bluuebunny/crossref_metadata_2025 huggingface dataset:
Housing market with informal density agglomeration: Investigating the form-context transition of urban village in China
Authors: Wu Yihao
Published: January 2025

The prevailing discourse in urban planning often relegates the concept of ‘urban informality’ to its margins, typically viewing it as an aberration or market failure needing correction rather than a developmental phase warranting integration. While studies and policies of urban redevelopment have shifted from large-scale, clean-sweep practices to less radical, sustainable regeneration approaches, the local variations and fiscal complexity of these informal settlements render it onerous to find an adaptive spatial governance mode. Focussing on urban villages in Shenzhen, China, this study integrates the concept of the ‘form-context ensemble’ with spatial equilibrium models, thus proposing a revised framework that better accommodates the irregularities (hyper-density but below-market prices) introduced by urban informality with empirical evidence. Our empirical analysis shows that dense settlements under the expected value curve (EVC) can help mitigate housing cost disparities between income groups, while redevelopment will bring the externality to shift the EVC to a higher level, thus enlarging the discrepancy. We propose a three-way trade-off matrix between value, access and amenity for assessing the utility of urban villages, providing a comprehensive framework for balancing various factors in housing policy design and delivery. Our findings suggest that preserving some imformal settlements may enahnce general welfare and economic equity, even as cities pursue selective formalization. This paves the way for adopting a classification scheme and concerted measures for making targeted regeneration policies from municipal management or planning perspectives.
Interfaith prejudice in the United States: The role of social identity complexity
Authors: Bergstrom Veronica NZ , Chasteen Alison L
Published: January 2025

Interfaith prejudice continues to be an understudied challenge in the United States. In three studies, the present research focused on prejudice between atheists and Christians and assessed the role that social identity complexity (SIC), the degree of overlap that an individual perceives between their various social identities, plays in these biases, as well as tested a novel intervention method using SIC to reduce bias. Study 1 assessed the relationship between SIC and prejudice for atheists and Christians and found that higher SIC in Christians was associated with lower levels of prejudice, but SIC was unrelated to prejudice for atheists. Study 2 tested the utility of an SIC intervention for reducing prejudice in Christians and showed a small increase in SIC but no reduction in prejudice towards atheists. A mini meta-analysis in Study 3 assessed the relationship between SIC and prejudice across all three studies and fully replicated Study 1. This line of work was an important first step in uncovering the relationship between SIC and interfaith intolerance for atheists and Christians in the United States. The findings suggest that SIC interventions may have potential for reducing prejudice in Christians, but future researchers will need to use methods that can be tested longitudinally for greater impact.
Sjogren’s Syndrome Complicated by Naso-Orbito-Cerebral Mucormycosis: A Case Report
Authors: Xu Yalin , Chen Qingyong , Sun Dezhong , Wang Dongqing , Lv Huaiqing
Published: January 2025

Background: Sjogren’s syndrome (SS) is a chronic inflammatory autoimmune disease characterized by exocrine gland dysfunction. Mucormycosis is a rare yet life-threatening opportunistic fungal infection caused by Mucor species, with a high mortality rate. In patients undergoing long-term immunosuppressive therapy or corticosteroid use, especially when compounded by conditions such as diabetes or hyperlipidemia, Mucor can become pathogenic. Medical Record Description: We retrospectively analyzed the clinical data of a patient with Sjogren’s syndrome complicated by rhinocerebral mucormycosis, focusing on its clinical presentation and progression. The patient was admitted to the hospital 20 days prior with symptoms of a “nasal infection” caused by a furuncle on the nose. The condition progressively worsened, resulting in nasofacial skin ulceration and necrosis, with black eschar formation around the affected area. Upon admission, comprehensive evaluations, including rapid histopathological and fungal tests, confirmed the diagnosis of mucormycosis. Despite surgical intervention under general anesthesia and antifungal therapy, the clinical outcome was ultimately fatal. Conclusion: Mucor infections commonly occur in patients with immunodeficiency and severe underlying diseases. The clinical manifestations are diverse, often presenting with skin tissue necrosis and the formation of black eschar. Fungal culture and histopathological examination remain the gold standards for diagnosing mucormycosis, while imaging studies are crucial for evaluating the extent of fungal dissemination and bone involvement. Given the rapid progression of the disease, early diagnosis and prompt treatment are critical for improving survival rates.
Trade Integration and Supply Disruptions: Sharing the Pain From a Russian Gas Shut-off to Europe
Authors: Albrizio Silvia , Bluedorn John , Brasier Rachel , Koch Christoffer , Pescatori Andrea , Stuermer Martin
Published: January 2025

How does market size—which increases with greater trade integration—affect the economic propagation of supply shocks? We examine this question through the case of a Russian gas shut-off to the European Union (EU). An open-economy, multi-sector general equilibrium model suggests that the adverse economic impact on the EU shrinks five-fold if trade integration with the global liquefied natural gas (LNG) market is considered. Greater international integration provides a buffer for the EU through trade. The flip side of integration is that other LNG importers around the world see adverse effects from higher prices. Still, the overall, combined economic damage for the EU and other LNG importers with integration is less than half of that in the counterfactual case without. Fostering more trade integration can help make economies more resilient to supply shocks.

