bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gendering the second demographic transition: gender asymmetry, gendered tension, and cohabitation in contemporary urban China
Authors: Zhou Yun 
Published: November 2022

AbstractThe Second Demographic Transition (SDT) framework highlights individuals’ ideational shift toward greater individualism in explaining the rise of non-marriage unions. Contemporary China has seen a substantial increase in premarital cohabitation. Drawing on 65 in-depth interviews with highly educated young urban Chinese women and men, this article examines the gendered ways in which young Chinese adults perceive and make decisions about premarital cohabitation, as they envision their ideal lives and what autonomy and self-realization mean to them. I demonstrate that while male respondents predominantly view cohabitation positively as a risk-reduction strategy for avoiding incompatible marriages, female respondents still consider cohabitation to be a risk-amplification arrangement in practice that increases the possibility of uncertain marriage prospect, unsafe sex, and reputational damages. Young women, but not men, often have to strategize—through carefully managing information disclosure—about persistent parental expectations that discourage women’s premarital cohabitation. As a result, while male respondents regard marriage to be neither the necessary precondition nor the end goal of cohabitation, female respondents, who otherwise emphasize autonomy and individualistic fulfillment, continue to desire a close linkage between cohabitation and marriage. Leveraging the unique strength of qualitative data in demographic research, this article articulates thegender asymmetryin how women and men perceive cohabitation’s risks, benefits, and link to marriage. I elucidate thegendered tensionbetween privately-held ideals of individualism vis-à-vis enduring social norms of female marriageability, as women and men differentially navigate parental expectations surrounding cohabitation. In so doing, this article makes a theoretical contribution by bringing a careful treatment of gender into the SDT framework.
Financing-Related Drivers and Barriers for Circular Economy Business: Developing a Conceptual Model from a Field Study
Authors: Saarinen Arttu , Aarikka-Stenroos Leena 
Published: November 2022

AbstractThe transition toward sustainability and the circular economy is shaping technology investment and business, leading to there being growing interest in financial aspects of circular economy businesses. As research on circular economy drivers and barriers, in addition to the literature on circular economy business and finance, has not yet provided a comprehensive view on drivers of and barriers to circular economy business financing, this study takes a theory-developing qualitative approach. It integrates extant theoretical knowledge and empirical new insights from an extensive field study in Finland, Europe, based on over 270 data sources, including interviews, workshops, reports, and media documents. From these data sources, this paper analyzes and conceptualizes the driving and inhibiting factors that have shaped the sources, criteria, and subjects of circular economy business financing. The study results that the sources of financing—being public and private sources—apply diverse criteria for financing, such as valuation and profitability of circular business models, their type, investment costs, and their business potential for financing industry itself, when they assess different subjects of financing, such as individual companies’ circular businesses, supply chains, and joint projects. Findings show that many factors that could serve as drivers have considered inhibitors. As a theoretical contribution, our study develops a conceptual model on the key factors shaping the financing of CE businesses and set of propositions on these factors inhibit and drive CE financing. Our findings provide guidance for practitioners such as managers and policy makers who aim to advance circular economy business.
Mycostructures—growth-driven fabrication processes for architectural elements from mycelium composites
Authors: Biala Eliza , Ostermann Martin 
Published: November 2022

