bluuebunny/crossref_metadata_2025 huggingface dataset:
Rest‐Activity Rhythms Are Associated With Prevalent Cardiovascular Disease, Hypertension, Obesity, and Central Adiposity in a Nationally Representative Sample of US Adults
Authors: Makarem Nour , German Charles A. , Zhang Zhanhao , Diaz Keith M. , Palta Priya , Duncan Dustin T. , Castro‐Diehl Cecilia , Shechter Ari
Published: December 2023

Background

Rest‐activity rhythms (RARs), a measure of circadian rhythmicity in the free‐living setting, are related to mortality risk, but evidence is limited on associations with cardiovascular disease (CVD) and its risk factors.

Methods and Results

Participants included 4521 adults from the 2013 to 2014 National Health and Nutrition Examination Survey physical activity monitoring examination. Wrist‐worn ActiGraph GT3X+ data were used to estimate RARs. Multivariable logistic models evaluated associations of RARs with prevalent CVD, hypertension, obesity, and central adiposity. Participants (mean age, 49 years) in the highest versus lowest tertile of relative amplitude (greater circadian rhythmicity) had 39% to 62% lower odds of prevalent CVD, hypertension, obesity, and central adiposity. A more active wake period was associated with 19% to 72% lower CVD, hypertension, obesity, and central adiposity odds. Higher interdaily stability (regular sleep‐wake and rest‐activity patterns) was related to 52% and 23% lower CVD and obesity odds, respectively. In contrast, participants in the highest versus lowest tertile of intradaily variability (fragmented RAR and inefficient sleep) had >3‐fold and 24% higher CVD and obesity odds, respectively. A later and less restful sleep period was associated with 36% to 2‐fold higher CVD, hypertension, obesity, and central adiposity odds. A statistically significant linear trend was observed for all associations (
P
‐trend<0.05).

Conclusions

A robust, stable, and less fragmented RAR, an active wake period, and an earlier and more restful sleep period are associated with lower prevalent CVD, hypertension, obesity, and central adiposity, with evidence of a dose‐response relationship. The magnitude, timing, and regularity of sleep‐wake and rest‐activity patterns may be important targets for reducing cardiovascular risk.
Right Ventricular‐Vascular Uncoupling Predicts Pulmonary Hypertension in Clinically Diagnosed Heart Failure With Preserved Ejection Fraction
Authors: Chen Zheng‐Wei , Chung Yi‐Wei , Cheng Jen‐Fang , Huang Chen‐Yu , Chen Ssu‐Yuan , Lin Lian‐Yu , Lai Hung‐Chun , Wu Cho‐Kai
Published: December 2023

Background

Pulmonary hypertension (PH) is highly prevalent in patients with heart failure with preserved ejection fraction (HFpEF), and it is a strong predictor of adverse outcomes. We aimed to determine possible echocardiographic parameters to predict the presence of PH in patients with HFpEF

Methods and Results

A total of 113 patients with HFpEF were prospectively enrolled from November 2017 to July 2022. The patients underwent invasive cardiac catheterization and simultaneous echocardiography at rest and during exercise. The parameters indicating right ventricle‐pulmonary artery uncoupling, including tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and tricuspid annular systolic velocity (TAS’)/PASP were calculated. Receiver operating characteristic curve analysis was used to determine the optimal cut‐off points of TAPSE/PASP and TAS’/PASP to differentiate patients with HFpEF with PH from those without PH. Sixty‐eight patients with HFpEF with PH and 45 without PH were included. Those with PH had lower TAPSE/PASP and TAS’/PASP at rest and during exercise compared with those without PH. Both resting/stress TAPSE/PASP and TAS’/PASP were correlated with rest/exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In multivariable regression analysis, TAPSE/PASP remained a significant predictor of exercise pulmonary capillary wedge pressure and mean pulmonary artery pressure. In receiver operating characteristic curve analysis, the optimal cut‐off points of TAPSE/PASP and TAS’/PASP to differentiate patients with HFpEF with PH from those without PH were ≤0.62 and ≤0.47, respectively.

Conclusions

Right ventricle‐pulmonary artery uncoupling is closely correlated with abnormal rest/exercise hemodynamics (pulmonary capillary wedge pressure and mean pulmonary artery pressure) in patients with HFpEF. TAPSE/PASP and TAS’/PASP can be useful parameters to detect PH in patients with HFpEF.
Impact of Bariatric Surgery on Left Ventricular Structure and Function
Authors: Hughes Diarmaid , Aminian Ali , Tu Chao , Okushi Yuichiro , Saijo Yoshihito , Wilson Rickesha , Chan Nicholas , Kumar Ashwin , Grimm Richard A. , Griffin Brian P. , Tang W. H. Wilson , Nissen Steven E. , Xu Bo
Published: December 2023

Background

Obesity leads to an increased risk of cardiovascular disease morbidity and death, including heart failure. Bariatric surgery has been proven to be the most effective long‐term weight management treatment. This study investigated the changes in cardiac structure and function after bariatric surgery, including left ventricular global longitudinal strain.