JEL Classification: E23, E32, F51, N70, N74, Q41, Q43
Effectiveness of Extended Screening and Brief Intervention (X-SBI) on Substance Misuse and Related Outcomes in Correctional Settings
Authors: Ghosh Abhishek , Pillai Renjith R , Vij Jatina , Maulik Pallab K , Bhanker Nisha , Thakur Urvashi , Rani Ritu , Basu Debasish
Published: January 2025

Background:

Screening and brief intervention (SBI), effective in community health care, show inconsistent results in correctional settings (CS). We hypothesized that SBI needs adaptation for the incarcerated population. The study aimed to evaluate the effectiveness of extended SBI (X-SBI) for substance misuse in CS.

Methods:

A controlled trial was conducted in two federal CSs in India. X-SBI included coping skills training, risk behavior counseling, and acceptance-based stigma reduction, while the control group received screening, advice, and brief psychoeducation. Both groups received three sessions with 188 participants each, with a “moderate risk” of SUD. Measurements included the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), Timeline Follow-up for drug and alcohol use frequency, Overdose Risk Information, HIV risk-taking behavior scales, Self-reporting questionnaire, and Internalized Stigma of Substance Abuse scale. Follow-ups were done at three- and six months post-intervention.

Results:

All participants were men. No initial differences in ASSIST scores or substance use frequencies were noted. ASSIST scores for all substances were significantly reduced at follow-ups. X-SBI showed better outcomes in reducing ASSIST scores for primary substances and illicit drugs, with small effect sizes (η2 = .06–.10). Reductions in drug and alcohol use were noted in both groups, with X-SBI showing a greater decrease in illicit drug use at six months. X-SBI had higher transition rates to the “action” stage of motivation and significant declines in overdose and HIV risk behaviors, mental distress, and stigma scores.

Conclusion:

Integrating three-session X-SBI into CS may effectively address substance misuse.

Trial Registration:

Clinical Trial Registry, India (Reference No. CTRI/2022/01/0391XX)
Patterns of reflux in patients with CEAP C2 disease compared to patients with C6 venous ulceration
Authors: Gadhoke Neel , Deol Zoe , Kennedy Richard , Lakhanpal Sanjiv , Pappas Peter J.
Published: January 2025

Objective

CEAP categorizes patients based on disease progression and severity. Whether disease severity is associated with specific patterns of reflux is currently unknown. We hypothesize that patterns of reflux in patients with C2 and C5/6 disease will differ.

Design

Multi-center retrospective cohort analysis.

Methods

From January 2015 to December 2020, we performed a retrospective review of reflux patterns in 21 335 patients and 31 727 limbs in symptomatic patients with C2 or C5/6 disease. Patterns of reflux in Great (GSV), Small (SSV), Deep and Perforators (Perf), were analyzed in patients with and without junctional reflux. The GSV and SSV were divided into six and three segments respectively. The number of perforators with reflux were categorized as 1-3 above and below-knee and deep system reflux was divided into three segments.

Results

Of the 21 335 patients the average age and female/male distribution was the following: C2 (54.13 ± 13.82, 21 410/5047), C5/6 (64.75 ± 14.75, 1514/1755) ( p ≤ .001). When SFJ reflux is present, 6-segment GSV reflux was most prevalent (C2, 14.85% vs C5/6, 27.50). Without junctional reflux, above knee reflux was more common in C2 disease, while below knee reflux was more common in C5/6 disease ( p ≤ .01). Three segment SSV reflux was more prevalent in C2 patients (26.67% vs 16.27%, p ≤ .001). Below knee perforator reflux was more prevalent in C5/6 patients (79.56% vs 73.53%, p ≤ .01). Combined CFV/FV/POPV reflux was more prevalent in C5/6 patients (38.5% vs 20.5%, p ≤ .001).

Conclusion

The presence of junctional reflux is more closely associated with disease location (above- vs below-knee) than with disease classification. SFJ reflux is more likely to present with extensive above knee disease. Isolated below-knee reflux is more significantly associated with C5/6 disease, independent of junctional reflux. Conversely, isolated above-knee superficial reflux is significantly associated with C2 disease and junctional reflux.
Advances in clinical translation of stem cell-based therapy in neurological diseases
Authors: Wang Yu , Cao Yirong , Xie Wanqing , Guo Yunlu , Cai Jiayi , Huang Tingting , Li Peiying
Published: January 2025

Stem cell-based therapies have raised considerable interest to develop regenerative treatment for neurological disorders with high disability. In this review, we focus on recent preclinical and clinical evidence of stem cell therapy in the treatment of degenerative neurological diseases and discuss different cell types, delivery routes and biodistribution of stem cell therapy. In addition, recent advances of mechanistic insights of stem cell therapy, including functional replacement by exogenous cells, immunomodulation and paracrine effects of stem cell therapies are also demonstrated. Finally, we also highlight the adjunction approaches that has been implemented to augment their reparative function, survival and migration to target specific tissue, including stem cell preconditioning, genetical engineering, co-transplantation and combined therapy.
Arthroscopic-assisted uniportal spinal surgery for treatment of lumbar burst fractures complicated with neurological symptoms: a case report
Authors: Chen Hai-Wei , Wang Zhi-Qiang , Jing Peng-Ju , Ma Dong-Hong , Wang Wen-Bo , Song En , Li Pei-Wu , Cheng Peng
Published: January 2025

