bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutional inconsistencies and professionals’ hidden institutional work in Russian pandemic-affected healthcare: The material dimension
Authors: Borozdina Ekaterina , Temkina Anna
Published: December 2024

In recent years, medical sociology has produced a significant amount of publications about the effects of the COVID-19 pandemic on medical care provision and healthcare professionalism around the globe. This study builds on this line of research by looking at a rarely discussed case of pandemic management—the case of Russia’s centralized and state-dominated medical sector. In our analysis, we focus on the organizational level and the institutional work of front-line health professionals. Using a neoinstitutional theoretical lens, we show how, as a result of the conflict between professional and managerial logics, pockets of extreme institutional uncertainty emerged within Russian healthcare: “non-COVID” healthcare facilities and hospitals rapidly restructured for COVID-19 care. Qualitative interviews with healthcare professionals indicate that institutional misalignment inside these “gray zones” translated into the material dimension, significantly impeding the effectiveness of the pandemic response. While sociological literature frequently portrays Russian health professionals as fully subjected to administrative constraints and disempowered, our data allows us to trace their informal institutional work and agency during the health crisis. Through these materially mediated work, our informants attempted to deal with both the challenges of the pandemic and institutional contradictions of the Russian healthcare system. Professionals’ institutional work brought some improvements to Russia’s pandemic-affected clinical settings. However, being informal and purposefully hidden, it neither constituted a viable solution for medical organizations, nor contributed to the strengthening of professionals’ autonomy.
“Switch it up”: A qualitative analysis of BDSM switches
Authors: Bennett Theodore
Published: December 2024

As the field of BDSM studies continues to develop, further research is needed that explores the wide range of internal diversity within the BDSM population. Part of this diversity results from differences between BDSM participants in terms of their BDSM role preferences. Switches are a category of BDSM participants who take on both dominant-type and submissive-type BDSM roles. Although switches comprise a substantial part of the BDSM population they have been largely overlooked within academic research. This article involves 15 in-depth interviews with self-identified switches. It uses constructivist grounded theory to analyse what being a switch means to switches and the factors that switches consider when deciding which BDSM role to take on at a particular time. This analysis generates a complex account of BDSM switches that conceptualises how switches are open to diverse BDSM activities/roles, connect switching to their sense of self, experience varying limitations on their role flexibility, and play differently when engaging with fellow switches. This analysis also generates a theoretical model that explains how switches make situational role choices.
The Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT) intervention: A personalized approach to dementia risk reduction
Authors: Barnes Deborah E , Balderson Benjamin H , Shulman Lisa , Rosenberg Dori E , Matson Theresa E , Mettert Kayne D , Delaney Kristin , King Deborah , Adams Kristin , Fleckenstein Lynn , Peltz Carrie B , Idu Abisola , Larson Eric B , Yaffe Kristine , Dublin Sascha
Published: December 2024

Background

Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimer's disease and all-cause dementia, but little is known about which factors individuals are most willing to address or how they prefer to address them.

Objective

To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT).

Methods

In SMARRT, older adults worked with a health coach and nurse over 2 years to set incremental, personalized goals to reduce dementia risk. We performed quantitative analyses to summarize the numbers of goals per risk factor and qualitative content analyses of health coach and nurse notes to describe types of goals and useful strategies.

Results

82 dementia-free adults (70 to 89 years) with at least two dementia risk factors participated in the SMARRT intervention arm (mean age, 76 ± 5 years; 72% women; 11% Black/African American, 4% Asian, 3% Hispanic, 7% another non-White race). Participants set a median of 12 health coach goals and 1 nurse goals. The risk factors participants chose to work on most frequently were physical activity (95%), hypertension (72%), and cognitive activity (60%). Participants reported that the most useful strategies included support and accountability from the health coach/nurse, setting small goals, and learning to manage setbacks.

Conclusions

When given support, older adults at increased risk for dementia set a wide range of goals to reduce dementia risk. A flexible, personalized approach that focuses on setting feasible goals and managing setbacks provides a useful framework for dementia risk reduction.
Stepwise identification of prodromal dementia: Testing a practical model for primary care
Authors: Levy Boaz , D'Ambrozio Gianna
Published: December 2024

Background

Prodromal dementia is largely underdiagnosed in primary care.

Objective

To develop a clinical model for detecting prodromal dementia within the operative boundaries of primary care practice.

Methods

The study employed the Functional Activities Questionnaire (FAQ) and Montreal Cognitive Assessment (MoCA) to evaluate a “functional-cognitive” step-down screening model, in which the MoCA is administered subsequent to reported symptoms on the FAQ. It classified participants from the Alzheimer's Disease Imaging Initiative to three diagnostic categories: (1) healthy cognition (n = 396), (2) mild cognitive impairment without conversion (n = 430), and (3) prodromal dementia assessed 24 months before diagnosis (n = 164).

