bluuebunny/crossref_metadata_2025 huggingface dataset:
Architectural Holarchy of the Next Generation Manufacturing System
Authors: Frumuşanu Gabriel , Epureanu Alexandru
Published: January 2022

Nowadays, the global energy network can generate and transmit, between any two points belonging to it, high quantity of energy. During recent years, a global information network, able to process, store, and transmit huge amounts of information, has been developed as well. These networks entirely cover the industrial space, already giving the opportunity to make permanently available, in any of its points, at any time, as much as needed, both energy and information. On the other hand, the mass customization trend has led to the pronounced increase of “manufacturing to order” (MTO) production, taking place in a higher and higher number of small & medium enterprises. At this level, a given manufacturing system cannot be quickly and appropriately configured to a given product, due to production high variability in range. As consequence, the manufacturing system is, quite always, more or less unadjusted to the manufactured product, its performance being significantly affected. Starting from here, the challenge is to make a conceptual rebuilding of the manufacturing system, aiming to increase its degree of appropriateness to products, by taking advantage from the opportunities brought by the existence of global energy & information networks. This paper approach is to see the next generation manufacturing system as holonic modular cyber-physical system. System architecture permanently accords to the manufactured product requirements. The function, procedure, topology and holarchy model of the system are presented. The main features of the system are also revealed.
Opportunities and challenges for small-scale aquaculture: The stakeholders’ perspective in Los Lagos Region-Chile
Authors:   University of Wyoming, Department of Economics United States, Albers Heidi J. , Baquedano Marjorie ,   Universidad de Concepción, Departamento de Educación Médica, Chávez Carlos ,   Universidad de Talca, Dresdner Jorge ,   Universidad de Concepción, Departamento de Economía, Yubini Kelly ,   Universidad de Concepción, Departamento de Sociología
Published: January 2022

We identify and explore the potential opportunities and challenges for promoting and expanding small-scale aquaculture (SSA) as an additional income-generating activity for coastal communities in southern Chile. Based on a conceptual model of SSA adoption decisions, we conducted field key informant semistructured interviews with stakeholders in the Los Lagos region and in the regional capital city, Puerto Montt. We conducted a qualitative analysis of the interviews to identify potential resource users’ perceptions of current SSA opportunities. Interpreting the content analysis results through the lens of economic decisions in the conceptual model, we find that weak monitoring and enforcement, difficulties in adapting to new jobs, limited recent spatial planning, constraints on access to marine user rights, and insufficient market development for marine products are among the main obstacles to the adoption of SSA. The stakeholders view SSA as an opportunity to expand marine-based productive activities under the continuous decline in wild fisheries. SSA adoption is perceived as a gradual transition process that requires cultural capital and knowledge, given the lack of familiarity with management and the legal and economic aspects of aquaculture. In contrast to the concerns of potential SSA adopters, government stakeholders emphasize concern over the lack of definitions for SSA, norms, and regulations. We discuss how public policy to promote SSA in Chile could target the key concerns of potential SSA adopters.
Data challenges in the measurement of agricultural productivity: Lessons from Chile
Authors:   University of Connecticut (UConn), Bravo-Ureta Boris E. , Jara-Rojas Roberto ,   Universidad de Talca (Chile), Moreira Victor ,   Universidad Austral de Chile, Riveros Patricio ,   Universidad de Chile
Published: January 2022

Productivity measurement and analysis have motivated considerable theoretical and empirical work in recent decades. Models that have enjoyed noticeable expansion are stochastic production frontiers for panel data. These models have proven very useful in total factor productivity (TFP) measurement and the analyses of its components. However, the related empirical literature in Latin America and the Caribbean has been limited, and a likely reason for this gap is data constraints. This article examines the setting surrounding the measurement and analysis of productivity in the Chilean agricultural sector. The specific objectives are to (1) provide a summary of key agricultural productivity measures and recent associated methodological advances; (2) present an overview of micro studies reporting technical efficiency and TFP in Chile; (3) portray the major sources of agricultural data available in the country; and (4) discuss salient features of the agricultural data systems used in Australia and the United States. The paper ends by identifying challenges and possible improvements to the prevailing data system that could strengthen the measurements and monitoring of productivity in Chile. The analysis suggests that the country needs substantial improvements in the collection and analysis of agricultural statistics to develop TFP and related research. This line of work is a critical step to enhance competitiveness and to foster adaptations to climate change, as well as to fully participate in efforts sponsored by the IFAD, FAO and the OECD to monitor progress toward the SDGs. On the positive side, several avenues are available to move toward a more robust agricultural statistical architecture.
Innovative Rural Entrepreneurship in Chile
Authors:   Instituto de Ciencias Sociales, Universidad de O’Higgins, Modrego Félix , Foster William ,   Departamento de Economía Agraria, Pontificia Universidad Católica de Chile
Published: January 2022

