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Excessive monetary compensation and existing contractual agreements of influencers limit the ability of many firms to engage in effective influencer seeding. The authors suggest a forward-looking approach of targeting prospective influencers —while they are still largely unknown (e.g., a few months after their platform registration)—and signing them to endorse the firm in the future (e.g., more than a year later). This approach has the potential to significantly reduce costs. However, as only rarely do newly registered users ultimately become influencers (and as signals are weak), the authors propose a novel framework to cope with this rare-event problem. For empirical demonstration and application, the authors conduct data-based simulations using a data set from a worldwide leading audio platform. Every wave of newly registered users is associated with a profit potential stemming from future endorsements by prospective influencers. With knowledge about the order of magnitude of the return on successful influencer spend, managers applying the framework can extract around 20% of this profit potential (if the return is around three times the spend). [ABSTRACT FROM AUTHOR]

On user-generated content platforms, individuals and firms alike seek to build and expand their follower base to eventually increase the reach of the content they upload. The bulk of the seeding literature in marketing suggests targeting users with a large follower base, that is, high-status influencers. In contrast, some recent studies find targeting lower-status influencers to be a more effective seeding policy. This multimethod article shifts the focus from the follower base of the seeding target to the focal content creator. The authors propose accelerating natural triadic closure by leveraging first-degree followers as interconnectors to target second-degree followers, that is, the nearby (low-status) influencers (who are interconnected with the focal content creator). Empirical studies document that this seeding target is much more effective for building and expanding the follower base, compared with targeting influencers who are not interconnected with the focal content creator—that is, the remote (both high- and low-status) influencers—by 2,300% and 46%, respectively. These studies on the acceleration of natural triadic closure are augmented by a preregistered field experiment to obtain convergent validity of the findings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The Bayley Scales of Infant Development (BSID) is the most used diagnostic tool to identify neurodevelopmental disorders in children under age 3 but is challenging to use in low-resource countries. The Ages and Stages Questionnaire (ASQ) is an easy-to-use, low-cost clinical tool completed by parents/caregivers that screens children for developmental delay. The objective was to determine the performance of ASQ as a screening tool for neurodevelopmental impairment when compared with BSID second edition (BSID-II) for the diagnosis of moderate-to-severe neurodevelopmental impairment among infants at 12 and 18 months of age in low-resource countries. METHODS: Study participants were recruited as part of the First Bites Complementary Feeding trial from the Democratic Republic of Congo, Zambia, Guatemala and Pakistan between October 2008 and January 2011. Study participants underwent neurodevelopmental assessment by trained personnel using the ASQ and BSID-II at 12 and 18 months of age. RESULTS: Data on both ASQ and BSID-II assessments of 1034 infants were analysed. Four of five ASQ domains had specificities greater than 90% for severe neurodevelopmental delay at 18 months of age. Sensitivities ranged from 23% to 62%. The correlations between ASQ communications subscale and BSID-II Mental Development Index (MDI) (r=0.38) and between ASQ gross motor subscale and BSID-II Psychomotor Development Index (PDI) (r=0.33) were the strongest correlations found. CONCLUSION: At 18 months, ASQ had high specificity but moderate-to-low sensitivity for BSID-II MDI and/or PDI

Abstract Having people around, especially if they provide social support, often leads to positive outcomes both physically and mentally. Mere social presence is especially beneficial when it comes from a loved one or romantic partner. In these studies, we aim to expand the understanding of how the presence of one’s romantic partner affects emotion regulation in parental situations. Specifically, we examined how partner presence influences the parent’s emotional intensity, emotion regulation, and interpretation of their child’s emotion regulation. We examined these questions in parents of both non-autistic children (Study 1) as well as autistic children (Study 2), which we hypothesize leads to more intense emotional interactions. The parents of autistic children were better able to regulate their emotions when their partners were present compared to when they were absent. Furthermore, in both studies, parents’ ratings of their children’s ability to regulate their emotions were higher when their parent’s partner was present compared to when the partner was absent. However, in both studies, we found no significant difference in the parents’ emotional intensity when their partners were present compared to when their partners were absent during the emotionally charged interaction with their child. Our findings help highlight the impact of partner presence on parent and child emotion regulation.