Results

Analyses indicated that the step-down model (Model 1) performed significantly better than an alternative model that applied the FAQ as a single measure (Model 2) and compared well with another model that administered both screening measures to all participants (Model 3). Gradient Boosting Trees classifications yielded the following estimations for Model 1/Model 2/ Model 3, respectively: Sensitivity = 0.87/0.77/0.89, Specificity = 0.68/0.47/0.70, PPV = 0.73/0.40/0.75, NVP = 0.84/0.81/0.87, F1 Score = 0.79/0.52/0.81, AUC = 0.78/0.67/0.79.

Conclusions

These analyses support the proposed model. The study offers algorithms for validated measures, which were developed from a well characterized clinical sample. Their accuracy will likely improve further with new data from diverse clinical settings. These results can serve primary care in a timely manner in light of the recent advances in pharmacological treatment of dementia and the expected increase in demand for screening.
Real-life reliability of plasma pTau181, Aβ42/Aβ40, and pTau181/Aβ42 measured by Lumipulse G600II in predicting cerebrospinal fluid amyloid status
Authors: Imperiale Daniele , Atzori Cristiana , Angeloro Daniele Pio , Murgioni Amelia , Bagatin Alessia , Secci Valentina , Calcagno Andrea , Capobianco Marco , Coletti Moja Mario , Rota Eugenia , Bongioanni Maria Roberta , Rosso Mara , Godi Laura , Barra Massimo , De Mattei Marco , Bonzanino Massimo , Ferrandi Delfina , Rainero Innocenzo , Lopiano Leonardo , Bozzali Marco
Published: December 2024

Background

Alzheimer's disease (AD) is the most common neurodegenerative dementia, with diagnosis traditionally reliant on clinical criteria. Cerebrospinal fluid (CSF) biomarkers like pTau181 and Aβ42/Aβ40 ratio significantly improve diagnostic accuracy but are invasive. Plasma biomarkers measured by automated assays offer a non-invasive alternative.

Objective

To evaluate the diagnostic performance of plasma pTau181, Aβ42/Aβ40, and pTau181/Aβ42 ratios in predicting CSF amyloid status in a real-life clinical setting.

Methods

Data from consecutive patients whose plasma and CSF samples sent to our laboratory between March and October 2022, were retrospectively analyzed. Plasma and CSF pTau181, Aβ42, and Aβ40 levels were measured using the Lumipulse G600II platform. CSF amyloid status was classified as amyloid-positive (A+) or amyloid-negative (A-) based on the Aβ42/Aβ40 ratio. Statistical analyses included Spearman correlation, receiver operating characteristic (ROC) curves, and multivariate logistic regression to evaluate biomarker performance.

Results

Among 165 individuals (83 females), 29.1% were classified as A+. Significant correlations were found between plasma and CSF biomarkers, with the highest for the pTau181/Aβ42 ratio (ρ=0.620, p < 0.0001). ROC analysis showed the pTau181/Aβ42 ratio had the highest diagnostic performance (AUC 0.818), followed by pTau181 (AUC 0.794) and Aβ42/Aβ40 (AUC 0.775). Combining plasma biomarkers in age-adjusted models improved diagnostic accuracy (AUC up to 0.846).

Conclusions

Plasma biomarkers measured by the Lumipulse G600II platform show strong potential in predicting CSF amyloid status and possibly reduces the need for lumbar punctures. These findings support the potential use of plasma assays in the early diagnosis of AD. Anyway, further validations in larger multicenter cohorts are mandatory.
Consequences of digital platforms’ use on the work–life balance of Brazilian journalists
Authors: Lelo Thales , Meneses Gabriela Silva , Pereira Fábio Henrique
Published: December 2024

This study investigates the influence of digital platforms on the work–life balance of Brazilian journalists. It comprises empirical research with 35 news professionals, including 35 semi-structured interviews and 33 diary materials. Data were qualitatively analyzed using the thematic networks approach. Findings reveal that digital platforms have influenced the work–life balance of journalists in conflicting ways, encompassing positive, mixed, and negative effects. In this sense, news workers have employed various practices to limit their use of digital media and promote work–life balance. Overall, this study presents a more comprehensive description of the impact of digital platforms in journalism. It also highlights these technologies’ prominence to positive or negative spillovers between personal and professional spheres. Last, it introduces a cognitive map of the actions put in place by a professional group to keep their digital media use under some control, which may also be seen as practices of journalistic disconnection.
How to catch the investor’s eye when going green in the Spanish hospitality industry
Authors: Bou Ysàs Silvia , Teixidó-Navarro Francesc , Martinez-Blasco Monica , Santomà Vicens Ricard , Prior Sanz Francesc
Published: December 2024