Successful policies seeking to promote rural entrepreneurship require a conceptual model consistent with the features of rural spaces and free of stereotypes of entrepreneurship as being only technologically sophisticated. The objective of this essay is, first, to argue that rural areas can be fertile ground for entrepreneurial activities in middle-income countries such as Chile and, second, to discuss policy options to achieve the goal of encouraging a more innovative entrepreneurship in rural areas. The scientific literature on entrepreneurship and the definitions, types and roles of entrepreneurship in development are reviewed. The literature on the location of entrepreneurship is summarized to understand the drivers of observed territorial differences in entrepreneurial activity. One conclusion is that rural areas face a (seemingly) adverse economic geography for entrepreneurship, although there is a recent tendency for amenities-led growth. We then present the geography of rural entrepreneurship in Chile. Contrary to conventional wisdom, the rates of entrepreneurship in Chilean rural areas are high, although presumably of a limited growth potential under current conditions. Nevertheless, this entrepreneurial base provides a stock of knowledge from which a greater sophistication could be reached, and we discuss potential policy approaches to stimulate more innovative rural entrepreneurship. In the case of Chile, available policy options are coherent with the recently enacted National Rural Development Policy. A systemic, amenity-based approach gives middle-income countries opportunities for the development of more innovative rural entrepreneurship through territorial policies that provide local public goods and improve living conditions.
Agriculture 4.0? Studying the evidence for automation in Chilean agriculture
Authors:   Center for Economics and Social Policy, Universidad Mayor Chile, Perez-Silva Rodrigo , Campos Jorge ,   University of Reading
Published: January 2022

In recent decades, computing-based technologies have been large contributors to the current digital and knowledge economy. This process has led to changes in the structure of employment and variations in relative wages across workers in skill distribution, with computing-based technologies representing the technological shift shaping current and future labor demand. In this regard, how job tasks might be replaced or complemented by computing-based technologies becomes a new and critical aspect in explaining how technological progress drives labor demand. Agriculture, as well as other sectors, has taken advantage of this technical progress, with emergent technologies contributing to the shift toward Agriculture 4.0. In the case of Chile, the evidence points to an overall reduction in the agricultural labor force and to an increase in the relative number of salaried workers within agriculture, particularly those in temporary jobs. However, nothing has been said about the types of tasks being performed in the sector, its evolution over time, and its relationship with automation. If agriculture is under a technological upgrading process, then we should expect the reduction in the number of salaried workers to be accompanied by an increase in the relative skillset of those still in the industry performing non-routine tasks. Contrary to what one might expect, our results suggest that the participation of routine tasks in agriculture has only increased over time, pointing to a low adoption of computing-based technologies compared to other economic sectors within the Chilean economy.
Towards Sustainable Agriculture in Chile, Reflections on the Role of Public Policy
Authors:   Pontificia Universidad Católica de Chile, Melo Oscar , Báez Nadia ,   Department of Pasture Science, Institute of Animal Science Cuba, Acuña Daniela ,   Department of Sustainability and Climate Change, Office of Agricultural Studies and Policies, ODEPA, Ministry of Agriculture Chile
Published: January 2022

Given the increasing demand for agricultural products and the environmental degradation that current agricultural practices generate, there is an urgent need to change the activity. Sustainable agriculture emerges as an attractive alternative to mitigate the adverse effects of the activity on the environment, increase its resilience to global change, and increase the current population’s quality of life without sacrificing that of future generations. However, identifying effective policies that can achieve these goals remains elusive. In Chile, this sector has been one of the drivers of growth and poverty reduction but still faces many environmental and social challenges, and there is a growing public demand for achieving sustainability from an economic, environmental, and social perspective. Public and private institutions have made relevant efforts to increase Chilean agriculture sustainability. However, the need to transition towards sustainable agriculture is still not recognized by all stakeholders. In this article, we review current challenges and policies to achieve a more sustainable agriculture in Chile.
In vitro effects of Sunset Yellow on Chromosomal Damage and Sister Chromatid Exchanges in Human Peripheral Lymphocytes
Authors: Algarni Awad A.
Published: January 2022

Sunset Yellow (SY) is an organic azo dye that is used extensively as a coloring agent in many industries, such as cosmetics, pharmaceuticals ,and foodstuffs. Many studies have conflicting results about the genotoxicity effect of SY. Thus, the purpose of this study was to provide additional data concerning SY genotoxicity in human lymphocytes by using chromosomal aberrations (CAs) and sister chromatid exchanges (SCEs) assay. Four concentrations of Sunset Yellow (1, 5, 20 ,and 50 mg/ml) were used on human lymphocyte cultures. Positive and negative controls were mitomycin C and distilled water, respectively. Compared to the control, SY caused a significant increase in CAs and SCEs frequencies at all concentrations. A total of five types of CAs were observed, such as gaps, fragments, RCF, stickiness,and polyploidy. According to the present results, high concentrations of SY are genotoxic in vitro to cultured human lymphocytes. To determine its full genotoxicity potential, SY should be tested in other test systems.
Presentation of Small Bowel Volvulus in East Africa
Authors: Wismayer Richard
Published: January 2022

Introduction: A benign gastrointestinal surgical condition involving torsion of part or all of a segment of small bowel on its mesenteric axis is small bowel volvulus (SBV). The clinical presentation is similar to acute mesenteric ischaemia and hence a preoperative clinical diagnosis is difficult to obtain. In developing countries, as a presenting surgical cause of small bowel obstruction it has contributed to a significant burden. The aim of this case report was to discuss a typical case of small bowel volvulus in a developing country and highlight the importance of resuscitation and early surgical intervention.