Abstract Introduction Carbapenemase-producing Enterobacterales (CPE) are an important public health threat, with costly operational and economic consequences for NHS Integrated Care Systems and NHS Trusts. UK Health Security Agency guidelines recommend that Trusts use locally developed risk assessments to accurately identify high-risk individuals for screening, and implement the most appropriate method of testing, but this presents many challenges. Methods A convenience sample of cross-specialty experts from across England met to discuss the barriers and practical solutions to implementing UK Health Security Agency framework into operational and clinical workflows. The group derived responses to six key questions that are frequently asked about screening for CPE. Key findings Four patient groups were identified for CPE screening: high-risk unplanned admissions, high-risk elective admissions, patients in high-risk units, and known positive contacts. Rapid molecular testing is a preferred screening method for some of these settings, offering faster turnaround times and more accurate results than culture-based testing. It is important to stimulate action now, as several lessons can be learnt from screening during the COVID-19 pandemic, as well as from CPE outbreaks. Conclusion Further decisive and instructive information is needed to establish CPE screening protocols based on local epidemiology and risk factors. Local management should continually evaluate local epidemiology, analysing data and undertaking frequent prevalence studies to understand risks, and prepare resources– such as upscaled screening– to prevent increasing prevalence, clusters or outbreaks. Rapid molecular-based methods will be a crucial part of these considerations, as they can reduce unnecessary isolation and opportunity costs.

Abstract Background Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area. Methods In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020–2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates. Results Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02–2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28–1.64), and bathing (aRR: 1.21, 95%CI: 1.06–1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07–3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52–2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55–6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36–4.89) than participants living in permanent housing. Conclusion WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID—especially those who are unsheltered.

Traumatic brain injury (TBI) is a global health challenge; however, penetrating brain injury (PBI) remains under-represented in evidence-based knowledge and research efforts. This study utilized data from the Trauma Quality Improvement Program (TQIP) of the National Trauma Data Bank (NTDB) to investigate outcomes of PBI as compared with clinical-severity-matched non-penetrating or blunt TBI. A total of 1765 patients with PBI were 1:1 propensity score-matched for clinical severity with blunt TBI patients. The intent of PBI was self-inflicted in 34.1% of the cases, and the mechanism was firearm-inflicted in 89.1%. Mortality was found to be significantly more common in PBI than in the severity- matched TBI cohort (33.9% vs. 14.3 %, p?0.001) as was unfavorable outcome. Mortality was mediated by withdrawal of life-sustaining therapies (WOLST) 30% of the time, and WOLST occurred earlier (median 3 days vs. 6 days, p?

Abstract Familial gastrointestinal stromal tumors (GIST) are rare. We present a kindred with multiple family members affected with multifocal GIST who underwent whole genome sequencing of the germline and tumor. Affected individuals with GIST harbored a germline variant found within exon 13 of the KIT gene (c.1965T>G; p.Asn655Lys, p.N655K) and a variant in the MSR1 gene (c.877 C > T; p.Arg293*, pR293X). Multifocal GISTs in the proband and her mother were treated with preoperative imatinib, which resulted in severe intolerance. The clinical features of multifocal GIST, cutaneous mastocytosis, allergies, and gut motility disorders seen in the affected individuals may represent manifestations of the multifunctional roles of KIT in interstitial cells of Cajal or mast cells and/or may be suggestive of additional molecular pathways which can contribute to tumorigenesis.

We examine emerging practices of pronoun disclosure, discovery, and repair after the procedural turn in pronoun politics, which shifted attention from the substantive question of which pronouns should be used to the procedural question of how preferred pronouns, whatever they might be, could be effectively communicated to others. Drawing on interviews with and observations of college students and recent graduates who are committed in principle to using preferred pronouns, we consider how they seek to do so in practice, focusing on practices of disclosure, discovery, and repair. We underscore the gap between the knowledge that is required in principle to use preferred pronouns consistently and the imperfect knowledge that pronoun-users have in practice, and we show how the use of preferred pronouns creates new forms of interactional accountability.

