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Purpose: This paper studies early stages of actor mobilization for institutional change within Swedish esports. Design/methodology/approach: The authors employ interpretative phenomenological analysis. Findings: The authors' findings explain how actors become motivated to act in critical reflections linked to conflicting legitimacy judgments and emotionally charged personal struggles. Moreover, the findings show how, as actors get activated in collective action, they identify efficacy lines around valid domains and experience emotionally charged collective endeavors. Furthermore, the findings explain how particularities in early experiences project legitimacy aspirations that orient collective action toward validity ends and particular values and ideals shaping actors' grassroots movements. Originality/value: This study adds to legitimacy and institutional change theory through individual actors' perspectives, providing key insights into how they are motivated, activated, and oriented. This study is the first to investigate grassroots activists' personal stories in esports. [ABSTRACT FROM AUTHOR]

Background Statistically significant decreases in methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAIs) occurred in Veterans Affairs (VA) hospitals from 2007 to 2019 using a national policy of active surveillance (AS) for facility admissions and contact precautions for MRSA colonized (CPC) or infected (CPI) patients, but the impact of suspending these measures to free up laboratory resources for testing and conserve personal protective equipment for coronavirus disease 2019 (COVID-19) on MRSA HAI rates is not known. Methods From July 2020 to June 2022 all 123 acute care VA hospitals nationwide were given the rolling option to suspend (or re-initiate) any combination of AS, CPC, or CPI each month, and MRSA HAIs in intensive care units (ICUs) and non-ICUs were tracked. Results There were 917 591 admissions, 5 225 174 patient-days, and 568 MRSA HAIs. The MRSA HAI rate/1000 patient-days in ICUs was 0.20 (95% confidence interval [CI],.15–.26) for facilities practicing "AS + CPC + CPI" compared to 0.65 (95% CI,.41–.98; P <.001) for those not practicing any of these strategies, and in non-ICUs was 0.07 (95% CI,.05–.08) and 0.12 (95% CI,.08–.19; P =.01) for the respective policies. Accounting for monthly COVID-19 facility admissions using a negative binomial regression model did not change the relationships between facility policy and MRSA HAI rates. There was no significant difference in monthly facility urinary catheter-associated infection rates, a non-equivalent dependent variable, in the policy categories in either ICUs or non-ICUs. Conclusions Facility removal of MRSA prevention practices was associated with higher rates of MRSA HAIs in ICUs and non-ICUs. [ABSTRACT FROM AUTHOR]

Background: Percutaneous left atrial appendage occlusion (LAAO) devices have emerged as alternatives to anticoagulation for embolic stroke prevention in patients with non-valvular atrial fibrillation (NVAF). The left atrial appendage is known to produce vasoactive neuroendocrine hormones involved in cardiovascular homeostasis. The hemodynamic impact of LAA occlusion on cardiac function remains poorly characterized. Methods: This is a single-center, retrospective study of sixty-seven consecutive patients who received LAAO utilizing the WATCHMAN device from May 2017 to June 2019. All patients received a comprehensive 2D transthoracic echocardiogram (TTE) prior to the procedure and a post-procedural TTE. 2D echocardiographic pre-/post-procedural measurements including left ventricular ejection fraction, tricuspid regurgitation, estimated pulmonary artery pressure, diastolic parameters, and left atrial and right ventricular strain were statistically analyzed using the paired t-test. Results: Seventy percent of study patients were male with an overall mean age of 73.0 ± 9.0 years. Analysis of post-procedural LAAO revealed statistically significant improvement in left ventricular ejection fraction (52.4 ± 12.6 vs. 56.7 ± 12.7, p < 0.001), an increase in mitral E/e′ (14.1 ± 6.5 vs. 18.3 ± 10.8, p < 0.001), and a decrease right ventricular global longitudinal strain (RVGLS) (− 17.5 ± 4.6 vs. − 19.6 ± 5.7, p = 0.027) as compared to pre-procedural TTE. Peak left atrial longitudinal strain (PALS) improved post-LAAO (20.6 ± 12.2 to 22.9 ± 12.9, p = 0.040) with adjustment for cardiac arrhythmias. Post-LAAO, heart failure hospitalizations occurred in 23.9% of patients. Conclusions: Percutaneous LAAO results in real-time atrial and ventricular hemodynamic changes as assessed by echocardiographic evaluation of LV filling pressures (E/e′), PALS, RVGLS, and LVEF. [ABSTRACT FROM AUTHOR]