Presentation of case: A 35 year old lady admitted to hospital with a 3 day history of colicky central abdominal pain. She reported a long period of fasting and sudden ingestion of food. On physical examination her abdomen was moderately distended with minimal tenderness. Laboratory investigations were normal and a plain abdominal X-ray revealed features suggestive of small bowel obstruction. After resuscitation the patient was taken for a laparotomy where evidence of SBV was found. An omental band adhesion was divided, the volvulus untwisted and the small bowel was all viable. The patient made an uneventful postoperative recovery.

Discussion: The incidence of SBV is higher in Africa, Asia and the Middle East compared to the Western world. Secondary SBV is more commonly found in older age groups however primary SBV is more common in children. The most common complaints of SBV includes abdominal pain, abdominal distention and vomiting. The mortality rate due to SBV has been found to be decreasing with early diagnosis due to abdominal CT scanning. This reduction in mortality is due to a reduction in the incidence of gangrene of the SBV.

Conclusions: Due to the high mortality and variable presentation, surgeons must consider small bowel volvulus a probably diagnosis in a patient with abdominal pain and features of small bowel obstruction. Early surgical intervention is necessary to reduce the morbidity and mortality from SBV.
Emergency Clinician Buprenorphine Initiation, Subsequent Prescriptions, and Continuous Prescriptions
Authors: Dekker Annette M. , Schriger David L. , Herring Andrew A. , Samuels Elizabeth A.
Published: February 2025

Importance

Rates of opioid use disorder (OUD) and associated mortality in the US remain high. Treatment of OUD with buprenorphine reduces morbidity and mortality. There have been national efforts to expand buprenorphine initiation to the emergency department (ED), where many patients with low treatment access seek medical care. Adoption and trends of emergency clinician buprenorphine prescribing are unknown.

Objective

To describe emergency clinician buprenorphine initiation for OUD, subsequent prescriptions, and changes over time in California.

Design, Setting, and Participants

Observational retrospective study of buprenorphine prescriptions in the California Controlled Substance Utilization Review and Evaluation System (CURES) database from January 1, 2017, to December 31, 2022. Any patient aged 18 to 79 years with a California zip code who filled a buprenorphine prescription in CURES and their California prescribers were eligible for inclusion.

Exposure

Buprenorphine prescription by an emergency clinician.

Main Outcomes and Measures

Outcomes included (1) the number of patients prescribed buprenorphine; (2) the number of clinicians prescribing buprenorphine; (3) the number and characteristics of buprenorphine prescriptions; (4) the percentage of emergency clinician buprenorphine initiation prescriptions with subsequent linkage to a second prescription and continuous prescriptions, also reported as a continuation ratio; and (5) days and number of initiation prescriptions prior to continuous prescriptions.

Results

In this retrospective observational study, 345 024 patients received 3.8 million buprenorphine prescriptions from 21 099 clinicians in California from 2017 to 2022. The mean age of patients at the time of first buprenorphine prescription was 37 years; 8187 (67%) were male. Emergency clinicians increased from 2% (n = 78) to 16% (n = 1789) of buprenorphine prescribers in 2017 and 2022, respectively (P < .001). Buprenorphine initiation prescriptions by emergency clinicians increased from 0.1% (n = 53) to 5% (n = 4493) of all initiation prescriptions in 2017 and 2022, respectively (P = .001). The continuation ratio for patients to receive a second prescription within 40 days of an ED initiation was 2.8 (10 823/3916). The continuation ratio for patients to start 180 days or more of continuous prescriptions within 40 days of ED buprenorphine initiation was 18.3 (10 823/593) and 9.1 within 1 year (5989/655 [2017-2021 data]).

Conclusions and Relevance

These findings suggest increasing prescription of buprenorphine for OUD by California emergency clinicians from 2017 to 2022, with approximately 1 in 9 patients going on to receive continuous buprenorphine prescriptions within 1 year.
Risk of Cardiovascular Morbidity and Mortality in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Survivors
Authors: Chiu Hsien-Yi , Chiu Ying-Ming
Published: February 2025

Importance

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) cause diffuse epidermal detachment and necrosis. Patients who survive the initial SJS/TEN episodes are affected by various sequelae.

Objective

To investigate the risks of cardiovascular morbidity and mortality in SJS/TEN survivors.

Design, Setting, and Participants

This was a nationwide population-based cohort study using data from Taiwan’s National Health Research Institute Database linked to the National Register of Death databases for 1998 to 2021. Survivors of SJS/TEN were identified and matched with non-SJS/TEN participants by age, sex, and Charlson Comorbidity Index. Data analysis was performed from November 2023 to June 2024.

