Longitudinal metabolite and protein trajectories prior to diabetes mellitus diagnosis in Danish blood donors: a nested case-control study.

AIMS/HYPOTHESIS: Metabolic risk factors and plasma biomarkers for diabetes have previously been shown to change prior to a clinical diabetes diagnosis. However, these markers only cover a small subset of molecular biomarkers linked to the disease. In this study, we aimed to profile a more comprehensive set of molecular biomarkers and explore their temporal association with incident diabetes. METHODS: We performed a targeted analysis of 54 proteins and 171 metabolites and lipoprotein particles measured in three sequential samples spanning up to 11 years of follow-up in 324 individuals with incident diabetes and 359 individuals without diabetes in the Danish Blood Donor Study (DBDS) matched for sex and birth year distribution. We used linear mixed-effects models to identify temporal changes before a diabetes diagnosis, either for any incident diabetes diagnosis or for type 1 and type 2 diabetes mellitus diagnoses specifically. We further performed linear and non-linear feature selection, adding 28 polygenic risk scores to the biomarker pool. We tested the time-to-event prediction gain of the biomarkers with the highest variable importance, compared with selected clinical covariates and plasma glucose. RESULTS: We identified two proteins and 16 metabolites and lipoprotein particles whose levels changed temporally before diabetes diagnosis and for which the estimated marginal means were significant after FDR adjustment. Sixteen of these have not previously been described. Additionally, 75 biomarkers were consistently higher or lower in the years before a diabetes diagnosis. We identified a single temporal biomarker for type 1 diabetes, IL-17A/F, a cytokine that is associated with multiple other autoimmune diseases. Inclusion of 12 biomarkers improved the 10-year prediction of a diabetes diagnosis (i.e. the area under the receiver operating curve increased from 0.79 to 0.84), compared with clinical information and plasma glucose alone. CONCLUSIONS/INTERPRETATION: Systemic molecular changes manifest in plasma several years before a diabetes diagnosis. A particular subset of biomarkers shows distinct, time-dependent patterns, offering potential as predictive markers for diabetes onset. Notably, these biomarkers show shared and distinct patterns between type 1 diabetes and type 2 diabetes. After independent replication, our findings may be used to develop new clinical prediction models.

Association between e-scooter temporal usage patterns with injuries resulting in admission to a level one trauma center.

BACKGROUND: As e-scooters have become common modes of transportations in urban environments, riding e-scooters has become a common mechanism of injury. This study examines the relationship between when riders are using these devices (i.e. day of week, and time of the day) and injury incidence based on data from a large U.S. city. METHODS: This study is a retrospective cohort study of patients in the trauma registry at a level one trauma center. Registry data were combined with a publicly available dataset of all e-scooter trips that occurred during the study period. Frequency of injuries and trips were analyzed using ANOVA. Poisson regressions were conducted to calculate incidence rate ratios associated with injury incidence by day of the week and time of day. RESULTS: A total of 194 injured e-scooter patients were admitted to the trauma center during the study period. Patients were injured most often on Fridays (21%) and most often presented between 18:00-23:59 (38%). E-Scooter riders in general, most often rode on Saturdays (20%) and between 12:00-17:59 (44%). There was no significant relationship between day of week and injury. Riders in the early morning (IRR = 16.7, p < .001 95% CI: 10.5, 26.6), afternoon (IRR = 2.0, p = .01 95% CI: 1.2, 3.4), and evening (IRR = 3.7, p < .001 95% CI: 2.3, 6.2) had significant increased injury incidence compared to morning riders. CONCLUSION: E-Scooter injury incidence varies by the time of day. The time of day in which a person rides an e-scooter can have a significant impact on the likelihood that the person will sustain an injury.

"Just forget about it and move on": Stillbirth ruptured and repaired narratives beyond expectant futures.

The critical sociological literature has explored social prescriptions on women's reproductive lives, trajectories, outcomes and aftermaths. However, little attention has been given to how these prescriptions are expressed through temporal negotiations. This article delves into the narratives of Jewish-Israeli women who have experienced stillbirths. In their narratives, these women contest expectations directed towards them in interactions with professionals, family and friends. Within these expectations, a form of dictation over their future comes into being, where a new pregnancy should quickly precede the stillbirth. The focus here lies on how these women navigate and contest these temporal expectations, carving out space for stillbirth as a meaningful and painful event that should be granted attention and for alternative forms of remembering their stillborn and caring for them after their death. They reshape their narratives through what I call "thickening a present tense" and extend care to the stillborn in the aftermath of the stillbirth. This work contributes to scholarly inquiries into reproductive life and probing time as a socially prescribed mechanism for the value and social distribution of care.

