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Sleep problems associated with poor mental health and academic outcomes may have been exacerbated by the COVID-19 pandemic.
To describe sleep in undergraduate students during the COVID-19 pandemic.
This longitudinal analysis included data from 9523 students over 4 years (2018–2022), associated with different pandemic phases. Students completed a biannual survey assessing risk factors, mental health symptoms and lifestyle, using validated measures. Sleep was assessed with the Sleep Condition Indicator (SCI-8). Propensity weights and multivariable log-binomial regressions were used to compare sleep in four successive first-year cohorts. Linear mixed-effects models were used to examine changes in sleep over academic semesters and years.
There was an overall decrease in average SCI-8 scores, indicating worsening sleep across academic years (average change −0.42 per year; P-trend < 0.001), and an increase in probable insomnia at university entry (range 18.1–29.7%; P-trend < 0.001) before and up to the peak of the pandemic. Sleep improved somewhat in autumn 2021, when restrictions loosened. Students commonly reported daytime sleep problems, including mood, energy, relationships (36–48%) and concentration, productivity, and daytime sleepiness (54–66%). There was a consistent pattern of worsening sleep over the academic year. Probable insomnia was associated with increased cannabis use and passive screen time, and reduced recreation and exercise.
Sleep difficulties are common and persistent in students, were amplified by the pandemic and worsen over the academic year. Given the importance of sleep for well-being and academic success, a preventive focus on sleep hygiene, healthy lifestyle and low-intensity sleep interventions seems justified.
We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.
CHD care is resource-intensive. Unwarranted variation in care may increase cost and result in poorer health outcomes. We hypothesise that process variation exists within the pre-operative evaluation and planning process for children undergoing repair of atrial septal defect or ventricular septal defect and that substantial variation occurs in a small number of care points.
From interviews with staff of an integrated congenital heart centre, an initial process map was constructed. A retrospective chart review of patients with isolated surgical atrial septal defect and ventricular septal defect repair from 7/1/2018 through 11/1/2020 informed revisions of the process map. The map was assessed for points of consistency and variability.
Thirty-two surgical atrial septal defect/ventricular septal defect repair patients were identified. Ten (31%) were reviewed by interventional cardiology before surgical review. Of these, 6(60%) had a failed catheter-based closure and 4 (40%) were deemed inappropriate for catheter-based closure. Thirty (94%) were reviewed in case conference, all attended surgical clinic, and none were admitted prior to surgery. The process map from interviews alone identified surgery rescheduling as a point of major variability; however, chart review revealed this was not as prominent a source of variability as pre-operative interventional cardiology review.
Significant variation in the pre-operative evaluation and planning process for surgical atrial septal defect/ventricular septal defect patients was identified. If such process variation is widespread through CHD care, it may contribute to variations in outcome and cost previously documented within CHD surgery. Future research will focus on determining whether the variation is warranted or unwarranted, associated health outcomes and cost variation attributed to these variations in care processes.
We investigate the role of optimism bias in bull price expectations using incentivized lab-in-the-field experiments with Alabama and Tennessee cattle producers. We develop bull price prediction tasks and reward accurate predictions. We find that the EPD information provision prevents optimism bias from contaminating price expectations in the whole sample. However, we also document that, unlike buyers, sellers are prone to unrealistic optimistic expectations, and our results reveal that optimism bias can be moderated by the type of expected progeny difference information utilized, breed characteristics, and regional differences in cattle operations. We contribute to the literature by documenting the role of behavioral biases.
We determine optimal stocker strategies based on calving season, herd size, and the number of days of retention before marketing weaned calves. We estimate a hedonic pricing model for feeder cattle and incorporate this into a simulation model that considers the variability of cattle prices and feed costs. The profit and utility-maximizing decision for fall calving herd would be to retain weaned calves for 150-day postweaning. The producer marketing spring-born calves would prefer to sell these calves at weaning. The results are being utilized by extension to aid cattle producers in reducing their feed costs and increasing their profits.
The winemaking technique of saignée is common for some varietals, and the ensuing flavor profiles have been carefully analyzed by oenologists. However, we argue that saignée is fundamentally about economic tradeoffs between the quantity of primary wine that is ultimately produced, the quality (and thus, price) of that wine, and the amount of rosé wine that is bled off in the process. We develop the first theoretically-grounded economic model of saignée and analyze the model to shed light on the winemaker's optimal choice of saignée, and on the properties of wine and wine markets that should empirically give rise to more, or less, saignée. The model helps to explain several real-world regularities such as the absence of saignée for most Bordeaux wines, the specialization in rosé for many wines in Provence, and the practice of moderate amounts of saignée for varietals such as grenache and pinot noir.