STUDY OBJECTIVES: Sleep duration and intraindividual variability in sleep duration undergo substantial changes in adolescence and impact brain and behavioral functioning. Although experimental work has linked acute sleep deprivation to heightened limbic responding and reduced regulatory control, there is limited understanding of how variability in sleep patterns might interact with sleep duration to influence adolescent functioning. This is important for optimal balancing of length and consistency of sleep. Here, we investigated how objective indices of sleep duration and variability relate to stress, restfulness, and intrinsic limbic network functioning in adolescents. METHODS: A sample of 101 adolescents ages 14-18 reported their stressors, after which they wore wrist actigraph watches to monitor their sleep and rated their restfulness every morning over a 2-week period. They also completed a resting-state fMRI scan. RESULTS: Adolescents reporting more stress experienced shorter sleep duration and greater sleep variability over the 2-week period. Longer nightly sleep duration was linked to feeling more rested the next morning, but this effect was reduced in adolescents with high cumulative sleep variability. Sleep variability showed both linear and quadratic effects on limbic connectivity: adolescents with high sleep variability exhibited more connectivity within the limbic network and less connectivity between the limbic and frontoparietal networks than their peers, effects which became stronger once variability exceeded an hour. CONCLUSIONS: Results suggest that cumulative sleep variability is related to stress and limbic network connectivity and shows interactive effects with sleep duration, highlighting the importance of balancing length and consistency of sleep for optimal functioning in adolescence.

As computer-science-for-all initiatives continue to grow, many schools are looking for ways to introduce computer science skills and thinking to elementary-age children. Some initiatives have focused on coding as its own endeavor, not integrated with other subjects like mathematics, science, or literacy. Increasingly, developers and researchers are exploring ways that programming can be integrated into core subjects, although challenges remain to ensure they are mutually supportive of both subjects. The authors, a team of teachers and researchers, are investigating one such approach that integrates programming and elementary school mathematics, developing microworlds for Grades 2-5 that treat programming as a language to help children express and investigate mathematical ideas. In this article, the authors describe one of the programming environments they have developed, Number Line, and their observations of second graders' experiences and mathematical thinking while using this tool.

Multifunctional productive systems based on native species management, a new paradigm that counters colonial worldviews, offer sustainable sources of food and materials while preserving biodiversity. Despite extensive discussions in herbaceous and agricultural systems, applying this concept to native forests in Northern Patagonia remains unclear. Multifunctional system implementation can be approached from a fractal perspective, with evaluations at the stand level being essential for understanding ecological processes across scales. Here, we exemplify research and management for multiple native species, integrating results from 10 years of field experiments on the impacts of biomass harvesting intensity (HI) on nine Nature's Contributions to People (NCPs), including habitat creation, pollination, soil formation, hazard regulation, prevention of invasions, and provision of energy, food, materials, and options. Our findings reveal that some regulating NCPs peak with null HI, while certain material and regulating NCPs maximize at the highest HI. Low to intermediate HI (30–50%) show a more balanced provision of all NCPs. Our results suggest that some biomass extraction is necessary to enhance most NCPs, emphasizing the importance of balancing material provisioning and biodiversity conservation in management schemes. We propose future directions for designing multifunctional forest systems, advocating for low-density plantation of native tree species with high wood quality within the natural forest matrix. This approach may yield higher NCPs levels over time compared to the current cattle breeding and wood extraction system, with implications beyond Patagonia, considering historical associations of such practices with colonial worldviews globally.