Exposure

Cerebrovascular accidents (CVA) or ischemic heart disease (IHD) after SJS/TEN survival.

Main Outcomes and Measures

Cox proportional hazards models were used to estimate the hazard ratios (HRs) of CVA and IHD morbidity and mortality after SJS/TEN survival.

Results

The CVA cohort included 10 571 SJS/TEN survivors (mean [SD] age, 56.1 [18.5] years; 5358 females [50.7%] and 5213 males [49.3%]). The IHD cohort included 11 084 SJS/TEN survivors (mean [SD] age, 56.6 [18.6] years; 5561 females [50.2%] and 5523 males [49.8%]). The Cox proportional hazards model and competing risk regression model showed that compared with non-SJS/TEN participants, patients with SJS/TEN had higher risks of cardiovascular morbidity (CVA: HR, 1.65 [95% CI, 1.57-1.72] and subdistribution HR [sHR], 1.40 [95% CI, 1.33-1.46]; IHD: HR, 1.58 [95% CI, 1.51-1.65] and sHR, 1.32 [95% CI, 1.26-1.38]) and death due to cardiovascular disease (CVA: HR, 1.69; 95% CI, 1.46-1.96; IHD: HR, 1.55; 95% CI, 1.32-1.82). The increased cardiovascular mortality risks peaked at 1 year after SJS/TEN and persisted for 4 to 7 years. Older survivors and survivors admitted to an intensive care unit at SJS/TEN diagnosis had significantly higher cardiovascular mortality risk.

Conclusions and Relevance

In this cohort study, SJS/TEN had a lasting association with cardiovascular function after the acute phase. This suggests a need to mitigate the elevated cardiovascular morbidity and mortality risks among survivors. Further research using databases or registries with more comprehensive clinical data are needed to validate these results.
Febrile Ulceronecrotic Mucha-Habermann Disease
Authors: Shen Yi-Hsuan , Hung Yu-Ting
Published: February 2025

This case report describes an otherwise healthy 30-year-old man who presented with a sudden onset, rapidly progressive, and painful skin eruption accompanied by fever lasting for 1 week.
Patient-Physician Language Concordance and Cardiovascular Outcomes Among Patients With Hypertension
Authors: Reaume Michael , Labossière Mathieu N. , Batista Ricardo , Van Haute Stephanie , Tangri Navdeep , Rigatto Claudio , Bohm Clara , Prud’homme Denis , Tanuseputro Peter , Lix Lisa M.
Published: February 2025

Importance

Patients who live in minority language communities often receive health care services of lower quality and safety compared with patients who speak the majority language. Yet the outcomes associated with care provided by physicians who speak a patient’s primary language remain unknown.

Objective

To examine patient-physician language concordance and the risk of major adverse cardiovascular events (MACEs) among patients with hypertension.

Design, Setting, and Participants

This retrospective cohort study identified adults with self-reported hypertension in the Canadian Community Health Survey, a national survey that collects data from a representative sample of Canadians, from January 1, 2003, to December 31, 2014. Respondents (excluding those living in Quebec) had their hospitalization and mortality records linked to their survey responses. Data were analyzed from October 2023 to May 2024.

Exposures

Respondents’ primary home language was defined using language spoken most often at home. Language spoken with a regular physician was used to measure patient-physician language concordance. Respondents who spoke to their regular physician in their primary home language were classified as having received language-concordant care, while all other respondents were classified as having received language-discordant care.

Main Outcomes and Measures

MACEs within 5 years of survey completion.

Results

Among the 124 583 patients included in this study, 114 239 (91.7%) spoke English, 4790 (3.8%) spoke French, 325 (0.3%) spoke an Indigenous language, and 5229 (4.2%) spoke an allophone (ie, other) language. The mean (SD) age of the cohort was 63.7 (14.8) years; 57.1% of the patients reported their sex as female. Very few respondents who spoke an Indigenous language at home (<4.6%) received language-concordant care. For French-speaking patients, there was no statistically significant difference in the risk of MACE between those who received language-concordant care and those who received language-discordant care (hazard ratio [HR], 1.09; 95% CI, 0.86-1.36). Allophone-speaking patients who received language-concordant care were 36% less likely to experience MACE (HR, 0.64; 95% CI, 0.51–0.80) compared with allophone-speaking patients who received language-discordant care.

Conclusions and Relevance

This retrospective cohort study found large disparities in both access to language-concordant care and risk of MACEs. These findings suggest that language-concordant care could potentially improve the health of individuals in minority language communities.
Socioeconomic Differences in Vaccination Coverage After a Mandatory Vaccination Law, 1855-1900
Authors: Ukonaho Susanna , Lummaa Virpi , Briga Michael
Published: February 2025

Importance

Mandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown.

Objective

To examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900.

Design, Setting, and Participants

This population-based cohort study monitored 45 years (1855-1900) of Finland’s first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age <1 year) across different SEGs. Data were analyzed from October 2023 to January 2024.