Methods and Results

There were 398 consecutive patients who underwent bariatric surgery with pre‐ and postoperative transthoracic echocardiographic imaging at a US health system between 2004 and 2019. We compared cardiovascular risk factors and echocardiographic parameters between baseline and follow‐up at least 6 months postoperatively. Along with decreases in weight postoperatively, there were significant improvements in cardiovascular risk factors, including reduction in systolic blood pressure levels from 132 mm Hg (25th–75th percentile: 120–148 mm Hg) to 127 mm Hg (115–140 mm Hg;
P
=0.003), glycated hemoglobin levels from 6.5% (5.9%–7.6%) to 5.7% (5.4%–6.3%;
P
<0.001), and low‐density lipoprotein levels from 97 mg/dL (74–121 mg/dL) to 86 mg/dL (63–106 mg/dL;
P
<0.001). Left ventricular mass decreased from 205 g (165–261 g) to 190 g (151–236 g;
P
<0.001), left ventricular ejection fraction increased from 58% (55%–61%) to 60% (55%–64%;
P
<0.001), and left ventricular global longitudinal strain improved from −15.7% (−14.3% to −17.5%) to −18.6% (−16.0% to −20.3%;
P
<0.001) postoperatively.

Conclusions

This study has shown the long‐term impact of bariatric surgery on cardiac structure and function, with reductions in left ventricular mass and improvement in left ventricular global longitudinal strain. These findings support the cardiovascular benefits of bariatric surgery.
Investigation of Mesosphere and Lower Thermosphere Dynamics over Central and Northern Peru Using SIMONe Systems
Authors: Conte J. Federico , Chau Jorge L. , Yiğit Erdal , Suclupe José , Rodríguez Rodolfo
Published: December 2023

One year of Spread spectrum Interferometric Multistatic meteor radar Observing Network (SIMONe) measurements are analyzed and compared for the first time between two low-latitude locations in Peru: Jicamarca (12°S, 77°W) and Piura (5°S, 80°W). Investigation of the mean horizontal winds and tides reveals that mesosphere and lower thermosphere (MLT) planetary-scale dynamics are similar between these two locations, although differences can be seen in some tidal components, e.g., the diurnal tide. On the other hand, 28-day median values of the momentum fluxes obtained with 4-h, 4-km time–altitude bins indicate that the mesoscale dynamics differ significantly between Jicamarca and Piura, places separated by approximately 850 km. From the middle of July until October 2021, a strong acceleration of the background zonal wind by westward-propagating gravity waves (GWs) is observed above ∼90 km at both locations, although with larger amplitudes over Jicamarca. From the middle of January until April 2022, a second strong acceleration of the background zonal wind, again by westward-propagating GWs, is observed, but this time with larger amplitudes over Piura. The latter is further supported by the dominance of negative vertical gradients of the zonal momentum flux above 89 km of altitude. Thus, these results observationally confirm the previous studies based on general circulation model simulations indicating that the directions of the zonal GW drag and the zonal background wind coincide in the low-latitude MLT. The weak correlations between the horizontal wind gradients over Jicamarca and Piura reinforce the fact that the mesoscale dynamics are different at these two locations.
Contesting corporate responsibility in the Bangladesh garment industry: The local factory owner perspective
Authors: Fontana Enrico , Dawkins Cedric
Published: December 2023

In the developing economy of Bangladesh, local factory owners in the garment industry have felt great pressure to improve factory safety, but the costs for those improvements are not shared by the global apparel firms that wield immense influence over them. Consequently, we examine whether multi-stakeholder initiatives (MSIs), as vehicles of corporate social responsibility (CSR), offer platforms for democratic oversight or merely serve as new arenas to exercise corporate power. Given their role in connecting global and local contexts and their history of safety incidents, local factory owners possess a unique perspective on the impact and contested nature of CSR in global supply chains. This article presents a qualitative study of MSIs in the Bangladesh garment industry, particularly after the Rana Plaza collapse. Through interviews with local factory owners and executive managers, we explore the reasons behind their opposition to CSR as exercised by global apparel firms, and the contestation of those practices by their local business association. Our findings lead us to conclude that garment industry MSIs are unlikely to be effective without labor procurement practices that harmonize global and local interests to mitigate the competitive pressures on local factory owners.
Can TV Politics Improve the Trust Pattern of “Intimate Central Government and Alienate Local Government”?
Authors: Fan Hongmin , Liu Chang , Zhang Nan
Published: December 2023

