Negative Binomial Regression Analysis Research Articles

How do NPOs’ topics and moral foundations in gun-related issues influence public engagement on Twitter?

PurposeDrawing on the moral foundations theory (MFT), we examine what nonprofit organizations (NPOs) discuss and how NPOs engage in gun-related issues on Twitter. Specifically, we explore latent topics and embedded moral values (i.e. care, fairness, loyalty, authority, and sanctity) in NPOs’ tweets and investigate the effects of the latent topics and moral values on invoking public engagement.Design/methodology/approachData were retrieved by the Twint Python and the rtweet R packages. Finally, 5,041 tweets posted by 679 NPOs were analyzed via unsupervised topic modeling and the extended moral foundations dictionary (eMFD). Negative binomial regression analysis was employed for statistical analysis.FindingsNPOs’ engagement in gun-related issues mainly focuses on laws and policies, calling for action and collaborations, and school safety. All five moral foundations are more salient in the cluster of laws and policies. When NPOs discuss the above-mentioned three topics, the public is less likely to like or retweet NPOs’ messages. In contrast, NPOs’ messages with the sanctity foundation are most likely to receive likes and retweets from the public. The fairness foundation interacts with Cluster 3 of school safety on the number of likes.Originality/valueThis study enhances the understanding of gun-related social media discussions by identifying the crucial involvement of NPOs as major stakeholders. In addition, our study enriches the existing literature on NPOs’ social media communication by including moral values and their moral-emotional effects on public engagement. Finally, our study validates the eMFD dictionary and broadens its applicability to gun-related topics.

Unveiling the influence of global innovation networks on corporate innovation: evidence from the international semiconductor industry

In this study, we investigate the influence of global innovation networks (GINs) on the innovation output of semiconductor firms. Utilizing negative binomial regression and network analysis, we assess how network positions, specifically degree, betweenness, and closeness centrality, affect firms’ innovation performance, revealing significant positive impacts. Moreover, our results identify a positive U-shaped relationship between structural holes in GINs and innovation performance, suggesting that while moderate network engagement aids innovation, too much can be detrimental. This research provides key insights into optimizing GIN participation for better innovation results in the competitive semiconductor sector.

Evaluation of an obstetric and neonatal care upskilling program for community health workers in Papua New Guinea

Background60% of women in Papua New Guinea (PNG) give birth unsupervised and outside of a health facility, contributing to high national maternal and perinatal mortality rates. We evaluated a practical, hospital-based on-the-job training program implemented by local health authorities in PNG between 2013 and 2019 aimed at addressing this challenge by upskilling community health workers (CHWs) to provide quality maternal and newborn care in rural health facilities.MethodsTwo provinces, the Eastern Highlands and Simbu Provinces, were included in the study. In the Eastern Highlands Province, a baseline and end point skills assessment and post-training interviews 12 months after completion of the 2018 training were used to evaluate impacts on CHW knowledge, skills, and self-reported satisfaction with training. Quality and timeliness of referrals was assessed through data from the Eastern Highlands Province referral hospital registers. In Simbu Province, impacts of training on facility births, stillbirths and referrals were evaluated pre- and post-training retrospectively using routine health facility reporting data from 2012 to 2019, and negative binomial regression analysis adjusted for potential confounders and correlation of outcomes within facilities.ResultsThe average knowledge score increased significantly, from 69.8% (95% CI:66.3-73.2%) at baseline, to 87.8% (95% CI:82.9-92.6%) following training for the 8 CHWs participating in Eastern Highlands Province training. CHWs reported increased confidence in their skills and ability to use referral networks. There were significant increases in referrals to the Eastern Highlands provincial hospital arriving in the second stage of labour but no significant difference in the 5 min Apgar score for children, pre and post training. Data on 11,345 births in participating facilities in Simbu Province showed that the number of births in participating rural health facilities more than doubled compared to prior to training, with the impact increasing over time after training (0–12 months after training: IRR 1.59, 95% CI: 1.04–2.44, p-value 0.033, > 12 months after training: IRR 2.46, 95% CI:1.37–4.41, p-value 0.003). There was no significant change in stillbirth or referral rates.ConclusionsOur findings showed positive impacts of the upskilling program on CHW knowledge and practice of participants, facility births rates, and appropriateness of referrals, demonstrating its promise as a feasible intervention to improve uptake of maternal and newborn care services in rural and remote, low-resource settings within the resourcing available to local authorities. Larger-scale evaluations of a size adequately powered to ascertain impact of the intervention on stillbirth rates are warranted.