Abstract Melanism, the process of heavier melanin deposition, can interact with climate variation at both micro and macro scales, ultimately influencing color evolution in organisms. While the ecological processes regulating melanin production in relation to climate have been extensively studied, intraspecific variations of melanism are seldom considered. Such scientific gap hampers our understanding of how species adapt to rapidly changing climates. For example, dark coloration may lead to higher heat absorption and be advantageous in cool climates, but also in hot environments as a UV or antimicrobial protection mechanism. To disentangle such opposing predictions, here we examined the effect of climate on shaping melanism variation in 150 barred grass snakes (Natrix helvetica) and 383 green whip snakes (Hierophis viridiflavus) across Italy. By utilizing melanistic morphs (charcoal and picturata in N. helvetica, charcoal and abundistic in H. viridiflavus) and compiling observations from 2002 to 2021, we predicted that charcoal morphs in H. viridiflavus would optimize heat absorption in cold environments, while offering protection from excessive UV radiation in N. helvetica within warm habitats; whereas picturata and abundistic morphs would thrive in humid environments, which naturally have a denser vegetation and wetter substrates producing darker ambient light, thus providing concealment advantages. While picturata and abundistic morphs did not align with our initial humidity expectations, the charcoal morph in N. helvetica is associated with UV environments, suggesting protection mechanisms against damaging solar radiation. H. viridiflavus is associated with high precipitations, which might offer antimicrobial protection. Overall, our results provide insights into the correlations between melanin‐based color morphs and climate variables in snake populations. While suggestive of potential adaptive responses, future research should delve deeper into the underlying mechanisms regulating this relationship.

Abstract The genus Sinningia comprises about 80 species and can be recognized, among Gesneriaceae, by its herbaceous or sometimes subshrubby habit and tuberous, perennial structure at the base of the stem. This work is a taxonomic treatment of Sinningia in the state of Paraná. Descriptions, a dichotomous key, illustrations, and information about the distribution and phenological data on flowering and fruiting are provided. Sinningia is the largest genus of Gesneriaceae in the state of Paraná, where there are 18 species that occur mainly in rainforest, grasslands or Cerrado and are rupicolous, terrestrial, or epiphytic plants.

Summary: Background: In 2023 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared endemic, yet hospital admissions have persisted and risen within populations at high and moderate risk of developing severe disease, which include those of older age, and those with co-morbidities. Antiviral treatments, currently only available for high-risk individuals, play an important role in preventing severe disease and hospitalisation within this subpopulation. Here, we further explore the public health and economic benefits of extending target populations for treatment, and assess efficacy thresholds for a treatment strategy to be cost-saving. Methods: We adapted an individual-based transmission model of SARS-CoV-2, OpenCOVID, which was calibrated and validated to 2020–2023 Swiss, European, and Northern Hemisphere epidemiological data. We used the model to estimate hospitalisations and overall costs for preventatively treating three risk groups for a full range of treatment efficacies and coverages with, besides vaccination and hospital treatments, no other interventions in place. We further calculated efficacy thresholds for strategies to be cost-saving. A global sensitivity analysis was conducted to test the sensitivity of all outcomes for a wide range of treatment properties, emerging variant properties, and vaccination coverages. Findings: In a high vaccination coverage setting, we found that a high efficacy antiviral treatment given to all those at high-risk could reduce hospitalisations by up to 40%. When expanding treatment coverage to also include all those at moderate-risk, an additional 50% of hospitalisations could be averted. Targeting both high-risk and moderate-risk groups was found to be cost-saving for a treatment efficacy greater than ∼40%. This threshold was found to be robust regardless of vaccination coverage and emerging variant properties, but highly sensitive to treatment costs. Interpretation: For a sufficiently efficacious antiviral treatment, expanding the target population to include both high-risk and moderate-risk groups should be considered. Equitable treatment costs are found crucial in achieving the best possible public health and health economic outcomes. Funding: Botnar Research Centre for Child Health (DZX2165 to MAP), the Swiss National Science Foundation Professorship of MAP (P00P3_203450) and Swiss National Science Foundation NFP 78 Covid-19 2020 (4079P0_198428 to MAP).

Limestone calcined clay cements (LC3) signify a trend in the construction sector aimed at reducing environmental impacts. However, the fresh state behavior of these cements, especially concerning clay properties and their interaction with chemical admixtures, needs to be better understood and investigated. This study is designed to assess the impact of a polycarboxylate-based superplasticizer (ADV) and a clay-mitigating (CM) admixture, along with exploring the synergistic effects that arise from combining both admixtures on the properties of LC3 cements. Hydration kinetics were evaluated in cement pastes using isothermal calorimetry and in-situ XRD, while fresh state properties were evaluated by rotational rheometry. The calorimetry results showed that the CM admixture provides a delay in the aluminate reactions of all LC3 systems, while it does not significantly affect the hydration of Portland cement pastes, suggesting a pronounced interaction of this admixture with clay particles. The incorporation of the CM admixture did not yield favorable workability conditions in LC3 mixtures when compared to the effectiveness of the ADV. In general, the assessment indicates that the CM admixture lacks effective dispersion capabilities and exhibits a limited influence on the formation of hydrated products in LC3 cements produced with calcined kaolinitic clay.