The growing integration of environmental sustainability within the hospitality industry, driven by both ethical and financial motivations, underscores the need to understand the investment criteria valued by stakeholders. However, limited research exists on how investors specifically evaluate sustainable investments in this sector. Drawing on existing literature that highlights the positive financial and operational impacts of sustainability initiatives, this study investigates factors influencing sustainable investment decisions in the Spanish hospitality sector. Grounded in focus group interviews conducted with a representative sample of investors aligned with the current structure of investment practices in the Spanish hospitality industry, this study employs an adapted concept mapping methodology enhanced by consensus analysis using the global index of consensus indicator. This approach enables the quantitative measurement of consensus among investors, providing a structured view of the criteria shaping sustainable investment choices. Findings reveal that while financial motivations continue to dominate investment decisions, environmental considerations are becoming increasingly significant, particularly those aligning with consumer expectations and stakeholder engagement in sustainable practices. Results suggest that environmentally friendly initiatives must demonstrate clear economic benefits to attract investment; sustainability must be financially viable. By aligning environmental goals with profitability, sustainable investments can appeal to a broader range of investors, promoting responsible practices in the hospitality sector while ensuring long-term returns.
“Cuz They Straight and Everything”: Barriers to Reporting Among Gay Latino Male Sexual Assault Survivors
Authors: Jacobson López Daniel , García Antonio
Published: December 2024

There remains a paucity of research examining the barriers to reporting sexual assault among gay and bisexual male assault survivors, despite much higher sexual assault victimization rates for gay and bisexual men. Few researches have examined barriers for gay Latino and/or Black male sexual assault survivors, specifically focusing on the role of racism and homophobia. To address this gap in literature, our study examined the specific barriers to reporting sexual assault for gay Latino (including Black) male sexual assault survivors, with a focus on how their multiple marginalized identities influenced their decision-making process. The study consisted of 14 gay Latino sexual assault survivors from six cities in the United States who participated in one-on-one semistructured in-depth interviews. Our data revealed three themes: (a) Bias and Discrimination, which describes how racism, homophobia, and gendered ideology serve as barriers to reporting sexual assault; (b) the Unjust Reporting Process focuses on the unnecessarily difficult, complex, and unclear timely reporting process; and (c) Retraumatization, which describes how participants were likely to be retraumatized by reporting. Content analysis was conducted and methodology consistent with this analysis was completed. Our findings provide recommendations to enhance the reporting process for gay Latino male sexual assault survivors which include law enforcement practices (e.g., Training tailored for engaging with LGBTQIA+ individuals and male survivors) as well as agency-wide practices (e.g., trainings and groups specifically for gay and bisexual men of color). All practices should be survivor centered and trauma-informed.
Bridging Perspectives: Utilizing Interpretative Phenomenological Analysis (IPA) to Inform and Enhance Social Interventions
Authors: Hartman Andrew , Squires Vicki
Published: December 2024

Traditional approaches to designing social interventions often originate from the perspectives of social engineers, overlooking the nuanced experiences of those directly impacted by the intervention. Employing an Interpretative Phenomenological Analysis (IPA) methodological approach creates an opportunity for the researcher to delve into the world of those who access services and provide a more holistic understanding of the dynamics surrounding the social issues. This paper explores the multifaceted role of IPA within social interventions, emphasizing ways in which IPA can bridge the gap between social engineers and service users within the context of student affairs programming. By immersing researchers in the subjective worlds of participants, IPA offers a unique lens through which to understand both the underlying factors necessitating social programs and also the intricate experiences of those affected by societal challenges. Additionally, the paper speaks to the educational dimension, highlighting the benefits of training students in qualitative research methodologies, particularly IPA, and its utility in designing social programs.
Chinese triads and the notion of territory
Authors: Lo T Wing , Kwok Sharon I
Published: December 2024

Territory, where a network of influence and business interests can be developed, is an important feature of criminal organizations. While some research on organized crime by Chinese triads has been published in recent years, the concept of triad territory is still under-researched. This article discusses what a triad territory is and how it is formed, managed and defended. Through qualitative research, it is found that triad business is territorial in nature. Different triad societies have their own turfs and monopolize certain geographical territories or economic sectors. Territory is important for the survival of triad societies, not only because most of their business operates within the territory but also because they rely on the territory to maintain social networks, exchange criminal market information, gather intelligence and source business opportunities. This article concludes that a triad territory is structurally, culturally and cognitively embedded, and is a defensible social and economic space of a triad society.
Outcomes after critical care admission in people with a learning disability
Authors: Messer Ben , Harrison Emily , Carter Alison , Clement Ian , Gillott Holly , Ho Ching Khai , Ross Thomas , Lane Nicholas , Tedd Hilary
Published: December 2024

Introduction:

People with learning disabilities experience worse healthcare outcomes than the general population. There is evidence that they are more likely to experience avoidable mortality and less likely to receive critical care interventions during an acute illness. Decisions regarding critical care admission or intervention must be based on evidence of whether a patient will receive lasting benefit from a critical care admission. We therefore investigated outcomes from critical care admissions in people with learning disabilities and compared them to general critical care patients.

Methods:

People with learning disabilities who were admitted to our critical care unit were identified via our coding department, from the Intensive Care National Audit and Research Centre (ICNARC) database and from our local electronic patient record. Mortality and length of stay outcomes for people with learning disabilities were recorded following critical care admission over a 5 years period and compared with the general critical care cohort over the same 5 years period. Longer term survival of patients with learning disabilities was also recorded.