Road vehicle collision suicide in Australia: Trends, collision types, and individual characteristics.

Suicide by road vehicle collision in Australia is under-explored with mixed findings. We aimed to address this research gap by examining time trends, different types of vehicle collision, and individual characteristics related to vehicle-collision suicide. We retrospectively analyzed deaths by suicide between 1st January 2001 and 31st December 2017 in Australia, using coronial records from the National Coronial Information System. The travel mode used and collision counterpart were retrieved from records of death by vehicle-collision suicide using all available information. We conducted negative binomial regression analysis to examine annual changes in suicide rate by vehicle collision on a public road (N = 640) and other methods of suicide (N = 41,890), and logistic regression analysis to examine individual characteristics associated with the likelihood of dying by suicide via road vehicle collision. Overall, the national suicide rate involving road vehicle collision significantly increased, while the rate by other methods significantly decreased. Drivers accounted for 61% of suicide events by vehicle collision, of which 72% were single-vehicle collisions (commonly involving a tree). For multiple-vehicle collision suicide events, 82% involved collision with a truck. Pedestrians accounted for more than one-third of suicide events, of which 58% involved collision with a truck and 23% involved collision with a car/van. Individuals who were male (odds ratio 1.15; 95% CI 0.88-1.50), aged <25 years old (odds ratio 5.27; 95% CI 3.05-9.10), non-Indigenous (odds ratio 3.36; 95% CI 1.71-6.62), and born overseas (odds ratio 1.40; 95% CI 1.10-1.79) were more likely to die by vehicle-collision suicide than by other methods of suicide. This study provides a better understanding of road vehicle collision suicide in Australia and informs future research directions on topic. Our findings can be used to inform suicide prevention initiatives to reduce vehicle-collision suicide deaths.

The prevalence and prognostic value of diabetes and hypertension in patients treated for cholera during the ongoing Syrian conflict

ObjectivesLittle work has been done investigating the prevalence and impact of comorbidities on cholera outcomes within conflict settings. We describe the clinical outcomes of patients treated for cholera in Latakia, Syria, during the 2022–2023 cholera outbreak. MethodsWe performed a single-centre retrospective observational cohort study of patients admitted to the hospital with suspected cholera between 15th December 2022 and 15th February 2023 at National Hospital, Latakia, Syria. Multivariable negative binomial regression analysis was used to investigate the variables’ relationship to hospital length of stay. ResultsThe study involved 89 patients admitted to the hospital; none were vaccinated against cholera. Cholera rapid diagnostic test was positive in 91 % of patients. Half of the patients (51 %) were male; a third (35 %) had hypertension, and a fifth (19 %) had diabetes. One patient passed away during admission. Patients who were male, had diabetes and were hypertensive tended to have longer hospital stays in univariable analysis. When these factors were added to a multivariable negative binomial model (consisting of age, gender, hypertension and diabetes), male sex (IRR: 4.1, 95 % CI: 1.28–6.2, p = 0.001), the presence of hypertension (IRR: 2.1,95 % CI: 1.14 to 4.1, p = 0.004) and diabetes (IRR: 2, 95 % CI: 1.2 to 2.7, p = 0.001) were independent predictors of longer hospital stays. ConclusionIn conflict settings, hypertension and diabetes are common in patients admitted to hospital with cholera and are associated with longer hospital stays. Mortality from cholera, however, was low. Our findings highlight the importance of comorbidity control in mitigating excess morbidity during infectious disease outbreaks within conflict areas.

Emophilia: psychometric properties of the emotional promiscuity scale and its association with personality traits, unfaithfulness, and romantic relationships in a Scandinavian sample.

