bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporomandibular disorder as risk factor for radiation‐induced trismus in patients with head and neck cancer
Authors: Pauli Nina , Fagerberg Mohlin Bodil , Mejersjö Christina , Finizia Caterina
Published: November 2021

Objectives

The aim of this study was to investigate if patients with temporomandibular disorders (TMD) prior to head and neck cancer (HNC) treatment are at higher risk of developing trismus after oncological treatment.

Materials and Methods

Eighty‐three study patients underwent detailed dental examination prior oncological treatment and 6 months after radiotherapy completion, including evaluation of temporomandibular jaw function, palpation of the jaw muscles, and measurement of mouth opening capacity. TMD criteria were based on both clinical examination findings and patient‐reported symptoms. TMD at baseline was used in regression analysis in order to predict restricted mouth opening.

Results

At the 6 months follow‐up more than a third of the patients (35%) were examined with reduced mouth opening of >20% compared to baseline. A majority of the patients had bilateral tenderness of both the temporal and the masseter muscle. At the 6 months follow‐up, 42% of the study patients reported mouth opening problems. About one‐third of the patients suffered from fatigue and stiffness of the jaw as well as pain when mowing the jaw. Two questions from the validated symptom‐specific Gothenburg Trismus Questionnaire were found to be related to a statistically significant increased risk of restricted mouth opening after radiotherapy; “During the last week, have you felt: Pain on moving the jaw?” (OR [95% CI] 5.9 (1.2–29.4) [p = 0.030]) and “During the last week, have you felt pain and tenderness in the muscles of mastication?” (OR [95% CI] 5.90 [1.19–29.40] [p = 0.030]).

Conclusions

TMD is common amongst HNC patients. Patients who suffer from pain in the jaw muscles and pain when moving the jaw before start of treatment are at higher risk of radiation‐induced trismus after 6 months. Clinicians should strive for optimizing the patients pain treatment and oral health before, during, and after radiotherapy.
Phenotypic heterogeneity of COVID‐19 pneumonia: clinical and pathophysiological relevance of the vascular phenotypea
Authors: Bertini Matteo , D'Aniello Emanuele , Di Ienno Luca , Gibiino Federico , Tavazzi Guido , Volta Carlo Alberto , Contoli Marco , Papi Alberto , Campo Gianluca , Ferrari Roberto , Rapezzi Claudio
Published: November 2021

Recent data support the existence of a distinctive ‘vascular’ phenotype with the involvement of both pulmonary parenchyma and its circulation in COVID‐19 pneumonia. Its prompt identification is important for the accurate management of COVID‐19 patients. The aim is to analyse the pro and contra of the different modalities to identify the ‘vascular’ phenotype. Chest computed tomography scan and angiogram may quantify both parenchyma and vascular damage, but the presence of thrombosis of pulmonary microcirculation may be missed. Increased d‐dimer concentration confirms a thrombotic state, but it cannot localize the thrombus. An elevation of troponin concentration non‐specifically reflects cardiac injury. Echocardiogram and electrocardiogram provide specific signs of right ventricular pressure overload. This is particularly relevant for the ‘vascular’ phenotype, which does not necessarily represent the result of thrombo‐embolic venous complications, but more frequently, it is the result of pulmonary microcirculation thrombosis in situ and needs immediate therapeutic action.

Condensed abstract

Despite diagnosis of the ‘vascular’ phenotype of COVID‐19 pneumonia may be subtle, the evidence indicates a reasonable possibility of identifying it already in the initial stage of the infection. Chest computed tomography scan and angiogram, increased d‐dimer concentration, and elevation of troponin concentration may be not sufficient to identify ‘vascular’ phenotype. Echocardiogram and electrocardiogram provide specific signs of right ventricular pressure overload. This is particularly relevant for the ‘vascular’ phenotype, which does not necessarily represent the result of thrombo‐embolic venous complications, but more frequently, it is the result of pulmonary microcirculation thrombosis in situ and needs immediate therapeutic action.
IoT‐assisted irregular environmental event determination for health analysis of pregnant females
Authors: Manocha Ankush
Published: November 2021