Exposure

A mandatory smallpox vaccination law for all children.

Main Outcomes and Measures

Vaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law.

Results

A total of 40 008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]).

Conclusions and Relevance

In this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.
Clinician Experiences With Ambient Scribe Technology to Assist With Documentation Burden and Efficiency
Authors: Duggan Matthew J. , Gervase Julietta , Schoenbaum Anna , Hanson William , Howell John T. , Sheinberg Michael , Johnson Kevin B.
Published: February 2025

Importance

Timely evaluation of ambient scribing technology is warranted to assess whether this technology can lessen the burden of clinical documentation on clinicians.

Objective

To investigate the association of ambient scribing technology with efficiency, quality, and perceived burden of clinical documentation in the outpatient setting.

Design, Setting, and Participants

This prospective, single-group pre-post quality improvement study was conducted between April and June 2024 in the outpatient setting of an academic health system in Philadelphia, Pennsylvania. Participants included physicians, nurse practitioners, and physician assistants. Data were analyzed from July to August 2024.

Exposure

Access to an artificial intelligence–driven ambient scribing tool for outpatient notes.

Main Outcomes and Measures

The primary outcomes were time in notes per appointment, same-day appointment closure, after-hours work time, perceived burden of clinical documentation, and comments on clinicians’ experiences using ambient scribing. A mixed-effects model was used. Both objective metrics and survey feedback were obtained. Targeted perspective questions, designed to assess clinician-perceived patient engagement and perceived documentation burden, were assessed on a 7-point Likert scale. Standard System Usability Scale (SUS) and net promoter score (NPS) formulas were used to analyze usability and recommendability data.

Results

This study included 46 clinicians from 17 different medical specialties, with a mean (SD) of 11.1 (8.7) years in practice. From baseline to post intervention, use of the ambient scribing tool was associated with 20.4% less time in notes per appointment (from 10.3 to 8.2 minutes; P < .001), 9.3% greater same-day appointment closure (from 66.2% to 72.4%; P <.001), and 30.0% less after-hours work time per workday (from 50.6 to 35.4 minutes per workday; P = .02). Targeted perspective questions showed more favorable scores. Open-ended qualitative feedback from clinicians showed a range of positive, negative, and mixed feedback regarding their use of ambient scribing technology. SUS scores showed that the ambient scribing tool was easy to use. NPSs reflected the mixed qualitative feedback.

Conclusions and Relevance

In this quality improvement study, the use of ambient scribe technology was associated with greater efficiency of outpatient clinical documentation, lower mental burden of documentation for clinicians, and greater sense of engagement with patients during outpatient appointments. Additional studies exploring urgent care settings, examining patient experience, and comparing multiple tools will be important to better understand the effect of ambient scribing on ambulatory care.
Maternal RSVpreF and Infant Nirsevimab Immunizations Uptake During Respiratory Syncytial Virus Season
Authors: Litman Ethan A. , Hsieh Tina Yi Jin , Modest Anna M. , Clarke Kathleen , Dzinoreva Melissa , Perrinez Valerie , Apraku Bondzie Esther , Gallup Lydia , Schonberg Eleanor , Rowe Marjorie , Locke K’ara , Oginni Oluwaseyi , Jones Robert , Zera Chloe A. , Collier Ai-ris Y.
Published: February 2025

This cohort study evaluates the use rate of respiratory syncytial virus (RSV) vaccines to prevent RSV-related lower respiratory tract disease among infants.
Predicting Diagnostic Progression to Schizophrenia or Bipolar Disorder via Machine Learning
Authors: Hansen Lasse , Bernstorff Martin , Enevoldsen Kenneth , Kolding Sara , Damgaard Jakob Grøhn , Perfalk Erik , Nielbo Kristoffer Laigaard , Danielsen Andreas Aalkjær , Østergaard Søren Dinesen
Published: February 2025

Importance

The diagnosis of schizophrenia and bipolar disorder is often delayed several years despite illness typically emerging in late adolescence or early adulthood, which impedes initiation of targeted treatment.

Objective

To investigate whether machine learning models trained on routine clinical data from electronic health records (EHRs) can predict diagnostic progression to schizophrenia or bipolar disorder among patients undergoing treatment in psychiatric services for other mental illness.

Design, Setting, and Participants

This cohort study was based on data from EHRs from the Psychiatric Services of the Central Denmark Region. All patients aged 15 to 60 years with at least 2 contacts (at least 3 months apart) with the Psychiatric Services of the Central Denmark Region between January 1, 2013, and November 21, 2016, were included. Analysis occurred from December 2022 to November 2024.

Exposures

Predictors based on EHR data, including medications, diagnoses, and clinical notes.

Main Outcomes and Measures

Diagnostic transition to schizophrenia or bipolar disorder within 5 years, predicted 1 day before outpatient contacts by means of elastic net regularized logistic regression and extreme gradient boosting (XGBoost) models. The area under the receiver operating characteristic curve (AUROC) was used to determine the best performing model.