'I am just a shadow of who I used to be'-Exploring existential loss of identity among people living with chronic conditions of Long COVID.

Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being-in-the-world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard-to-express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly.

The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances.

BACKGROUND: The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. SUMMARY: Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space. KEY MESSAGE: This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.

What Is It Like to Be in Alcohol Addiction Recovery? A Dialectical Phenomenological Analysis.

INTRODUCTION: Currently, there is no scientific consensus on the concept of alcohol addiction recovery beyond substance use control. This conceptual issue challenges the implementation of therapeutic strategies and mental health policies that are unrestricted to symptomatic remission. Aiming to contribute to its definition, this study aimed to examine the recovery experience of individuals with alcohol addiction using dialectical phenomenological psychopathology (DPP) as a theoretical and methodological framework. METHODS: A dialectical phenomenological analysis was conducted through an examination of online interviews with eight Brazilian, São Paulo state citizens who were self-declared to be undergoing alcohol addiction recovery (or who declared that they had completely recovered). RESULTS: Participants' reports generated eight categories that were subdivided into two groups. The first group indicated experiential elements of recovery, such as changes in self-relation, changes in interpersonal relations, and changes in time relations, giving new meanings to suffering and alcohol use, and recovery as a continuous process. The second group referred to how the participants interpreted recovery according to their worldviews: as a spiritual experience, moral reformation, and mentality change. CONCLUSION: These categories can be understood through the lens of DPP as a process of change in the subjects' being in the world, characterized by the continued management of their existential imbalances in the dimensions of spatiality, temporality, selfhood, and intersubjectivity. The results are preliminary when it comes to conceptualizing recovery but may help future studies to develop recovery-oriented therapeutic strategies.

Temporal topic model for clinical pathway mining from electronic medical records.

BACKGROUND: In recent years, the discovery of clinical pathways (CPs) from electronic medical records (EMRs) data has received increasing attention because it can directly support clinical doctors with explicit treatment knowledge, which is one of the key challenges in the development of intelligent healthcare services. However, the existing work has focused on topic probabilistic models, which usually produce treatment patterns with similar treatment activities, and such discovered treatment patterns do not take into account the temporal process of patient treatment which does not meet the needs of practical medical applications. METHODS: Based on the assumption that CPs can be derived from the data of EMRs which usually record the treatment process of patients, this paper proposes a new CPs mining method from EMRs, an extended form of the traditional topic model - the temporal topic model (TTM). The method can capture the treatment topics and the corresponding treatment timestamps for each treatment day. RESULTS: Experimental research conducted on a real-world dataset of patients' hospitalization processes, and the achieved results demonstrate the applicability and usefulness of the proposed methodology for CPs mining. Compared to existing benchmarks, our model shows significant improvement and robustness. CONCLUSION: Our TTM provides a more competitive way to mine potential CPs considering the temporal features of the EMR data, providing a very prospective tool to support clinical diagnostic decisions.

Dealing With Temporality in Patients With Life-Limiting Disease: An International Qualitative Study.

The prospect of death influences people's thoughts about and how they deal with their remaining time. We aimed to understand whether patients with progressive, life-limiting diseases are oriented in the past, present, or future and how they deal with temporality. We conducted 57 in-depth interviews with end-of-life patients in 10 countries using thematic analysis at three levels (i.e., locally in three countries, with codes shared in the three-country subgroup, and in all 10 countries with a codebook that we developed). We found that the patients' thoughts were oriented toward all three time levels (i.e., past, present, and future). Complementing these levels, we identified another, namely, the future after death. Each time level included patients actively and passively dealing with their thoughts. Past themes were remorse and regret, nostalgia, and coming to terms with past choices; present themes were feeling grateful for being alive, a time for farewells, and living for the day; future themes were worries about the future, to miss out, hope, ideas about death and dying, and planning the near future; and future after death themes were not being there, worries about loved ones, and preparations for a future after death. A changed view on lifetime and avoidance of thinking about a certain time level related to several time levels, while desire to die fluctuated between levels and between acting on and feeling about it. Living for the day, worries about the future, and worries about the well-being of loved ones were common themes in all countries.