Emophilia is a suggested stable phenomenon referring to how often and easily an individual falls in love (Jones, 2011). The current study investigated the psychometric properties of the Emotional Promiscuity Scale (EPS, i.e., a measure of emophilia) and its association with personality traits, romantic relationships, and unfaithfulness in a Scandinavian sample. The sample consisted of 2,607 participants, who were recruited through Norwegian and Swedish newspapers. Descriptive analyses of the EPS and a confirmatory factor analysis (CFA) to verify the previously obtained two-factor structure were conducted. Correlations between emophilia and the Big Five and Dark Triad traits were calculated to investigate the discriminative validity of the EPS. Lastly, negative binomial regression analyses were run in which emophilia comprised the independent variable and the number of romantic relationships and number of times being unfaithful constituted the dependent variables. The EPS had satisfactory internal reliability and the responses to the items were normally distributed. The CFA indicated a two-factor structure, although the two factors correlated highly, justifying collapsing them into one dimension. Emophilia showed satisfactory discriminant validity (r < 00.40) against the personality traits included. Lastly, emophilia was positively associated with the number of romantic relationships and times being unfaithful. Future research should aim to improve our understanding of the psychological and behavioral aspects of emophilia.

Associations between healthcare use and migration background in persons with dementia: A cohort study in the Netherlands

Background: Qualitative research shows barriers in access to healthcare for persons with a migration background, possibly leading to healthcare inequalities. We aimed to compare healthcare use between older community-dwelling persons with a migration background and native Dutch persons with dementia. Methods: Observational cohort study using electronic health records of NIVEL Primary Care Database (2013–2014) linked to nationwide administrative registries managed by Statistics Netherlands. We included all community-dwelling persons with dementia in the Netherlands aged 65 years and older. Negative binomial and logistic regression analyses were conducted to assess differences in healthcare use outcomes. The largest migrant groups (persons born in Surinam, Turkey and Morocco) were studied separately. Results: 138,864 persons with dementia were included in the study, whereof 3,991 persons with a migration background and 132,477 native Dutch persons. Moroccan-born persons showed 1.46 higher odds of having an unplanned hospital admission compared to native Dutch persons (95 % Confidence Interval [CI] 1.22–1.74). Persons with a migration background used less professional home care (Odds Ratio [OR] 0.55, 95 %CI 0.51–0.59), and received less home visits from their general practitioner (OR 0.50, 95 %CI 0.43–0.57) than native Dutch persons. Moroccan-born persons had more often an out-of-hours general practitioner consultation compared to native Dutch persons (Incidence Rate Ratio 1.36, 95 %CI 1.18–1.57). Conclusions: We found significant quantitative differences in healthcare use between persons with a migration background and native Dutch persons with dementia. Further research is needed to gain insight into the reasons of these differences, with consideration of specific migration background.

Racial Differences in Treatment Intensity at the End of Life Among Older Adults with Heart Failure: Evidence from the Health and Retirement Study.

Background: Black Americans experience the highest prevalence of heart failure (HF) and the worst clinical outcomes of any racial or ethnic group, but little is known about end-of-life care for this population. Objective: Compare treatment intensity between Black and White older adults with HF near the end of life. Design: Negative binomial and logistic regression analyses of pooled, cross-sectional data from the Health and Retirement Study (HRS). Setting/Subjects: A total of 1607 U.S. adults aged 65 years and older with HF who identify as Black or White, and whose proxy informant participated in an HRS exit interview between 2002 and 2016. Measurements: We compared four common measures of treatment intensity at the end of life (number of hospital admissions, receipt of care in an intensive care unit (ICU), utilization of life support, and whether the decedent died in a hospital) between Black and White HF patients, controlling for demographic, social, and health characteristics. Results: Racial identity was not significantly associated with the number of hospital admissions or admission to an ICU in the last 24 months of life. However, Black HF patients were more likely to spend time on life support (odds ratio [OR] = 2.16, confidence interval [CI] = 1.35-3.44, p = 0.00) and more likely to die in a hospital (OR = 1.53, CI = 1.03-2.28, p = 0.04) than White HF patients. Conclusion: Black HF patients were more likely to die in a hospital and to spend time on life support than White HF patients. Thoughtful and consistent engagement with HF patients regarding treatment preferences is an important step in addressing inequities.

