) has been linked to physical health problems (e.g. unhealthy lifestyle and dietary habits), its relationship with mental health aspects (e.g. social phobia) remains underexplored. Therefore, this study aims to explore how social phobia relates to consumers’ engagement with O2ODA. Design/methodology/approach This study adopted a survey design. Framed by the protection motivation theory (PMT), a two-stage online survey was conducted in China, and the collected data (N = 451) were analyzed using partial least squares structural equation modeling. Findings Social phobia, together with coping appraisal components (i.e. response efficacy, self-efficacy, and response costs), predicted consumers’ behavioral intention to use O2ODA. Furthermore, social phobia exerted a direct positive influence on use behavior and weakened the effect of intention on behavior. Originality/value The study extends the PMT into a novel consumer-technology context, broadens the scope of problematic technology use from a hedonic domain into a utilitarian one, and demonstrates the link between O2ODA engagement and mental health (i.e. social phobia).

Introduction With the advent of the information economy era, incidents of personal data breaches have occurred frequently, and the issue of personal information protection has become increasingly prominent. As primary users of Internet services, college students have seen their information security behavior emerge as a focal point of both academic inquiry and public concern. Investigating the factors influencing these behaviors holds substantial significance for enhancing the quality of university-based information security education and advancing the development of safe campus ecosystems. Methods Based on the Protection Motivation Theory (PMT), this study constructed hypotheses about influencing factors of information security behavior among college students. Drawing on urban distribution across China, 23 cities were selected for data collection, with college students as the target population. A total of 3,030 valid questionnaires were ultimately retained. Data analysis was conducted by SPSS 20.0, including reliability tests, validity tests and regression analysis, to systematically explore the relationship between information security behavior and threat appraisal (perceived threat) as well as coping appraisal (self-efficacy, response efficacy and response cost). Results Empirical analysis indicates that perceived threat, self-efficacy, and response efficacy exert a significant positive effect on college students’ information security behavior, among which response efficacy demonstrates the strongest positive impact. Conversely, response cost shows a significant negative impact on college students’ information security behavior. Discussion These findings not only help enrich the knowledge system in the field of information security, but also provides practical insights for strengthening the campus information security environments. Furthermore, they provide actionable insights for policymakers tasked with addressing issues in information security behavior.

Background/Objectives: Maternally derived antibody (MDA) levels of porcine circovirus 2 (PCV2) may eventually interfere with humoral response and vaccination efficacy. This study aimed to evaluate the efficacy of a ready-to-use PCV2d and Mycoplasma hyopneumoniae combined vaccine in piglets with different PCV2 MDA levels at vaccination in an experimental inoculation with a heterologous viral genotype. Methods: Forty-eight piglets were allocated into vaccinated (V) and non-vaccinated (NV) groups with high (H) and low (L) PCV2 MDA subgroups (H-V, H-NV, L-V, L-NV). At 3 weeks of age, the piglets received either one dose of vaccine or placebo. Five weeks later, all animals were intranasally challenged with a PCV2b inoculum. Body weight was registered at different time points. Blood samples, peripheral blood mononuclear cells and tracheobronchial lymph nodes (TBLN) were collected and used to assess viraemia, viral load, humoral and cellular responses and histological lesions. Results: The V group showed higher PCV2 antibody levels from challenge onwards, along with a lower percentage of viraemic pigs and reduced viral load in serum at 2 and 3 weeks post-challenge (wpc) and in TBLN tissues compared to the NV group. The H-V group had the highest antibody levels post-challenge, showed no detectable viraemia and had a lower overall amount of virus in tissues. The NV group (especially H-NV) exhibited increased levels of IFN-γ, IFN-α and TNF-α post-challenge. Conclusions: The tested vaccine elicited humoral and cellular immune responses and reduced viral presence in serum and tissues, demonstrating efficacy in a PCV2 subclinical infection model despite high MDA levels at the time of vaccination. Understanding both humoral and cellular immune responses according to different MDA levels can help design more effective vaccination strategies against PCV2.

Cervical cancer is a major global health issue, particularly in developing countries. Pap smear-based cervical cancer screening (CCS) is crucial for prevention. The Protection Motivation Theory (PMT) aids in understanding psychological factors influencing CCS behaviors. This study investigated CCS determinants among Iranian women using Rogers’ PMT. This cross-sectional study involved 254 women visiting health centers in Kermanshah and Tehran in 2024. A modified PMT was used with a validated questionnaire measuring fear, perceived vulnerability, perceived intensity, response efficacy, self-efficacy, response cost, demographics, and CCS-related knowledge, attitudes, and practices. Path analysis was conducted using AMOS. Participants exhibited a mean CCS behavior score of 3.62 (SD = 2.07). Path analysis revealed significant negative total effects on CCS behavior for fear (Standardized Estimate = −0.238, p = 0.009), response cost (Standardized Estimate = −0.111, p = 0.006), and perceived vulnerability (Standardized Estimate = −0.064, p = 0.021). Conversely, positive total effects on CCS behavior were observed for response efficacy (Standardized Estimate = 0.049, p = 0.003), protection motivation (Standardized Estimate = 0.155, p = 0.01), self-efficacy (Standardized Estimate = 0.106, p = 0.007), knowledge (Standardized Estimate = 0.011, p = 0.002), and attitude (Standardized Estimate = 0.052, p = 0.007). Fear, response costs and perceived vulnerability negatively impact CCS behavior among Iranian women, while perceived intensity, response efficacy, protection motivation, knowledge, attitude, and self-efficacy are positive factors. The PMT-based model can guide educational programs to promote CCS behavior, informing targeted counseling and program development to enhance CCS uptake.

