Carpal tunnel release (CTR) is one of the most commonly performed hand surgeries, with both open and endoscopic techniques widely used. This study analyzes US historical trends in CTR utilization among Medicare beneficiaries and projects future procedural volumes through 2040. Medicare Part B National Summary data from 2000 to 2022 were used to estimate annual procedural volumes for open (Current Procedural Terminology [CPT] 64721) and endoscopic (CPT 29848) CTR. Adjustments were made to account for the increasing proportion of Medicare Advantage enrollees. Four forecasting models-log-linear, Poisson regression, negative binomial regression, and auto-regressive integrated moving average (ARIMA)-were applied. Model performance was evaluated using mean absolute error and root mean square error, with ARIMA selected for its superior predictive accuracy. From 2000 to 2022, the annual volume of open CTR increased by 180%, while endoscopic CTR grew by 959%. Auto-regressive integrated moving average projections indicate that open CTR will continue to grow at an average annual rate of 2.0%, reaching an estimated 424 271 procedures by 2040. Endoscopic CTR is projected to increase at a faster rate of 2.42% annually, with a forecasted volume of 184 723 by 2040. Despite this growth, open CTR is expected to remain the predominant approach. Carpal tunnel release utilization has increased substantially in the United States, with endoscopic techniques growing at a faster rate than open CTR. Despite this trend, open CTR is projected to remain the predominant approach. Future research should assess the economic impact, patient-reported outcomes, and factors influencing the adoption of each technique.

Abstract Traditional concrete made with the use of Portland cement is the industry standard and widely used in construction. However, it faces significant challenges in terms of long-term durability and reliability, particularly when exposed to harsh environmental conditions over prolonged periods. The major concern is the development of microcracks, which can compromise the structural integrity of the material. To combat these issues, extensive research is ongoing in the development of self-healing concrete through the use of biomineralizing bacteria that can detect and heal the cracks automatically, eliminating the need for analytical monitoring or human intervention. Additionally, researchers are exploring the use of different materials, ranging from polymers to synthetic materials, including nanoparticles, to enhance the functionality of concrete, apart from its load-bearing ability, which essentially develops a form of multifunctional concrete. In this review, we aim to discuss the different technologies that are being studied for the development of sustainable multifunctional concrete; the different materials used, the protocols involved and their overall mechanistic properties to facilitate a comparison and summarize the future research. We also aim to segregate and discuss which approach results in better outcomes, considering the economic factors, including scalability and ease of use in terms of application in the real world.

Background The pathological diagnosis of mediastinal lesions is crucial for precision oncology. While endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the preferred minimally invasive method for visceral mediastinal lesions, its diagnostic yield can be limited for high-risk lesions surrounded by great vessels. This case demonstrates that under such complex anatomical constraints, a meticulously planned CT-guided percutaneous biopsy serves as a safe and effective alternative. Case presentation A middle-aged male patient was highly suspected of having lung cancer with mediastinal metastasis based on clinical and radiological findings. Two successive bronchoscopic biopsies of the pulmonary lesion failed to yield a diagnosis. Although the medical team recommended EBUS-TBNA at a tertiary hospital, the patient opted for a CT-guided biopsy at our institution after considering personal convenience and economic factors. The target was a high-risk mediastinal lymph node located within the vascular “core area” between the aorta and superior vena cava. Intervention and outcome Preprocedural planning with contrast-enhanced CT simulated three potential trajectories (transcostochondral, transsternal, transpulmonary). The transsternal approach was prioritized to avoid lung parenchyma, thereby eliminating the risk of pneumothorax—a critical consideration given the patient’s comorbid emphysema and bullae. The initial transcostochondral approach was abandoned due to pain upon vascular contact and restricted maneuverability. The subsequent transsternal approach was successfully performed using a coaxial biopsy system to navigate the narrow vascular space, followed by tract embolization upon needle withdrawal. The procedure was safe, with only minimal, self-resolving mediastinal emphysema. Adequate tissue cores were obtained, enabling a definitive diagnosis of metastatic lung adenocarcinoma. Conclusion For complex mediastinal lesions where standard approaches are unsuitable or declined by the patient, a meticulously planned CT-guided percutaneous biopsy based on three-dimensional anatomical assessment is a feasible and valuable diagnostic strategy.