Indoor environment pollution is one of the significant concerns related to the individual's health of every category. As a majority of the population is spending their time indoors, the research on environment monitoring is realized on priority. In this research, the correlation between the indoor environment and health is determined to predict the health severity of pregnant females in real‐time. The proposed solution employs IoT‐enabled smart sensors for data acquisition. The accumulated data is processed over the fog‐cloud platform for data quantification. To classify the irregular events from the processed data, the machine learning‐assisted Weighted‐Naïve Bayes (W‐NB) classification technique is deployed on the fog layer. Furthermore, a deep learning‐inspired multilayered convolutional neural network‐long short‐term memory (M‐CNN‐LSTM) model is proposed to determine the scale of health severity. Moreover, a two‐phased alert generation mechanism is proposed to deal with the case of a medical emergency by generating notifications to the concerned medical specialists. The performance of the system is validated by performing several experimental simulations over the environmental and health datasets comprised of nearly 38 356 instances. The performance of the proposed solution is evaluated in terms of event classification, severity prediction, temporal delay efficiency, and overall performance stability. The calculated outcomes registered considerable performance over the several state‐of‐the‐art decision‐making approaches.
Causation, not collinearity: Identifying sources of bias when modelling the evolution of brain size and other allometric traits
Authors: Walmsley Sam F. , Morrissey Michael B.
Published: November 2021

Many biological traits covary with body size, resulting in an allometric relationship. Identifying the evolutionary drivers of these traits is complicated by possible relationships between a candidate selective agent and body size itself, motivating the widespread use of multiple regression analysis. However, the possibility that multiple regression may generate misleading estimates when predictor variables are correlated has recently received much attention. Here, we argue that a primary source of such bias is the failure to account for the complex causal structures underlying brains, bodies, and agents. When brains and bodies are expected to evolve in a correlated manner over and above the effects of specific agents of selection, neither simple nor multiple regression will identify the true causal effect of an agent on brain size. This problem results from the inclusion of a predictor variable in a regression analysis that is (in part) a consequence of the response variable. We demonstrate these biases with examples and derive estimators to identify causal relationships when traits evolve as a function of an existing allometry. Model mis-specification relative to plausible causal structures, not collinearity, requires further consideration as an important source of bias in comparative analyses.
Quality of life, mood, and cognitive performance in older adults with cognitive impairment during the first wave of COVID 19 in Argentina
Authors: Aragón Irina , Flores Ignacio , Dorman Guido , Rojas Galeno , Sierra Sanjurjo Natalia , O’Neill Santiago
Published: November 2021

Background and Objectives

In Argentina, government has established lockdown on 19 March 2020 to decrease SARS‐COV‐2 infection. The study aim was to understand how mandatory quarantine imposed due to COVID‐19 pandemic has affected quality of life, mood, and cognitive performance of older adults with cognitive impairment.

Design

Longitudinal descriptive–observational study.

Participants

Patients with cognitive impairment attending to online cognitive training sessions.

Measurements

Participants have completed by themselves Quality of Life in Alzheimer's Disease scale (QOL‐AD), Beck Depression Inventory (BDI‐II), Test your Memory (TYM), and an attention and executive task created by our institution. Same assessments were done at the beginning of the lockdown and 7 months later.

Results

Fifty‐one adults were included. An increase in BDI‐II score (p = 0.049) and worse performance in one of the executive attention tests (p = 0.012) have been found. No significant differences in QOL‐AD, TYM, verbal fluency, or memory tests total scores have been observed. Reviewing scales subitems, differences in changes in sleep habits (p = 0.021), energy level decrease (p = 0.004), worse subjective record of memory capacity (p = 0.028), and decrease in ability to do housework (p = 0.007) have been shown. In those who lived alone, BDI and TYM higher scores in BDI‐II (p = 0.030) (p = 0.022) have been found.

