Comparative Research Study Research Articles

Operative vs Nonoperative Treatment of Acute Cholecystitis in Older Adults With Multimorbidity.

Acute cholecystitis in older patients with multimorbidity is associated with a high risk of morbidity and mortality. Debate exists as to whether operative or nonoperative treatment is the most appropriate approach. To compare the effectiveness of operative and nonoperative treatment in older adults with multimorbidity who are hospitalized emergently with acute cholecystitis. This was a nationwide retrospective comparative effectiveness research study conducted in the US from 2016 to 2018 that used both an inverse propensity weight analysis and an instrumental variable analysis. The study participants were Medicare beneficiaries with multimorbidity hospitalized emergently with acute cholecystitis. Previously validated qualifying comorbidity sets were used to identify multimorbidity. Data were analyzed from April 1, 2016, to December 31, 2018. Treatment assignment of operative or nonoperative treatment for acute cholecystitis. The primary outcome was 30- and 90-day mortality. Secondary outcomes included readmission rates, emergency department (ED) revisit rates, and cost. A preference-based instrumental variable approach was used to isolate circumstances for which the decision to operate is in clinical equipoise. Our hypothesis was that operative treatment would be associated with decreased mortality compared with nonoperative management. Among the 32 527 included patients, the median age was 78.8 years (IQR, 72.4-85.2 years), and 21 728 patients (66.8%) underwent cholecystectomy. Of the 10 799 patients (33.2%) who received nonoperative treatment, 3462 (32.1%) received a percutaneous cholecystostomy tube. Among all patients, operative treatment was associated with a lower risk of 30-day mortality (risk difference [RD], -0.03; P < .001) and 90-day mortality (RD, -0.04; P < .001) compared with nonoperative treatment. Among patients for whom the treatment decision was in clinical equipoise, mortality was similar for the operative and nonoperative treatment groups; operative treatment was associated with a lower risk of 30-day readmissions (RD, -0.15; P < .001) and 90-day readmissions (RD, -0.23; P < .001) as well as a lower risk of 30-day ED revisits (RD, -0.09; P < .001) and 90-day ED revisits (RD, -0.12; P < .001). The risk-adjusted cost of operative treatment was higher at the index hospitalization (+$2870.84; P < .001) and lower at 90 days (-$5495.38; P < .001) and 180 days (-$9134.66; P < .001) compared with nonoperative treatment. The findings of this comparative effectiveness research study suggest that risk-adjusted operative treatment of acute cholecystitis in older patients with multimorbidity was associated with lower rates of 30- and 90-day readmissions and ED revisits compared with nonoperative treatment and a lower cost by 90 days. These findings further suggest that when uncertainty exists regarding the most appropriate treatment approach for this challenging population, strong consideration should be given to operative treatment.

Semantic Clinical Artificial Intelligence vs Native Large Language Model Performance on the USMLE

