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The COVID-19 pandemic and associated lockdowns raised concerns about their impact on substance use among young people.
Objectives/Aims:
The aim of this study is to investigate the potential changes in alcohol and drug-related medical hospital admissions during the pandemic compared to pre and post pandemic years among individuals aged 15–24 in Ireland.
Methods:
Data from the Hospital Inpatient Enquiry (HIPE) database, covering emergency hospital admissions from 2017 to 2022, were analysed. Lockdown and control periods were identified, and admission rates for drug-related hospital admissions (DRHA) were calculated per population and per 100 all-cause admissions. The study also examined changes in alcohol-related hospital admissions (ARHA) and explored the contribution of different drug categories to DRHA during lockdowns.
Results:
We found that there was an increase in drug-related hospital admissions (DRHA) among individuals aged 15–24 years during the periods of hard lockdowns, comparing the three periods of hard lockdown from 2020 to 2021 with corresponding weeks in control years. The median rate of DRHA per million per week during the lockdowns was 23.8 (inter-quartile range [IQR] 19.0 – 29.9) while it was 18.2 (IQR 13.7–22.2) during the control weeks (p<0.001). DRHA accounted for a median 3.81% of admissions during lockdown weeks while they comprised 2.16% during the control weeks.
Conclusions:
Our findings suggest that an adverse effect of pandemic restrictions appears to be increased acute drug-related problems requiring medical management among youth aged 15–24 years.
Everyone is talking about bots. Much of the discussion has focused on downsides. It is too easy to use bots to cheat, but there are also many ways to use bots to improve your writing. Good writers use thesauruses. It is not cheating to use bots as a modern version of a thesaurus. It is also not cheating to use recommendation systems in a responsible way.
Theoretical perspectives propose that positive childhood experiences (PCEs) are associated with adult mental health symptoms. The aim of the current study was to conduct a meta-analysis to evaluate the correlations between PCEs and adult mental health symptoms. 41 unique studies (N = 74,492) were included. Significant, negative, medium-to-large, effects were observed between PCEs and each mental health symptom (medium-to-large for overall mental health: r = −.268; and depression: r = −.273; for anxiety: r = −.246; and PTSD: r = −.243), indicating that higher levels of PCEs are linked to fewer mental health difficulties in adulthood. Meta-regression analyses identified current age at the time of mental health assessment and adverse childhood experiences (ACEs) as significant moderators. Specifically, the promotive effects of PCEs were stronger among younger adults and weakened with higher ACEs exposure, particularly in relation to overall adult mental health symptoms, depression, PTSD, and anxiety. In contrast, no significant moderation effects were found for sex or the type of PCEs measurement tool used. Integrated prevention frameworks that combine ACEs prevention with PCEs promotion can enhance mental health across the lifespan by addressing both risk and promotive pathways and providing developmentally tailored support.
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a significant public health concern, disproportionately affecting socioeconomically disadvantaged populations, including individuals experiencing poverty, homelessness, incarceration, and injection drug use. This scoping review synthesizes existing literature on factors influencing CA-MRSA occurrence and community transmission in these populations. A comprehensive search of PubMed, MEDLINE, and Scopus for studies published between January 2000 and February 2024 identified 3,223 articles, of which 40 met the inclusion criteria. Findings indicate that the CA-MRSA burden remains high, with community transmission influenced by factors, such as limited access to hygiene resources, structural barriers to care, and social network dynamics. Surveillance and intervention strategies remain largely healthcare-focused, with limited data on community-level transmission and risk. This review highlights the urgent need for targeted public health interventions and the adoption of expanded, innovative surveillance methods, such as genomic epidemiology, to better track and mitigate CA-MRSA transmission in vulnerable populations. As antibiotic resistance continues to rise, future research should prioritize longitudinal studies and community-based surveillance to develop effective, population-specific infection prevention, and control strategies.
To evaluate the impact of implementation of a conditional reflex urine culturing strategy on urine culture rates, antimicrobial use, and clinical outcomes in hospitalized adults.
Design:
Pre-post quasi-experimental study.
Setting:
Emergency departments and inpatient units within a large, integrated healthcare system in Northeast Ohio, comprising 10 medical centers.
Patients:
Adult patients with a urine culture ordered from June 1, 2018, to May 31, 2023.
Methods:
A system-wide intervention was implemented on June 1, 2020, requiring urinalysis (UA) with pyuria findings to trigger a urine culture order. We compared urine culture rates, antimicrobial use (measured by days of therapy [DOT] and days of antimicrobial spectrum coverage [DASC]), and clinical outcomes between pre-and post-intervention periods.