Lumbar burst fractures account for 21% to 58% of all thoracolumbar fractures. L5 lumbar burst fractures are rare, comprising 1.2% of spinal burst fractures. This report discusses the optimal treatment for an adolescent with an L5 lumbar burst fracture and neurological symptoms caused by a high-fall injury, which involved surgical decompression and spinal fixation. Complete decompression and fixation of the L5 lumbar burst fracture, complicated by neurological symptoms, were achieved using arthroscopic-assisted uniportal spinal surgery (AUSS) combined with percutaneous pedicle screw fixation (PPSF). The AUSS approach, used alongside PPSF, significantly improved the vertebral canal occupation rate, increased the anterior edge height ratio of the damaged vertebra, and alleviated the lower back pain and nerve root symptoms postoperatively. AUSS combined with PPSF is a minimally invasive technique for treating lumbar burst fractures, effectively relieving compression of the vertebral canal and nerves caused by fracture fragments.
Wind-driven pumped storage system design
Authors: Abdelmagid Tasneem I.M. , Siddig Mohammed Hashim
Published: January 2025

Wind power is unsteady due to the stochastic nature of wind. Pumped storage is a reliable technology for hydropower storage and generation. This paper aims to regulate wind power with a pumped storage facility by designing a mathematical model of a stand-alone wind-driven pumped storage. The available wind continuously pumps water to a high-elevation upper reservoir, while electricity is generated per demand. A case study was developed in eastern Sudan, and results show that wind energy can be regulated using pumped storage. The scheme had a 71% roundtrip efficiency, with a monthly energy yield of 23 GWh sufficient to support the whole population of the Red Sea State in Sudan. This result indicates the good potential of a wind-driven pumped storage system to deliver continuous electricity using intermittent wind. Such a scheme will benefit the developing countries in Africa, where the requirements of this system are easily found.
Dynamic Spatio-Temporal Residual Hypergraph Convolutional Networks for Traffic Flow Forecasting
Authors: Su Jun , Wang Hairu , Przystupa Krzysztof , Kochan Orest , Liu Donghua
Published: January 2025

In recent years, more and more scholars have applied graph neural networks in combination with other modules to the field of traffic flow forecasting and achieved outstanding results. Most of these graph-based methods describe pairwise relationships between two objects, but in real transportation networks, the relationships between objects are often of a high order. To effectively learn the higher-order relationships between objects, this paper proposes a dynamic spatio-temporal residual hypergraph convolutional network for traffic forecasting (Res-DSTHGCN). In this paper, we combine dynamic spatio-temporal graph convolution and dynamic spatio-temporal residual hypergraph convolution to capture more global spatio-temporal features than models with only spatio-temporal graph convolution or only spatio-temporal hypergraph convolution. Meanwhile, the hypergraph convolutional network enhanced by residual connectivity improves the oversmoothing problem that may occur in the traditional hypergraph convolutional network (HGCN) along with the continuous stacking of layers. It is proved that the prediction accuracy of the method proposed in this paper is improved by conducting experiments for comparison with other baselines.
Three-Stage Collaborative Optimization Method Under Bus Self-Coordinated Holding
Authors: Xi Jiaojiao , Zhou Xuemei , Ma Jie
Published: January 2025

Reducing the volatility in the operation of public transport is still an important consideration when seeking to maintain efficient and stable operations. In this study, stations and intersections are considered as a whole, and a self-coordinated holding strategy is developed based on the fluctuation of passenger flows and the characteristics of signals during off-peak periods. On this basis, a collaborative optimization is carried out in combination with signal priority and speed control. The mathematical model is established with the goal of minimizing passenger travel and enterprise operation costs. A section of the K2 line in Ganzhou City is selected for a case study. The improved discrete binary particle swarm optimization algorithm (DPSO) is then used for the calculations. The simulation and comparison of the arrival time distribution, headway deviation, and travel time index before and after the optimization show that reliability, stability, and efficiency have been improved by the optimization, which verifies the effectiveness of the optimization method.
Biodegradation study in FBS media of polycaprolactone patch as a potential prenatal treatment for myelomeningocele
Authors: Benabdderrahmane K , Stirnemann J , Ramtani S , Falentin-Daudré C
Published: January 2025