AbstractThe paper discusses how characteristics of the mycelium growth process—namely different growth effectiveness depending on the nutrition content of the substrate, gradual solidification of the inoculated substrate, and bio-welding—can be a driving force for developing sustainable biofabrication processes of mycelium based composites (MBC) for architectural application. To explore this potential one-semester (12 weeks) seminar and one block seminar (2 weeks) with master-level students were held at the University of Stuttgart, and independent work within the Institute IBK2 was performed. The free experimentation with fabrication tactics resulted in the emergence of different investigation paths, tested with small-scale demonstrators, from which the most interesting three this paper presents in detail. The first is the two-phase printing process of mycelium substrate and subsidiary reusable support materials. It applied tests with the small, inorganic, loose substances (plastic pellets) extractable mechanically and meltable substances (wax) extracted by heating. The second path of investigation followed lost formworks created from hemp strings positioned inside the material. Finally, the third path is a particular case of lost formwork approach utilizing different tubular bandages stuffed with MBC and utilizing it later as a thick filament for other different form-giving deposition practices: layering, hanging, braiding, and knotting. All three investigation paths prove feasible, although their upscaling potential correlates strongly with the successful automation of the processes using CNC machines, which could provide the precision and sterility needed for this highly heterogenous and sensitive material. In addition, further developments in the material cultivation protocols are indispensable to provide a higher repetition of the results.
Impact of coronavirus disease 2019 (COVID-19) pandemic on antimicrobial consumption and antimicrobial resistance at a small, local hospital in Japan
Authors: Sasaki Yasuhiro , Yano Masataka , Umehara Ayumi , Tagashira Yasuaki 
Published: November 2022

Abstract
The coronavirus disease 2019 (COVID-19) pandemic negatively affected antimicrobial stewardship programs at hospitals throughout Japan by diverting resources toward managing the pandemic. However, antimicrobial stewardship needs to continue regardless of hospital size or supervening crises. Herein, we discuss the impact of COVID-19 on antimicrobial stewardship at a small, local hospital in Japan.
Headache and Dizziness after Roller Coaster Rides: A Case Series of 31 Patients
Authors: Moskatel Leon S. , Smirnoff Liza 
Published: November 2022

ABSTRACT:Previous literature on roller coaster injuries focuses on catastrophic injuries. We conducted a retrospective study of 31 adults with headache or dizziness after roller coaster rides. Twenty five of 31 (81%) patients presented with new or worsening headache, predominantly migraine (15/25, 60%), including 8/25 (32%) with chronic migraine. Of the chronic migraine patients, 4/8 (50%) already had the diagnosis and presented with an exacerbation. Five of the 25 (20%) were ultimately found to have a cerebrospinal fluid (CSF) leak. While persistent symptoms appear to be relatively rare, patients with chronic migraine and potential CSF leaks should consider skipping these attractions.
Law and the production of precarious work in Europe: an introduction
Authors: Bogoeski Vladimir , Costamagna Francesco 
Published: November 2022

AbstractThe introductory article sets out the background and the content of the Symposium on ‘Law and the Production of Precarious Work in Europe’. The analysis builds on the premise that European (EU) law, together with international and national law, is constitutive of precarious forms of work and work relations in different national and local contexts. The Symposium takes issue with the specific legal frameworks and regimes that are related to structuring various forms of precarious and exploitable labour, by exploring how (EU) law orders the world of work through legal regimes and regulatory frameworks governing specific forms of labour mobility across borders, as well as by looking at the other components of the structures and institutional interactions underlying the broader political economy where precarious forms of work materialise.
Female athlete triad affects rat intestinal morphology and sucrase-isomaltase expression
Authors: Aoki Kai , Ebina Kei , Shingu Hana , Kioka Kazuki , Sugasawa Takehito , Kawakami Yasushi , Takekoshi Kazuhiro , Omi Naomi 
Published: November 2022

AbstractFemale athletes follow a strict diet and perform rigorous exercise to boost their performance, which induces health issues called the female athlete triad (FAT), defined as the combination of disordered eating, amenorrhoea and low bone mineral density. It is known to have a significant effect on bones. However, its effects on the small intestine, which is responsible for nutrient uptake into the body, remain unclear. In this study, we created an animal model of FAT to examine its effects on digestive and absorptive molecules in the small intestine. Thirty 5-week-old female Sprague-Dawley (sd) rats with an initial body weight of about 147 g were divided into control (Con, n = 7), exercise (Ex, n = 7), food restriction (FR, n = 8) and exercise plus food restriction (FAT, n = 8) groups. The rats were subjected to 4 weeks of wheel running (Ex, FAT) and 50–40 % food restriction (FR, FAT) to examine the effects on bone and typical digestive enzymes and transporters in the jejunum. Two-way ANOVA and the Kruskal–Wallis test were used for statistical analysis of normal and non-normal data, respectively. Four weeks of exercise and food restriction decreased bone weight (vs. other group P < 0·01) and bone breaking power (vs. other group P < 0·01). Villus height decreased in the jejunum (vs. other group P < 0·01), but the expression of typical macronutrients digestive enzyme and absorptive molecules remained unchanged. In contrast, sucrase-isomaltase gene (v. Ex P = 0·02) and protein expression were increased (vs. other group P < 0·05). The study findings show that FAT affects sucrase-isomaltase without histone methylation changes.
Cognitive behavioral therapy in patients with deep brain stimulation for obsessive-compulsive disorder: a matched controlled study
Authors: Graat Ilse , Franken Sophie , van Rooijen Geeske , de Koning Pelle , Vulink Nienke , de Kroo Mirjam , Denys Damiaan , Mocking Roel 
Published: November 2022