The hierarchical and descending trust pattern among Chinese citizens toward governments at all levels, characterized by a stronger trust in the central government and a weaker trust in local governments, often leads to the “Tacitus trap” in local government governance. As a new platform for public participation and local government supervision, can TV political programs improve the trust pattern of “intimate central government and alienate local government,” and achieve a balance of trust between the central and local governments? Using data from the Social Consciousness Survey Data of Netizens 2018, we conducted an empirical analysis of the impact of TV political programs on residents’ trust patterns toward different levels of government. The results of this study show that: first, the opening of TV political programs can significantly narrow the trust gap between the central and local governments. This primarily achieved by significantly increasing the level of trust that residents have in the provincial government. Second, influence mechanism reveals that the introduction of of TV political programs can reduce the residents’ trust gap between central and local governments mainly by bolstering government transparency, fortifying government responsiveness, and boosting residents’ political efficacy. Third, the heterogeneity analysis indicates that TV political programs can significantly improve the trust gap between central and local governments among various groups, including women, youth, democratic party members and the public, high digitalization ability, residents in the east and provincial capital cities. Fourth, during the COVID-19 pandemic, the opening of TV political programs significantly increase residents’ trust in the central government but do not significantly raise residents’ trust in local governments. This may, to some extent, reinforce the trend of “intimate central government and alienate local government” among the public .
Spiritualizing psychiatry: Transpersonal psychology, DSM, and Brazilian research about spirituality
Authors: BACCETTO Lucas
Published: December 2023

This article analyzes the trajectory of the diagnostic category ‘Religious or Spiritual Problem’, included in 1994 in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, the main diagnostic manual of North American psychiatry. Three moments of this trajectory are highlighted here: the beginning with transpersonal psychology, the debate around its inclusion in the DSM-IV, and the mobilization of the category in psychiatric research about spirituality in Brazil. Drawing on an array of material gathered through archival, bibliographical, and ethnographic research, I point out that the trajectory of ‘Religious or Spiritual Problem’ mirrors the shifts in spirituality scholarly debates in social sciences, from New Age practices to their institutionalized forms. Although psychiatry is known to historically pathologize religious or spiritual experience, I argue that the mobilization of such category acts toward legitimizing contemporary psychiatric research about spirituality.
Self-Tracking among Young People: Lived Experiences, Tensions and Bodily Outcomes
Authors: Alevizou Panayiota , Michaelidou Nina , Daskalopoulou Athanasia , Appiah-Campbell Ruby
Published: December 2023

Self-tracking enables people to quantify and measure lifestyle and fitness activities and experiences. Our study focuses on the role of self-tracking in young people’s relationship with their body and their lived, ‘fleshy’ experiences in the social world. We draw on 23 in-depth interviews with young people using a life story approach. Our findings show that self-tracking affords young people to engage in different types of ‘body work’, to care for and transform their body that is in constant flux by treating it as either a ‘private’ or ‘shared’ project. We contribute to ongoing debates about the role of self-tracking in young people’s lives by offering a holistic approach that considers the individual and social circumstances that render self-tracking an ongoing, iterative, cumulative and embodied process of discovery, learning and lived and ‘fleshy’ experience.
Impact of social support and religiosity/spirituality on recovery from acute cardiac events and heart surgery in Switzerland
Authors: Eglin Micha , Schmid Jean-Paul , Ronel Joram , Khatami Ramin , Leiggener Christoph , Koenig Harold G. , Hefti René
Published: December 2023

Objective

The aim of this study was to evaluate the impact of social support and religiosity/spirituality (R/S) on the recovery from an acute cardiac event or cardiac surgery during cardiac rehabilitation (CR).

Methods

In this prospective study, a convenience sample of 159 patients participating in a CR program were enrolled. Religiosity/spirituality, social support, anxiety, depression, health related quality of life (QoL), and exercise capacity (6-min walk test, cycle ergometer test) were assessed.

Results

Social support was significantly associated with less anxiety ( p < .01), less depression ( p < .01), and better QoL ( p < .05) on admission. After adjustment for age, gender, education level, and morbidity, social support remained significantly associated with less depression ( p < .001). Religiosity/spirituality was significantly associated with less depression ( p < .05), better QoL ( p < .05), and better exercise capacity ( p < .05) at admission. After adjustment for covariates, however, significance was lost. There were no significant impact of either social support or R/S on the course of CR measured by change in QoL or exercise capacity.

Conclusion

Social support may be a protective factor against depression in the recovery from cardiac events or surgery. Neither social support nor R/S had a significant impact on the course of the 3-week CR program.
Transfer-Intending Women in Computing: An Exploratory Analysis of Trends, Characteristics, and Experiences Shaping Women’s Computing Participation
Authors: Blaney Jennifer M. , Rodriguez Sarah L. , Stevens Amanda R.
Published: December 2023

Objective: Community college transfer pathways are critical for advancing gender equity in STEM. Yet, community college students are often ignored within studies of women’s participation in undergraduate computing. In a first effort to address this gap in the literature, this paper explores the composition of transfer-intending computing students over time (Study One) and gender differences in the characteristics and experiences of transfer-intending computing students (Study Two). Methods: This descriptive paper uses Center for Community College Student Engagement (CCCSE) survey data. Study One relies on a sample of nearly 30,000 transfer aspirants in computing across the United States between 2011 and 2019, allowing us to explore trends over time. Study Two examines a subset of over 9,000 students from the most recent survey cohort, providing a more nuanced snapshot of transfer-intending computing students. Descriptive statistics were used to examine how student experiences differ by gender and race/ethnicity. Results: Study One findings show that women’s representation among transfer-intending computing students has declined over time. Study Two results reveal that, relative to men, women spend more time caregiving, commuting, studying, in student groups, and utilizing advising services, pointing to unique demands on women’s time. We also identify significant differences in how Black and Indigenous women financed their college, relative to other women. Conclusions: While women are underrepresented among transfer-intending computing students, they represent a diverse group to support. We point to recommendations for policy and practice to support transfer-intending women in STEM and future research that considers intersectional identities among this diverse group.
God, Grace, and Equality in 2 Cor. 8.13–14
Authors: Briones David E
Published: December 2023