Results:

297 critical care admissions in 176 people with learning disabilities were identified. The general critical care cohort included 6224 admissions in 4976 patients. The standardised mortality rate in people with learning disabilities admitted to critical care was 0.59 compared to the general critical care cohort which was 0.98. Mortality outcomes remained better in patients with learning disabilities compared to the general critical care cohort in invasively ventilated patients and in people with profound and multiple learning disability. Critical care length of stay was longer in people with learning disabilities. 12 month mortality was 14.8% in the learning disability cohort. By the end of the study, 23.9% of people with learning disabilities had died after a mean of 482 days following their first critical care admission. Patients who are currently still alive after having survived to hospital discharge following critical care admission have lived an average of 1129 days. After only 7.4% of critical care admissions in people with learning disabilities was there an increase in dependence on assistance in activities of daily living.

Discussion:

We have shown that people with learning disabilities are more likely to survive following a critical care admission than general critical care patients. This is regardless of whether they were invasively ventilated or whether they had profound and multiple learning disabilities. Critical care admission and invasive ventilation are associated with good short and longer term mortality.
A rare association of Guillain–Barré syndrome/Miller–Fisher syndrome overlap syndrome and Herpes Simplex Virus Type 1 infection: trigger or exacerbating factor?
Authors: Alberti Claudia , Molitierno Nicola , Iacobelli Virginia , Velardo Daniele , Comi Giacomo Pietro , Corti Stefania , Parisi Mosè , Abati Elena
Published: December 2024

Guillain–Barré syndrome (GBS) and its variants represent a spectrum of acute, immune-mediated polyneuropathies with heterogeneous clinical presentations and underlying etiologies. While infectious triggers are common precursors to these disorders, the association between viral infections and autoimmune neurological conditions remains an area of active investigation. Here, we report a case of GBS/Miller–Fisher syndrome overlap syndrome in an 80-year-old male presenting with dysarthria, dysphonia, ophthalmoplegia, areflexia, and postural instability following an upper respiratory tract infection. Cerebrospinal fluid analysis revealed the unexpected detection of herpes simplex virus type 1 DNA. Treatment with intravenous immunoglobulin therapy and acyclovir resulted in a progressive recovery of neurological symptoms. This case emphasizes the role of viral infections in differential diagnosis or as potential triggers for autoimmune neurological disorders highlighting the efficacy to addressed therapy in such complex cases.
Assessment of stress in mothers of babies admitted to neonatal intensive care unit and the influence of maternal and infant characteristics on the stress levels
Authors: Haribalakrishna Anitha , Utture Alpana , Nanavati Ruchi
Published: December 2024

Objectives

The study was aimed to assess the maternal stress level due to their infant’s neonatal intensive care stay and to understand the factors contributing to it.

Method

This prospective observational study was conducted in the level III neonatal intensive care unit (NICU) of a tertiary level public hospital in India. Mothers ( N = 100) were interviewed according to the Parental Stress Score (PSS) questionnaire, during days 6–8 of their infant’s admission to the NICU.

Results

Maternal stress was found to be highest due to sights and sounds in the NICU followed by alteration of the parental role. Stress due to staff behaviour and communication was least stressful followed by baby look and behaviour. The stress due to sights and sounds was significantly higher than stress due to baby’s look and behaviour [(2.7 ± 1.4 vs 1.98 ± 2.02), p = 0.004] and staff behaviour [(2.7 ± 1.4 vs 1.58 ± 1.31), p = 0.00] while was not significantly higher than stress due to parental role [(2.7 ± 1.4 vs 2.29 ± 1.60), p = 0.055]. The stress level due to baby’s look and behaviour was not significantly higher than parental role [(1.98 ± 2.02 vs 2.29 ± 1.60), F = 1.4, p = 0.23] or staff behaviour [(1.98 ± 2.02 vs 1.58 ± 1.31), F = 2.7, p = 0.09]. The demographic characteristics such as maternal age, parity, educational stress, type of delivery, gestation, need of ventilatory support, feed intolerance and kangaroo mother care (KMC) in infants individually did not significantly affect the stress scores.

Conclusion

The involvement of mothers in neonatal care while the infants were in the NICU, early KMC and involvement of mothers in enteral feeding practices may alleviate her stress levels.
Attitudes and practices surrounding obstetric hemorrhage among patients and providers
Authors: Calderon Joaquin A , Potarazu Savita , Phillips Jaclyn M , Macri Charles J , Ahmadzia Homa K
Published: December 2024

Background

Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide and the second most frequent cause of pregnancy related death in the United States. There are discernible differences among healthcare providers in identifying risk factors and managing obstetric hemorrhage. Furthermore, there is limited data on patient’s awareness and attitudes toward hemorrhage risk factors and preventive measures, as well as their involvement in clinical decisions. This project aimed to identify educational gaps for providers and patients in preventing and managing postpartum hemorrhage to optimally reduce maternal morbidity and mortality.

Methods

Cross-sectional anonymous surveys were distributed among obstetric patients and providers at a single maternity healthcare center from November 2022 to June 2023.