With advances in care, an increasing number of individuals with single-ventricle CHD are surviving into adulthood. Partners of individuals with chronic illness have unique experiences and challenges. The goal of this pilot qualitative research study was to explore the lived experiences of partners of individuals with single-ventricle CHD.
Partners of patients ≥18 years with single-ventricle CHD were recruited and participated in Experience Group sessions and 1:1 interviews. Experience Group sessions are lightly moderated groups that bring together individuals with similar circumstances to discuss their lived experiences, centreing them as the experts. Formal inductive qualitative coding was performed to identify salient themes.
Six partners of patients participated. Of these, four were males and four were married; all were partners of someone of the opposite sex. Themes identified included uncertainty about their partners’ future health and mortality, becoming a lay CHD specialist, balancing multiple roles, and providing positivity and optimism. Over time, they took on a role as advocates for their partners and as repositories of medical history to help navigate the health system. Despite the uncertainties, participants described championing positivity and optimism for the future.
In this first-of-its-kind pilot study, partners of individuals with single-ventricle CHD expressed unique challenges and experiences in their lives. There is a tacit need to design strategies to help partners cope with those challenges. Further larger-scale research is required to better understand the experiences of this unique population.
We estimate a hedonic pricing model to determine producers’ value for bull expected progeny differences (EPDs), genomic-enhanced EPDs, and phenotypic traits. Birth weight EPD, ribeye area EPD, sale weight, age, frame score, and other factors had a statistically significant impact on bull prices. GE-EPDs were not associated with a change in the bull sales prices expect for weaned calf value and birth weight EPDs. Including weaned calf value and GE-EPDs in a bull hedonic pricing model provides a unique contribution. The results from this work will inform educational programming for bull purchasers on using new economic selection indices and GE-EPDs.
The western Antarctic Peninsula harbours a diverse benthic marine community where dense canopies of macroalgae can dominate the shallow subtidal zone (0–40 m or greater). In the lower portion of this range (below 25–35 m depending on topography), invertebrates such as sponges and echinoderms can be found in greater abundance due to reduced competition for space from the algal species. Dendrilla antarctica (previously Dendrilla membranosa) is a common demosponge that thrives in both communities and is known for producing diterpene secondary metabolites as a defence against sympatric sea star and amphipod predators. Omnivorous mesograzers such as amphipods inhabit both communities; however, they are in greatest abundance within the macroalgal canopy. Due to the differences between habitats, it was hypothesized that specific amphipod species not susceptible to the defensive metabolites of D. antarctica would take refuge from predators in the chemically defended sponge. Analysis of the metabolome and amphipod communities from sponges in both habitats found correlations of metabolic profile to both abundance and habitat. These studies serve to inform our understanding of the complex ecosystem of the Antarctic benthos that stands to be dramatically altered by the rapidly changing climate in the years to come.
To examine differences in surgical practices between salaried and fee-for-service (FFS) surgeons for two common degenerative spine conditions. Surgeons may offer different treatments for similar conditions on the basis of their compensation mechanism.
The study assessed the practices of 63 spine surgeons across eight Canadian provinces (39 FFS surgeons and 24 salaried) who performed surgery for two lumbar conditions: stable spinal stenosis and degenerative spondylolisthesis. The study included a multicenter, ambispective review of consecutive spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network registry between October 2012 and July 2018. The primary outcome was the difference in type of procedures performed between the two groups. Secondary study variables included surgical characteristics, baseline patient factors, and patient-reported outcome.
For stable spinal stenosis (n = 2234), salaried surgeons performed statistically fewer uninstrumented fusion (p < 0.05) than FFS surgeons. For degenerative spondylolisthesis (n = 1292), salaried surgeons performed significantly more instrumentation plus interbody fusions (p < 0.05). There were no statistical differences in patient-reported outcomes between the two groups.
Surgeon compensation was associated with different approaches to stable lumbar spinal stenosis and degenerative lumbar spondylolisthesis. Salaried surgeons chose a more conservative approach to spinal stenosis and a more aggressive approach to degenerative spondylolisthesis, which highlights that remuneration is likely a minor determinant in the differences in practice of spinal surgery in Canada. Further research is needed to further elucidate which variables, other than patient demographics and financial incentives, influence surgical decision-making.
Recent excavations by the Ancient Southwest Texas Project of Texas State University sampled a previously undocumented Younger Dryas component from Eagle Cave in the Lower Pecos Canyonlands of Texas. This stratified assemblage consists of bison (Bison antiquus) bones in association with lithic artifacts and a hearth. Bayesian modeling yields an age of 12,660–12,480 cal BP, and analyses indicate behaviors associated with the processing of a juvenile bison and the manufacture and maintenance of lithic tools. This article presents spatial, faunal, macrobotanical, chronometric, geoarchaeological, and lithic analyses relating to the Younger Dryas component within Eagle Cave. The identification of the Younger Dryas occupation in Eagle Cave should encourage archaeologists to revisit previously excavated rockshelter sites in the Lower Pecos and beyond to evaluate deposits for unrecognized, older occupations.