Results

The study included 24 449 patients (median [Q1-Q3] age at time of prediction, 32.2 [24.2-42.5] years; 13 843 female [56.6%]) and 398 922 outpatient contacts. Transition to the first occurrence of either schizophrenia or bipolar disorder was predicted by the XGBoost model, with an AUROC of 0.70 (95% CI, 0.70-0.70) on the training set and 0.64 (95% CI, 0.63-0.65) on the test set, which consisted of 2 held-out hospital sites. At a predicted positive rate of 4%, the XGBoost model had a sensitivity of 9.3%, a specificity of 96.3%, and a positive predictive value (PPV) of 13.0%. Predicting schizophrenia separately yielded better performance (AUROC, 0.80; 95% CI, 0.79-0.81; sensitivity, 19.4%; specificity, 96.3%; PPV, 10.8%) than was the case for bipolar disorder (AUROC, 0.62, 95% CI, 0.61-0.63; sensitivity, 9.9%; specificity, 96.2%; PPV, 8.4%). Clinical notes proved particularly informative for prediction.

Conclusions and Relevance

These findings suggest that it is possible to predict diagnostic transition to schizophrenia and bipolar disorder from routine clinical data extracted from EHRs, with schizophrenia being notably easier to predict than bipolar disorder.
Comparing International Revision Incidence of Commonly Used Breast Implants
Authors: Vrolijk J. Juliët , Becherer Babette E. , Garduce Patrick , Pourghaderi Ahmad Reza , Young-Afat Danny A. , van der Hulst René R. J. W. , Farrell Gillian , Walker Melanie , Tansley Patrick , Mureau Marc A. M. , Earnest Arul , Ahern Susannah , Rakhorst Hinne A.
Published: February 2025

Importance

Despite the widespread use of breast implants, to date, no large-scale international studies on long-term revision incidence of different implant types have been conducted.

Objective

To determine whether international data could be combined using a harmonized dataset to increase power and investigate clinically relevant differences in complication-related revision incidence between breast implant types.

Design, Setting, and Participants

This multicenter, population-based cohort study used data from the Australian Breast Device Registry and the Dutch Breast Implant Registry from 2016 to 2021. Time-to-event analysis was performed using a frailty Cox proportional hazards regression model with pooled data. The study included all permanent breast implants that were inserted for primary postmastectomy or benign breast reconstruction or cosmetic augmentation. Data were analyzed from January 1, 2016, through December 31, 2021.

Exposure

Permanent breast implants grouped based on implant shape, shell, and fill.

Main outcomes and measures

Complication-related revision incidence between breast implant types.

Results

Data exchange between registries was successful. In total, 21 115 reconstructive and 129 854 cosmetic breast implants inserted in patients with a median (IQR) age of 47 (38-55) years and 31 (25-38) years, respectively, were included. Overall complication-related revision was 6.3% for reconstructive and 1.2% for cosmetic implants. For reconstructive implants, hazard ratios (HRs) for implant types showed no significant differences compared with anatomical textured-silicone implants. For cosmetic implants, anatomical polyurethane-silicone implants showed a lower risk of revision (HR, 0.38; 95% CI, 0.22-0.64) compared with anatomical-textured-silicone implants. At 5 years, no significant differences in cumulative revision incidence were observed between implant types for either reconstructive or cosmetic implants.

Conclusions and relevance

This study showed that international datasets can be pooled to assess real-world incidence of breast implant revision, which is anticipated to generate a foundation on which future breast implant studies can be based.
Mobile Devices Restricted—Updating the Surgical Timeout
Authors: McCarthy James E. , Rao Venkat K.
Published: February 2025

This Viewpoint discusses smartphone use in the operating room.
Identification of a basal body‐localized epsilon‐tubulin in Leishmania
Authors: Seth Arunava , Das Anubhab , Datta Rupak
Published: February 2025

Epsilon‐tubulins have been identified in only a few organisms to date. We identified an epsilon‐tubulin in Leishmania major (Lmε‐tubulin) exhibiting significant sequence similarity and conservation of functional domains with its counterparts. It is expressed in both promastigote and amastigote forms of the parasite. For localization studies, we generated a Leishmania strain expressing the endogenous Lmε‐tubulin tagged with mNeonGreen by CRISPR‐Cas9. Imaging of this strain revealed that Lmε‐tubulin is located near the kinetoplast and at the flagellar base, indicating basal body localization. Lmε‐tubulin is not part of the microtubular network since its localization remained unaltered upon treatment with nocodazole, a microtubule disruptor. This is the first experimental identification of an ε‐tubulin not only in Leishmania but in the entire Trypanosomatidae family.
Cybernationalism
Authors: LaSaine Emma‐Claire
Published: February 2025