Large language models (LLMs) are being implemented in health care. Enhanced accuracy and methods to maintain accuracy over time are needed to maximize LLM benefits. To evaluate whether LLM performance on the US Medical Licensing Examination (USMLE) can be improved by including formally represented semantic clinical knowledge. This comparative effectiveness research study was conducted between June 2024 and February 2025 at the Department of Biomedical Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, using sample questions from the USMLE Steps 1, 2, and 3. Semantic clinical artificial intelligence (SCAI) was developed to insert formally represented semantic clinical knowledge into LLMs using retrieval augmented generation (RAG). The SCAI method was evaluated by comparing the performance of 3 Llama LLMs (13B, 70B, and 405B; Meta) with and without SCAI RAG on text-based questions from the USMLE Steps 1, 2, and 3. LLM accuracy for answering questions was determined by comparing the LLM output with the USMLE answer key. The LLMs were tested on 87 questions in the USMLE Step 1, 103 in Step 2, and 123 in Step 3. The 13B LLM enhanced by SCAI RAG was associated with significantly improved performance on Steps 1 and 3 but only met the 60% passing threshold on Step 3 (74 questions correct [60.2%]). The 70B and 405B LLMs passed all the USMLE steps with and without SCAI RAG. The SCAI RAG 70B model scored 80 questions (92.0%) correctly on Step 1, 82 (79.6%) on Step 2, and 112 (91.1%) on Step 3. The SCAI RAG 405B model scored 79 (90.8%) correctly on Step 1, 87 (84.5%) on Step 2, and 117 (95.1%) on Step 3. Significant improvements associated with SCAI RAG were found for the 13B model on Steps 1 and 3, the 70B model on Step 2, and the 405B parameter model on Step 3. The 70B model was significantly better than the 13B model, and the 405B model was not significantly better than the 70B model. In this comparative effectiveness research study, SCAI RAG was associated with significantly improved scores on the USMLE Steps 1, 2, and 3. The 13B model passed Step 3 with RAG, and the 70B and 405B models passed and scored well on Steps 1, 2, and 3 with or without augmentation. New forms of reasoning by LLMs, like semantic reasoning, have potential to improve the accuracy of LLM performance on important medical questions. Improving LLM performance in health care with targeted, up-to-date clinical knowledge is an important step in LLM implementation and acceptance.

Link adaptation techniques for throughput enhancement in LEO satellites: a survey

&lt;p&gt;In addition to the rapid geometric change of low earth orbit (LEO) satellites, the earth-to-space channel suffers from various attenuations that affect the communication link. To overcome this challenge, the link adaptation technique emerges as a key solution to optimize the transmission performance of LEO satellites, especially the data throughput. The existing contributions in the literature remain scattered across the research board, and a comprehensive survey of this research area still lacks at this stage. The present survey examines various link adaptation methods, mainly variable coding and modulation, adaptive coding and modulation, and hybrid methods using artificial intelligence. In addition, this study explains how this technique leverages a set of recommended standards and cost-effective technologies, such as software-defined radio (SDR) and field programmable gate arrays (FPGA), to fine-tune transmission strategies. Lastly, the paper provides a comparative study of the current research on this field and sheds light on future directions, where the need for higher data throughput makes emerging learning-based techniques and new experimental standards a necessity.&lt;/p&gt;

Innovation intermediaries in the digital transformation process. A comparative case study of research and technology organisations in the US and the UK

Innovation intermediaries in the digital transformation process. A comparative case study of research and technology organisations in the US and the UK

Neoadjuvant Chemoradiotherapy vs Chemoimmunotherapy for Esophageal Squamous Cell Carcinoma

The association of neoadjuvant chemoimmunotherapy (NCIT) vs chemoradiotherapy (NCRT) with tumor downstaging and survival in locally advanced esophageal squamous cell carcinoma (ESCC) remains unclear because of limited evidence. To compare the associations of NCIT and NCRT with tumor regression and long-term survival in patients with locally advanced ESCC. In this comparative effectiveness research study, from January 2016 to March 2023, patients with locally advanced ESCC who underwent esophagectomy following NCRT or NCIT were identified from a prospective database of 8 high-volume esophageal surgery centers in China. Follow-up began on the date of surgery and continued until the last recorded contact or March 2024, whichever occurred first. Data were analyzed between April and September 2024. The primary end points were 2-year overall survival (OS) and disease-free survival (DFS). Secondary end points included major pathologic response (MPR) and pathologic complete response (pCR). Cox proportional hazard regression analysis was used to investigate the risk factors for OS and DFS. The study included 1428 patients (median [IQR] age, 63 [57-68] years; 1184 men [82.9%]), with 704 patients in the NCRT group and 724 patients in the NCIT group. After propensity score matching, there were 532 patients in each group. The 2-year OS (81.3% vs 71.3%; hazard ratio, 1.57; 95% CI, 1.26-1.96; P < .001) and DFS (73.9% vs 63.4%; hazard ratio, 1.37; 95% CI, 1.11-1.69; P < .001) rates were significantly higher in NCIT group than in the NCRT group. The NCRT group had a higher MPR rate than that of the NCIT group (71.8% vs 61.5%), whereas the pCR rates were similar (25.9% vs 22.9%). Multivariable Cox analysis demonstrated that NCIT and MPR were independently associated with both OS and DFS. The NCIT group exhibited a lower overall recurrence rate (126 patients [23.7%] vs 190 patients [35.7%]) and distant metastasis rate (72 patients [13.5%] vs 133 patients [25.0%]), although locoregional metastasis rates were similar (98 patients [18.4%] vs 111 patients [20.9%]). Better OS and DFS were obtained for the NCIT group than for the NCRT group, regardless of whether adjuvant immunotherapy was given. Compared with NCRT, patients with locally advanced ESCC receiving NCIT had better 2-year OS and DFS. The decrease in distant metastasis may be the main reason, but further prospective randomized clinical trials are needed to verify this finding.