Results:
The intervention resulted in an 85.4% reduction in urine culture rates (0.54 vs 3.71 per 100 patient days). Antimicrobial use decreased, with DOT per 100 patient days dropping by 11.5% and DASC/DOT by 16.1%. No significant differences were observed in Clostridioides difficile infection rate, subsequent bloodstream infections with urinary pathogens, or mortality between pre- and post-intervention groups.
Conclusions:
A conditional reflex urine culturing strategy implemented as part of a diagnostic stewardship framework reduced urine culture and antimicrobial use without adverse clinical outcomes. This highlights the potential of diagnostic stewardship to optimize antimicrobial use in hospitalized adults.
Quarries are information-rich anthropic landscapes, but their unique characteristics often limit the effectiveness of traditional archaeological documentation strategies. Here, the authors present a novel interdisciplinary method for the documentation and analysis of these landscapes, focusing on two ancient marble quarries on the Mediterranean island of Naxos. The workflow, combining lidar, photogrammetry, sculptural and architectural study, geoscience, ecological study and archaeological survey, provides a means for the systematic documentation of quarry landscapes in the Mediterranean and beyond, and aims to promote an understanding of premodern extractive activities not as isolated occurrences but as important aspects of interconnected, evolving landscapes.
This study aims to assess the knowledge and determine the level of compliance with human immunodeficiency virus (HIV) post exposure management (PEM) among dentists.
Design:
A descriptive cross-sectional study was done among 114 dentists.
Setting:
Study was done among dentists in two Nigerian tertiary hospitals.
Participants:
All dentists available, who consented to the study during the period of data collection were included in the sample. Three cadres of dentists; house officers, residents and consultants, were involved in the study.
Methods:
Using self-administered questionnaires, information was sought on knowledge of managing exposures-first aid and prophylaxis as well as compliance when exposed. Data was analyzed using the SPSS statistical software.
Results:
Nearly all respondents, 111(97.4%), reported having heard about HIV PEM. Exposure incidents most frequently identified by respondents were needlestick injuries, 111(97.4%). Majority of the dentists recognized practices such as flushing exposed mucous membranes with water, 97(85.1%), and washing skin injuries with soap and water, 75(65.8%), as first aid for exposure incidents, while 20(17.5%) endorsed inappropriate measures like applying bleach to the wound. Seventy-one (62.3%) reported awareness of a HIV PEM protocol in their institution while 39(33.3%) were uncertain, with only 25(21.9%) reporting routine practice of the protocol. Fifty-six (49.1%) of the respondents had experienced an exposure of which only 30(53.6 %) reported and 32(57.1%) requested blood tests for the source patient(s).
Conclusion:
The level of compliance with post exposure management is inadequate, therefore there is a need to update the knowledge and device methods of encouraging compliance with HIV PEM protocol among dentists.
We identify a parsimonious set of factors from a large pool of candidates for explaining hedge fund returns, ranging from equity market, anomaly, and trend-following factors to macroeconomic factors. The resulting 9-factor model, including five anomaly factors, outperforms existing hedge fund models both in sample and out of sample, with a significant reduction in alphas while showing substantial cross sectional performance heterogeneity. Further analysis based on fund holdings confirms the model’s ability to capture returns from arbitrage trading. Overall, the anomaly factors help quantify hedge fund strategies and risk exposures and improve fund performance evaluation.
Vibration control in structures is essential to mitigate undesired dynamic responses, thereby enhancing stability, safety, and performance under varying loading conditions. Mechanical metamaterials have emerged as effective solutions, enabling tailored dynamic properties for vibration attenuation. This study introduces a convolutional autoencoder framework for the inverse design of local resonators embedded in mechanical metamaterials. The model learns from the dynamic behaviour of primary structures coupled with ideal absorbers to predict the geometric parameters of resonators that achieve desired vibration control performance. Unlike conventional approaches requiring full numerical models, the proposed method operates as a data-driven tool, where the target frequency to be mitigated is provided as input, and the model directly outputs the resonator geometry. A large dataset, generated through physics-informed simulations of ideal absorber dynamics, supports training while incorporating both spectral and geometric variability. Within the architecture, the encoder maps input receptance spectra to resonator geometries, while the decoder reconstructs the target receptance response, ensuring dynamic consistency. Once trained, the framework predicts resonator configurations that satisfy predefined frequency targets with high accuracy, enabling efficient design of passive controllers of the syntonized mass type. This study specifically demonstrates the application of the methodology to resonators embedded in wind turbine metastructures, a critical context for mitigating structural vibrations and improving operational efficiency. Results confirm strong agreement between predicted and target responses, underscoring the potential of deep learning techniques to support on-demand inverse design of mechanical metamaterials for smart vibration control in wind energy and related engineering applications.