Introduction Cognitive impairment is reported in a variety of clinical conditions including Alzheimer’s disease, Parkinson’s and ‘long-COVID’. Interestingly, many of these clinical conditions are also associated with microbial dysbiosis. This comanifestation of cognitive and microbiome findings in seemingly unrelated maladies suggests that they could share a common mechanism and potentially presents a treatment target. Although a rapidly growing body of literature has documented this comorbid presentation within specific conditions, an overview highlighting potential parallels across healthy and clinical populations is lacking. The objective of this umbrella review, therefore, is to summarise and synthesise the findings of these systematic reviews.Methods and analysis On 2 April 2023, we searched MEDLINE (Pubmed), Embase (Ovid), the Web of Science (Core Collection), the Cochrane Library of Systematic Reviews and Epistemonikos as well as grey literature sources, for systematic reviews on clinical conditions and interventions where cognitive and microbiome outcomes were coreported. An updated search will be conducted before completion of the project if the search-to-publication date is >1 year old. Screening, data abstraction and quality assessment (AMSTAR 2, A MeaSurement Tool to Assess systematic Reviews) will be conducted independently and in duplicate, with disagreements resolved by consensus. Evidence certainty statements for each review’s conclusions (eg, Grading of Recommendations Assessment, Development and Evaluation (GRADE)) will be extracted or constructed de novo. A narrative synthesis will be conducted and delineated by the review question. Primary study overlap will be visualised using a citation matrix as well as calculated using the corrected covered area method.Ethics and dissemination No participant-identifying information will be used in this review. No ethics approval was required due to our study methodology. Our findings will be presented at national and international conferences and disseminated via social media and press releases. We will recruit at least one person living with cognitive impairment to collaborate on writing the plain language summary for the review.PROSPERO registration number CRD42023412903

El presente trabajo explora la naturaleza jurídica de la hipoteca que se constituye para asegurar deudas ajenas; tras comprobar las dificultades dogmáticas de dicha figura, la proyecta en los diversos procedimientos concursales previstos en la Ley 20.720, que contiene la regulación de insolvencia en Chile. Todo ello con el fin de evidenciar múltiples vacíos y problemas prácticos que pueden terminar dificultando el logro de la finalidad de estos procedimientos, al menos en lo que respecta a la pretensión de maximización de las posibilidades de cobro de los acreedores.

Objectives There is little evidence guiding the management of grade I–II traumatic splenic injuries with contrast blush (CB). We aimed to analyze the failure rate of nonoperative management (NOM) of grade I–II splenic injuries with CB in hemodynamically stable patients.Methods A multicenter, retrospective cohort study examining all grade I–II splenic injuries with CB was performed at 21 institutions from January 1, 2014, to October 31, 2019. Patients >18 years old with grade I or II splenic injury due to blunt trauma with CB on CT were included. The primary outcome was the failure of NOM requiring angioembolization/operation. We determined the failure rate of NOM for grade I versus grade II splenic injuries. We then performed bivariate comparisons of patients who failed NOM with those who did not.Results A total of 145 patients were included. Median Injury Severity Score was 17. The combined rate of failure for grade I–II injuries was 20.0%. There was no statistical difference in failure of NOM between grade I and II injuries with CB (18.2% vs 21.1%, p>0.05). Patients who failed NOM had an increased median hospital length of stay (p=0.024) and increased need for blood transfusion (p=0.004) and massive transfusion (p=0.030). Five patients (3.4%) died and 96 (66.2%) were discharged home, with no differences between those who failed and those who did not fail NOM (both p>0.05).Conclusion NOM of grade I–II splenic injuries with CB fails in 20% of patients.Level of evidence IV.