Myelomeningocele (MMC) is a congenital defect of the spine characterized by meningeal and spinal cord protrusion through open vertebral archs, and its exposure to the amniotic fluid. Given that the progression of neuronal loss begins early in fetal life, an early coverage of the defect is required to improve the neurological outcomes. Several studies have proposed patches as an alternative to full surgical repair, to achieve an early protection of the spine and possibly reduce the rate of complications of current prenatal surgical procedures. In our previous work, we developed a biocompatible, watertight and biodegradable patch to improve in utero MMC repair. This patch offers an anti-adhesive internal surface to prevent adhesion to spinal cord tissue, and a bioactive external surface to promote tissue coverage. The aim of this study is to assess the patch’s in vitro degradation in an amniotic-fluid-like medium and investigate the surface functionalization effect, to understand its mechanism and predict the patch’s behavior over time. The study was carried out for 24 weeks in FBS medium and after each period the samples were characterized by differential scanning calorimetry, scanning electron microscopy, steric exclusion chromatography, toluidine blue assay and contact angle measurement. The results revealed a progression of PCL hydrolysis over time, characterized by a decrease in molar mass and evidence of erosion as observed by SEM. Furthermore, this process appears to be accelerated by ozonation, compared to surface functionalization without ozonation. The latter can be considered as the most suitable technique to preserve the patch structure over time, while benefiting from the grafting polymers properties during the first weeks of implantation.
Application of waste materials for concrete and composite railway sleeper production: A review
Authors: Safari Fatemeh , Rezaie Mohamad , Esmaeili Morteza , Habibnejad Korayem Asghar
Published: January 2025

Railways are more energy efficient than any other mode of transportation, offering an opportunity to reduce energy consumption, CO2 emissions, and air pollution. However, to reduce the high maintenance costs and activities, the application of waste materials in the railway industry has received attention; they are used as ballast, sub-ballast, and sleeper constituent elements. Sleepers have shown promising potential for recycled material usage, and concrete and composite sleepers have received more attention. Therefore, railway sleepers employ a variety of materials such as waste rubber, silica fume, slag, fibres, fly ash, coal ash, recycled concrete aggregate, and recycled plastics. Considering the vast scope of the subject, a comprehensive technical study gap in producing sleepers with waste material applications is perceived. This paper is written to collect the investigations on waste materials application on the physical, mechanical, dynamical, and durability performance of railway sleepers. In this paper, concrete and composite railway sleepers have been considered. Then, waste impacts are gathered, compared, tabulated, and the mechanisms are discussed to evaluate the study focus and scope for future research. This study shows that silica fume, slag, and fly ash improved the mechanical properties of concrete sleepers, while crumb rubber negatively affected the mentioned properties and increased the concrete damping capability. Pozzolans are noted to have a positive role in durability characteristics. Fibres improved the mechanical and durability performance of composite sleepers. Rubber has also improved the durability and flexibility of composite sleepers but decreased strength.
Fossil fuel curse and green transition: The role of renewable energy and green R&D
Authors: Makhmudov Nuriddin , Jeon Wooyoung
Published: January 2025

Many researchers have documented the effects of deploying natural resources on gross domestic product (GDP) growth and confirmed the existence of the resource curse phenomenon. Furthermore, several studies have proved that factors such as institutional quality, trade openness, and commodity price volatility can alter the effects of natural resource deployment on economic growth. However, few studies have considered the effect of green transition on the resource curse. While transitioning to a green economy poses the threat of reducing the potential revenues from exporting natural resources in resource-abundant economies, it can contribute to economic growth by reducing fossil fuel dependance, increasing energy efficiency, and increasing green competitiveness. In this study, we analyze how fossil fuel rents affect GDP growth and study the interactive effects of renewable energy and investment in green research and development. By using the data of 109 countries for the period 1990–2020, we conduct a panel analysis. The results confirm the existence of the resource curse effect, whereby fossil fuel rents hinder economic growth. In addition, increasing renewable energy deployment can alleviate the adverse effects of fossil fuel rents. This mitigation can occur through a reduction in the domestic consumption of fossil fuels, increased access to international trade, and infrastructure investments. Lastly, increasing investments in green research and development mitigates the adverse effects of fossil fuel deployment. This result is achieved because of increases in energy efficiency, investment in human capital, and green competitiveness. We conclude that active green transitioning, especially in fossil-fuel-rich economies, can lead countries to sustainable growth.
High-Yield Generation of Glucose-Responsive Pseudoislets From Murine Insulinoma Cells for In Vitro Studies and Longitudinal Monitoring of Graft Survival In Vivo
Authors: Gonzalez Grisell C. , Li Chris M. , Pasolini Ilaria , Pete Sophia I. , Verheyen Connor , Vignolo Sofia M. , De Toni Teresa , Stock Aaron A. , Tomei Alice A.
Published: January 2025