Cybernationalism refers to the expression, construction, or organization of nationalism through use of the Internet. Alternately called
digital nationalism
,
Internet nationalism
, and
virtual nationalism
, this form of nationalism is unique to the information age. Internet communication differs from traditional print media in terms of its geographical reach and temporality, its participatory nature and the opportunities it offers for anonymity, and the dominance of English‐language and US‐based digital technology companies. These features influence the process of national identity formation, organizing opportunities for insurgent nationalist movements, and opportunities for states to solidify hegemonic nationalisms through the Internet.
Race, Racism, and Mental Health
Authors: Talbert Ryan D. , Ren Junlan
Published: February 2025

Informed by insights from the stress process model and critical race theory, this entry offers a concise synthesis of sociological inquiry into associations between race/ethnicity and mental health. As a racialized social system and fundamental determinant of health, racism shapes ethnoracial variation in mental health via inequitable stress exposure, access to resources, and institutional responses. Research generally identifies more similarities than differences in mental health across races/ethnicities, though patterns often depend on the measure used. When differences arise, Asian, Latinx, and Black Americans typically have a lower prevalence of mental illness than white Americans and Native Americans, though extensive variation exists within all of these groups. Future inquiry can benefit from critically examining the social determinants of mental health that extend from systemic racism (e.g., racialized stressors). The diversifying ethnoracial composition and heterogeneity within groups provide an opportunity for scholarship to enhance understanding and theorizing of associations between race/ethnicity and mental health.
Corrections
Authors: Moraro Piero
Published: February 2025

This entry outlines the history of the correctional system, focusing on the evolution in prison design from the eighteenth to the twenty‐first century. It presents the main arguments in the debate about the aims and justifications of state punishment. It also covers current trends in corrections, including the dominance of managerialism and risk management, and the rise of trauma‐informed approaches to prisons. Finally, recent arguments for reform of the correctional system, including penal abolitionism, are discussed.
Economic Development
Authors: Beamish Rob
Published: February 2025

Economic development studies are concerned with how nation‐states have, could, and/or should improve their populations' quality of life, reduce the infant mortality rate, and increase life expectancy through economic development. Despite the assessments of different development initiatives after World War II and the rise of development studies, there is no consensus on how best to pursue these goals. Nonetheless, the politically and socially important pursuit of economic development continues, and involves scholars, nation‐states, regional and international organizations, nongovernmental organizations, and philanthropic foundations. This entry examines six different phases of economic development and their theoretical perspectives during the post‐World War II period: the theory of modernization, which extended from 1945 into the 1960s; the development theory of Andre Gunder Frank and world‐systems theories of Immanuel Wallerstein that dominated in the 1960s and 1970s; the 1980s “developmental state” or “hard state” approach following the development successes of the East Asian Tigers; the neoliberal approach that took hold in the 1980s; the neoinstitutional approach beginning in the 1990s; and the rethinking of economic development in terms of genuine progress indicators rather than gross domestic product.
Media and the Public Sphere
Authors: Carpentier Nico
Published: February 2025

Reflections on media and the public sphere draw heavily on Habermas's definition of the concept. Alternative models have been developed, that build on the Habermasian approach, such as Nancy Fraser's counterpublics, although the concept is declining in popularity. This entry argues that how the field of communication and media studies uses the concept to make sense of the role of communication in noninstitutionalized politics is characterized by three dimensions: the normative versus the neutralized‐descriptive, the media‐centric versus the society‐centric, and the structural(ist) versus the cultural(ist).
Poverty and Free Trade
Authors: Henning Christoph
Published: February 2025

This entry discusses the dominant approaches to poverty in economic theory and argues that they are fundamentally flawed: they do not work in practice and rely on questionable models of ideal markets. Neoliberalism has led to increasing poverty worldwide and needs to be overcome by a more substantial understanding of poverty (not only relying on money and markets, but on real functions and the good life).
Popular Culture Forms: Zoos
Authors: Franklin Adrian
Published: February 2025

The number of zoos (zoological gardens) around the world grew dramatically during the twentieth century from 120 in 1920, to 309 by 1959, to 883 by 1978, though their visitor numbers peaked in the 1960s. By the 1980s, however, zoos still rivaled most other leisure attractions. San Diego and Washington zoos are both visited by over 3 million people annually, London Zoo by over 1.3 million, Berlin Zoo by 2.5 million, Ueno Zoological Gardens in Tokyo by 7.2 million, and Beijing Zoo by 8 million.
Stratification, Race/Ethnicity and
Authors: Kaplan David H.
Published: February 2025

This entry examines the different ways by which ethnicity/race and stratification are conjoined. It first looks into how separate ethnic groups can be placed within ranked systems, and various means by which social stratification is manifest. It then explores how stratification can heighten and even create ethnic distinctions. It shows how ethnic stratification, especially when coupled with spatial segregation, actively damages the life prospects and opportunities for members of subordinate ethnic groups. Finally, it discusses the phenomenon of ethnonationalism which upholds ethnic stratification at the national scale.
Women's Health
Authors: Shinberg Diane S.
Published: February 2025