Results

The study cohort included 629 patients and 22 providers. Most of participants, 84% ( n = 526), lack knowledge or are uncertain about the risk factors associated with postpartum hemorrhage. When participants were asked how likely they would be willing to accept a preventative medication to reduce the risk of postpartum hemorrhage, 55% ( n = 344) responded “very likely” followed by 28% ( n = 176) as “somewhat likely”. Patients are likely to accept preventative medications to reduce the risk of postpartum hemorrhage. The majority of providers, 73% ( n = 16), express confidence in using tranexamic acid for postpartum hemorrhage treatment.

Conclusion

There is lack of knowledge among pregnant patients about the risk factors for hemorrhage and the standard medications to prevent it. Despite this, most participants are willing to receive preventive medication. Practice patterns regarding the prevention and management of hemorrhage should be part of a shared decision making between patients and providers.
Correlation of predelivery Rotational Thromboelastometry readings with the risk of postpartum hemorrhage during delivery: The ROTEM Study
Authors: Calderon Joaquin A , Ebeid Ahmed M , Lee Sean M , Ahmadzia Homa K
Published: December 2024

Background

Inconsistency in defining postpartum hemorrhage (PPH), and the inability of current tools and approaches to accurately predict PPH have led to the exploration of innovative methods. Rotational thromboelastometry (ROTEM) point-of-care technology provides real-time assessment of the clotting process facilitating time-efficient hemostatic interventions. Our study investigates the utility of ROTEM parameters for predicting individual risk of PPH.

Methods

This multi-site, prospective observational cohort study recruited 92 women who underwent scheduled cesarean delivery and normal spontaneous vaginal delivery at university-affiliated hospitals from 2018 to 2023. We included women between 18 and 50 years old at ≥34 weeks of gestation. Subjects were approached in the hospital pre-admission testing unit during their routine pre-operative blood draws, typically at least 72 h in advance of their planned cesarean delivery. Participants were also enrolled at the hospital once they arrived for admission a few hours before their procedure. ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, maximum clot formation (MCF), maximum lysis, were measured preoperative.

Results

We found significant effects of age, blood loss type, delivery mode, gestational age, and maximum lysis on blood loss. The reduced model predicted that every one-percent increase in maximum lysis was associated with a 44-milliliter increase in blood loss and every one-year increase in age was associated with a 19-milliliter increase in blood loss. On average, cesarean deliveries resulted in 522 more milliliters of blood loss than normal spontaneous vaginal delivery.

Conclusion

The ROTEM EXTEM maximum lysis parameter has a significant effect on blood loss. Larger prospective clinical trials in conjunction with a prompt definition of the ranges of reference values will strengthen these advances to provide a rapid assessment and guide early interventions to prevent severe obstetric bleeding.
Challenging acquired pulmonary interstitial emphysema in an extreme preterm infant: A case report and review of literature
Authors: González López Clara , Lareu Vidal Sonia , Álvarez Muñoz Víctor , Crehuet Gramatyka David , González Sánchez Susana , Ibáñez Fernández Aleida , Arias Llorente Rosa Patricia
Published: December 2024

Background

Pulmonary interstitial emphysema (PIE) can occur in the immature lungs of preterm infants due to overdistension from mechanical ventilation.

Case Report

Preterm female infant (26 weeks of gestational age, 950 grams) born via urgent cesarean section, APGAR 1/3/6. Invasive mechanical ventilation during the first day of life transitioned to noninvasive positive pressure ventilation (NIPPV), afterward initially stable. Apnea and bradycardia noted at 20 days of life, requiring endotracheal intubation, with complementary studies showing right PIE. Progressive emphysema deterioration, air trapping, and left lung atelectasis, with hemodynamic repercussion despite positioning, high-frequency oscillatory ventilation, and hemodynamic support with dopamine and dobutamine. Selective left intubation attempted positioning the infant, unsuccessful. Due to failure of conventional therapies and impossibility to achieve selective intubation, pediatric surgery performed endobronchial balloon occlusion with angioplasty balloon inflated with contrast with fluoroscopy control. Progressive improvement, weaning ventilatory settings with acceptable oxygenation. Balloon was retired after 5 days. Mechanical ventilation was discontinued at 52 days of life. Infant was discharged without respiratory support nor oxygen at 100 days of life.