Compared to primary pancreatic islets, insulinoma cell-derived 3D pseudoislets offer a more accessible, consistent, renewable, and widely applicable model system for optimization and mechanistic studies in type 1 diabetes (T1D). Here, we report a simple and efficient method for generating 3D pseudoislets from MIN6 and NIT-1 murine insulinoma cells. These pseudoislets are homogeneous in size and morphology (~150 µm), exhibit functional glucose-stimulated insulin secretion (GSIS) up to 18 days (NIT-1) enabling long-term studies, are produced in high yield [>35,000 Islet Equivalence from 30 ml culture], and are suitable for both in vitro and in vivo studies, including for encapsulation studies. To enable non-invasive longitudinal monitoring of graft survival in vivo, we transduced NIT-1 cells with green fluorescent protein-luciferase and confirmed comparable morphology, viability, and GSIS to untransduced cells in vitro. After subcutaneous implantation, we show capability to monitor graft survival in immunodeficient mice, recurrence of autoimmunity in non-obese diabetic mice, and allorejection in C57BL/6 mice. Overall, this platform provides an accessible protocol for generating high yields of 3D pseudoislets and non-invasive longitudinal monitoring of graft survival in different models offer advantages over primary islets for optimization and mechanistic studies of β cell biology, drug discovery, T1D pathogenesis and prevention, and β cell transplantation.
Dying in a Homophobic Nation: Addressing Healthcare Disparities, Advance Care Planning and Surrogate Decision-Making Challenges for Sexual and Gender Minority Older Adults at End-of-Life
Authors: Menzer Heather
Published: January 2025

Promoting autonomy in medical decision-making is an essential part of palliative care. Therefore, palliative care providers should prioritize supporting the autonomy of sexual and gender minority (SGM) older adults, a community that has historically suffered from healthcare disparities. This support is particularly significant when an illness or injury renders a patient unable to make medical decisions, necessitating the designation of a surrogate decision-maker. Surrogate decision-maker policies vary by state and largely do not represent patients whose support systems are outside of the biological family. This article reviews healthcare disparities experienced by SGM older adults, including higher rates of certain health conditions and barriers to accessing care due to stigma and discrimination. It also highlights the compounded challenges faced by SGM individuals who are part of racial and ethnic minority groups. The lack of inclusive surrogate decision-making policies exacerbates these disparities, as many SGM older adults do not have legally recognized partners or children to act as decision-makers. The absence of inclusive policies for surrogate decision-making results in distress for patients, families, loved ones, and medical providers. This article discusses the importance of advance care planning and completion of advance directives for this population to ensure patient wishes are respected. Palliative providers need to advocate for surrogate decision-maker policies that are more inclusive of families of choice.
From learning to action: Advancing career pathways implementation in vocational rehabilitation
Authors: Chun Jina , Anderson Catherine A. , Gaertner Beth E.
Published: January 2025

Background

Career pathways are critical in the vocational rehabilitation (VR) of individuals with disabilities, linking education, training, and employment to improve career outcomes.

Objective

This report explores the establishment of the Career Pathways Learning Community, the development of the Career Pathways Toolkit, and the transition to the Implementation Group, highlighting how these initiatives support effective career development frameworks for individuals with disabilities within VR systems.

Methods

A nationwide recruitment process brought together 61 stakeholders, including counselors and administrators from various state VR agencies, to form a Learning Community focused on six key elements of Career Pathways. This effort facilitated the design of a customizable Toolkit and established an Implementation Group to apply it.

Results

The Toolkit consists of four sections: an introduction to the Career Pathways model, an exploration of its advantages, a comprehensive implementation guide, and evaluation strategies. It provides valuable resources for enhancing career development for individuals with disabilities, while the Implementation Group fosters systems change within VR practices.

Conclusion

The development and implementation of Career Pathways within VR systems are crucial for enabling individuals with disabilities to achieve sustainable employment. The Career Pathways Toolkit, created by the Learning Community facilitated by VRTAC-QE, serves as a practical resource for fostering systems change. Collaborative efforts through the Implementation Group aim to enhance access to meaningful employment opportunities and promote a more inclusive workforce.
Processes and outcomes of a 14-month apprenticeship learning community: Toolkit development and practice implications
Authors: Rumrill Stuart , Austin Bryan , Knauf Jim , Kosciulek John
Published: January 2025

Background

Despite the prevailing view that apprenticeships offer many unique benefits to workers with disabilities, people with disabilities are vastly underrepresented in these programs.

Objective

This paper describes a 14-month apprenticeship learning community facilitated by the authors and the toolkit for practitioners and key stakeholders that it produced.

Methods

The learning community met 14 times as a large group over a 14-month period. During these meetings, facilitated by the authors, members shared problems, solutions, and insights related to apprenticeships, and actively worked towards creating the apprenticeship toolkit.

Results

The toolkit is a comprehensive manual for potential apprentices, their families, rehabilitation/vocational counselors, employers, and other stakeholders. It covers topics such as basic knowledge of apprenticeships, steps for entering, navigating, and completing an apprenticeship program, tips for successful interagency collaboration, and guidance on disability disclosure.