AbstractBackgroundDeep brain stimulation (DBS) is effective for refractory obsessive-compulsive disorder (OCD). Post-operative cognitive behavioral therapy (CBT) may augment the effects of DBS, but previous results are conflicting. Here, we investigated whether CBT augments the effect of DBS for OCD.MethodPatients with and without CBT following DBS of the ventral anterior limb of the internal capsule were included. First, we analyzed Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) and Hamilton Depression Rating Scale (HAM-D) scores before, during and after CBT in all patients with CBT. Second, we matched patients with and without CBT based on clinical baseline variables and initial response to DBS and compared the course of Y-BOCS and HAM-D scores over the same timeframe.ResultsIn total, 36 patients with and 16 patients without CBT were included. Average duration of CBT was 10.4 months (s.d. 6.4). In the 36 patients with CBT, Y-BOCS scores decreased on average by 3.8 points (14.8%) from start until end of CBT (p = 0.043). HAM-D scores did not decrease following CBT. Second, 10 patients with CBT were matched to 10 patients without CBT. In both groups, Y-BOCS scores decreased equally from start until end of CBT or over a similar timeframe (10% in CBT group v. 13.1% in no-CBT group, p = 0.741).ConclusionsObsessive-compulsive symptoms decreased over time in patients with and without post-operative CBT. Therefore, further improvement may be attributed to late effects of DBS itself. The present study emphasizes the need for prospective randomized controlled studies, examining the effects of CBT.
Long-term efficacy of brief psychological treatments for common mental disorders in Myanmar refugees in Malaysia: 12-month follow-up of a randomized, active-controlled trial of integrative adapt therapy v. cognitive behavioral therapy
Authors: Tay Alvin Kuowei , Mohsin Mohammed , Foo Cheryl Yunn Shee , Rees Susan , Silove Derrick 
Published: November 2022

AbstractBackgroundLong-term efficacy of brief psychotherapies for refugees in low-resource settings is insufficiently understood. Integrative adapt therapy (IAT) is a scalable treatment addressing refugee-specific psychosocial challenges.MethodsWe report 12-month post-treatment data from a single-blind, active-controlled trial (October 2017–August 2019) where 327 Myanmar refugees in Malaysia were assigned to either six sessions of IAT (n = 164) or cognitive behavioral treatment (CBT) (n = 163). Primary outcomes were posttraumatic stress disorder (PTSD), depression, anxiety, and persistent complex bereavement disorder (PCBD) symptom scores at treatment end and 12-month post-treatment. Secondary outcome was functional impairment.Results282 (86.2%) participants were retained at 12-month follow-up. For both groups, large treatment effects for common mental disorders (CMD) symptoms were maintained at 12-month post-treatment compared to baseline (d = 0.75–1.13). Although participants in IAT had greater symptom reductions and larger effect sizes than CBT participants for all CMDs at treatment end, there were no significant differences between treatment arms at 12-month post-treatment for PTSD [mean difference: −0.9, 95% CI (−2.5 to 0.6), p = 0.25], depression [mean difference: 0.1, 95% CI (−0.6 to 0.7), p = 0.89), anxiety [mean difference: −0.4, 95% CI (−1.4 to 0.6), p = 0.46], and PCBD [mean difference: −0.6, 95% CI (−3.1 to 1.9), p = 0.65]. CBT participants showed greater improvement in functioning than IAT participants at 12-month post-treatment [mean difference: −2.5, 95% CI (−4.7 to −0.3], p = 0.03]. No adverse effects were recorded for either therapy.ConclusionsBoth IAT and CBT showed sustained treatment gains for CMD symptoms amongst refugees over the 12-month period.
Demonstration of a ‘leapfrog’ randomized controlled trial as a method to accelerate the development and optimization of psychological interventions
Authors: Blackwell Simon E. , Schönbrodt Felix D. , Woud Marcella L. , Wannemüller Andre , Bektas Büsra , Braun Rodrigues Max , Hirdes Josefine , Stumpp Michael , Margraf Jürgen 
Published: November 2022