Conclusions

PIE treatment is based in conventional measures (respiratory support and positioning) but eventually might require alternative techniques when the first fail, with limited work in pediatric population and further technical limitations in the preterm infants.
Digital Economy, Consumption Upgrading and Domestic Demand Level: An Empirical Analysis of PVAR Based on Provincial Panel Data
Authors: Fan Jianhong , Zhang Jiaxuan , Wu Huichao , Liang Chen
Published: December 2024

This study selects provincial panel data from 2008 to 2019 and constructs a panel vector autoregressive (PVAR) model to explore the bidirectional interactive relationship between digital economy, consumption upgrading and domestic demand level through the Granger causality test, the analysis of impulse response function and variance decomposition. Firstly, the GMM estimation results show that there is a significant bidirectional interactive effect between digital economy and domestic demand level, and a significant bidirectional interactive effect between digital economy and consumption upgrading, while the interactive effect between consumption upgrading and domestic demand level is weak. Secondly, the analysis of impulse response function shows that domestic demand level can sustainably promote the development of digital economy, and the promotion effect of digital economy on domestic demand level is immediate. However, in the long run, digital economy has a gradually weakening hindering effect on domestic demand level. Digital economy and consumption upgrading show a “V-shaped” relationship. The shackles of mutual promotion between consumption structure and scale still exist. Thirdly, the analysis of variance decomposition shows that the mutual contribution rate of digital economy and domestic demand level is low, the mutual contribution rate of digital economy and consumption upgrading is high, and the mutual contribution rate of consumption upgrading and domestic demand level is low. The implications in this study can help drive digital economy development, promote consumption upgrading and raise domestic demand level.
U.S. Midwest Farmers’ Perspectives about the Trade Dispute with China: Information Needs, Claims, Concerns, and Solutions
Authors: Qu Shuyang , Rodriguez Lulu , Zhang Wendong , Li Minghao , Cork Erin
Published: December 2024

In 2019, sales of American agricultural products to China nearly dried up as Beijing retaliated against U.S. tariffs on Chinese imports. We solicited farmers’ perceptions of risks engendered by the trade dispute through a survey of 304 corn and soybean growers in the states of Iowa, Illinois, and Minnesota. We found that farmers’ risk perceptions were affected more by psychometric factors. That is, they expressed fear and dread about the trade war fallout in the perceived absence of credible information regarding government plans of action, updates on trade negotiations, and expert recommendations. Findings point to the value of including farmers’ perspectives to help navigate negotiations regarding future trade disputes.
Research on the Supervision Mechanism of Voluntary Food Safety Information Disclosure: An Evolutionary Game Analysis
Authors: Bi Wentai , Chen Suyun , Zhu Panpan , Li Zongze , Cao Qingzi
Published: December 2024

Food safety is a significant livelihood and critical social security issue. However, few people are aware of the interests of multiple actors in the voluntary disclosure of food safety information. In order to solve the “market failure” and “government failure” caused by information asymmetry in the Chinese food market, this study constructs a game model of voluntary food safety information disclosure consisting of food enterprises, consumers, and the government. Stable equilibrium points and optimal decision-making strategies under different constraints were analyzed using replicated dynamic equations. Matlab software was used to simulate the game model to examine the interaction of the three parties in strategy selection, and an econometric model was used for empirical testing to clarify the interaction between the interests and behaviors of each party. The study results show that the interests of food enterprises, consumers, and the government and the realization of their claims have become critical constraints on food safety. Food enterprises are responsible for the voluntary disclosure of food safety information. Consumers and governments should strengthen collaborative supervision and linkage mechanisms to actively guide them toward substantive information disclosure. Government penalties, consumer subsidies, and food enterprises rewards for substantive information disclosure strategies can effectively promote substantive information disclosure by food enterprises. Therefore, this study contributes to a comprehensive understanding of the micro-mechanisms and differential impact effects of voluntary food safety information disclosure and provides a reference for decision-making to improve the quality of voluntary corporate food safety information disclosure and promote the modernization of the food safety governance system and governance capacity.
Pediatric Concussion Injuries in Soccer: Emergency Department Trends in the United States From 2012 to 2023
Authors: Sullivan Georgia R. , Lin Eugenia A. , Hoffer Alexander , Richardson Meghan , Chhabra Anikar
Published: December 2024

Background:

Because of growing concerns regarding repeated head trauma, in 2016, the United States Soccer Federation (USSF) banned headers for athletes aged ≤10 years and limited athletes aged 11 to 13 years to practicing headers for 30 minutes per week.

Purpose:

To assess whether the USSF header policy was associated with fewer soccer-related concussions after the 2015 season.

Study Design:

Descriptive epidemiology study.

Methods:

A retrospective cohort from the National Electronic Injury Surveillance System database was assessed. Age, sex, and injury type were extracted for all soccer-related emergency department visits between January 1, 2012, and December 31, 2023. Univariate and multiple regression analyses were used to assess concussions as a percentage of all soccer-related injuries based on sex, age group (6-9, 10-13, and 14-17 years), and year. The following time frames were assessed: 2012-2015, 2016-2019, and 2020-2023.