Conclusion

Mandatory quarantine imposed due to COVID‐19 pandemic was associated with worsening of mood, some quality‐of‐life variables, and decrease in attention in older adults with cognitive impairment in Argentina.
Complexity offering opportunity: Mutual learning between Zhejiang Geely Holding Group and Volvo Cars in the post‐acquisition process
Authors: Jonsson Anna , Vahlne Jan‐Erik
Published: November 2021

Research Summary

While much of the literature on complex global environments builds on studies of multinationals from mature markets, little is known about how firms from emerging markets understand and cope with complexity. This paper builds on a longitudinal case study of Zhejiang Geely Holding Group (ZGH) in the post‐acquisition process of Volvo Car Group (VCG) and its efforts to learn how to learn in order to catch up with the internationalization process as means for developing capabilities and compete in the global automotive industry. Building on the Uppsala model, we contribute with insights how an emerging market multinational understands complexity and organize the post‐acquisition process to explicitly emphasize the importance of mutual learning to develop and exploit opportunities to improve the business.

Managerial Summary

A key finding is that ZGH doesnotunderstand complexity only as a risk that should be coped with, managed and controlled—following the western idea of risk management—but also as an opportunity for learning. While the importance of knowledge management and organizational learning is often emphasized as a means to achieve competitive advantage, it is seldom as easily managed in practice. Building on insights from ZGH we illustrate that to enable knowledge development and mutual learning, top‐management from the acquiring firm needs to emphasize learning and trust the acquired firm rather than controlling it. It is equally important that the acquired firm trust the intentions of the new owner and reflect on the interest in learning—not least to improve and remain valuable.
Pay for beauty? A contingent perspective of CEO facial attractiveness on CEO compensation
Authors: Li Mingxiang , Triana María del Carmen , Byun Seo‐Young , Chapa Olga
Published: November 2021

The physical attractiveness stereotype maintains that what is beautiful is good. Does this also apply to Chief Executive Officers (CEOs) and influence their compensation? There are numerous debates on CEO compensation, and scholars have long been interested in understanding the factors that impact CEO compensation. Of the empirical studies investigating the antecedents of CEO compensation, little attention has been paid to CEO facial attractiveness. Drawing mainly from the physical attractiveness stereotype, we argue that CEO attractiveness increases CEO compensation, and the effect becomes stronger when the CEO has worked as a CEO in other firms, but weaker when the CEO is female or works for a high‐technology firm. We tested our hypotheses by coding facial attractiveness for all CEOs in S&P 500 firms over 10 years (861 CEOs and 4,395 firm‐year observations). Results partly support our predictions and show that the effect of CEO facial attractiveness on compensation is not only robust but also economically significant. Moderating effects were found using prior CEO experience and high tech industry as moderators. However, we found no moderating effect of CEO gender on the relationship between CEO facial attractiveness and compensation. This study suggests that CEO compensation is not an entirely rational process, and compensation committees appear to be biased in favor of beautiful individuals.
Emotion identification by dynamic entropy and ensemble learning from electroencephalogram signals
Authors: Ashokkumar S. R. , Anupallavi S. , MohanBabu G. , Premkumar M. , Jeevanantham V.
Published: November 2021

Emotions are biologically based psychological states brought on by neurophysiologic changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. In order to assure active collaboration and trigger appropriate emotional input, accurate identification of human emotions is important. Poor generalization capacity induced by individual variations in emotion perceptions is indeed a concern in the current methods of emotion recognition. This work proposes a new dynamic pattern learning system based on entropy to allow electroencephalogram (EEG) signals for subject‐independent emotion recognition with strong generalization and classification through Recurrent Neural Network and Ensemble learning. First, dynamic entropy measurements are used to derive consecutive entropy values over time from EEG signals in quantitative EEG calculations. Experiment findings indicate that in order to distinguish negative and positive emotions, the highest average accuracy of 94.67% is achieved. In addition, the findings have completely shown that this approach produces outstanding performance for emotion detection across individuals relative to recent studies.
Pharmacists role in addressing health disparities—Part 1: Social determinants of health and their intersectionality with medication use, health care utilization, and health outcomes
Authors: Osae Sharmon P. , Chastain Daniel B. , Young Henry N.
Published: November 2021