An analysis of time conceptualisations and good care in an acute hospital setting.

This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.

The role of temporality in adolescent refugees' sense of well-being.

Adolescent refugees confront a complex interplay of trauma arising from forced displacement, resettlement, and the challenges of transitioning from childhood to adulthood. Using photovoice methodology, this study engaged 14 Iraqi and Syrian adolescent refugees now residing in the United States with the aim to illuminate their well-being experiences. Our findings show that temporal continuities and discontinuities in adolescent refugees' lives contributed to their sense of well-being by helping satisfy their basic psychological needs for autonomy, competence, relatedness, and safety. Temporal continuities involved drawing upon past resources and formulating future career aspirations based on present experiences. Temporal discontinuities encompassed contrasting past and present and processing adversities endured. This study underscores that, beyond current circumstances, the interpretation of life experiences over extended timeframes influences the well-being of adolescent refugees.

The End of the Beginning? Temporality and Bioagency in Pandemic Research.

This paper deals with the ways in which the intellectual and political history of AIDS can assist in the chronological conceptualization of a pandemic such as COVID-19 as it is unfolding. It problematizes the idea of pandemic "beginnings" and "ends" to show that such definitions are shaped by the disciplinary location and thematic foci of relevant scholars. Central to this analysis is the notion that ethical and political contexts affect research on a pandemic in different ways at national and global levels at various points in its trajectory. The article develops this argument in relation to two main themes: firstly, with reference to the history of AIDS research in South Africa; secondly, with the philosophical concept of bioagency to understand the ways in which viruses and humans co-shape the course of epidemics over time. I first make the case for the development of historically informed, long-term ethnographic studies of COVID-19. Using bioagency as a point of departure to consider viruses as social actors, the essay then critiques the notion of bioinformationalism as catalyzing the widening accessibility of biomedical research. Instead, I discuss the biotechnology and pharmaceutical industries as protagonists in the operation of biocapital. I argue that the history of AIDS in South Africa can provide methodological and theoretical insights into how to interpret an unfolding epidemic, outlining an ambitious transdisciplinary research agenda for thinking about the temporality of a pandemic spanning the different, interconnected, scales of life.

Pain and temporality: a merleau-pontyian approach.

Chronic pain is a common disorder with enormous sociomedical importance. A major part of primary and secondary costs of illness is caused by the various pain syndromes. Nociception - the sensory perception of a painful stimulus - is a complex process relying on an intricate system of anatomical, neurophysiological and biochemical networks. This applies even more so to pain - the state of experiencing a nociceptive event, of interpreting it in terms of meaning for the affected individual and of suffering a range of emotions it elicits. This intricacy renders it obvious, that the empirical medical sciences alone cannot explain all aspects of pain. Hence, it has also become a focus of phenomenological research. One aspect of these investigations is the interaction of pain and the perception of the lived body's spatiality. The focus of this article will build on these concepts to develop a construct of the alteration of temporality caused by chronic pain and the effects this spells out for the affected subject. To this end, I will primarily draw on Merleau-Ponty's ideas of the lived body as well as on theories of enactivism and embodiment. I will also point out parallels to neuroscientific data, thereby demonstrating the proximity of phenomenology and neuroscience. A possible partial solution to the pain dilemma may be derived from psychology: techniques relying on cognitive behavioural intervention, awareness training, and existential analysis may provide alleviation to patients suffering from chronic pain.

Generations, events, and social movement legacies: Unpacking social change in English football (1980-2023).

This article critically employs the case of association football in England, from 1980 to 2023, as a social movement timescape, to examine the political consciousness and long-term mobilisations of a generation of football supporter activists, and their capacity to influence politics, and respond to new, emerging, critical junctures, through networks of trust and shared memories of historical events. This is of crucial importance to sociology because it reveals the tensions between what are considered legitimate and illegitimate social practices which characterise contemporary society's moral economy. Focusing on temporal contestations over regulation, policing, governance and cultural rituals, the article deconstructs the role of generations in social movements, and critically synthesises relational-temporal sociology and classic and contemporary work on the sociology of generations, to show how legacy operates as a multifaceted maturing concept of power and time. In English football's neoliberal timescape, the supporters' movement has reached a critical juncture; the future will require a new generation of activists, to negotiate, resist and contest the new hegemonic politics of social control and supporter engagement.