Results:

The proportion of concussions decreased from 8.2% of all soccer-related injuries in 2012-2015 to 6.1% in 2020-2023 ( P < .01). The relative risk reduction for soccer-related concussions presenting to an emergency department in 2020-2023 compared with 2012-2015 was 25.6%. Overall, the proportion of concussions among 10- to 13-year-old and 14- to 17-year-old players was higher than for 6- to 9-year-old players (6.6% and 8.9% vs 4.9%, respectively; P < .01). Despite having a lower frequency of soccer-related injuries overall, female players had a greater proportion of concussions than male players (9.6% vs 6.2% of all soccer-related injuries; P < .01). In the multiple regression analysis, injuries that occurred in 2020-2023 were associated with lower odds of concussion compared with 2012-2015 (odds ratio [OR], 0.75 [95% CI, 0.69-0.81]). Compared with 6- to 9-year-old and male players, the 10- to 13-year-old (OR, 1.30 [95% CI, 1.16-1.45]), 14- to 17-year-old (OR, 1.79 [95% CI, 1.61-1.99]), and female players (OR, 1.53 [95% CI, 1.43-1.63]) were associated with higher odds of concussion.

Conclusion:

A 25.6% reduction in the relative risk of presenting to the emergency department with a soccer-related concussion was found when comparing 2020-2023 (after USSF header policy implementation) with 2012-2015 (before policy implementation). The USSF youth soccer header policy may improve player safety by reducing head impacts in the pediatric population.
How individuals with psychosis develop and maintain resilience to suicidal experiences through psychological therapy: a qualitative study
Authors: Berry N. , Peters S. , Haddock G. , Scott A. , Harris K. , Cook L. , Awenat Y. , Gooding P. A.
Published: December 2024

Background

Almost half of people with psychosis have suicidal experiences. There is limited understanding of the processes underpinning psychological resilience to psychotic and suicidal experiences especially in people who have engaged with psychological talking therapies. Hence, the current study aimed to redress this gap by examining the perspectives of clients who had recent lived-experiences of psychosis, suicidality, and psychological therapy.

Methods

Semi-structured interviews were conducted with 35 participants who had psychosis and suicidal experiences in the three months prior to recruitment. Data were analysed using reflexive thematic analysis.

Results

There were four key psychological processes that contributed to resilience: (1) gaining a sense of control by nullifying perceptions of being controlled by overwhelming emotional and psychotic experiences, and instead, acquiring confident autonomy; (2) gaining a sense of hope facilitated by experiencing mental health problems on a fluctuating continuum, translating immersive positive memories into future possibilities, and embracing meaningful personal values; (3) developing genuine self-worth based on compassionate self-understanding, and affirmation of personal qualities; and (4) finding acceptance by being able to live alongside psychotic and suicidal experiences. Specific resilience components that participants developed through psychological therapy, together with their own knowledge and observations, were identified.

Conclusions

People who live with psychotic and suicidal experiences can, and do, experience psychological change and psychological resilience in response to psychological therapy. To promote resilience, practitioners should pursue a person-based, client-directed approach; embrace acceptance; and be open to exploring different ways of working with clients’ experiences of overwhelming thoughts and emotions.
Health care costs and service utilization in the first year following moderate to severe traumatic injury
Authors: Rasmussen Mari Storli , Zhang Yuan , Andelic Nada , Aas Eline
Published: December 2024

Background

Most of the previous studies on costs following trauma have focused solely on in-hospital costs and costs associated with the acute treatment and early rehabilitation. As a result, post-hospital costs are often neglected in the estimation of total costs. We aimed to describe service utilization and total costs for health care services, rehabilitation services, and social support in the periods 0–6 months and 7–12 months after moderate-to-severe traumatic injury. Further, we explored costs and their associations with sociodemographic, clinical and injury-related variables.

Methods

Data were obtained from a prospective, 12 months follow-up study of patients in all ages with moderate-to-severe traumatic injury determined by a New Injury Severity Score (NISS) > 9, admitted directly or within 72 h to the trauma referral centres in year 2020. Data on utilization of health care and rehabilitation services from the Norwegian Patient Register (NPR), the Municipal patient and user register (KPR), and the Norwegian Control and Payment of Health Reimbursements Database (KUHR) were used.

Results

A total of 601 patients were included, 24% with moderate and 76% with severe injuries. The overall mean total health care cost per patient in the first year after traumatic injury was 846,877 (SD 1,042,649) Norwegian Kroner (NOK). The mean total cost of rehabilitation per patient was 251,487 (SD 317,050) NOK. Most costs were attributable to secondary care in the first six months post-injury. Severely injured patients had a higher health care utilization and average cost compared to those with moderate injury. Injury severity factors were the most prominent cost drivers, and number of injuries, severe head, spine, and extremity injuries were significantly associated with higher costs during the first year following trauma.

Conclusions

The findings give a holistic insight into health care utilization and costs for patients across all ages with complex needs following trauma and can contribute to the planning and provision of services for this patient group.
Collaborative extended home-visits as a key to facilitating early support within the frame of a family centre in Sweden
Authors: Golsäter Marie , Andersson Ann-Christine
Published: December 2024

Background

All children should have the possibility to be healthy during childhood, according to the Convention on the Rights of the Child. In Sweden, the Child Health Services (CHS) support all parents and children from birth until the age of six to promote children’s health and development. Some Swedish regions have introduced an extended home-visit programme, with CHS nurses and social workers visiting first-time parents together to provide parental support in collaboration. The programme aims to expand the task of promoting the child’s health and increase the possibilities of discovering risk factors in families earlier. The aim of the present study is to describe the professionals’ experiences of collaboration when introducing the extended home-visit programme to a broader population within the frame of a family centre.