This forum contribution explores the strengths and limits of Noam Yuran’s innovative call for a new political economy of sex and desire. It has three prongs. First, I discuss Yuran’s compelling focus on the curious durability of monogamy as an institution. Second, I examine his analysis of thinkers such as Mandeville and Weber. Finally, I turn to the question of love. I suggest that Yuran’s approach opens a pathway to a more loving and more realistic political economy of intimacy and familial love, one that I suggest is missing in much critical theory today, particularly in the rhetoric of family abolitionists.
The Great Depression era provides a natural experiment to study the effects of employee stock ownership on productivity due to the unexpected nature of the stock market crash in 1929 and the predetermined expiration of employee stock offerings staggered throughout the 1930s. I collect information on employee stock ownership from reports by the National Industrial Conference Board, annual company reports and other primary sources, and then merge them with the US Census of Manufactures to form the main establishment-level dataset. The results indicate that companies with active programs had significantly lower establishment-level output growth and fewer hours worked per employee than firms with inactive ESOPs post-crash. These negative effects, however, can be mitigated in smaller firms where employees feel their effort level has non-negligible effects. To my knowledge, this is the first study to empirically investigate these early ESOPs as well as address how continuing an employee stock ownership program during a financial crisis affects productivity.
Joseph Raz’s service conception of legitimacy says citizens must obey the state when its directives allow them to comply with reason better than they would by deciding independently. Yet citizens’ capacity to decide for themselves is endogenous to state authority: the more they defer, the less competent they might become. Consequently, a state might secure its legitimacy through a self-fulfilling dynamic whereby citizens need state authority only because they have grown dependent upon it. This article diagnoses the problem and explains how the service conception can guard against it. Besides Raz's account, its argument applies to any theory of legitimacy with a “service” component.
This article explores the theme of the alchemical interpretations of medieval iconography through the life and the writings of Esprit Gobineau de Montluisant (c.1590–between 1652 and 1665). This French alchemist and poet indeed composed a dissertation on some of the ornaments on the main facade of Notre-Dame de Paris, in which he asserted that the sculptures that adorn it conceal alchemical allusions. This curious thesis, written by a practitioner who was in contact with leading political figures of his time, such as the diplomat Léon Bouthilier (1608–52) or the marshal Abraham Fabert d’Esternay (1599–1662), did not emerge from nothing. It is part of an exegetical literature that combines alchemical theories, scriptural allegories, and a sense of heritage for Gothic monuments that were often in disrepair at the time. Far from being anecdotal, Gobineau’s treatise continued to be studied and read over the following centuries by alchemists, writers, art critics and even archaeologists. This influence, albeit discreet, justifies rediscovering his life and his dissertation. It also reminds us of the need to consider works linked to Western esotericism in the study of European cultural and scientific history.
Mass dispersion in oscillatory flows is closely tied to various environmental and biological processes, differing markedly from dispersion in steady flows due to the periodic expansion and contraction of particle patches. In this study, we investigate the Taylor–Aris dispersion of active particles in laminar oscillatory flows between parallel plates. Two complementary approaches are employed: a two-time-variable expansion of the Smoluchowski equation is used to facilitate Aris’ method of moments for the pre-asymptotic dispersion, while the generalised Taylor dispersion theory is extended to capture phase-dependent periodic drift and dispersivity in the long-time asymptotic limit. Applying both frameworks, we find that spherical non-gyrotactic swimmers can exhibit greater or lesser diffusivity than passive solutes in purely oscillatory flows, depending on the oscillation frequency. This behaviour arises primarily from the disruption of cross-streamline migration governed by Jeffery orbits. When a steady component is superimposed, oscillation induces a non-monotonic dual effect on diffusivity. We further examine two well-studied shear-related accumulation mechanisms, arising from gyrotaxis and elongation. Although these accumulation effects are less pronounced than in steady flows due to flow unsteadiness, gyrotactic swimmers respond more strongly to the unsteady shear profile, significantly modifying their drift and dispersivity. This work offers new insights into the dispersion of active particles in oscillatory flows, and also provides a foundation for studying periodic active dispersion beyond the oscillatory flow, such as periodic variations in shape and swimming speed.
Morphological characters are central to phylogenetic inference, especially for fossil taxa for which genomic data are unavailable. While Bayesian methods have gained popularity in recent years, they typically assume characters evolve independently, despite known correlations among characters. Here, we assess the impact of character correlation and evolutionary rate heterogeneity on Bayesian phylogenetic inference using extensive simulations of binary characters evolving under independent and correlated models. We find that Bayesian inference assuming character independence accurately recovers tree topologies even when characters are strongly correlated or evolve under heterogeneous rates. However, branch lengths or clock rates tend to be underestimated, particularly under extreme rate heterogeneity. These biases are partially corrected using models that integrate over character-state heterogeneity. Our results demonstrate that Bayesian methods are robust to violations of character independence in topological inference, supporting their continued use in morphological phylogenetics.