What does ‘equality’ (ἰσότης) mean in 2 Cor. 8.13–14? What is the significance of the phrase ἀλλʼ ἐξ ἰσότητος (8.13)? To date, no one has sufficiently dealt with Paul’s striking use of ἐκ in the phrase ἐξ ἰσότητος. Dieter Georgi sought to explain it by comparing Paul’s use of ἰσότης with Philo’s understanding of the term as a divine cosmic power, but the majority of scholars have rightly rejected this comparison as unconvincing and implausible. However, in so doing, they overlook one of his major insights. Paul wrote ἐξ ἰσότητος (8.13). This article accounts for Paul’s otherwise unexpected use of ἐκ by advancing a new reading of ἀλλʼ ἐξ ἰσότητος (8.13) that takes seriously Paul’s broader theology of the Christ-gift in 2 Cor. 8–9. Contrary to many who reject the theological significance of ἰσότης in 2 Cor. 8.13–14, this article will disclose the nature of equality in Christ, God’s fundamental role in its realization, and its socially disruptive effects on gift-giving relationships in the church. What results is a sociotheological reading of ἰσότης, one that centers on the grace of God in Christ (2 Cor. 8.9).
Bringing the knowledge spillover theory of entrepreneurship to circular economies: Knowledge and values in entrepreneurial ecosystems
Authors: Audretsch David B , Fiedler Antje
Published: December 2023

Transitioning from a linear economy to a circular economy (CE) supports the realisation of societal values towards more sustainable development. This article identifies mechanisms by which circularity can be embedded in entrepreneurial ecosystems (EEs) through the flow of relevant knowledge and values. It presents a dynamic model that illustrates how reverse knowledge spillovers from entrepreneurs can complement traditional technological knowledge spillovers from incumbents, ultimately advocating for CE values and validating circular knowledge. The validated circular knowledge, in turn, alters the knowledge filter of incumbents, leading to shifts in their research and development (R&D) focus and their willingness to embrace new knowledge. This symbiotic relationship of knowledge spillovers between circular start-ups and incumbents can significantly enhance the motivation of participants in EEs to adopt CE values and leverage circular knowledge. Overall, the article shows how knowledge spillovers can facilitate a wider adoption of circular knowledge and CE values within EEs.
Information behavior and HIV/AIDS/STI awareness among Bangladeshi female sex workers: Do informational programs help?
Authors: Shuva Nafiz Zaman , Taisir Radia , Mallick Parvez Sazzad
Published: December 2023

Using de Certeau's concepts of “tactics” and “strategies,” this study explores the everyday information seeking behavior of female sex workers (FSWs) in Bangladesh. This study also examined the effectiveness of informational programs on HIV/AIDS and STI in empowering FSWs to negotiate condom use during sex. A mixed method research design was employed in this study, which included face-to-face surveys with 116 female sex workers (FSWs) and four focus group discussions (FGDs) with 23 street based FSWs. The study finds that Bangladeshi female sex workers use “tactics” in meeting their information needs. They reported rarely using formal information sources such as government agencies and indicated sometimes being harassed by law enforcement agencies because of their professional status, creating a distance between formal information agencies and their everyday life information seeking. Furthermore, FSWs reported having significant unmet information needs. The findings regarding the effectiveness of HIV/AIDS and STI informational programs indicated that simply providing ‘information’ may not be sufficient to empower FSWs to negotiate safer sexual practices with their clients.
Who With Whom: Matching Therapist and Client in Correctional Institutions
Authors: Heintzsch Ronja , Hamatschek Marie Joséphine
Published: December 2023

The current study investigated variables that are being considered when assigning psychotherapists to individuals convicted of sexual and violent offences. Its main aim is to inform practitioners and researchers alike of potentially beneficial combinations between therapist and client and infer hypotheses for future studies. A mixed-methods approach, combining interviews and a follow-up questionnaire, was employed. Nineteen interviews with forensic practitioners working in socio-therapeutic facilities in Germany were conducted. Relevant matching criteria were extracted from all interviews. 1.) Capacities of therapist, 2.) therapist’s professional background, 3.) (severity of) clinical disorder, 4.) personal fit, and 5.) fit of client into existing groups emerged as top five matching criteria. Directive therapists were viewed as a good match for antisocial or psychopathic offenders. Opinions diverged regarding personality similarity or complementarity in client-therapist dyads. A flexible matching approach may offer unique strengths to enhance treatment outcome. Implications and ideas for future research are discussed.
Professional qualifications, accreditation, and certification in library and information science schools: A global perspective
Authors: Oguz Fatih , Cunningham Chris , Bautista-Puig Núria , Braga Tiago Emmanuel Nunes
Published: December 2023