Methods

The study used a reflexive thematic qualitative approach with focus group interviews. All staff at the family centre were invited to participate: CHS nurses, social workers, and managers who worked with the extended home-visit programme. Data were collected through focus group interviews with each profession separately and analysed through reflexive thematic analysis.

Results

One overarching theme emerged: A key to facilitating early support. Three connected themes – Ease for everyone on the family’s terms, From working alone to becoming a team, and A matter of supporting structures – illuminated the participants’ experiences. Their driving force was early detection of risk factors or needs in the family, to be able to provide support. The collaboration was enhanced by the different professional competencies complementing each other. That all were located at the family centre together was also important to facilitate collaboration.

Conclusions

The extended home-visits were appreciated and experienced as useful by all participants. That a family centre organization already existed was one of the facilitators, functioning as a meeting point to expand the collaboration. The managers’ support was essential, and it was experienced as positive that the organization invested resources to allow employees to participate in the development of the extended home-visit programmes. This way of working has the potential to add value for the children and families, and the CHS would benefit from using the extended home-visit programme further.
CRISPR/Cas9-induced double-strand breaks in the huntingtin locus lead to CAG repeat contraction through DNA end resection and homology-mediated repair
Authors: Sledzinski Pawel , Nowaczyk Mateusz , Smielowska Marianna Iga , Olejniczak Marta
Published: December 2024

Background

The expansion of CAG/CTG repeats in functionally unrelated genes is a causative factor in many inherited neurodegenerative disorders, including Huntington’s disease (HD), spinocerebellar ataxias (SCAs), and myotonic dystrophy type 1 (DM1). Despite many years of research, the mechanism responsible for repeat instability is unknown, and recent findings indicate the key role of DNA repair in this process. The repair of DSBs induced by genome editing tools results in the shortening of long CAG/CTG repeats in yeast models. Understanding this mechanism is the first step in developing a therapeutic strategy based on the controlled shortening of repeats. The aim of this study was to characterize Cas9-induced DSB repair products at the endogenous HTT locus in human cells and to identify factors affecting the formation of specific types of sequences.

Results

The location of the cleavage site and the surrounding sequence influence the outcome of DNA repair. DSBs within CAG repeats result in shortening of the repeats in frame in ~ 90% of products. The mechanism of this contraction involves MRE11-CTIP and RAD51 activity and DNA end resection. We demonstrated that a DSB located upstream of CAG repeats induces polymerase theta-mediated end joining, resulting in deletion of the entire CAG tract. Furthermore, using proteomic analysis, we identified novel factors that may be involved in CAG sequence repair.

Conclusions

Our study provides new insights into the complex mechanisms of CRISPR/Cas9-induced shortening of CAG repeats in human cells.
A retrospective study of provisional outcomes of intracorporeal esophagojejunostomy versus extracorporeal anastomosis during laparoscopic total gastrectomy for gastric cancer. a single -center
Authors: Diallo Maladho Tanta , Shuai Zhao , Chen Bangquan , Yu Yantao , Yan Zhang , Sun Qiannan , Wang Daorong
Published: December 2024

Gastric cancer (GC) treatment is increasingly undergoing laparoscopic total gastrectomy (LTG) procedures. However, we conducted this research to evaluate postoperative outcomes, particularly surgical complications associated with intracorporeal and extracorporeal esophagojejunostomies using linear or circular stapling techniques following LTG for GC treatment. We aimed to compare short-term postoperative outcomes, such as surgical complications and anastomotic outcomes, between the two groups.

Method

From January 2020 to August 2022, we conducted a retrospective analysis of data from 160 consecutive patients diagnosed with GC who received either IEJ (n = 35) or EEJ (n = 125) during LTG. We utilized the Mann–Whitney U test to ascertain the statistical significance between the two groups. For comparing categorical variables, including numbers and percentages, we employed either the Pearson chi-square test, continuity correction, or Fisher's exact test as appropriate.

Results

The operative time was similar (IEJ: 184.57 ± 36.489 vs. EEJ: 189.22 ± 43.584; P = 0.565), however, the number of positive lymph nodes was performed more in the IEJ group (IEJ: 4.71 ± 6.114 vs. EEJ: 6.39 ± 9.067 (P = 0.305). The blood loss in the IEJ group was lower than that of the EEJ (IEJ: 73.1429.182 vs. EEJ: 100.6461.693 mL, P = 0.012). There were three anastomosis leakages in the EEJ and one in the IEJ group (EEJ, 3.2% vs. IEJ, 2.8%; P > 0.999). Anastomosis bleeding only occurred in the EEJ (EEJ 1%; P = 0.003). Although the EEJ linear stapling technique had two deaths (EEJ, 1.6%).

Conclusion

Although EEJ is frequently utilized in the linear stapling technique, research indicates that the use of IEJ minimizes the incidence of complications in LTG.