Conclusion

The learning community model successfully brings together people from diverse areas and backgrounds to brainstorm solutions to shared challenges. The toolkit is an effective resource for any worker or professional interested in apprenticeships. Implications for practice are provided.
Distribution Strategy, Capability Investment, and Government Regulation
Authors: Yuan Mao , Bernstein Fernando , Guan Xu , Wang Yulan
Published: January 2025

This paper investigates how a manufacturer’s internal sourcing capability and government regulation influence the supplier’s distribution strategy and the manufacturer’s sourcing and capability investment decisions. We consider a supply chain consisting of a supplier that produces a critical component, an independent manufacturer that also has the capability to produce the component in-house, and a dependent manufacturer without such capability. We first consider a scenario in which the supplier chooses its distribution strategy—either offering its component to both manufacturers or establishing an exclusive selling agreement with a single manufacturer. We explore how the supplier’s optimal distribution strategy (dual or exclusive selling) depends on the terms and process of the contract and on the independent manufacturer’s ability to produce a high-quality component in-house. We also show that, in equilibrium, the independent manufacturer may invest in a high capability level (leading to a high-quality component) as a strategic deterrent against the supplier’s decision to engage in an exclusive selling agreement with the dependent manufacturer. We further consider a setting with mandatory exclusion, imposed by government regulation, that affects free trade among parties. We show that mandatory exclusion can exacerbate or mitigate the independent manufacturer’s incentive to invest in internal sourcing capability, relative to a setting in which the supplier determines its distribution strategy in the absence of such government regulations. Moreover, we show that mandatory exclusion always hurts the supplier, but it can benefit or hurt the manufacturers as well as the consumers, depending on the independent manufacturer’s investment cost and the conditions leading to an exclusionary contract under free trade.
Effects of Women’s Participation in Household Decision Making on Skilled Birth Attendants Supervised Delivery in Bangladesh
Authors: Alam Md Badsha , Khanam Shimlin Jahan , Kabir Md Awal , Chowdhury Atika Rahman , Hassen Tahir Ahmed , Das Susmita , Khan Md Nuruzzaman
Published: January 2025

Background:

While the importance of women’s participation in household decision making in enhancing access to healthcare services is widely acknowledged, limited evidence exists on the link between women’s participation in household decision making and skilled birth attendants (SBA) supervised delivery. This study aims to fill this gap by examining the effects of women’s participation in household decision making on SBA supervised delivery in Bangladesh.

Methods:

Data of 3607 mothers who had given birth within 2 years of the survey date were extracted from the 2022 Bangladesh Demographic and Health Survey (BDHS) and analyzed. The outcome variable considered was SBA supervised delivery, and the primary explanatory variable was a composite index of women’s participation in household decision making generated from their responses regarding decision-making on own healthcare, large household purchases, and visits to their family or relatives. Multi-level mixed-effects logistic regression was used to explore the effects of women’s participation in household decision making on SBA supervised delivery, adjusted for potential confounders.

Results:

The reported prevalence of SBA supervised delivery was 70%. Women lacking participation power and moderately empowerment in household decision-making were 15% (aOR= 0.85, 95% CI: 0.66-1.08) and 20% less likely to had SBA supervised delivery (aOR = 0.80, 95% CI: 0.64-0.99) compared to those with high participation power, respectively. This association remained consistent across all 3 empowerment domains, with lower likelihoods of SBA supervised delivery among women lacking empowerment.

Conclusion:

The findings of this research affirm the positive effects of women’s participation in household decision making on SBA supervised delivery in Bangladesh. Recommendations include increasing women’s empowerment in household decision making and raising awareness and education about the importance of SBA supervised delivery.
Persian Mumia: A kingly gift and miraculous cure-all
Authors: Happe Samantha
Published: January 2025

Mumia is a bituminous material with legendary curative properties, whose meaning is dependent on its geographical and temporal contexts. To the Persians, mumia bore complex symbolic meanings associations with royal power and dynastic legitimacy, meanings it served to convey when employed as a diplomatic gift. Through the eighteenth and nineteenth centuries, mumia was included in ensembles to European princes by Shahs of the Safavid, Zand, and Qajar dynasties. By giving appropriate weight to the evidence of the exchanged gift itself and the context in its presentation, it is possible to better understand the underlying motivations of the giver in the three diplomatic encounters. This results in a shift away from a diplomatic history based on written documentation, towards a clearer, more accurate understanding of cross-cultural diplomatic exchanges grounded in the object.
The need for health equitable climate adaptation policies in Northern Europe
Authors: Rao Shilpa , Aunan Kristin , Budin-Ljøsne Isabelle , Di Ruscio Francesco , Gasparrini Antonio , Masselot Pierre , Pinna Pintor Matteo , Nordeng Zuzana , Ruuhela Reija , Kumar Bernadette
Published: January 2025

Socioeconomic conditions remain an important factor in determining health outcomes in Northern Europe. In this commentary, we argue for evidence-based temperature-related climate adaptation policies in Northern Europe that account for disparities in socioeconomic conditions and aim at universal health coverage. We highlight the role of spatial and occupational disparities in urban areas that can be important factors in increased physical and mental health impacts related to heat and cold. We further highlight how these factors interplay with exposure to air pollution and access to green areas and worsen health conditions. Adaptation to changing climatic conditions requires both physiological acclimatization and behavioral adaptation, both of which are difficult to assess for socioeconomically deprived communities. We argue for more equitable climate adaptation strategies that include i) better integration of health in climate change adaptation plans; ii) building climate resilient communities, and iii) integrated surveillance and health systems. These actions could be vital in spearheading research in new cross-cutting areas like climate change, migration, and health.
Advancing research and policy in climate and health in the Nordic countries: Key challenges and opportunities for future action
Authors: Rao Shilpa
Published: January 2025

Aim:

This editorial presents state of the art developments in research and policy in the newly emerging field of climate and health and examines the gaps in research, the relevance of Nordic research in a global context, and the need to place the climate–health agenda in the policy space.