A matter of time: auxin signaling dynamics and the regulation of auxin responses during plant development.

As auxin is a major regulator of plant development, studying the signaling mechanisms by which auxin influences cellular activities is of primary importance. In this review, we describe current knowledge on the different modalities of signaling, from the well-characterized canonical nuclear auxin pathway, to the more recently discovered or re-discovered non-canonical modes of auxin signaling. In particular, we discuss how both the modularity of the nuclear auxin pathway and the dynamic regulation of its core components allow specific transcriptomic responses to be triggered. We highlight the fact that the diversity of modes of auxin signaling allows for a wide range of time scales of auxin responses, from second-scale cytoplasmic responses to minute-/hour-scale modifications of gene expression. Finally, we question the extent to which the temporality of auxin signaling and responses contributes to development in both the shoot and the root meristems. We conclude by stressing the fact that future investigations should allow an integrative view to be built not only of the spatial control, but also of the temporality of auxin-mediated regulation of plant development, from the cell to the whole organism.

Dissociation and Temporality in Substance Abuse: A Clinical Phenomenological Overview.

The term "dissociation" encompasses a wide array of symptoms and phenomena, all sharing the common characteristic of involving altered states of consciousness where an individual temporarily loses the sense of continuity of their own identity. In the context of addiction pathology, however, the dissociative paradigm remains a topic of ongoing debate. It fluctuates between the description of individual dissociative symptoms and the notion of post-traumatic dissociation as a structural process. This process involves fragmentation that extends beyond the confines of perception and experience within a singular moment, instead ensuring a persistent discontinuity of the self throughout one's existence. Pathological addiction stresses the question of the donation of sense in this deep and dramatic experience; it situates individuals within a compressed and constricted realm of vital space, alongside a frozen perception of time. Within this context, every emotion, sensation, and comprehension becomes impaired. Consequently, we have embarked on a journey starting with a historical analysis: the aim was to construct an elucidative framework for the dissociative paradigm in the context of addiction. This involves an in-depth exploration of the fundamental constructs of trauma and temporality, examined through the lens of phenomenological perspective.

"As If There Are Two of Us": The Battle of Borderline Personality Disorder Diagnosis in Lived Time.

BACKGROUND: Although the experience of reception of borderline personality disorder (BPD) diagnosis was previously researched, the process of mental adjustment to this diagnosis remains both empirically and theoretically unexplored. Theoretical concepts describing the structure of lived time in borderline patients, which underlies adjustment to diagnosis, living with the diagnosis, and recovery from the disorder, namely, immediacy and instantaneity are not empirically verified. AIM: This study aimed to phenomenologically describe the process of mental adjustment to the diagnosis of BPD and to uncover its underlying temporal structure. METHODS: Semi-structured phenomenological interviews based on Giorgi's descriptive phenomenological psychological method and Cottle's Circles Test. The participants were 10 white, adult women diagnosed with BPD aged 20-32 years. RESULTS: The process of adjustment to BPD diagnosis comprises three following stages: (1) a cumulative feeling of inadequacy preceding the diagnosis, (2) the outburst of diagnosis, (3) a battle of Self fragments while adjusting to the diagnosis. Simultaneously, the diagnosis modifies the relationship between the self and illness in a way that previously scattered problematic issues become inscribed into the self as symptoms. At the same time, these symptoms are relatively separated from its "healthy" part. The temporal structure underlying this process is discontinuous. Particular temporal dimensions are distanced from one another, and the inner images of the past and present consist of unconnected, emotional peaks. The present resembles waking up from the lethargy of the past, while the future consists of two colliding scenarios - either being free of or in control of symptoms. CONCLUSION: Clinicians should pay more attention to the pathway of identification with BPD diagnosis and its underlying temporality. This is crucial for recovery and may allow adjusting therapeutic interventions to the patients' needs. Treatment should aim to enhance the patients' abilities to reflect upon their temporal experience to merge their fragmented narrative identity and better situate them in the recovery process.