In the zone of large-scale hostilities, the form and functional content of the urban environment of urbanized territories are undergoing changes. New prerequisites for the renewal of the territorial and spatial organization of the settlement system are being formed. The scale of clearance is already correlated with the scale of restoration construction. The formation of urbanized territories is determined by a complex of geographical, economic, and political factors. For the east of Ukraine, revolutionary urban planning changes have occurred. At this stage, the tasks of urban planning analysis of concepts and directions for restoring the regional structure arise. A typological analysis of objects and zones of mass destruction in urbanized territories has been performed in order to determine the principles and methods of dealing with waste from destruction at the stage of restoration of territories. The stages of the emergence of cities and agglomeration formations of the Luhansk region, which had a significant impact on the formation of typologically homogeneous areas of urban development, have been studied. A typological analysis of the cities of Severskodonetsk, Lysychansk and Rubizhne, which form an agglomeration that suffered large-scale destruction during hostilities, has been carried out. The agglomeration forms a reference object of research that combines the oldest and youngest cities of the Luhansk region. It has been determined that architectural and planning units can be classified by constructive features and by planning solutions. Groups of buildings and planning areas of a characteristic typology have been identified. Recommendations have been proposed regarding the possibility of reconstructing urban development, which takes into account the possibilities of changing the function and form of the urban environment. Typological analysis can be used within the framework of an expert method for developing design solutions for the reconstruction of destroyed cities..

Abstract Objective This study examined the impact of quality time spent with family in modifying the relationship between various negative home and social consequences of the pandemic and subsequent social and behavioral outcomes. Background Adverse consequences related to economic, health, and social factors were brought about by the COVID‐19 pandemic. In other contexts, family protective factors and resiliency have been found to mitigate similar adverse circumstances. Method This mixed‐method study included participants across five states ( N = 67). Quantitative methods included survey data on individual and family experiences related to work and education, home and social circumstances, and physical and emotional health. Qualitative measures included individual interviews to better understand familial experiences during the pandemic. Results Relationships between negative home life experiences and consequences of the pandemic and subsequent negative outcomes were found to be altered as levels of quality time spent with family and children increased. These results were replicated through robust qualitative data, which told the stories of families using quality time to support positive outcomes. Conclusion Findings suggest that quality time spent with family can be a point of emphasis for mitigating adverse social and health outcomes. Implications Quality time may serve as a low‐cost, accessible relational strategy that can be intentionally emphasized in prevention, intervention, and public health messaging to strengthen family resilience during periods of prolonged adversity.

This study examines the state-level factors influencing the absorption of foreign direct investment (FDI) and the decision-making of multinational enterprises (MNEs) to invest in foreign markets, with a particular focus on regulatory determinants along the firm life cycle. Building on recent evidence that institutional and regulatory quality significantly shape FDI inflows in developing economies (Krasniqi & Fetai, 2024; Topçu, 2023), the study uses data from the World Bank for six Western Balkan countries over the period 1998–2022. Using a panel data regression model, it identifies key institutional and economic factors affecting FDI inflows. The empirical results show that countries with lower tax rates on income and profits, stronger control of corruption, and simpler business entry procedures tend to attract higher levels of foreign investment. Furthermore, higher gross domestic product (GDP) per capita and a favorable business environment positively influence FDI decisions. These findings highlight the importance of transparent, efficient, and predictable regulatory frameworks in fostering investment attractiveness. The study offers important policy implications for governments in the region, suggesting that reforms aimed at improving institutional quality and reducing administrative barriers can significantly enhance FDI inflows. Future research could extend this analysis by incorporating qualitative dimensions such as political stability, infrastructure development, and legal enforcement to provide a more comprehensive understanding of the factors driving FDI in emerging economies.

Background: Suicide means self destruction. One can takes up any method to cause harm to himself. In Bangladesh there are different methods like ingestion of poison, hanging, drug overdose and in other countries most prevailing methods are gunshot. Suicide by hanging is common in Bangladesh. This study was done to identify the socio economic factors, other associated factors and post mortem examination finding of hanging cases. Material and Methods: This retrospective study was conducted among victims of hanging brought to Dhaka Medical College morgue during the period January 2015 to December 2015. Various identification data of the victim like age, sex, marital status, permanent address, suspension of dead body along with places of incidence, time and suspected causes of death were noted from the inquest report accompanying the dead bodies. Results: A total 376 cases of hanging was examined. Maximum no. of cases were within the age limit of 21- 30(36%) there were male predominance 208(55.32%) associated features of hanging we found maximum due to family disputes 110(29.3%) most of them used soft material as ligature material 245(64.6%). Conclusion: The high incidence of hanging in young male adults impose a serious effect in our economy. Journal of Brahmanbaria Med. Coll. Volume 07 Issue 01 Jan 2025 ; 8-10