How do citizens evaluate the judiciary in the wake of politically salient rulings? I argue that judicial checks on the government shape citizens’ attitudes about judicial institutions at large, but these effects are driven by instrumental considerations, namely partisanship. In particular, my account suggests that judicial checks – as specific instances of interbranch conflict – provide citizens with instrumental information that shapes their beliefs about the broader judiciary. Thus, I hypothesize that court rulings limiting the government’s power will undermine support for the judiciary among individuals aligned with the incumbent, but increase support among opposition sympathizers. I test these expectations by exploiting the timing of two judicial decisions in Argentina (enacted by a lower court and the Supreme Court) that invalidated a highly salient judicial reform promoted by the government in 2013. Using data from a survey fielded before and after the court rulings, I show that the decisions significantly decreased government supporters’ trust in the judiciary, while opposition supporters increased their trust only following the Supreme Court ruling. Moreover, suggestive evidence provides support for the mechanism proposed by my account – that judicial checks expose citizens to information that is primarily instrumental. This article contributes to our knowledge of the determinants of public support for judicial institutions involved in interbranch conflicts.
After World War II, many countries, including Nigeria, embraced Keynesian “welfarist” policies to stimulate economic growth and enhance the well-being of their citizens. However, in the late 1960s and early 1970s, a global economic crisis prompted a shift towards neoliberalism, leading to the commodification of social institutions and the implementation of policies such as privatization, trade liberalization and deregulation in Nigeria. This shift had a significant impact on Nigeria’s socio-legal economy, particularly in terms of property rights in company ownership. The article raises concerns about the structural injustice and growing inequality resulting from these neoliberal policies. It advocates for a legal framework that addresses these issues and proposes reconceptualizing private property rights in company ownership in Nigeria. This proposed framework aims to counter the dominance and power of property-owning elites and mitigate the structural injustice induced by neoliberal policies in Nigeria.
During the early twentieth century, Catalonia experienced a period of great cultural and musical development through the Noucentisme movement, which aimed to elevate its national culture to a symbol of high art. The xeremies (shawms) of the cobla ensemble, which played the sardana genre, were integrated into symphonic and chamber repertoire. This required the technical improvement of the tible (treble) and tenora (tenor) xeremies, but also encouraged the invention of new instruments in the shawm family. The barítona (baritone shawm) was premiered in 1930 by the Banda Municipal de Barcelona and represents a milestone in Catalan music in the tumultuous period before the Spanish Civil War.
Synthetic datasets, artificially generated to mimic real-world data while maintaining anonymization, have emerged as a promising technology in the financial sector, attracting support from regulators and market participants as a solution to data privacy and scarcity challenges limiting machine learning (ML) deployment. This article argues that synthetic data’s effects on financial markets depend critically on how these technologies are embedded within existing ML infrastructural ‘stacks’ rather than on their intrinsic properties. We identify three key tensions that will determine whether adoption proves beneficial or harmful: (1) data circulability versus opacity, particularly the ‘double opacity’ problem arising from stacked ML systems, (2) model-induced scattering versus model-induced herding in market participant behavior, and (3) flattening versus deepening of data platform power. These tensions directly correspond to core regulatory priorities around model risk management, systemic risk, and competition policy. Using financial audit as a case study, we demonstrate how these tensions interact in practice and propose governance frameworks, including a synthetic data labeling regime to preserve contextual information when datasets cross organizational boundaries.
This pilot cross-sectional study, conducted in two public hospitals in Malawi, assessed gestational diabetes mellitus (GDM) in pregnant women attending antenatal clinics and compared their dietary quality and food group consumption before and during pregnancy. The study targeted women aged 18 to 49 years within 24 to 28 weeks of gestation. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group criteria and assessed dietary quality before and during pregnancy using a 30-day qualitative food frequency questionnaire. We compared changes in dietary quality and specific food group mean scores using paired t-tests at p < 0.05. Of the 508 women enrolled, 22.7% were diagnosed with GDM. The overall diet quality significantly decreased during pregnancy compared to before; a similar trend was observed in women diagnosed with GDM compared to those without GDM (p < 0.0001). Among women with GDM, the mean score of the following food groups significantly (p < 0.05) decreased during pregnancy: cruciferous vegetables, deep orange vegetables and tubers, citrus fruits, deep orange fruits, other fruits, nuts and seeds, poultry, fish, low fat dairy, whole grains, and liquid oils and significantly (p < 0.05) increased in the following food groups; red meat, processed meat, sugar-sweetened beverages, sweets, sugary snacks and ice cream. In conclusion, GDM is prevalent in Malawian women enrolled in this study and is coupled with inadequate dietary quality, especially during pregnancy. Since dietary quality is pivotal to GDM management, more in-depth longitudinal dietary studies are needed to inform nutritional interventions to prevent and better manage GDM.