Internet-based emotion regulation training aimed at reducing violent revictimization and depressive symptoms in victimized depressed patients: Results of a randomized controlled trial

BackgroundDepressed patients who have become victim of violence are prone to revictimization. However, no evidence-based interventions aimed at reducing revictimization in this group exist. MethodsThis multicenter randomized controlled trial evaluated the effectiveness of an internet-based emotion regulation training (iERT) added to TAU in reducing revictimization, emotion dysregulation, and depressive symptoms in recently victimized, depressed patients compared to TAU alone. Adult outpatients (N = 153) with a depressive disorder who had experienced threat, physical assault, or sexual assault within the previous three years were randomly allocated to TAU+iERT (n = 74) or TAU (n = 79). TAU involved psychotherapy (mainly cognitive behavioral therapy [77.8 %]). iERT comprised six guided online sessions focused on the acquisition of adaptive emotion regulation skills. The primary outcome measure was the number of revictimization incidents at 12 months after baseline, measured with the Safety Monitor. Analyses were performed according to the intention-to-treat principle. ResultsBoth groups showed a large decrease in victimization incidents. Mixed-model negative binomial regression analyses showed that TAU+iERT was not effective in reducing revictimization compared to TAU (IRR = 0.97; 95%CI = 0.64,1.46; p = .886). Linear mixed-model analyses demonstrated that TAU+iERT yielded a larger reduction of emotion dysregulation (B = −7.217; p = .046; Cohens d = 0.33), but not depressive symptoms (B = −1.041; p = .607) than TAU. LimitationsThe study was underpowered to detect small treatment effects. Additionally, uptake of iERT was quite low. ConclusionsAlthough TAU+iERT resulted in a larger decrease of emotion dysregulation than TAU alone, it was not effective in reducing revictimization and depressive symptoms. Patients' revictimization risk substantially decreased during psychotherapy.

Pain sensitivity as a state marker and predictor for adolescent non-suicidal self-injury.

The pain analgesia hypothesis suggests that reduced pain sensitivity (PS) is a specific risk factor for the engagement in non-suicidal self-injury (NSSI). Consistent with this, several studies found reduced PS in adults as well as adolescents with NSSI. Cross-sectional studies in adults with borderline personality disorder (BPD) suggest that PS may (partially) normalize after remission or reduction of BPD symptoms. The objective of the present study was to investigate the development of PS over 1 year in a sample of adolescents with NSSI and to investigate whether PS at baseline predicts longitudinal change in NSSI. N = 66 adolescents who underwent specialized treatment for NSSI disorder participated in baseline and 1-year follow-up assessments, including heat pain stimulation for the measurement of pain threshold and tolerance. Associations between PS and NSSI as well as BPD and depressive symptoms were examined using negative binomial, logistic, and linear regression analyses. We found that a decrease in pain threshold over time was associated with reduced NSSI (incident rate ratio = 2.04, p = 0.047) and that higher pain tolerance at baseline predicted lower probability for NSSI (odds ratio = 0.42, p = 0.016) 1 year later. However, the latter effect did not survive Holm correction (p = 0.059). No associations between PS and BPD or depressive symptoms were observed. Our findings suggest that pain threshold might normalize with a decrease in NSSI frequency and could thus serve as a state marker for NSSI.