Methods:

We use a set of articles from the Special Issue on ‘Climate change and health in the Nordic countries’ in this journal to understand current research in climate and health. We identify three emerging areas that characterize the current focus of research: modelling climate change-induced exposures; health cross-linkages of the climate health agenda and targeted communication. On linking the ongoing research with several recent policies and projects within the EU and Nordic countries, we identify vital questions where future research needs to concentrate and discuss the challenges associated with this.

Results:

We identify three key questions related to interaction, vulnerable groups and equitable adaptation that will be crucial to future risk. We highlight a need for integrated study designs and innovative data analysis tools to help answer these questions.

Conclusion:

We conclude with proposing a path forward for the ‘Climate and Health’ research and policy agenda in the years to come.
Confidence and Preparedness of Wisconsin Speech-Language Pathologists and Graduate Students in Serving Bilingual Children
Authors: Martinez-Nieto Lourdes , Gilbertson Lynn
Published: January 2025

This study examined the self-perceived confidence and preparedness of 128 certified speech-language pathologists (SLPs) and 26 SLP graduate students in Wisconsin when serving bilingual children. Participants, monolingual or bilingual, completed an online survey. The relationship between confidence, preparedness, academic coursework, and continuing education was investigated. Results indicated that bilingual SLPs show higher confidence and preparedness levels than monolingual SLPs when working with bilingual children. However, both groups exhibited significantly higher confidence and preparedness when working with monolingual children. A regression analysis revealed that the number of continuing education courses (CEUs) significantly predicts confidence and preparedness levels for working with bilingual children. In contrast, the number of academic coursework topics covered did not significantly correlate with confidence or preparedness. The results highlight the need for specialized learning opportunities that focus on the complexities of bilingual service provision in improving the readiness of both monolingual and bilingual SLPs, and graduate students to serve bilingual populations effectively.
Latino Educational Leadership Matters: Connecting the Dots for Nourishing Latine Scholar Pathways and the Promise of Generational Transformation
Authors: Rodríguez Cristóbal
Published: January 2025

This article explores the vital role of Latino educational leadership in addressing systemic inequities and nourishing Latine students as solutions to our communities. Based on personal experiences ( testimonio), this reflection of Latino leadership demands culturally responsive leadership and representation in higher education. Moreover, Latino educational leadership demands for a systemic shift in education that values and nourishes the cultural wealth of Latino communities to foster generational success and equity for all students.
Dose Accuracy and Reliability of a Connected Insulin Pen System
Authors: Backfish Matthew , Kovalchick Kimberly , Albert Robert , Rosilio Myriam , Chigutsa Farai , Liao Birong
Published: January 2025

For people with diabetes on insulin injection therapy, insulin pen dose accuracy and reliability are key features. Dose accuracy of the Tempo PenTM with attached Tempo Smart ButtonTM [Module] (the system) was tested for three doses under standard atmospheric conditions. Reliability and the ability of the Module to detect, store, and transmit dose-related data were also tested. The system met the International Organization for Standardization 11608-1:2014 requirements for dose accuracy at all doses. Mean (standard deviation) doses were 0.010 mL (0.002), 0.299 mL (0.002), and 0.597 mL (0.004) for the 0.010-mL, 0.300-mL, and 0.600-mL doses, respectively. The Module also met requirements for data transfer after every injection. The system accurately delivered doses and reliably captured and stored insulin dosing information.
Cost-Effective Quality of Life Improvement While Reducing Health Care Professional Burnout With an AI-Driven Intervention for Personalized Medicine
Authors: Kelly Ryan Charles , Holt Richard I. G. , Price Hermione , Phiri Peter , Cummings Michael , Ali Amar , Patel Mayank , Barnard Ethan , Allard Sharon , Hunter Victoria , Rojkova Jana , Bolger Clare , Georgieva Daniela , Schinz Maren , Rothenbühler Martina , Lizoain Aritz , Barnard-Kelly Katharine
Published: January 2025

Background and Aims:

Burnout affects >50% of physicians and nurses. Spotlight-AQ is a personalized digital health platform designed to improve routine diabetes visits. We assessed cost-effectiveness, visit length, and association with health care professional (HCP) burnout.

Materials and Methods:

Complete case within-trial cost-effectiveness analysis embedded within a multicenter, parallel-group randomized controlled trial. Adults with diabetes were recruited from primary and secondary care. Intervention group participants completed the Spotlight-AQ pre-clinic assessment before each routine visit. Health status was assessed with EQ-5D-5L to calculate quality-adjusted life years (QALYs). Client Service Receipt Inventory measured downstream resource use. Total costs and QALYs were calculated using baseline-controlled seemingly unrelated regression with bootstrapping. Haemoglobin (HbA1c) data were collected. Health care professionals completed the Maslach Burnout Inventory at baseline and study end.