Library and information science schools and their accreditations play a crucial role in preparing individuals to become effective and competent library and information professionals. A number of efforts have been undertaken to analyze the accreditation standards and procedures for library and information science professionals in a specific context (e.g. country). However, there is limited research from a global perspective. This article provides an overview of the qualifications of library and information science professionals and accreditation and certification in library and information science schools around the world. A non-probability sampling strategy was employed to collect all this information. A total of 586 programs (e.g. undergraduate) from 198 library and information science schools in 69 countries was represented. The results show that an accredited national degree was the most required credential to work as a professional librarian in the field. Master’s degree programs appeared to be the most commonly offered degree programs at these schools, and English was the most popular language of instruction in all degree programs.
The organismic theory of development: Romantic roots of a vital concept
Authors: Wagoner Brady
Published: December 2023

Since the late 18th century, an organismic perspective has been contrasted with a mechanistic perspective. In the former, the whole dominates the parts, while in the latter, the parts dominate the whole. An organismic perspective further sees wholes as self-directed processes of progressive formation ( Bildung) rather than as static configurations or forms ( Gestalten). In sum, the organismic perspective focuses on living, developing, and interconnected wholes, in contrast to mechanical causality. This article explores the roots of the organismic perspective in Johann Wolfgang von Goethe’s scientific work (esp., his morphology), follows its influence through the 19th century, and highlights intersections within 20th-century psychology, particularly Heinz Werner’s organismic–developmental theory. Some key commonalities are a focus on the primacy of the whole, processes over products, the genetic method, (dis)continuities and transitions in development, the primordial unity of the senses, and the making of developmental comparisons. The organismic approach can be used today to revitalize our understanding of the dynamic constitution of culture and mind.
Book review: Gerard Postiglione, Christopher J. Johnstone, and Wesley R. Teter (Eds.), Handbook of Education Policy
Authors: Tilak Jandhyala B. G.
Published: December 2023

Gerard Postiglione, Christopher J. Johnstone, and Wesley R. Teter (Eds.), Handbook of Education Policy. Edward Elgar Publishing, 2023, xiv + 375 pp. £85.50, ISBN: 9781800375055 (Hardback).
Topics Included in Health Literacy Studies in Asia: A Systematic Review
Authors: Duong Hai , Chang Peter
Published: December 2023

The study aimed to review general and specific health literacy studies in different countries in Asia to understand the progress of health literacy researches in the region. English-published studies with quantitative measurements of health literacy were collected through a systematic search in PubMed, Cochrane Library, Embase, and Web of Science, without publication dates limitation. A total of 156 articles on general health literacy, oral, mental, disease-specific health literacy, and eHealth literacy were collected. General health literacy was the most covered topic in 89 articles, followed by eHealth Literacy. Health literacy studies have been conducted in 16 countries and have been increasingly concerned in most of the countries in Asia. China had the largest number of articles, followed by Taiwan. Four studies had participants from more than one country. Education, age, health status, incomes, and living/residential area were significantly associated with health literacy levels in 156 studies, with the prevalence of 55.8%, 28.2%, 20.5%, 17.9%, and 10.9%, respectively. Lower health literacy was related to poorer health outcomes or lower quality of life in 71 studies.
This Prompt or That Prompt: Applying a Trauma-Informed Lens to Writing Instruction for Students With and at Risk for EBD
Authors: Jolivette Kristine , Sanders Sara , Michael Elizabeth , Hackney Aimee J.
Published: December 2023

New science demonstrates how students with and at risk for emotional and behavioral disorders experience trauma at higher rates than their peers. When providing writing instruction to these students, it is imperative that the approaches used be viewed through a trauma-informed lens. This article describes steps teachers can take to view writing prompts and their administration of such prompts through a trauma-informed lens.
Examining the Smart City Generational Model: Conceptualizations, Implementations, and Infrastructure Canada's Smart City Challenge
Authors: Zwick Austin , Spicer Zachary
Published: December 2023

Cohen's Smart City Generational model has been the basis of understanding for the evolution of the Smart Cities movement. However, how does this model align with practitioners’ conceptualization of the term? Our research focuses on Infrastructure Canada's Smart City Challenge (SCC). Through 14 primary interviews and 20 finalist applications, this research reveals that practitioners overwhelmingly understand Smart City building as a government-driven, data-centric endeavor (Smart City 2.0), as opposed to being about vendor transactions (Smart City 1.0), resident engagement (Smart City 3.0), or community co-creation (Smart City 4.0), where the specific technology is of secondary importance to project objectives. We conclude that, rather than moving through distinct generations, the smart cities movement should be understood as a gradual process of municipal public administration modernization as local governments are becoming increasingly savvy and experienced about contracting with technology firms to address urban problems.
The Role of Age in Adult ADHD Quality Care: A Longitudinal Analysis of Electronic Health Record Data
Authors: Callen Elisabeth F. , Clay Tarin , Alai Jillian , Goodman David W. , Adler Lenard A. , Faraone Stephen V.
Published: December 2023

Objective:

Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs).