AbstractBackgroundThe scale of the global mental health burden indicates the inadequacy not only of current treatment options, but also the pace of the standard treatment development process. The ‘leapfrog’ trial design is a newly-developed simple Bayesian adaptive trial design with potential to accelerate treatment development. A first leapfrog trial was conducted to provide a demonstration and test feasibility, applying the method to a low-intensity internet-delivered intervention targeting anhedonia.MethodsAt the start of this online, single-blind leapfrog trial, participants self-reporting depression were randomized to an initial control arm comprising four weeks of weekly questionnaires, or one of two versions of a four-week cognitive training intervention, imagery cognitive bias modification (imagery CBM). Intervention arms were compared to control on an ongoing basis via sequential Bayesian analyses, based on a primary outcome of anhedonia at post-intervention. Results were used to eliminate and replace arms, or to promote them to become the control condition based on pre-specified Bayes factor and sample size thresholds. Two further intervention arms (variants of imagery CBM) were added into the trial as it progressed.ResultsN = 188 participants were randomized across the five trial arms. The leapfrog methodology was successfully implemented to identify a ‘winning’ version of the imagery CBM, i.e. the version most successful in reducing anhedonia, following sequential elimination of the other arms.ConclusionsThe study demonstrates feasibility of the leapfrog design and provides a foundation for its adoption as a method to accelerate treatment development in mental health. Registration: clinicaltrials.gov, NCT04791137.
Visual Framing: The Use of COVID-19 in the Mobilization of Hong Kong Protest
Authors: Whitworth Katherine , Li Yao-Tai 
Published: November 2022

AbstractThis study focuses on the Hong Kong Lennon Walls and the communications posted there. We assert that the physical placement of COVID-19 related images on the Lennon Walls of Hong Kong and the replication of symbols and iconography from the Umbrella Movement and the Anti-ELAB Movement situated COVID-19 discourse not only physically within but also symbolically within the contentious politics of Hong Kong. We conclude that the messages and images posted on Lennon Walls between January and April 2020 have used COVID-19 to extend public expression of sentiment on the debates around the Hong Kong government and to further mobilize a sense of Hong Kong identity against China. The findings contribute to the understandings of how the cultural politics surrounding the pandemic became a collective action frame in the mobilization of a localized Hong Kong political identity against the Hong Kong and Chinese governments.
Disability Discrimination and Patient-Sensitive Health-Related Quality of Life
Authors: Nielsen Lasse 
Published: November 2022

AbstractIt is generally accepted that morally justified healthcare rationing must be non-discriminatory and cost-effective. However, given conventional concepts of cost-effectiveness, resources spent on disabled people are spent less cost-effectively, ceteris paribus, than resources spent on non-disabled people. Thus, it is reasonable to assume that standard cost-effectiveness discriminates against the disabled. Call this thedisability discrimination problem.Part of the disability discrimination involved in cost-effectiveness stems from the way in which health-related quality of life is accounted for and measured. This paper offers and defends a patient-sensitive account of health-related quality of life, which can effectively make cost-effectiveness less discriminatory against the disabled and thus more morally justified.
Cost-Effectiveness and the Avoidance of Discrimination in Healthcare: Can We Have Both?
Authors: Lippert-Rasmussen Kasper 
Published: November 2022