Community Emergency Care Use by Veterans in an Era of Expanding Choice

Recently passed legislation aimed at improving access to care has considerably expanded options for veterans to receive emergency care in community, or non-Veterans Affairs (VA) settings. However, national trends in community emergency department (ED) use by veterans are unknown. To examine national, temporal trends in the frequencies and types of ED visits provided in community settings and explore the association between facilities' purchase of community care with facility and regional characteristics. Retrospective, observational cross-sectional study of ED visits over fiscal years (FY) 2016 to 2022. VA and community ED encounter data were obtained from the VA Corporate Data Warehouse and the Office of Integrated Veteran Care. Participants were veterans receiving ED care at VA facilities or paid for by the VA in the community. Data were analyzed from June to September 2023. The primary outcome measures included community ED visit volume, disposition, and payments over time. Also, the most common and costly ED visits were assessed. Negative binomial regression analysis examined associations between facility and regional characteristics and the rate of ED visits purchased in community settings relative to all ED visits. There were 19 787 056 ED visits, predominantly at VA facilities (14 532 261 visits [73.4%]), made by 3 972 503 unique veterans from FY 2016 to 2022. The majority of ED users were male (3 576 120 individuals [90.0%]), and the median (IQR) age was 63 (48-73) years. The proportion of community ED visits increased in absolute terms from 18% in FY 2016 to 37% in FY 2022. Total community ED payments, adjusted to 2021 dollars, were $1.18 billion in FY 2016 and over $6.14 billion in FY 2022. The most common reasons for ED visits in the community were for nonspecific chest pain (305 082 visits [6%]), abdominal pain (174 836 visits [3%]), and septicemia (149 968 visits [3%]). The average proportion of ED visits purchased by a VA facility increased from 14% in FY 2016 to 32% by FY 2022. In multivariable analyses, facilities with greater ED volume and low-complexity facilities had higher expected rates of community emergency care than lower volume and high-complexity facilities, respectively. As veterans increasingly use community EDs for acute, unscheduled needs, attention to factors associated with veterans' use of acute care services in different settings are important to identify access barriers and to ensure veterans' health care needs are met.

WHEN BLACK MOVEMENTS MATTER: CONTROLLING IMAGES AND BLACK LIVES MATTER PROTESTS IN MEDIA ATTENTION TO U.S. POLICE KILLINGS

This study investigates how the portrayal of Black criminality influences Black Lives Matter (BLM) protests and media attention to police-related deaths of Black individuals. While prior work examined how media norms, political contexts, and movement infrastructure influence media attention, little research has questioned whether the perceived worthiness of movement's claims shapes the capacity of protests to direct attention. Applying scholarship of controlling images, I test how victims’ armed status moderates the effect of BLM protests on media attention to Black policing deaths. Negative binomial regression analysis on coverage of 678 Black Americans killed by police from 2014-2016 in over 300 print media indicates local protests directly increased attention to nearby Black Americans but were moderated by armed status. Neither political contexts nor organizational presence influenced attention, suggesting BLM relied on the discursive power of protests. Findings highlight how controlling images and racialized threats influence movements along a matrix of domination.

Is tooth loss associated with oral health-related quality of life among young men? Findings from southern Brazil.

To determine the association between tooth loss and oral health-related quality of life (OHRQoL) among young men from southern Brazil. Cross-sectional study of 518 young men aged 18-19 years enlisted for mandatory military service in the Brazilian Army in two cities of southern Brazil in 2019-2021. Participants were clinically examined regarding gingivitis, dental caries experience (caries lesions, missing and filled surfaces), and malocclusion. A questionnaire collected socioeconomic information and the Oral Health Impact Profile 14 (OHIP-14). The outcome was OHRQoL, modeled as a discrete variable. The main explanatory variable was tooth loss due to caries (0 or ≥1). Negative binomial regression analysis was used; rate ratios (RR) and 95% confidence intervals (CI) were estimated. Tooth loss prevalence was 22.2%. Associations were detected between tooth loss and OHRQoL in the physical pain and handicap domains. Individuals with at least one missing tooth had 17% higher OHIP-14 scores in the physical pain domain (adjusted RR=1.17; 95%CI=1.01, 1.35) and 49% higher in the handicap domain (adjusted RR=1.49; 95%CI=1.03, 2.15) than those with no tooth loss. Tooth loss was negatively associated with OHRQoL among 18-19-year-old Brazilian Army conscripts, and this association was related to physical pain and handicap domains.