Health disparities or extreme gaps of health care across different groups of people are resulting in consequences for many Americans today. Pharmacists have an opportunity to play an important role in addressing health disparities across many populations. Contextualizing root causes of gaps in health care and outcomes and identifying potential solutions to address those root causes are important initial steps pharmacists can take to combat health disparities. In part 1 of this narrative review, social determinants of health (SDOH) are discussed to provide a framework for understanding health disparities highlighting the interconnectivity between SDOH, medication use, and health care utilization and outcomes. In part 2, recommendations for actionable interventions to pursue health equity are provided. PubMed and Web of Science were searched to identify articles published from inception until May 9, 2021. Articles in English were screened by title and abstract for relevance to pharmacists' involvement in addressing health disparities. References from identified journal articles were also screened to identify further relevant articles. Identifying potential solutions to address health disparities requires an understanding of contributing factors affecting gaps in health care and outcomes. Pharmacists are uniquely positioned to lead the charge in transforming current health systems to create a reduction of health disparities within our societies.
Guidance for emergency medicine pharmacists to improve care for people with opioid use disorder
Authors: Kelsch Jordan R. , Bailey Abby M. , Baum Regan A. , Metts Elise L. , Weant Kyle A.
Published: November 2021

The Emergency Medicine Pharmacist (EMP) is uniquely trained to play a vital role in the management of patients who use opioids and patients with opioid use disorder (OUD). The emergency department (ED) is at the forefront of the opioid epidemic, as it serves as a primary place of treatment for patients experiencing opioid overdose, opioid withdrawal, and other complications related to opioid use. Given the size of the epidemic and the limited availability of treatment facilities and providers, the ED provides an opportunity to meet the needs of this patient population. Emergency Medicine Pharmacists can take an active role in the expansion of access to treatment of OUD, overdose education and prevention, and harm‐reduction interventions. Emergency Medicine Pharmacists have the ability to identify patients who would benefit from therapy, initiate appropriate treatment, provide patient counseling and education, lead the development of institution‐specific protocols and clinical decision tools, and assist in the evaluation of current strategies at their institution. Emergency Medicine Pharmacists' knowledge and understanding of the pharmacology of the drugs used to treat OUD is unique and should be utilized to improve patient care for this population. Further, EMPs are poised to limit the emergence of OUD before it begins through the implementation of opioid stewardship activities both within the ED and upon discharge. This article seeks to review the ways in which EMPs can support efforts in the ED to improve the care of people with OUD.
Clinical genetic counselor experience in the adoption of telehealth in the United States and Canada during the COVID‐19 pandemic
Authors: Ma Daria , Ahimaz Priyanka R. , Mirocha James M. , Cook Lola , Giordano Jessica L. , Mohan Pooja , Cohen Stephanie A.
Published: November 2021