Methods:

Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms.

Results:

The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more.

Conclusion:

While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients.
Blunt solid organ injury: Resident operative experience on the decline
Authors: de Angelis Paolo , Chandramouli Mathangi , An Anjile , Gupta Aakanksha , Barie Philip S. , Winchell Robert J. , Narayan Mayur
Published: December 2023

Introduction

Duty-hour restrictions, improved non-operative management of injured patients, new or expanded fellowship programs, and the coronavirus disease 2019 (COVID-19) pandemic have hindered resident exposure to operative trauma in the United States. In this study, we investigated trends in resident operative experience in blunt trauma over a 22-year period.

Methods

Accreditation Council for Graduate Medical Education (ACGME) logs from 1999 to 2021 were reviewed. The yearly number of major trauma cases, trauma splenectomies (TS), and liver drainage/repairs (LDR) were extracted. We used the non-parametric Mann–Kendall test to analyze trends. Data are reported as mean ± standard deviation or median (estimated interquartile range, eIQR); alpha = 0.05.

Results

Records from 24,062 respondents were examined. The average number of trauma cases performed by all residents decreased from 42 ± 22 in 1999–2000 to 31 ± 18 in 2020–2021 ( p < .01); median number of cases decreased from 36 (30, 47) to 27 (22, 36). The proportion of TS performed by chief and junior residents among all trauma cases decreased from 9.5% to 7.1% (trend test, p < .01), and from 6.6% to 6.1% (trend test, p = .03) respectively. The proportion of LDR performed by chief and junior residents decreased from 6.9% to 4.7% (trend test, p < .01), and from 4.3% to 3.9% (trend test, p = .03) respectively.

Conclusions

Number of major trauma cases and two common procedures for blunt solid organ injury decreased significantly over the past two decades. These findings should serve as an indicator that structural changes in surgery residency training programs in the United States may be necessary to safeguard resident exposure to operative trauma cases.
Paired DBS and TMS Reveals Dentato-Cortical Facilitation Underlying Upper Extremity Movement in Chronic Stroke Survivors
Authors: Li Xin , Baker Kenneth B. , O’Laughlin Kyle , Chen Jacqueline , Hogue Olivia , Machado Andre G. , Plow Ela B.
Published: December 2023

Background

Cerebellum shares robust di-synaptic dentato-thalamo-cortical (DTC) connections with the contralateral motor cortex. Preclinical studies have shown that DTC are excitatory in nature. Structural integrity of DTC is associated with better upper extremity (UE) motor function in people with stroke, indicating DTC are important for cerebellar influences on movement. However, there is a lack of understanding of physiologic influence of DTC in humans, largely due to difficulty in accessing the dentate nucleus.

Objective

Characterize DTC physiology using dentate nucleus deep brain stimulation (DBS) combined with transcranial magnetic stimulation (TMS) in stroke.

Methods

Nine chronic stroke survivors with moderate-to-severe UE impairment (Fugl-Meyer 13-38) underwent a paired DBS–TMS experiment before receiving experimental dentate nucleus DBS in our first-in-human phase I trial (Baker et al., 2023, Nature Medicine). Conditioning DBS pulses were given to dentate nucleus 1 to 10 ms prior to supra-threshold TMS pulses given to ipsilesional motor cortex. Effects were assessed on motor evoked potentials (MEPs). Size of DBS-conditioned MEPs was expressed relative to TMS MEPs, where values >1 indicate facilitation.

Results

Dentate nucleus DBS led to facilitation of MEPs at short-latency intervals (3.5 and 5 ms, P = .049 and .021, respectively), a phenomenon we have termed dentato-cortical facilitation (DCF). Higher DCF was observed among patients with more severe UE impairment. Diffusion tensor imaging revealed microstructure of thalamo-cortical portion of DTC was related to higher corticomotor excitability.

Conclusions

Our in vivo investigation reveals for the first time in humans the intrinsic excitatory properties of DTC, which can serve as a novel therapeutic target for post-stroke motor recovery.
Video consulting for GP trainees
Authors: Leach Helen , Payne Rebecca , Hanson Isabel , King Kate
Published: December 2023

The COVID-19 pandemic prompted a dramatic shift towards remote and digital consulting in general practice. Supported by the wider political policy for ‘Digital-First’ primary care, many practices began offering a wider range of consultation modalities, including online, telephone and video options. Since the COVID-19 pandemic the proportion of appointments carried out remotely has slightly decreased, but still makes up a significant proportion of appointments. According to the latest data from NHS Digital, over a million video and online consultations took place in 2023 (the data does not differentiate between them). Video consulting is used more often in out-of-hours settings and for nursing home ward rounds. Remote consulting requires specific consultation skills, some interchangeable with other modes of consulting, and all important for future practice.
Treatment, Management, and Otolaryngology Consultation for Epistaxis in the Emergency Room: An Institutional Experience
Authors: Jacobs Daniel , Wang Vickie J. , Chao Janet R. , Manes R. Peter , Lee Yan H.
Published: December 2023

Background

Epistaxis is a common reason for emergency department (ED) visits, accounting for approximately 1 of every 200 ED visits in the United States annually and up to one-third of all otolaryngology (ENT)-related ED encounters.