AbstractMany ethical theorists believe that a given distribution of healthcare is morally justified only if (1) it is cost-effective and (2) it does not discriminate against older adults and disabled people. However, if (3) cost-effectiveness involves maximizing the number of quality-adjusted life-years (QALYs) added by a given unit of healthcare resource, or cost, it seems the pursuit of cost-effectiveness will inevitably discriminate against older adults and disabled patients. I show why this trilemma is harder to escape than some theorists think. We cannot avoid it by using age- or disability-weighted QALY scores, for example. I then explain why there is no sense of “discrimination” on which discrimination isbothunjust, and thus something healthcare rationing must avoid,andsomething cost-effective healthcare rationing inevitably involves. I go on to argue that many of the reasons we have for not favoring rationing that maximizes QALYs outside the healthcare context apply in healthcare as well. Thus, claim (1) above is dubious.
Cost-Effectiveness, Incompleteness, and Discrimination
Authors: Herlitz Anders 
Published: November 2022

AbstractThis paper argues that cost-effectiveness analysis in the healthcare sector introduces a discrimination risk that has thus far been underappreciated and outlines some approaches one can take toward this. It is argued that appropriate standards used in cost-effectiveness analysis in the healthcare sector fail to always fully determine an optimal option, which entails that cost-effectiveness analysis often leaves decision makers with large sets of permissible options. Larger sets of permissible options increase the role of decision makers’ biases, whims, and prejudices, which means that the discrimination risk increases. Two ways of mitigating this are identified: tinkering with standards used in the cost-effectiveness analysis and outlining anti-discrimination guidelines for decision makers.
Emergency Medical Services Preparedness in Dual Disasters: War in the Era of COVID-19 in Armenia
Authors: Woodward Christina A. , Hertelendy Attila J. , Hart Alexander , Voskanyan Amalia , Harutyunyan Hakob , Virabyan Anushavan , Mukhaelyan Artak , Mahon Selwyn E. , Issa Fadi S. , Adnan Mohd Syafwan , Stepanyan Taguhi , Ciottone Gregory R. 
Published: November 2022

AbstractIntroduction:Emergency Medical Services (EMS) is a critical part of Disaster Medicine and has the ability to limit morbidity and mortality in a disaster event with sufficient training and experience. Emergency systems in Armenia are in an early stage of development and there is no Emergency Medicine residency training in the country. As a result, EMS physicians are trained in a variety of specialties.Armenia is also a country prone to disasters, and recently, the Armenian EMS system was challenged by two concurrent disasters when the 2020 Nagorno-Karabakh War broke out in the midst of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic.Study Objective:This study aims to assess the current state of disaster preparedness of the Armenian EMS system and the effects of the simultaneous pandemic and war on EMS providers.Methods:This was a cross-sectional study conducted by anonymous survey distributed to physicians still working in the Yerevan EMS system who provided care to war casualties and COVID-19 patients.Results:Survey response rate was 70.6%. Most participants had been a physician (52.1%) or EMS physician (66.7%) for three or less years. The majority were still in residency (64.6%). Experience in battlefield medicine was limited prior to the war, with the majority reporting no experience in treating mass casualties (52.1%), wounds from explosives (52.1%), or performing surgical procedures (52.1%), and many reporting minimal to no experience in treating gunshot wounds (62.5%), severe burns (64.6%), and severe orthopedic injuries (64.6%). Participants had moderate experience in humanitarian medicine prior to war. Greater experience in battlefield medicine was found in participants with more than three years of experience as a physician (z-score −3.26; P value <.01) or as an EMS physician (z-score −2.76; P value <.01) as well as being at least 30 years old (z-score −2.11; P value = .03). Most participants felt they were personally in danger during the war at least sometimes (89.6%).Conclusion:Prior to the COVID-19 pandemic and simultaneous 2020 Nagorno-Karabakh War, EMS physicians in Armenia had limited training and experience in Disaster Medicine. This system, and the frontline physicians on whom it relies, was strained by the dual disaster, highlighting the need for Disaster Medicine training in all prehospital medical providers.