Since modern rural development results from a complex interaction between various exogenous forces, the sustainable development of rural communities in ecologically fragile areas is inherently a systemic endeavor. This study, guided by the social-ecological system theory, examines the impact of social, economic, political, natural, and other external factors on the sustainable development of rural communities in these areas. The goal is to gain a deeper understanding of the underlying causes of delayed development in these communities. The results are as follows: First, labor outflow, ecological fragility, and informal institutions significantly hinder the sustainable development of rural communities, while regional economic development demonstrates a strong positive relationship with the sustainability of rural communities. Second, regional economic development primarily influences the sustainability of communities through its impact on locational conditions. Communities closer to the county and town experience a more pronounced positive effect from regional economic development. Thirdly, informal institutions inhibit the sustainable development of rural communities by obstructing the land rights reform process. Finally, for small-scale communities, the inhibitory effect of ecological fragility and the facilitating effects of regional economic development are more substantial, while labor outflow and informal institutions exert a pronounced inhibitory effect primarily on large-scale communities. For low-poverty communities, labor outflow exerts a more significant inhibitory effect on community sustainability. In contrast, for high-poverty communities, the regional economic development contributes more significantly to sustainability, while ecological fragility and informal institutions have a stronger inhibitory effect.

Purpose This study examines the relationship between institutional and economic hardship factors in shaping entrepreneurship rates across countries. Specifically, it explores the impact of economic freedom as an institutional determinant and the Misery Index (sum of unemployment and inflation) as an indicator of economic hardship on business creation rates. The aim is to assess how these factors interact in fostering or constraining entrepreneurial activity. Design/methodology/approach A panel data analysis was conducted using data from 70 countries covering the period 2017–2023, resulting in 288 observations. An unbalanced panel data model was applied and fixed-effects and random-effects models were considered. The Hausman test indicated that the random-effects model was the appropriate specification for this dataset. The empirical approach allowed for a robust examination of the impact of economic freedom and the Misery Index on entrepreneurial activity. Findings The results reveal that an increase in the Misery Index negatively affects business creation, with a one-unit rise leading to a 2.3% decline in entrepreneurial activity (p = 0.0196). Conversely, economic freedom has a positive impact, as a one-point increase results in a 0.31% rise in entrepreneurial activity (p = 0.0079). However, the explanatory power of the model is limited (R2 = 16.39%), indicating that other contextual and individual-level factors significantly influence entrepreneurship rates. Originality/value This study contributes to the literature by providing empirical evidence about the interplay between economic freedom and economic hardship in shaping entrepreneurship rates. The study highlights the stronger negative impact of economic hardship relative to the positive effect of institutional quality. The findings underscore the need for further research on additional contextual and individual determinants of entrepreneurship, offering valuable insights for policymakers and stakeholders involved in fostering entrepreneurial ecosystems.

Purpose In the current context of increasing environmental concerns, this study aims to investigate the psychological and economic factors that drive consumers’ green apparel purchase intention. This study examines the combined effect of green self-identity and eco-consciousness mediated through perceived consumer effectiveness. It also assesses the moderating role of price sensitivity, particularly within the context of emerging markets. Design/methodology/approach A quantitative approach using the questionnaire method was conducted, and the proposed structural relationships were tested through structural equation modelling in AMOS. Findings The results indicate that green self-identity and eco-consciousness significantly enhance green apparel purchase intention, with perceived consumer effectiveness mediating this relationship. Furthermore, price sensitivity was found to moderate the effect of perceived consumer effectiveness on green apparel purchase intention. Originality/value It highlights the psychological and economic drivers of green apparel purchasing and enhances the understanding of sustainable consumer behaviour literature and delivers actionable recommendations to marketers and policymakers in promoting green apparel, framing pricing strategies and segmenting the market.

Agronomy is paramount: A case study on the mismatch between farm-scale measures and policy instruments for drought adaptation in Seewinkel, Austria.

Co-creating resilient community food systems: A systems approach using group model building.