Results:

A total of 98 adults (49 intervention) and 18 HCPs participated. Total costs: £243 (US$310) intervention arm versus £230 (US$293) control arm; incremental cost: £13 (US$16). Total QALYs: 0.362 intervention arm and 0.358 control arm, with an incremental QALY: 0.004. Spotlight-AQ intervention dominated usual care with a 68% probability of cost-effectiveness at a threshold of £30 000 (US$38 294) per QALY gained. Health care professionals reported reduced burnout, emotional exhaustion, depersonalization, and a greater sense of personal achievement. Doctors are more so than nurses.

Conclusion:

Spotlight-AQ has demonstrated cost-effective while delivering improved care and reduced HCP burnout.

Trial Registration:

ISRCTN15511689, registration date: November 1, 2021.
Know the Score: Empowering Sport Choices With a Straightforward Solution
Authors: Walker Daniel , Jukes Jade L.
Published: January 2025

Risk factors associated with depression in athletes include biological sex, physical pain, and history of sport-related concussion (SRC). However, although there are well-documented benefits of sport and physical activity on mental health, many sportspeople still take the risk of competing in contact sports. Therefore, this infographic, supported by scientific evidence, aims to provide sportspeople with an informed decision on their participation. This infographic can be used by sports clubs or governing bodies to illustrate the risk that SRC has on the mental health of sportspeople. Likewise, it highlights the elevated risk of being in physical pain and being a female sportsperson. Therefore, this infographic provides a simple message to enhance the decision-making process of sportspeople, ensuring they are making a better-informed choice of their sporting participation and making their own cost/reward judgment.
“Nobody Seemed to Notice My Work”: The Lived Experiences of Home Care Workers Assisting People With Chronic Diseases: A Phenomenological Study
Authors: Cacciapuoti Valentina , Simeone Silvio , Virgolesi Michele , Sterling Medeline R. , Dallago Elisa , Vellone Ercole , Alvaro Rosaria , Pucciarelli Gianluca
Published: January 2025

Introduction:

Home care workers (HCWs) are paid caregivers who provide support to patients with chronic conditions and functional limitations. Additionally, they provide emotional support to patients and familial support. Although several qualitative studies have been conducted on HCWs, they focused more on studying prevalently the lived experiences about the workplace violence, the end of life, stressor and resilience, during the COVID-19 pandemic or focused more in dementia and heart failure, but not on feelings and working conditions.

Methods:

The study was carried out using Cohen’s phenomenological methodology. The subjects were enrolled in several cities of Central Italy and interviewed with open questions to allow them full freedom of expression and asked to describe their lived experience of HCWs who helped people with chronic diseases. Each interview was recorded audio and lasted between 20 and 60 min. Researchers involved in the analysis were independently immersed in the data by reading and rereading the transcripts to gain a sense of the entire data set. The extrapolation of the themes followed. The individual researchers compared the various extrapolated themes.

Results:

Seventeen HCWs, all women, with a mean age of 54 years were enrolled in this study. All had more than a year (from 4 to 26 years) of experience in Italy, and almost the whole sample lived with the person they were assisting. Three themes were identified in the interviews: (1) feeling inadequate as a nurse, (2) feeling valued in this role, and (3) uncertain future. Feeling inadequate due to lack of training, difficulties related to the Italian language, or uncertainty about their future were topics identified by the HCWs.

Conclusions:

Since HCWs represent an important resource which, if properly trained, could positively influence the quality of life of the elderly population and a valid support for their families, understanding the lived experience can suggest interventions that could be implemented by a health care professional and provide evidence to inform political decision makers to increase the support for HCWs.
Overcoming Hesitancy and Barriers to Care with Integration of Telemedicine in a Free Student-run Health Clinic
Authors: Krysov Vikki A. , Balshin Michelle E. , Azar Elijah N. , Cernioglo Karina , Perekopskiy David , Nurpeissova Altynay T. , Shi Lucy Zhonglu
Published: January 2025

Introduction:

Nadezhda Clinic is a free student-run health clinic that provides culturally sensitive primary care services to the underserved Russian-speaking population of the greater Sacramento area. At the onset of the COVID-19 pandemic, the clinic suspended in-person services and solely offered telemedicine visits. Most patients were hesitant to utilize telemedicine due to poor technological literacy, privacy concerns, and a preference for in-person care.

Objective:

This quality improvement project aimed to evaluate whether the implementation of culturally sensitive telemedicine services and outreach strategies would help address patient hesitancy and barriers to care.

Methods:

Successful implementation of telemedicine was dependent on building trust with the community, providing multilingual technological assistance, and offering personalized support. Some measures that were reviewed in order to assess this included comparison of patient demographics, clinic attendance, and distance reached between in-person and telemedicine services.

Results:

Telemedicine implementation was associated with increased clinic attendance rates with a no-show rate as low as 13% when compared to in-person services with a no-show rate of 20%. Telehealth services also enabled the clinic to reach patients in rural areas up to 120 miles away.

Conclusions:

With the implementation of a culturally sensitive telemedicine protocol, Nadezhda Clinic achieved greater patient retention rates and reached patients at further distances, suggesting an overall reduction in hesitancy and barriers to care. Free clinics offering telemedicine are critical to further address healthcare disparities in marginalized communities.