Race/ethnicity and contexts: associations of racial/ethnic discrimination with underage youth’s alcohol use and drinking contexts

Background This study examined how racial/ethnic discrimination may shape alcohol use behaviors, related problems, and contexts of alcohol use among underage youth (<21 years old). Age group differences were also explored. Methods Cross-sectional data were obtained from California youth identified as racial and ethnic minoritized youth (n = 605; ages 14–20). An adapted version of the Everyday Discrimination Scale was used to assess racial/ethnic discrimination. Demographics were also assessed. Outcomes included drinking status, past-6-month alcohol frequency and quantity, number of types of alcohol-related problems, risk for alcohol addiction, and past-6-month alcohol frequency and quantity in public and private settings. Multinomial, negative binomial, and linear regression analyses were conducted, controlling for demographics and exposure to context settings. Results Experiencing racial/ethnic discrimination was positively associated with lifetime drinking, any past-6-month drinking, and risk for alcohol addiction. It was also positively associated with the past-6-month typical number of drinks participants consumed in public settings. Age-group differences were observed with some greater risks for older underage youth (18–20 years old). Conclusions Findings suggest the importance of trauma-informed interventions for youth of diverse racial/ethnic groups and for addressing racial/ethnic discrimination in schools or communities to address alcohol use inequities in young people.

Overcoming Uncertainty in Novel Technologies: The Role of Venture Capital Syndication Networks in Artificial Intelligence (AI) Startup Investments in Korea and Japan

This paper investigates how historical inter-firm syndication networks influence venture capitalists’ (VCs) propensity to invest in startups pursuing novel, uncertain technologies, with a focus on artificial intelligence (AI). We theorize that VCs’ positional attributes within cumulative syndication networks determine their access to external expertise and intelligence that aid AI investment decisions amidst informational opacity. Specifically, reachability to prior AI investors provides referrals and insights transmitted across short network paths to reduce ambiguity. Additionally, VC brokerage between disconnected industry clusters furnishes expansive, non-redundant information that is pivotal for discovering and assessing AI opportunities. Through hypotheses grounded in social network theory, we posit network-based mechanisms that equip VCs to navigate uncertainty when engaging with ambiguous innovations like AI. We test our framework, utilizing comprehensive historical records of global venture capital investments. Analyzing the location information of VC firms in this database, we uncovered a history of 14,751 investments made by Korean and Japanese firms. Using these data, we assembled an imbalanced panel dataset from 1984 to 2022 spanning 230 Korean and 413 Japanese VCs, with 4508 firm-year observations. Negative binomial regression analysis of this dataset reveals how historical relational patterns among venture capital firms foster readiness to evaluate unfamiliar innovations.

School Goal Structures and Violence Against Educators Before and During COVID-19

ABSTRACT We examined relations of U.S. teachers’ perceptions of mastery and performance goal structures to violence perpetrated against them before and during COVID-19. We hypothesized that perceptions of an instructional emphasis on mastery (i.e. mastery goal structure) would be related to lower levels of victimization, whereas perceptions of an emphasis on performance (i.e. performance goal structure) would be related to greater victimization. Using a sample of 9,363 teachers, we conducted negative binomial regression analyses, controlling for teacher and school characteristics. Perceptions of a performance goal structure were related to higher levels of teacher-directed violence, whereas perceptions of a mastery goal structure were related to lower levels of violence. Results underscore the benefits of school mastery versus performance goal structures for bolstering student motivation and teacher safety.

Racial disparities in law enforcement/court-ordered psychiatric inpatient admissions after the 2008 recession: a test of the frustration-aggression-displacement hypothesis.

Societies under duress may selectively increase the reporting of disordered persons from vulnerable communities to law enforcement. Mentally ill African American males reportedly are perceived as more threatening relative to females and other race/ethnicities. We examine whether law enforcement/court order-requested involuntary psychiatric hospitalizations increased among African American males shortly after ambient economic decline-a widely characterized population stressor. We identified psychiatric inpatient admissions requested by law enforcement/court orders from 2006 to 2011 across four US states (Arizona, California, New York, North Carolina). Our analytic sample comprises 13.1 million psychiatric inpatient admissions across 95 counties over 72months. We operationalized exposure to economic downturns as percent change in monthly employment in a metropolitan statistical area (MSA). We used zero inflated negative binomial and linear fixed effects regression analyses to examine psychiatric inpatient admissions requested by law enforcement/court orders following regional employment decline over a time period that includes the Great Recession of 2008. Declines in monthly employment precede by one month a 6% increase in psychiatric hospitalizations requested by law enforcement/court order among African American males (p < 0.05), but not among other race/sex groups. Estimates amount to an excess of 2554 involuntary admissions among African American males statistically attributable to aggregate-level employment decline. Economic downturns may increase involuntary psychiatric commitments among African American males. Our findings underscore the unique vulnerability of racial/ethnic minorities during economic contractions.