The Physical and Mental Health of Post-9/11 Female and Male Veterans: Findings from the Comparative Health Assessment Interview Research Study.

Background: Females are the fastest-growing group in the veteran population, yet there is a paucity in the literature of sex-specific results from studies of chronic disease in veterans that limit our understanding of their health issues. This study provides nationally representative estimates of the physical and mental health of females and males from the Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veteran population. Methods: Data from the 2018 Comparative Health Assessment Interview Research Study (CHAI), a cross-sectional nationwide survey of the health and well-being of OEF/OIF/OND veterans and a comparison sample of U.S. nonveterans, were analyzed to provide sex-stratified and deployment-stratified lifetime prevalence estimates and adjusted relative odds of physical and mental health conditions in a large population-based study of OEF/OIF/OND veterans. Results: Overall, female veterans were significantly more likely to report cancer, respiratory disease, irritable bowel syndrome/colitis, bladder infections, vision loss, arthritis, back/neck pain, chronic fatigue syndrome, migraine, posttraumatic stress disorder, and depression. Male veterans were significantly more likely to report obesity, diabetes, heart conditions, hypertension, high cholesterol, hearing loss, fractures, spinal cord injury, sleep apnea, and traumatic brain injury. Both males and females who deployed were significantly more likely to report adverse health outcomes than those who did not deploy. Conclusion: This article reports sex-stratified and deployment-stratified lifetime prevalence estimates and adjusted relative odds of physical and mental health conditions in a large population-based study of OEF/OIF/OND veterans. This study demonstrates the value of epidemiological research on female veterans and its importance in understanding the burden of disease in the female veteran population.

Glucose-Lowering Medications and Risk of Chronic Obstructive Pulmonary Disease Exacerbations in Patients With Type 2 Diabetes