Patients with epilepsy suffer from a higher mortality rate than the general population, a portion of which is not due to epilepsy itself or comorbid conditions. Sudden unexpected death in epilepsy (SUDEP) is a common but poorly understood cause of death in patients with intractable epilepsy and often afflicts younger patients. The pathophysiology of SUDEP is poorly defined but does not appear to be related to prolonged seizure activity or resultant injury. Interestingly, a subset of patients with confirmed long QT syndrome (LQTS) present with a seizure phenotype and may have concurrent epilepsy. In this case, we present a patient who initially presented with a seizure phenotype. Further workup captured PMVT on an outpatient event monitor, and the patient was subsequently diagnosed with LQTS1. A substantial number of patients with LQTS initially present with a seizure phenotype. These patients may represent a subset of SUDEP cases resulting from ventricular arrhythmias. Appropriate suspicion for ventricular arrhythmias is necessary for proper arrhythmia evaluation and management in patients presenting with epilepsy. [ABSTRACT FROM AUTHOR]

New information and communication technologies continue to spread rapidly into the Asian marketplace, which has led to new patterns of leisure consumption, one of the most popular being digital gaming. However, in Vietnam there is limited research on gaming as a leisure activity. The purpose of this study is to explore the phenomenon of digital gaming in Vietnam to better understand how it is practiced in this culture. Semi-structured interviews were conducted with twenty-five gaming industry figures and gamers. Thematic analysis was used to guide data collection and analysis. The findings indicate that glocalisation, socialised gaming practices and competitiveness characterise the Vietnamese gaming experience. The distinct culture of Vietnam combined with globalised gaming consumption habits has created new modes of play culture, and hence leisure experiences that are growing in pervasive and influential ways. [ABSTRACT FROM AUTHOR]

Globally, eSports is growing in influence in media. However, it represents a unique phenomenon in the modern mediascape as it is expanding beyond the online digital world and becoming interwoven in the offline, physical world. Jönköping, a mid-sized Swedish city that hosts the DreamHack winter and summer events, provides the setting for how this offline context is being facilitated and shaped to maximize the benefits of eSports' increasing cultural relevance and value. By conceptualizing the local eSports scene as a market, this article synthesizes 17 interviews with local actors to answer the question: What offline actions do actors engage in to facilitate and shape the local eSports market? This article provides actionable insights from a strategic media management perspective that can enable others to engage with and develop local offline eSports markets to provide a platform for media creation. [ABSTRACT FROM AUTHOR]

A growing body of research on character education offers the opportunity to derive lessons on effective practice. While there is little focused research on the effectiveness of specific practices, reviews of effective programs have been mined for well over a decade to reach conclusions about "what works in character education." More recent reviews and meta-analyses offer the opportunity for a review of reviews. This article examines 8 reviews and identifies 42 evidence-based practices. However, such a list can be unwieldy by itself. Hence, a conceptual framework of 6 foundational character educational principles (PRIMED) is presented and used as an organizational structure for the 42 practices. In addition, a comparison is made of practices that have been shown to support academic achievement and those shown to foster character development, showing substantial overlap in effective academic and character practices. [ABSTRACT FROM AUTHOR]

The article discusses potential risk factors for death and intermittent mechanical ventilation (IMV) among a unique hospitalized population with coronavirus disease 2019. It mentions lack of influence that chronic lung disease, immunocompromise, tobacco use, and obesity in either IMV initiation or mortality; and also mentions use of robust random forest models to allow for improved control of confounders.