Purpose This study investigates the impact of energy-efficient features on university students’ perceptions of rent affordability in Northern Ghana. Design/methodology/approach Employing a quantitative research design, the study analysed survey data from 320 students residing in purpose-built hostels across three universities in Northern Ghana. Logistic regression analysis was employed to examine the impact of economic, environmental, social and technological factors on students’ perceptions of rental affordability. The research framework was grounded in the value–belief–norm (VBN) theory. Findings The analysis revealed that energy-efficient attributes, such as reduced utility costs and improved indoor comfort, have a positive influence on perceptions of affordability. Nevertheless, students’ evaluations were more heavily shaped by tangible factors, including the actual rent price, housing type and proximity to campus. Although energy-efficient housing offers potential long-term savings, most students exhibited reluctance to pay a premium for these features, mainly due to constrained financial resources and limited awareness of the associated benefits. Practical implications The findings highlight the importance of tenant education and the implementation of policy incentives to promote sustainable and affordable housing options for students. Universities and private developers are encouraged to integrate affordability with targeted awareness campaigns when designing and marketing student accommodations. Originality/value This research offers original insights by focusing on student renters in the Global South, an often-underrepresented group in housing market studies. The study offers valuable and context-specific perspectives on the intersection of affordability and sustainability within emerging rental markets.

Abstract Subjective well-being has gained increasing attention in both academic research and policymaking, leading to a growing body of literature examining its determinants. Yet, factors affecting the subjective well-being of older adults have remained underexplored. This study investigates the impact of social, political, economic, and demographic factors on older adults' life satisfaction using the seventh wave of the World Values Survey (2017–2022) which includes individuals’ responses from 58 countries across the Americas, Europe, Asia, and Africa. A global perspective is crucial for understanding how varying economic performances, political conditions, and social policies shape the well-being of older adults. The geographical diversity of the sample enables a global comparison, capturing a wide range of social, political, and cultural contexts. By employing multilevel mixed-effects regression models, we account for both within-country and between-country variations, integrating both individual-level and country-level data. The findings indicate that social capital, political governance, and economic performance significantly affect life satisfaction. Interpersonal trust, institutional confidence, social group membership, quality governance, and democracy are positively associated with subjective well-being whereas corruption and inflation are negatively associated. Notably, political governance is found to be the leading factor affecting the life satisfaction of adults aged 50-64, while it is social capital for those aged 65 and above. Social and political factors have played an increasingly influential role during the pandemic. These findings emphasize the importance of developing tailored interventions that consider regional, temporal, and age-related differences to effectively meet the diverse needs of older adults.

Introduction:Preeclampsia (PE) is the second most common cause of maternal death worldwide. Geographic, sociodemographic, racial, and economic factors have all been proposed as contributors to the rate variations of PE. Among them, seasonal factors (temperature and humidity) may influence PE. Climate change has been connected to the global pattern of PE. The study was conducted to find out the hospital prevalence of SPE in different seasons in a tertiary hospital in the Southeastern part of Bangladesh and its influence on feto-maternal outcomes. Methods:This cross-sectional study was performed in the Department of Obstetrics and Gynecology, Chittagong Medical College Hospital (CMCH) from February 2021 to January 2022. The study year was divided into four seasons: Summer (March to May), Monsoon (June to August), Autumn (September to November), and Winter (December to February) according to the seasons of Bangladesh. The prevalence of SPE and meteorological differences in the four seasons and over the English calendar month was compared. Results:In the past year, 19183 obstetrics patients were hospitalized, 14661 births were documented, and 8,908 CS occurred. Pregnancy-related hypertension was 2150, PE was 1597 (8.33% of all hospitalizations), and SPE was 1315 (6.80% hospital prevalence). Eclampsia was 552 Winter has the most SPE (8.01%) and Autumn the least (5.97%). Winter SPE risk was much higher than Autumn (OR + 1.37, 95% CI: 1.18-1.59). Summer had 22.44% delivery rates, whereas Autumn had 53%. SPE-related CS was lowest in Monsoon (9.78%) and highest in Winter (13.54%). SPE-related CS was 1.38 times higher in winter using the Monsoon as the reference season. Monthly SPE prevalence was 5.23%–9.28%. Average monthly temperature was adversely connected with S. PE admission (r= -0.71; P=0.01). Of 1,315 SPE admissions, 27 women died (2.05%). Others were released alive. There were 64 maternal deaths during the research. SPE killed 42.19% of mothers in four seasons. SPE caused 33 stillbirths (2.92%) out of 1132 deliveries. SPE accounted for 12.09% of 273 SB from all sources in four seasons. Conclusion:This study supports the concept of seasonal influence on the admittance of preeclampsia patients. In the tropical climate, the incidence appeared to be higher in the Winter, with peaks at inter-seasonal periods, when the weather is cooler than the rest of the year. So, a lower temperature is linked to severe Preeclampsia. Understanding the relationship of SPE with Bangladesh's different seasons will help identify the triggering factors of PE and eclampsia(EC). J Bangladesh Coll Phys Surg 2026; 44: 40-46