ImportanceRecent studies have suggested that sodium-glucose cotransporter-2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase 4 inhibitors (DPP-4is) may benefit patients with chronic obstructive pulmonary disease (COPD). However, clinical evidence is lacking on their comparative association with COPD exacerbations in US patients with type 2 diabetes (T2D).ObjectiveTo compare the risk of moderate or severe COPD exacerbations among SGLT-2is, GLP-1RAs, and DPP-4is.Design, Setting, and ParticipantsThis comparative effectiveness research study used data from three 1:1 propensity score–matched cohort studies that emulated 3 target trials comparing patients 40 years or older with T2D and active COPD who initiated treatment with SGLT-2is vs DPP-4is, GLP-1RAs vs DPP-4is, and SGLT-2is vs GLP-1RAs. Data were from 3 US insurance claims databases: the Optum deidentified Clinformatics Data Mart Database (2013-2023), IBM Health MarketScan (2013-2021), and Medicare fee for service (2013-2020). The data analysis was conducted from January to June 2024.ExposuresInitiation of SGLT-2i or DPP-4i, GLP-1RA or DPP-4i, and SGLT-2i or GLP-1RA for the 3 target trials, respectively.Main Outcomes and MeasuresFirst occurrence of a moderate or severe COPD exacerbation, defined as a filled prescription for oral glucocorticoids in association with an outpatient COPD visit or hospitalization for COPD. Incidence rates, incidence rate differences (IRDs), and hazard ratios (HRs) with 95% CIs were calculated.ResultsThere were 27 991, 32 107, and 36 218 pairs in the SGLT-2i vs DPP-4i, GLP-1RA vs DPP-4i, and SGLT-2i vs GLP-1RA propensity score–matched cohorts, respectively (mean [SD] age, 70.8 [8.6] and 70.7 [8.8], 70.4 [8.5] and 70.4 [8.2], and 69.8 [8.7] years, respectively; 13 767 [49.2%] and 13 847 [49.5%], 17 622 [54.9%] and 17 620 [54.9%], and 18 807 [51.9%] and 18 854 [52.1%] female individuals, respectively). During a median follow-up of 145 (IQR, 61-355) days of treatment, the risk of moderate or severe COPD exacerbation was lower among those treated with SGLT-2is vs DPP-4is (9.26 vs 11.4 per 100 person-years [PYs]; HR, 0.81; 95% CI, 0.76-0.86; IRD/100 PYs, −2.20; 95% CI, −2.83 to −1.58) and among those treated with GLP-1RAs vs DPP-4is (9.89 vs 11.49 per 100 PYs; HR, 0.86; 95% CI, 0.81-0.91; IRD/100 PYs, −1.60; 95% CI, −2.18 to −1.02), with minimal differences among those treated with SGLT-2is vs GLP-1RAs (9.47 vs 10.00 per 100 PYs; HR, 0.94; 95% CI, 0.89-1.00; IRD/100 PYs, −0.55; 95% CI, −1.09 to −0.01). Results were consistent across sensitivity and subgroup analyses.Conclusions and RelevanceThe results of this comparative effectiveness research study suggest that SGLT-2is and GLP-1RAs were associated with a reduced risk of moderate or severe COPD exacerbations compared with DPP-4i in adults with T2D and active COPD. This may inform prescribing of glucose-lowering medications among patients with T2D and active COPD.

Review on the Implementation and Impact of the Comprehensive and Progressive Agreement for Trans-Pacific Partnership on China's Pharmaceutical Economy

Background: The ‘Intellectual Property Rights’ chapter of the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) sets high international standards for intellectual property rights (IPR) protection, particularly with regard to pharmaceutical patents. Even though some of the provisions are currently suspended, the stringent nature of these provisions poses undeniable challenges to member states, and likewise they have become an obstacle to China's IPR negotiations when joining the CPTPP. Objective: Analyze the CPTPP drug patent rules and their application in China's intellectual property law, evaluate the adaptability and challenges of China's drug patent protection system, and put forward suggestions for improving China's drug patent protection system through comparative research. Methods: A qualitative analysis This study is a qualitative theoretical study, using text research, comparative research, and case study methods. It tracks relevant research on pharmaceutical patents in the HeinOnline database, LexisNexis, WIPO database, and Cnki, and uses the China Judgment online to search for cases related to pharmaceutical patent disputes for a comprehensive analysis. Results: A high-standard pharmaceutical patent protection system is characterized by four critical rules established in the CPTPP. China's current pharmaceutical patent laws largely meet the CPTPP's requirements. Despite this alignment, there are notable deficiencies in the legal implementation aspect. Conclusion: While China's pharmaceutical patent laws are fundamentally compliant with CPTPP standards, further enhancements in legal implementation are necessary to mitigate potential risks associated with joining the agreement.

Documenting drone remote sensing: a reality-based modelling approach for applications in cultural heritage and archaeology

This paper addresses the design of open, reproducible, and transferable workflows for remote sensing data processing in archaeology, the specific case being drone (UAS) remote sensing data. In the context of increased application of remote sensing, stimulated by both recent technological developments, as well as threats to the buried archaeological record by developments such as agricultural intensification and climate change, it is important to allow the archaeological community to really benefit from the multitude of remote sensing applications and their diverging modalities. With the ever-increasing remote sensing datasets spread throughout the field of cultural heritage and archaeology, it has become even more important to be able to clearly communicate the process from data capture to the eventual visualised data model and further archiving and dissemination. This is crucial to scientific transparency required for the assessment of data quality, for example to allow for evaluating interpretations, comparative research, and replication studies. The ultimate goal is to permit data publication adhering to FAIR (Findable, Accessible, Interoperable, Reusable) principles, for which a good metadata documentation is a cornerstone.