Aims: One of the primary determinants of blood flow in regional vascular beds is perfusion pressure. Our aim was to investigate if reduction in blood pressure during the treatment of decompensated heart failure would be associated with worsening renal function (WRF). Our secondary aim was to evaluate the prognostic significance of this potentially treatment-induced form of WRF.Methods and Results: Subjects included in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial limited data were studied (386 patients). Reduction in systolic blood pressure (SBP) was greater in patients experiencing WRF (-10.3 ± 18.5 vs. -2.8 ± 16.0 mmHg, P < 0.001) with larger reductions associated with greater odds for WRF (odds ratio = 1.3 per 10 mmHg reduction, P < 0.001). Systolic blood pressure reduction (relative change > median) was associated with greater doses of in-hospital oral vasodilators (P ≤ 0.017), thiazide diuretic use (P = 0.035), and greater weight reduction (P = 0.023). In patients with SBP-reduction, WRF was not associated with worsened survival [adjusted hazard ratio (HR) = 0.76, P = 0.58]. However, in patients without SBP-reduction, WRF was strongly associated with increased mortality (adjusted HR = 5.3, P < 0.001, P interaction = 0.001).Conclusion: During the treatment of decompensated heart failure, significant blood pressure reduction is strongly associated with WRF. However, WRF that occurs in the setting of SBP-reduction is not associated with an adverse prognosis, whereas WRF in the absence of this provocation is strongly associated with increased mortality. These data suggest that WRF may represent the final common pathway of several mechanistically distinct processes, each with potentially different prognostic implications. [ABSTRACT FROM AUTHOR]

Aims One of the primary determinants of blood flow in regional vascular beds is perfusion pressure. Our aim was to investigate if reduction in blood pressure during the treatment of decompensated heart failure would be associated with worsening renal function (WRF). Our secondary aim was to evaluate the prognostic significance of this potentially treatment-induced form of WRF. Methods and results Subjects included in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial limited data were studied (386 patients). Reduction in systolic blood pressure (SBP) was greater in patients experiencing WRF (−10.3 ± 18.5 vs. −2.8 ± 16.0 mmHg, P < 0.001) with larger reductions associated with greater odds for WRF (odds ratio = 1.3 per 10 mmHg reduction, P < 0.001). Systolic blood pressure reduction (relative change > median) was associated with greater doses of in-hospital oral vasodilators (P ≤ 0.017), thiazide diuretic use (P = 0.035), and greater weight reduction (P = 0.023). In patients with SBP-reduction, WRF was not associated with worsened survival [adjusted hazard ratio (HR) = 0.76, P = 0.58]. However, in patients without SBP-reduction, WRF was strongly associated with increased mortality (adjusted HR = 5.3, P < 0.001, P interaction = 0.001). Conclusion During the treatment of decompensated heart failure, significant blood pressure reduction is strongly associated with WRF. However, WRF that occurs in the setting of SBP-reduction is not associated with an adverse prognosis, whereas WRF in the absence of this provocation is strongly associated with increased mortality. These data suggest that WRF may represent the final common pathway of several mechanistically distinct processes, each with potentially different prognostic implications. [ABSTRACT FROM AUTHOR]

Objectives: Worsening renal function (WRF) during the treatment of decompensated heart failure, frequently defined as an absolute increase in serum creatinine ≥0.3 mg/dl, has been reported as a strong adverse prognostic factor in several studies. We hypothesized that this definition of WRF is biased by baseline renal function secondary to the exponential relationship between creatinine and renal function. Methods: We reviewed consecutive admissions with a discharge diagnosis of heart failure. An increase in creatinine ≥0.3 mg/dl (WRFCREAT) was compared to a decrease in GFR ≥20% (WRFGFR). Results: Overall, 993 admissions met eligibility. WRFCREAT occurred in 31.5% and WRFGFR in 32.7%. WRFCREAT and WRFGFR had opposing relationships with baseline renal function (OR = 1.9 vs. OR = 0.51, respectively, p < 0.001). Both definitions had similar unadjusted associations with death at 30 days [WRFGFR OR = 2.3 (95% CI 1.1–4.8), p = 0.026; WRFCREAT OR = 2.1 (95% CI 1.0–4.4), p = 0.047]. Controlling for baseline renal insufficiency, WRFGFR added incrementally in the prediction of mortality (p = 0.009); however, WRFCREAT did not (p = 0.11). Conclusions: WRF, defined as an absolute change in serum creatinine, is heavily biased by baseline renal function. An alternative definition of WRF should be considered for future studies of cardio-renal interactions. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]