The University of Wisconsin Population Health Institute (PHI) Model of Health, grounded in models developed over a decade ago, provides a framework for prioritizing health-related investments including setting agendas, implementing policies, and sharing resources for improving community health and health equity. The model includes multiple determinants of health and two broad health outcomes (length and quality of life). We adapted the PHI Model of Health to cancer outcomes. Using county-level publicly available data, health factor summary measures were derived in three areas: health infrastructure including health promotion and clinical care, physical environment, and social and economic factors. A composite health factor z-score was calculated as the weighted (40%, 15%, and 45%, respectively) average of the summary measures for each county, and k-means clustering was used to create unequally sized county groups with lower (healthier) to higher (less healthy) z-scores. We fit age-adjusted negative binomial regression models to estimate rate ratios and 95% CI for cancer mortality in relation to county health factor cluster. Age-adjusted cancer mortality rates increased across the 10 county health factor clusters for all-cancers as well as for lung, colorectal, breast, and prostate cancers. Rate ratios generally increased across the 10 health factor clusters for all cancers combined and for specific cancer types. Compared with counties with the most favorable health factor conditions, the counties with the least favorable conditions had an all-cancer mortality rate ratio of 1.49 (95% CI, 1.39 to 1.60). The PHI model of health adapted to cancer outcomes provides an approach for linking community-specific conditions to the interventions that hold promise to directly address drivers of the cancer burden.

The article is devoted to the analysis of the dynamics of ethnopolitical processes in two subregions of the North Caucasus – Stavropol Krai and Karachay-Cherkess Republic. The purpose of the article is to clarify medium-term forecasts of the dynamics of the ethnopolitical situation in the two territories, taking into account the latest threats and challenges. The study is based on a combination of three approaches: conflictological approach, risk studies and geopolitical paradigm. The empirical base was formed on the basis of long-term monitoring of the ethnopolitical situation and confessional processes. Content analysis of regional information resources, event analysis of the regional ethnopolitical situation, factor analysis based on the study of statistical data, and expert surveys were used. The results presented in the article are based on research work conducted in 2022-2025. Factors of destabilization of the ethnopolitical situation are organized into three blocks: threats to the constitutional order; risks in the political and administrative sphere; risks in the socio-economic sphere. It was concluded that the authorities in two regions managed to curb the sharp increase in threats and risks to ethnopolitical stability caused by the aggravation of geopolitical processes. The dynamics of factors determining the development of the regional ethnopolitical situation in the middle of the third decade of the 21st century, the absence of resonant conflicts with ethnic component and protest activity make it possible to steadily prolong the positive conflict scenario in Stavropol Krai for the second half of the decade. For Karachay-Cherkessia, the most likely is an inertial moderate conflict scenario. Thus, Stavropol Krai and the Karachay-Cherkessia Republic are the "western pole of stability" in the North Caucasus. The analysis showed a much more complex determination of the regional ethnopolitical process compared to traditional explanatory models. Economic factors, traditionally considered as one of main sources conflict generators, do not show a significant impact on the dynamics of ethnosocial and ethnopolitical processes. At present, such role play specific features of functioning of regional political regimes: the effectiveness of authorities, the mechanism for the formation of power, the depth of clan ties, corruption. An important factor in ensuring stability in the communities of the two territories is the dominance of secularism both in power relations and in public life in general.

"A never-ending cycle": The structural, economic and social (re)production of blood-borne virus transmission and bacterial infection amongst people who inject drugs in Queensland prisons.

Midwifery as a career choice for school leavers: A scoping review of the international literature.

Migration trajectories, uncertainty and health: a conceptual review.