Objectives

To detail reasons for ENT consultation for epistaxis in the ED, understand how consultation impacts patient care, assess follow-up patterns after emergency care, and study patient care after transfer or referral into the ED.

Methods

Retrospective chart review of 592 adult patients with epistaxis managed in a tertiary care ED setting between 2017 and 2018. Patients with known follow-up, ENT consult in the ED, or admission were included, while patients with trauma, recent head and neck surgery, or abnormal anatomy were excluded.

Results

The most common reasons for ENT consultation for epistaxis were for advanced management, referral to the ED from an outside facility or provider, and recent head and neck surgery. In total, 48.2% of patients treated for epistaxis in the ED received an ENT consultation. ENT consultation was associated with a higher likelihood of receiving absorbable or nonabsorbable packing (92.4% vs 36.1%). In total, 40.4% of patients referred into the ED from an outside facility or provider had no change in their management after receiving an ENT consult. Patients referred to the ED and White patients were significantly more likely to receive an ENT consult. Secondary analyses revealed that more White patients had an established outpatient ENT provider than patients of other races. On multivariate analysis, patients who received an ENT consult spent 75.2 min longer in the ED.

Conclusion

The high percentage of patients referred or transferred to the ED for epistaxis management with no change in interventions after ENT consultation indicates a continued need to develop more precise clinical care pathways. Additionally, there may be gaps between White and non-White patients in access to ENT care.
The effect of “Housing First” on mobile and digital media usage by people experiencing homelessness: A program evaluation based on a randomized controlled trial in Spain
Authors: Martínez-Cantos José-Luis , Martín-Fernández Juan-Ángel , Panadero Sonia
Published: December 2023

In 2014, a non-governmental organization called HOGAR SÍ initiated the Hábitat program as a pioneer attempt to implement the Housing First model in Spain. The present study is part of the evaluation of this program, which was carried out from May 2015 to February 2020 using a form of a randomized controlled trial. The treatment group was compared with a control group (people experiencing homelessness but not selected as Hábitat users), keeping track of their evolution over 18 months. Among the many dimensions that were evaluated (coverage of basic needs, life satisfaction, victimization, physical and mental health, etc.), the study analyzed social support and leisure activities involving the use of mobile media and other communication technologies—along similar lines to some previous research. The main results show that participating in the Hábitat program brought a few improvements in digital inclusion. That is the case of the higher use of mobile phones to receive calls, to connect to the Internet, or to have contact with relatives, partners, or friends. These gains seem to be significant for the increase in perception of available social support by Hábitat users, whereas these changes did not occur in the comparison group to the same extent. Additionally, participating in the program enhances satisfaction with leisure time, as well as the frequency of carrying out some activities such as shopping, watching TV, or doing a pastime or hobby. It could be concluded that the Hábitat program achieved significant improvements in areas beyond specific housing services. The positive effects regarding social support and leisure activities seem to be partly channeled through mobile phones and digital applications; nevertheless, we are aware that further research and discussion on the active role of these technologies in helping people experiencing homelessness is still necessary.
A Picture Is Worth A Thousand Shares: The Case of Destination Canada’s Social Media Visual Storytelling Campaign
Authors: Lever Michael W. , Elliot Statia
Published: December 2023

This case is designed to assess the visual storytelling social media strategy created by Destination Canada (DC), the country’s national destination marketing organization, regarding their objective, to drive demand among international travelers, to uncover insights into how it has performed since the devastating impact of COVID-19, and how the future might unfold. DC curates and shares a variety of unique photos and videos to their Instagram page on a near-daily basis, inspiring users to connect emotionally with the brand, develop a desire to visit, and ultimately choose to travel to Canada. Despite success to date with their strategy, DC has faced unprecedented challenges in the face of the COVID-19 pandemic, which have made their path forward unclear. In this case, students will draw upon visual storytelling and social media engagement concepts in tourism and marketing to examine key data related to DC’s campaign and Instagram engagement across their posts, and ultimately piece together the key information required to evaluate the effectiveness of DC’s campaign, along with where changes may be needed for DC to remain engaged with users post-pandemic.
Service Needs, Context of Reception, and Perceived Discrimination of Venezuelan Immigrants in the United States and Colombia
Authors: Scaramutti Carolina , Schmidt Renae Danielle , Ochoa Lucas Gregorio , Brown Eric Christopher , Vos Saskia Renee , Mejia Trujillo Juliana , Perez Gomez Nicolas Augusto , Salas-Wright Christopher , Duque Maria , Schwartz Seth
Published: December 2023

Executive Summary

Millions of Venezuelans have fled their country in hopes for a better future outside the political and financial turmoil in their home country. This paper examines the self-reported needs of Venezuelans in the United States and Colombia. Specifically, it looks at perceived discrimination in each country and its effect on the service needs of Venezuelan immigrants. The authors used data from a larger project conducted in October to November 2017 to perform a qualitative content analysis on the specific services that participants and others like them would need following immigration. The sample consisted of 647 Venezuelan immigrant adults who had migrated to the United States ( n = 342) or Colombia ( n = 305).