ОБЩЕСТВЕННАЯ СКУЛЬПТУРА КАК ФАКТОР ФОРМИРОВАНИЯ ЭСТЕТИЧЕСКОГО ОПЫТА И ГОРОДСКОЙ ИДЕНТИЧНОСТИ

The article analyzes the role of public sculpture in shaping citizens' aesthetic experience and urban identity. The research is based on an interdisciplinary approach combining methods from aesthetics, sociology of art, and urban studies. The methodology includes literature analysis, comparative research, and case studies. The author examines the diverse functions of public sculpture: aesthetic, symbolic, social, and communicative. Based on the analysis of theoretical works and practical examples ("Cloud Gate" in Chicago, "Muzeon" Park in Moscow, "Hong Kong Sculpture Project," "Gateway Arch" in St. Louis, "People on the River" ensemble in Vyksa), the key factors influencing the perception of public sculpture are identified: cultural context, artistic quality, spatial integration, and community involvement. Recommendations for effective integration of sculpture into urban space are proposed, including the development of clear selection procedures, engagement of local residents, interdisciplinary collaboration, educational programs, and post-project monitoring. The necessity of a comprehensive approach that takes into account artistic, social, and urban aspects to enhance aesthetic impact and strengthen urban identity is substantiated.

The Role of Fiscal Policy in Economic Growth: A Comparative Analysis of Developed and Developing Countries

This objective is to provide a comparative research study that explores the role that fiscal policy plays in economic growth, with a special focus on both industrialized nations and developing countries. The study will explore the effect that fiscal policy has on economic development. Another area that is examined in this study is the connection that exists between fiscal policy and economic development. Another way of putting it is that it is a convoluted link that, depending on the economic climate in which it is being evaluated, might take on a somewhat different aspect. Given the nature of the relationship that exists between fiscal policies and expanding economies, it may be difficult to comprehend the link. The role that fiscal policy plays in the process of economic growth is influenced by a variety of factors, each of which has its own unique effect. Factors such as the organization of the government and the economy, as well as the specific channels through which fiscal policies are implemented, are included in this category. There is a significant gap between the industrialized nations and the developing countries in terms of the significance that fiscal policy plays in the process of economic growth. This gap is particularly pronounced in the development countries. In order to accomplish the aim of shining light on these discrepancies, which will be accomplished via the evaluation of empirical data and theoretical frameworks, the purpose of this comparative research is to achieve the purpose of illuminating light. Over a variety of different routes, fiscal policy has the potential to impact economic development. When it comes to industrialized nations, fiscal management that is solid often results in lower interest rates, which in turn supports private investment and consumer activity. In contrast, successful fiscal policies may boost human capital development in poor countries by directing public expenditure on education and infrastructure in a targeted manner, which can result in long-term economic gains.

The Full Names of Ethnic Chinese in Vietnam and Thailand: A Comparative Cultural Perspective

The ethnic Chinese in Vietnam and Thailand share certain similarities and comparable migration histories. However, differences have emerged due to distinct national policies and the varying processes of cultural adaptation and coexistence in each country. The Chinese community in Southeast Asia presents a complex and diverse case, not only because they exist as an ethnic group today but also because they historically held the status of foreign nationals in many countries. Chinese names and surnames are not merely personal identifiers; they are also deeply tied to ethnic identity through the lens of nationality. Drawing on the theoretical frameworks of comparative research and identity studies, this article examines the similarities in typologies and the differences in naming practices among ethnic Chinese in Vietnam and Thailand, using documented sources. It explores the causes of these similarities and differences, offering insights into community structures and collective thought. The study concludes with lessons for national governance, culturally appropriate engagement, and fostering mainstream identities within these communities.