A hedonic model was employed to examine factors impacting feeder cattle prices at a monthly video auction in Tennessee. Home-raised cattle were estimated to have a $2 per cwt. premium and cattle that have been tested for PI-BVDV (persistent infections with bovine viral diarrhea virus) sold for a premium of $1.19 per cwt. We also show how price varies across sale months for steers and heifers, suggesting opportune times to market gender-specific lots. Corn price was interacted with an average weight per head of the lot to show that lighter cattle were negatively affected, while heavier cattle prices were positively affected by increasing corn prices.
In authoritarian regimes, repression encourages private actors to censor not only themselves, but also other private actors—a behavior we call “regime-induced private censorship.” We present the results of a correspondence experiment conducted in Russia that investigates the censorship behavior of private media firms. We find that such firms censor third-party advertisements that include anti-regime language, calls for political or non-political collective action, or both. Our results demonstrate the significance of other types of censorship besides state censorship in an important authoritarian regime and contribute to the rapidly growing literature on authoritarian information control.
A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic.
To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children.
Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher’s exact, and Wilcoxon rank sum.
Thirty-nine children with median (interquartile range) age 7.8 (3.6–12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26–61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04).
Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.
Written for an audience of students, general readers, and economists alike, this Element is a primer on the field of the economics of conflict and peace. It offers a reasonably comprehensive, systematic, and detailed overview - even if in broad strokes - of the field's orthodox and heterodox history of thought and current theories and evidence. The authors view this Element as a baseline account on which to build a future, separate and more fully developed, work on the economics of peace, economic growth, and human development. Altogether, the Element contextualizes the field of conflict and peace economics, outlines its history of thought, highlights examples of current theoretical and empirical scholarship in the field, and maps trajectories for further research.
ABSTRACT IMPACT: Patients living in overcrowded zip codes were at increased risk of contracting severe COVID-19 after controlling for confounding disease and socioeconomic factors OBJECTIVES/GOALS: This study sought to examine whether residences in over-crowded zip codes with higher reported over-crowding represented an independent risk factor for severe COVID-19 infection, defined by presentation to an emergency department. METHODS/STUDY POPULATION: In this zip code tabulated area (ZCTA)-level analysis, we used NYC Department of Health disease surveillance data in March 2020 merged with data from the CDC and ACS to model suspected COVID-19 case rates by zip code over-crowdedness (households with greater than 1 occupant per room, in quartiles). We defined suspected COVID-19 cases as emergency department reported cases of pneumonia and influenza-like illness. Our final model employed a multivariate Poisson regression models with controls for known COVID-19 clinical (prevalence of obesity, coronary artery disease, and smoking) and related socioeconomic risk factors (percentage below federal poverty line, median income by zip-code, percentage White, and proportion of multigenerational households) after accounting for multicollinearity. RESULTS/ANTICIPATED RESULTS: Our analysis examined 39,923 suspected COVID-19 cases across 173 ZCTAs in NYC between March 1 and March 30 2020. We found that, after adjusted analysis, for every quartile increase in defined over-crowdedness, case rates increased by 32.8% (95% CI: 22.7%% to 34.0%, P < 0.001). DISCUSSION/SIGNIFICANCE OF FINDINGS: Over-crowdedness by zip code may be an independent risk factor for severe COVID-19. Social distancing measures such as school closures that increase house-bound populations may inadvertently worsen the risk of COVID-19 contraction in this setting.
Sperm morphometric and morphologic data have been shown to represent useful tools for monitoring fertility, improving assisted reproduction techniques and conservation of genetic material as well as detecting inbreeding of endangered primates. We provide here for the first time sperm morphologic and morphometric data from Cercopithecus neglectus, Cercopithecus cephus, Papio papio and critically endangered Cercopithecus roloway, as well as comparative data from other Cercopithecinae species, i.e. Allochrocebus lhoesti, Mandrillus sphinx and Papio anubis. Following collection from the epididymis, spermatozoa were measured for each species for the following parameters: head length, head width, head perimeter, head area, midpiece length and total flagellum length, and the head volume, ellipticity, elongation, roughness and regularity were then calculated. Our data are consistent with both the general morphology and the morphometric proportions of Cercopithecinae sperm. Some specificities were observed, with C. cephus displaying a narrow head (width = 2.76 ± 0.26 µM) and C. roloway displaying a short midpiece (6.65 ± 0.61 µM). This data set represents an important contribution, especially for Cercopithecus roloway, one of the most endangered monkeys in the world, and further data on additional specimens coupled to data on mating systems and reproductive ecology should allow a better understanding of the mechanisms underlying these morphological differences across primate species.