Women's health encompasses the physical, emotional, and social health and well‐being associated with female reproductive and sexual development over the life cycle, or any medical condition that is more common among people who identify as women. The sociology of women's health includes the study of gendered politics within medicine, medical training, doctor–patient interactions, self‐care, illness behavior, and healthcare utilization. Women's health can be more broadly construed to include the relationships between gender inequality (gender as a social institution) and health, even among men.
A Radiation‐Activated and Self‐Cascade Nano‐Immunostimulator Triggers a Potent Abscopal Effect Against Distant Tumors
Authors: Shao Bianfei , Liang Xiuqi , Xiang Zhongzheng , Liu Fang , Zeng Yuanyuan , He Tao , Zhu Shunyao , Li Xinchao , Gao Huile , Mi Peng , Liu Lei , Gong Changyang
Published: February 2025

Radiotherapy (RT) inhibits local tumors by stimulating reactive oxygen species (ROS) generation, and sometimes suppresses distant tumors known as the abscopal effect. However, the abscopal effect is rarely observed in clinic, due to insufficient tumor‐associate antigens (TAAs) and weak immune stimulation. Here, a radiation‐activated and self‐cascade nano‐immunostimulator (RAIDER) is fabricated to trigger a potent abscopal effect against distant tumors by unleashing cascade‐amplified ROS generation and boosting antigen presentation. After accumulation in tumors, RAIDER undergoes HAase‐triggered deshielding and charge‐reversal, and GE11 enriched liposomal core and CpG are both released. Under following RT, protoporphyrin IX‐induced Cherenkov radiation‐photodynamic therapy (CR‐PDT) elicits ROS generation, leading to disintegration of RAIDER and catalase (CAT) burst release. Meanwhile, by the combination of RT, CR‐PDT, and CAT‐induced O2 supply, self‐cascade ROS generation is achieved to enhance lysis of tumor cells and release of massive TAAs. Subsequently, the co‐stimulation of TAAs and the released CpG activates dendritic cell maturation to boost antigen presentation, resulting in a strong systemic immune response. Combined with RT, RAIDER exhibits a potent abscopal effect, with an average distant tumor growth inhibition of ≈70.3%. Overall, the strategy amplifies antitumor effect of RT from local to systemic, holding a potential against local and distant tumors.
High‐Performance Magnesium‐Organic Batteries Enabled by a Multielectron Redox‐Bipolar Polyaniline Cathode
Authors: Zhao Yazhen , Zhou Miao , Zeng Xiaoqin , Yang Jun , Wang Jiulin , NuLi Yanna
Published: February 2025

Rechargeable magnesium batteries (RMBs) are emerging as a safer, high‐capacity alternative to lithium‐ion batteries due to the high volumetric capacity and reduced dendrite formation of magnesium anode. Among different cathodes of RMBs, bipolar‐type materials further enhance the energy density of RMBs by balancing high redox potential with specific capacity. Herein, the application of emeraldine base polyaniline (PANI) as a bipolar‐type cathode material for RMBs is explored. PANI exhibits both p‐ and n‐type charge storage behaviors, enabling a high specific capacity of 186.8 mAh g−1 with stable cycling performance at the current density of 200 mA g−1 and a high power density of 6341.8 W kg−1 superior to traditional materials. First principle calculations and ex situ characterizations reveal that the molecular structure of PANI supports a bipolar charge storage mechanism. Additionally, the pouch cells based on PANI demonstrate reliable operation and flexibility, positioning PANI as a promising cathode for advanced RMBs and other energy storage systems.
Dual‐Functional Layer Engineering Unlocking Dendrite‐Free and High‐Performance Zinc Metal Anodes
Authors: Liu Yanan , Xie Jichang , Ding Ye , Xu Jie , Huang Dongsheng , Wang Yingke , Chen Shuai , Hu Qionglei , Xu Liangliang , Yang Lijun
Published: February 2025

Developing a highly stable and dendrite‐free zinc (Zn) anode is crucial for the commercial application of aqueous Zn‐ion batteries. Herein, a dual‐functional layer interface is constructed on the Zn anode surface via femtosecond laser processing strategy, and the effect of periodic micro–nano structures on accelerating the transport dynamics of Zn ions and suppressing dendrite growth is investigated. The surface oxide layer exhibits strong affinity and a low diffusion barrier for Zn ions, significantly inhibiting corrosion and side reactions. Meanwhile, the subsurface dislocation layer can suppress the deposited stress and provide uniform stress distribution to improve the strain resistance of the electrode. These integrated merits enable Zn anodes with the dual‐functional layer a high reversibility of 99.11% for 1000 cycles, and impressive cyclability for 2678 h at 2 mA cm−2/1 mAh cm−2. The assembled full cell exhibits a maximum of 1300 cycles with an enhanced capacity retention rate. Notably, the large‐area pouch cell maintains stable cycling for 100 h and exhibits excellent flexibility in flexible Zn‐ion battery systems. This work highlights the crucial role of femtosecond laser‐induced periodic micro–nano structures in optimizing Zn deposition and stimulates the precise control of dislocation characteristics for achieving highly reversible Zn anodes.