The health-promoting lifestyle behaviors of healthcare employees in Qatar - A cross-sectional comparative study.

Background: The World Health Organization (WHO) considers health to be a fundamental human right. Health is a resource that enables people to lead productive lives on an individual, social, and economic level. In Qatar, there are a limited number of studies addressing the health-promoting lifestyle behaviors of healthcare employees. Aim: The aim of this study was to compare the health-promoting lifestyle of at-risk and non-risk groups of employees working in Hamad Medical Corporation (HMC), the largest secondary and tertiary healthcare provider in the State of Qatar. Methods: This was a cross-sectional comparative research study of all categories of healthcare employees working in HMC facilities. Participants with a body mass index (BMI) >30 kg/m2, smokers, or those with pre-existing non-communicable diseases (NCDs) were classified as the at-risk group, and individuals without any of these factors were classified as the non-risk group. Data were collected through an online survey using an adopted scale, Adolescent Health Promotion Short Form (AHP-SF), after approval by the Institutional Review Board (IRB) of HMC. Results: The age of the participants ranged from 22 to 69 years and the majority of them were female (64.07%). Most of the respondents were overweight or obese, accounting for 42.99% and 26.68% of the sample, respectively. Interestingly, 87.64% of the participants were non-smokers and approximately 70% had no chronic diseases. The overall AHP-SF score was 60.01/84±12.32, with the highest score from the "life appreciation" subscale (12.68/16±2.84) and the lowest score from the "exercise" subdomain (7.05/12±2.93). Five subdomains - nutrition, social support, health responsibility, exercise, and stress management - of the AHP-SF scale showed no significant statistical differences between at-risk and non-risk groups. However, the "life appreciation" scale showed significant statistical differences between the at-risk (12.91/16±2.69, p=0.04) and non-risk (12.42/16±2.98) groups. The AHP-SF scores varied significantly across the participants' regions of origin, with Americans having the highest score (63.93/84±10.67, p=0.03) compared to other regions. Conclusions: Healthcare employees moderately practice health-promoting lifestyle behaviors. The lowest scores were in the exercise subdomain, suggesting that more interventions are required to improve these behaviors. Healthcare organizations are ideal settings to implement comprehensive workplace wellness programs and awareness campaigns that can motivate employees to take greater responsibility for their own health and influence the wider community to adopt health-promoting lifestyle behaviors.

Difference and Diversity: A Comparative Study of Hu Shi's and Lu Xun's Research on Water Margin

Both Hu Shi()and Lu Xun()conducted considerable research and evaluations on Water Margin()and its major sequels. Various factors, such as historical context and personal perspectives, contributed to the divergence in their views. Hu Shi distinguished between Water Margins utility in the New Literature Movement and its ideological content. While he elevated Water Margins status as "vernacular" literature, he did not endorse certain ideological aspects within the text. Lu Xun, on the other hand, affirmed the revolutionary spirit in Water Margin but criticized its incompleteness and feudal characteristics. The contrasting evaluations of the same text by Hu Shi and Lu Xun in the same era stem from their differing perspectives and positions.

Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents

The practice of deprescribing antihypertensive medications is common among long-term care residents, yet the effect on cardiovascular outcomes is unclear. To compare the incidence of hospitalization for myocardial infarction (MI) or stroke among long-term care residents who are deprescribed or continue antihypertensive therapy. This comparative effectiveness research study used target trial emulation with observational electronic health record data from long-term care residents aged 65 years or older admitted to US Department of Veterans Affairs community living centers between October 1, 2006, and September 30, 2019, and taking at least 1 antihypertensive medication. Analyses were conducted between August 2023 and August 2024. A reduction in the number of antihypertensive medications or dose (by ≥30%), assessed using barcode medication administration data. Incidence of MI and stroke hospitalization up to 2 years was assessed using International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. A pooled logistic regression model with inverse probability of treatment weighting (IPTW) and inverse probability of censoring weighting (IPCW) was used to estimate per-protocol effects. Of 13 096 long-term care residents (97.4% men; median age, 77 years [IQR, 70-84 years]) taking antihypertensive medication, 17.8% were deprescribed antihypertensive medication over a period of 12 weeks. The estimated unadjusted cumulative incidence of stroke or MI hospitalization over 2 years was similar among residents who were and were not deprescribed antihypertensives in per-protocol analyses (11.2% vs 8.8%; difference, 2.4 percentage points [95% CI, -2.3 to 7.1 percentage points]). Participant characteristics were balanced after applying IPTW and IPCW; all standardized mean differences were less than 0.05. After full adjustment for confounding and informative censoring, the per-protocol analysis results showed no association of antihypertensive deprescribing with MI or stroke hospitalization (hazard ratio, 0.93; 95% CI, 0.70-1.26). In this comparative effectiveness research study, deprescribing antihypertensive medication was not associated with risk of hospitalization for MI or stroke in long-term care residents. These findings may be informative for long-term care residents and clinicians who are considering deprescribing antihypertensive medications.

Perceived social support moderates the relations between mental health symptoms and current suicidal ideation.

Despite efforts to identify risk factors associated with suicidal ideation (SI), less work has been conducted to highlight protective factors to promote prevention. Perceived social support has been shown to positively impact a wide range of psychological outcomes; however, prior efforts exploring whether perceived social support moderates the relationship between mental health (MH) symptoms and current SI among men and women have been hampered by limitations. To address knowledge gaps, data from the Comparative Health Assessment Interview Research Study was used to evaluate whether (a) perceived social support moderates the relationship between mental health symptoms (posttraumatic stress, anxiety, alcohol use, depressive) and current SI among veterans and nonveterans; (b) the strength of this moderating effect varies by gender and veteran status; and (c) the strength of this moderating effect varies by social support source (significant other, friend, family). Results suggest that perceived social support is more protective against SI for those with lower levels of mental health symptoms (≤ 25th percentile) than for those with higher symptom levels (≥ 75th percentile). Findings were largely consistent across study groups, support sources, and mental health symptoms examined; however, a significant moderating effect on the alcohol use-SI relationship was only observed for veteran men. Those with a lower mental health symptom severity may receive more benefit from strategies aimed at increasing perceived social support compared to those with higher symptom severity. Research is needed to match protective factors to individual phenotypes, with the goal of engaging those living with SI in more effective interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

AI-Generated Content: Legal Challenges &amp; Potential Reforms

Artificial Intelligence (AI) is quickly altering numerous markets, including those involving creative jobs such as art, music, and literature. As AI remains to progress and come to be significantly sophisticated, it tests the existing lawful system, especially in the locations of copyright, copyright, and possession legal rights. This article explores whether our present legal system is properly prepared to manage the intricacies and moral problems posed by sophisticated AI modern technologies. By evaluating various lawful systems, evaluating relevant case studies, and exploring existing lawful challenges, this paper intends to understand the level to which our laws have the ability to properly attend to issues related to content created by AI. This study uses study, comparative research study, thorough literary works review, and historical analysis to discover the intersection in between AI and copyright law. Lastly, the paper recommends possible lawful changes and reforms to aid balance the requirement for technology with copyright security, making sure a fair and fair lawful structure.

Researcher and partner perspectives on the relationship between engagement in research and three uses of patient-centered comparative clinical effectiveness research study findings