Long-term efficacy and safety of vagus nerve stimulation in treatment-resistant depression: A systematic review.

BackgroundAndrogenetic alopecia (AGA) is a common dermatologic condition with significant psychological and social impact. Treatment remains challenging due to heterogeneity in patient response and limited long-term efficacy data.ObjectiveTo develop expert consensus guidelines for the diagnosis and management of AGA tailored to the Egyptian population, considering region-specific clinical and systemic factors.MethodsA modified Delphi process was conducted in two rounds. Initially, a structured, evidence-informed questionnaire was distributed to 1,000 practicing dermatologists across Egypt; 723 completed the survey. Responses were analyzed and refined into consensus statements, which were subsequently evaluated by a panel of 20 senior dermatology professors. Statements achieving ≥75% agreement were considered consensus.ResultsTwenty-seven consensus statements were established and categorized into seven key areas: diagnosis, minoxidil, antiandrogens, low-level laser therapy, adjuvant treatments, hair transplantation, and counseling/hair aids. These recommendations reflect a synthesis of current evidence and national clinical experience.ConclusionThis consensus provides a regionally relevant, evidence-based framework for AGA management in Egypt. It emphasizes individualized care, multidisciplinary strategies, and the integration of emerging therapies, and may serve as a model for practice in similar healthcare settings.

Cross-linked selenolipoic acid nanoplatform modulates intracellular and extracellular reactive oxygen species for cancer immunotherapy.

Understanding how individuals translate disaster information into protective actions is central to enhancing disaster preparedness. This study applies Protection Motivation Theory (PMT) in conjunction with Mastery of Life (MOL) to examine the cognitive mechanisms underpinning cyclone preparedness in the Indian Sundarbans, a region characterized by high vulnerability and recurrent cyclonic events. Using survey data from 1352 respondents and Structural Equation Modelling, the study investigates how disaster-related information affects key PMT constructs i.e., threat appraisal and coping appraisal, and how these appraisals interact with MOL typologies to shape preparedness intentions and behaviours. Results indicate that timely, credible information significantly improves perceived threat severity, susceptibility, self-efficacy, and response efficacy, while reducing the influence of maladaptive responses. MOL dimensions, particularly optimistic-cognitive and defensive-affective orientations, enhance problem-solving capacity and positively mediate the relationship between cognitive appraisal and action. In contrast, pessimistic orientations diminish preparedness intent. The findings highlight the importance of integrating information delivery systems with local experiential knowledge and psychosocial factors to strengthen risk communication and community resilience. This research contributes to the evidence base for interdisciplinary disaster preparedness strategies, advocating for theory-informed, context-specific interventions to reduce cyclone risk in vulnerable settings.

Obesity is a growing global health concern with profound effects on immune function and vaccine efficacy. This study investigated the impact of obesity on immune responses to tick-borne encephalitis virus (TBEV) vaccination and infection using a mouse model. Mice on a high-fat diet (HFD) exhibited increased body weight, fat mass and a pre-diabetic state compared to standard chow diet (SCD) controls. After vaccination with the TBEV vaccine (Encepur), HFD mice showed significantly lower TBEV-specific IgG litres and neutralizing antibody levels compared to SCD mice. Splenocyte counts per organ mass were significantly higher in vaccinated SCD mice compared to their HFD counterparts, correlating with the elevated IgG litres observed in the SCD group. These results underscore the critical role of diet in shaping the immune response and vaccine efficacy. Following TBEV infection, HFD mice did not display increased disease severity or elevated viral litres in the serum, spleen or brain relative to SCD controls, indicating that obesity did not exacerbate viral replication or dissemination. However, a sex-dependent effect of obesity on the humoral immune response was observed. Male HFD mice produced antibody litres comparable to their SCD counterparts, suggesting minimal impact of obesity on their immune response. In contrast, female HFD mice exhibited significant impairments in TBEV-specific IgG and neutralizing antibody production compared to female SCD mice, as well as both male HFD and male SCD groups. These findings highlight a complex interplay between obesity, sex and immune function, with obesity disproportionately impairing the immune response after TBEV vaccination and infection.

Persistent viral evolution, rapid waning of vaccine-induced immunity, and the heightened vulnerability of elderly populations remain major challenges for COVID-19 vaccination strategies. In this study, we systematically assessed immune responses elicited by the ancestral spike protein formulated with four distinct adjuvants in mouse models. We demonstrate that an optimized adjuvant formulation markedly enhances the magnitude and breadth of antibody responses, potentiates T-cell immunity, and rapidly induces sustained peak antibody titers against both homologous virus and Omicron variants. Vaccine-induced antibody responses were significantly attenuated in aged mice, and furthermore, both the protective efficacy of antibodies and inflammatory cytokine responses upon viral challenge were impaired in aged animals. These results provide compelling evidence that rational adjuvant selection is critical for enabling recombinant vaccines to achieve rapid-onset, broad, and durable immune protection. Furthermore, our study offers new mechanistic insights into the reduced vaccine efficacy observed in the elderly.

What drives or discourages fraud-safe behavior in digital transactions? a BRT perspective.

What drives public support for health policies ? The protection-motivated mediating model of institutional trust and risk paradox.