Temporal Belonging: Loss of Time and Fragile Attempts to Belong with Alzheimer's Disease.

Building on 12 months of ethnographic fieldwork among people with Alzheimer's disease living in Denmark, I argue that the loss of a sense of time caused by Alzheimer's is not a subjective loss, but rather an intersubjective one. Alzheimer's disease entails living with desynchronized rhythms, time that can be made painfully explicit, and numbers becoming increasingly tricky to manage. Drawing on Thomas Fuchs' theory of how individuals live in "basic contemporality," I explore moments of temporal rupture, and how people with Alzheimer's challenge their social relations due to their different sense of time. The article contributes to ongoing discussions about belonging. Taking inspiration from Tine Gammeltoft's description of how belonging entails fragile attempts at being part of something larger, and is thus a joint social practice, I show how one dimension of belonging's fragility is the inability to be in synch with social time. By proposing the notion of temporal belonging, I suggest that sustaining a sense of belonging is also about being able to participate in the rhythms and tempo of social life.

Time in the State of Dementia Caregiving in South Korea: When Care Becomes (Non-)Waiting.

Exploring how time emerges as a central problem for lone family caregivers of people with dementia, this article draws attention to care as a way of being in time with others. In addition to active doings that are oriented toward achieving goods that have drawn much attention in recent anthropological discussion on care, care of an intimate other often entails the state of being for the caregiver on which another person's way of being in the present heavily relies. Examining how time is experienced among caregivers who strive to live in the dyadic world of home-based dementia care in South Korea, I consider care as (non-)waiting both in the long term, anticipating the end of the state of caregiving, and in everyday life anticipating small and large fluctuations and interruptions. In the state of caregiving, time is experienced as tense, repetitive, and chronic, which needs to be endured in order for an intimate other to be within the family. Lone caregivers' accounts of the overwhelming weight of care-time both allow and demand us to consider care as a way of being in time with the other, and attend to the experiences of lived time constituted by the difficult intersubjective relationship and its effects on the possibility of having a sense of the near future. This article calls for attention to caregiving as a state in which temporalization becomes challenging, if not impossible.

Corpses in Clinical Space and the Preposterous Temporality of Pandemic Care.

Articulations of the chasm between ideal and attainable forms of care surfacing throughout the coronavirus (COVID-19) pandemic have highlighted the proliferation of unceremonious deaths associated with inequitable conditions. This paper reconsiders the preposterous temporality of pandemic care by following corpses in and out of clinical space. Written from the perspective of a MD/PhD student's encounter with a corpse replacing the patient on the medicine ward prior to pandemic onset, this paper asks how corpses might interrupt narratives of clinical care. Sifting through Eugène Ionesco's 1954 play "Amédée," Édouard Glissant's rejection of the tragic heroine, Achille Mbembe's positing of viscerality as autopsy, and David Marriott's theorization of blackness as corpsing among other engagements, I conceptualize how corpses might refigure clinical spaces as preposterous realms wherein distinctions between a before and after falter. Considering the continuities between an apparent before and after, I argue that the contemporary concerns punctuating the pandemic as a unique period in time might not be as contemporary as they first appear. Taking cues from literary analysis and fictional works, I engage the corpse as a figure that prompts a rethinking of what might constitute ideal as well as failed care. I argue that corpses in clinical space signal a critique of the ideal narrative arc, one that centers the medical provider as heroine/hero in the midst of tragedy. Turning to the corpse as an interruptive figure, I ask what this dominant narrative might ultimately demand of its cast of characters-protégé, provider, and patient.

Recalibrating Everyday Futures during the COVID-19 Pandemic: Futures Fissured, on Standby and Reset in Mass Observation Responses.

This article contributes to sociologies of futures by arguing that quotidian imaginations, makings and experiences of futures are crucial to social life. We develop Sharma's concept of recalibration to understand ongoing and multiple adjustments of present-future relations, focusing on how these were articulated by Mass Observation writers in the UK during the early part of the COVID-19 pandemic. We identify three key modes of recalibration: fissure, where a break between the present and future means the future is difficult to imagine; standby, where the present is expanded but there is an alertness to the future, and; reset, where futures are modestly and radically recalibrated through a post-pandemic imaginary. We argue for sociologies of futures that can account for the diverse and contradictory ways in which futures emerge from and compose everyday life at different scales.