BackgroundThe uptake of research findings into clinical practice is critical to providing health care that improves health outcomes for patients. This study explored how Patient-Centered Outcomes Research Institute (PCORI) awardees perceive the relationship between engagement of patients and other partners in research and three uses, or applications, of patient-centered comparative clinical effectiveness research (CER) study findings, which may lead to uptake in clinical practice: (1) Integration into clinical practice guidelines, recognized point-of-care decision tools, or documents that may inform policy; (2) Implementation beyond the study, including at sites outside of the study setting or patient populations; and (3) Active dissemination of findings to specific audiences by parties external to the study team.MethodsThis exploratory qualitative study examined awardee and partner perceptions of what led to each use of study findings and how engaged partners contributed. We purposively selected PCORI-funded research projects with documentation of each use and conducted virtual interviews with 42 individuals (15 PIs or project leads, 2 research team members, and 25 partners) from 17 projects. We conducted thematic analysis of individual projects or project sets, across projects within each use case, and across the three uses.ResultsParticipants described three primary activities in which engaged partners made contributions before, during and after CER studies that facilitated the use of study findings: (1) generating relevant study findings, (2) distributing study findings strategically, and (3) making connections to people or organizations outside the study team. In addition, engagement continued to facilitate the use of study findings during subsequent PCORI-funded implementation and dissemination-specific projects, with partners adapting interventions and creating and tailoring dissemination messages and products. Finally, participants described attributes of teams’ engagement approaches that may have supported partner contributions, including early and ongoing engagement, leveraging partners’ connections and understanding of community needs, and using multiple engagement approaches.ConclusionThis study identified examples of how engagement can help facilitate the use of CER study findings, especially when engagement contributions occur in meaningful ways. Findings from this study suggest a framework for future research on the relationship between engagement in research and uptake of study findings into clinical practice.

Comparative Effectiveness of Antipsychotics in Patients With Schizophrenia Spectrum Disorder

Antipsychotics are the cornerstone of maintenance treatment in schizophrenia spectrum disorders, but it is unclear which agents should be prioritized by prescribers. To investigate the clinical effectiveness of antipsychotics, including recent market entries, in comparison with oral olanzapine in relapse and treatment failure prevention among individuals with schizophrenia spectrum disorder. This comparative effectiveness research study with a within-individual analysis included data from Swedish health care registers of inpatient and specialized outpatient care, sickness absence, and disability pensions among all individuals aged 16 to 65 years who were diagnosed with schizophrenia spectrum disorder from January 1, 2006, to December 31, 2021, including an incident cohort and a prevalent cohort. Specific antipsychotics. The risks for psychosis relapse hospitalization and treatment failure (psychiatric hospitalization, death, or change in an antipsychotic medication) were adjusted for the temporal order of treatments, time since cohort entry, and concomitant drugs. Comparisons of all antipsychotics with oral olanzapine, the most commonly used antipsychotic, were investigated. Among the full cohort of 131 476 individuals, the mean (SD) age of the study cohort was 45.7 (16.2) years (70 054 men [53.3%]). During a median follow-up of 12.0 years [IQR, 5.2-16.0 years], 48.5% of patients (N = 63 730) experienced relapse and 71.1% (N = 93 464) underwent treatment failure at least once. Compared with oral olanzapine, paliperidone 3-month long-acting injectable (LAI) was associated with the lowest adjusted hazard ratio (AHR) in the prevention of relapses (AHR, 0.66; 95% CI, 0.51-0.86), followed by aripiprazole LAI (AHR, 0.77 [95% CI, 0.70-0.84]), olanzapine LAI (AHR, 0.79 [95% CI, 0.73-0.86]), and clozapine (AHR, 0.82 [95% CI, 0.79-0.86]). Quetiapine was associated with the highest risk of relapse (AHR, 1.44 [95% CI, 1.38-1.51]). For prevention of treatment failure, paliperidone 3-month LAI was associated with the lowest AHR (AHR, 0.36 [95% CI, 0.31-0.42]), followed by aripiprazole LAI (AHR, 0.60 [95% CI, 0.57-0.63]), olanzapine LAI (AHR, 0.67 [95% CI, 0.63-0.72]), and paliperidone 1-month LAI (AHR, 0.71 [95% CI, 0.68-0.74]). This comparative effectiveness research study demonstrated large differences in the risk of relapse and treatment failure among specific antipsychotic treatments. The findings contradict the widely held conception that all antipsychotics are equally effective in relapse prevention.

Racial Differences in Pain Assessment and False Beliefs About Race in AI Models

This comparative effectiveness research study examines the association between racial differences in pain assessment and false beliefs about biologization of race by large language models compared with a human baseline.