Its findings indicate statistically significant differences between the two countries. Venezuelan immigrants in the United States were more likely to identity mental health and educational service needs, while those in Colombia were more likely to list access to healthcare, help finding jobs, and food assistance. When looking at perceived discrimination, means scores for discrimination were significantly greater for participants who indicated needing housing services, who indicated needing assistance enrolling children in school and who indicated needing food assistance, compared to participants who did not list those needs. Venezuelans who had experienced greater negative context of reception were less likely to indicate needing mental health services, where 11.9 percent of those who did not perceive a negative context of reception responded that they needed mental health services.

Evaluating existing service networks will be essential in working to bridge the gap between the services provided to and requested by Venezuelans. Collaboration between diverse government actors, community-based organizations (CBOs) and other stakeholders can help identify gaps in existing service networks. CBOs can also facilitate communication between Venezuelan immigrants and their new communities, on the need to invest in necessary services.
How Decision Making Develops: Adolescents, Irrational Adults, and Should AI be Trusted With the Car Keys?
Authors: Edelson Sarah M. , Roue Jordan E. , Singh Aadya , Reyna Valerie F.
Published: December 2023

This paper reviews the developmental literature on decision making, discussing how increased reliance on gist thinking explains the surprising finding that important cognitive biases increase from childhood to adulthood. This developmental trend can be induced experimentally by encouraging verbatim (younger) versus gist (older) ways of thinking. We then build on this developmental literature to assess the developmental stage of artificial intelligence (AI) and how its decision making compares with humans, finding that popular models are not only irrational but they sometimes resemble immature adolescents. To protect public safety and avoid risk, we propose that AI models build on policy frameworks already established to regulate other immature decision makers such as adolescents.
One size fits all: How the “Ethiopian Highlands” made Bale Mountains National Park inscrutable
Authors: Chignell Stephen M. , Ramachandran Aishwarya , Satterfield Terre
Published: December 2023

The categories we use to make sense of a place are never neutral. Scientific classifications can maintain ignorance about some aspects of a landscape, even as they create knowledge about others. This article considers this in the context of Ethiopia's Bale Mountains National Park, a landscape whose hydrologic and socio-cultural characteristics have been made inscrutable through the convergence of imperial legacies, processes of knowledge production, and complex biophysical properties. We use the example to conduct a genealogy of the notion of the “Ethiopian Highlands” and its associated metaphors, tracing the political-economic, biophysical, and epistemic factors by which this category came into use, and how these intersected to maintain a particular yet partial vision of the region. By critically analyzing bibliometric data, historical sources, and chains of reasoning in the scientific literature, we show how a small group of foreign experts erroneously conflated the landscapes, peoples, and environmental concerns of one area with those of another. Together these forces reify imperial gazes, perpetuate degraded wilderness narratives, and overlook significant geologic, (paleo)climatic, sociocultural, and land use differences. The result is a simplistic understanding of a distinct hydrosocial landscape, the perpetuation of conflict and resentment, and poorer conservation outcomes.
Latent Class Groups of Concurrent Substance Use Among Adolescents in an Urban Community: Correlates With Mental Health, Access to Drugs and Alcohol, and Risk Perception
Authors: Lardier David T. , Davis Alexandra N. , Verdezoto Carolina S. , Cruz Lynda , Magliulo Sabrina , Herrera Andriana , Garcia-Reid Pauline , Reid Robert J.
Published: December 2023

Background:

Concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of this study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations.

Method:

This study examined data among adolescents in an underserved urban community (N = 1789; 56.90% female; 70.86% Hispanic/Latino/a; meanage = 15.96 ± 1.56). Using latent class analysis (LCA) and multinomial logistic regression modeling, analyses identified independent correlates of latent class membership.

Results:

Five latent classes (LC) were identified including LC group 1: Predominant alcohol use and limited to no concurrent-drug use (n = 213; 11.9%); LC group 2: Concurrent drug and alcohol use including methamphetamine, marijuana and synthetic marijuana use, and alcohol use (n = 74; 4.2%); LC group 3: Concurrent drug and alcohol use, with no marijuana use (n = 204; 11.39%); LC group 4: High Concurrent drug use and alcohol use (n = 204; 11.40%); and LC group 5: Concurrent drug use without alcohol use (n = 1101; 61.52%). Significant between group differences were noted between latent class groups and sociodemographic characteristics. Multinomial logistic regression models identified the associations between sociodemographic characteristics and corollary clinical features of substance use on latent class groupings of alcohol and concurrent drug use.

Conclusion:

Understanding concurrent substance use LC groups among adolescents is essential to providing targeted interventions and treatment programs, as well as early intervention programs that may help reduce substance use during adolescence.