Sub-anesthetic dose of esketamine decreases postoperative opioid self-administration after spine surgery: a retrospective cohort analysis

The use of intraoperative sub-anesthetic esketamine for postoperative analgesia is controversial. In this study, the impact of sub-anesthetic esketamine on postoperative opioid self-administration was determined. Patients who underwent spinal surgery with patient-controlled analgesia (PCA) from January 2019 to December 2021 were respectively screened for analysis. Postoperative PCA was compared between patients who received a sub-anesthetic esketamine dose and patients who were not treated with esketamine (non-esketamine group) with or without propensity score matching. Negative binomial regression analysis was used to identify factors associated with postoperative PCA. Patients who received intraoperative sub-anesthetic esketamine self-administered less PCA (P = 0.001). Azasetron, esketamine, and dexamethasone lowered the self-administration of PCA (IRR with 95% confidential interval, 0.789 [0.624, 0.993]; 0.581 [0.458, 0.741]; and 0.777 [0.627, 0.959], respectively). Fixation surgery and drinking were risk factors for postoperative PCA (1.737 [1.373, 2.188] and 1.332 [1.032, 1.737] for fixation surgery and drinking, respectively). An intraoperative sub-anesthetic dose of esketamine decreases postoperative opioid self-administration. Azasetron and dexamethasone also decrease postoperative opioid consumption. The study is registered at www.chictr.org.cn (ChiCTR2300068733).

Work-family conflicts and sickness absence-a register-linked cohort study among young and early midlife employees.

Work-family conflicts (WFC) have been associated with poor mental health, poor self-rated health and sickness absence. However, studies on short sickness absence are lacking and more information is needed also about long sickness absence regarding the direction of WFC, and potential explaining factors particularly among young and early middle-aged employees. The Helsinki Health Study baseline survey (2017) among 19- to 39-year-old municipal employees (N = 3683, 80% women, response rate 51.5%) was linked to employer's sickness absence data. The associations of work-to-family conflicts (WTFC) and family-to-work conflicts (FTWC) with short (1-7 days) and long (over 7 days) sickness absence were analyzed using negative binomial regression analysis. Covariates were age, gender, family-related factors and work-related factors. Stratified analyses by occupational class were performed. The results are presented as rate ratios and their 95% confidence intervals. High WTFC were associated with short (1.25, 1.12-1.40) and long (1.37, 1.11-1.70) sickness absence. High FTWC were also associated with short (1.12, 1.03-1.22) and long (1.24, 1.06-1.45) sickness absence. Adjustment for family-related factors strengthened the associations, whereas adjustment for work-related factors abolished the associations between WTFC and sickness absence. Associations between WFC and sickness absence were observed among two lowest occupational classes only. WFC are associated with both short and long sickness absence. Work-related factors including the quality of supervisory work and shift work play a role in the association. Intervention studies could determine if improvements in combining work and family life lead to a reduction in sickness absence.

Nuancing Regional Geography: An Analysis of the Evolution and Mechanism of Intercity Cooperation Network in the Guangdong‐Hong Kong‐Macao Greater Bay Area

AbstractThis article presents an analysis of the evolution and mechanisms of the intercity cooperation network of the Guangdong‐Hong Kong‐Macao Greater Bay Area (GBA). Based on spatial analysis, social network analysis, and zero‐inflated negative binomial regression analysis, the following key findings are reported: First, the GBA's intercity cooperation network unfolds a strong trend away from a centralized structure towards a polycentric pattern and networked regional governance. Second, the GBA's intercity cooperation is marked by unevenness and path dependence, with high‐level linkages almost exclusively the purview of the area's most economically developed cities. Third, heavily cultivated by economic globalization and national power, the heightening of intercity cooperation is the result of condensed switching among jurisdictions where both endogenous and exogenous factors have rearranged and characterized by uneven development trends.