The COVID‐19 pandemic has significantly impacted the service delivery model (SDM) of clinical genetic counseling across the United States and Canada. A cross‐sectional survey was distributed to 4,956 genetic counselors (GCs) from the American Board of Genetic Counselors and Canadian Association of Genetic Counselors mailing lists in August 2020 to assess the change in utilization of telehealth for clinical genetic counseling during the COVID‐19 pandemic compared with prior to the pandemic. Data from 411 eligible clinical genetic counselors on GC attitudes and their experiences prior to and during the pandemic were collected and analyzed to explore the change in SDM, change in appointment characteristics, change in billing practices, GC perceived benefits and limitations of telehealth, and prediction of future trends in SDM in the post‐pandemic era. The study showed the overall utilization of audiovisual and telephone encounters increased by 43.4% and 26.2%, respectively. The majority of respondents who provided audiovisual and telephone encounters reported increased patient volume compared with prior to the pandemic, with an average increase of 79.4% and 42.8%, respectively. There was an increase of 69.4% of GCs rendering genetic services from home offices. The percentage of participants who billed for telehealth services increased from 45.7% before the pandemic to 80.3% during the pandemic. The top GC perceived benefits of telehealth included safety for high‐risk COVID patients (95.2%) and saved commute time for patients (94.7%). The top GC perceived limitations of telehealth included difficulty to conduct physician evaluation/coordinating with healthcare providers (HCP) (73.7%) and difficulty addressing non‐English speaking patients (68.5%). Overall, 89.6% of GCs were satisfied with telehealth; however, 55.3% reported uncertainty whether the newly adopted SDM would continue after the pandemic subsides. Results from this study demonstrate the rapid adoption of telehealth for clinical genetic counseling services as a result of the COVID‐19 pandemic, an increase in billing for these services, and support the feasibility of telehealth for genetic counseling as a longer term solution to reach patients who are geographically distant.
Redefining the high‐grade B cell lymphoma with double/triple rearrangements of MYC and BCL2/BCL6 genes. Learning from a case report
Authors: Rodríguez‐Pinilla Socorro María , Salgado Rocío Nieves , Chamizo Cristina , Santonja Carlos , Stewart Peter , Carvajal Nerea , McCafferty Neil , Manso Rebeca , Morillo Daniel , Piris Miguel Ángel , González de Castro David
Published: November 2021

We report a patient initially diagnosed with a triple hit high‐grade B cell lymphoma (HGBL‐TH), in which further morphologic, immunohistochemical, and next‐generation sequencing studies of subsequent specimens disclosed it to be a germinal center diffuse large B cell lymphoma (GC‐DLBCL) with BCL2/BCL6 gene translocations, PVT1‐deletion, and gain of MYC genes evolving from a previous follicular lymphoma. However, fluorescence in situ hybridization (FISH) studies with the break‐apart probe for MYC gene showed a fusion and two separated signals (red and green, respectively) leading to the interpretation of MYC gene translocation and a false diagnosis of a TH‐lymphoma, according to the recent WHO classification. Nevertheless, PVT1 deletion plus MYC gain/amplification has been described as a cause of the double‐hi transcription profile. These data highlight the need for new criteria to identify these highly aggressive lymphomas.
PAD4 controls chemoattractant production and neutrophil trafficking in malaria
Authors: Cela Drinalda , Knackstedt Sebastian Lorenz , Groves Sarah , Rice Christopher M , Kwon Jamie Tae Wook , Mordmüller Benjamin , Amulic Borko
Published: November 2021

Peptidylarginine deiminase 4 (PAD4) is a key regulator of inflammation but its function in infections remains incompletely understood. We investigate PAD4 in the context of malaria and demonstrate a role in regulation of immune cell trafficking and chemokine production. PAD4 regulates liver immunopathology by promoting neutrophil trafficking in a Plasmodium chabaudi mouse malaria model. In human macrophages, PAD4 regulates expression of CXCL chemokines in response to stimulation with TLR ligands and P. falciparum. Using patient samples, we show that CXCL1 may be a biomarker for severe malaria. PAD4 inhibition promotes disease tolerance and may represent a therapeutic avenue in malaria.
Multicentric Study on High‐Frequency Ultrasound Characterization of Calcium Deposits in Dermal and Subcutaneous Calciphylaxis and Calcinosis
Authors: Gamissans Marta , Giavedoni Priscila , Roe Esther , Sánchez Julia , Quintana‐Codina Monica , Garbayo‐Salmons Patricia , Vidal David , Riera‐Martí Núria , López‐Llunell Cristina , Romaní Jorge , Wortsman Ximena
Published: November 2021

Objectives

Calcium depositions are frequent in multiple inflammatory dermatosis, they can be explored by ultrasound (US) but the patterns of these depositions have not yet been described. The aim of this study is to describe different patterns of calcium deposition in inflammatory dermatoses.

Methods

The clinical and US data of 58 patients from 7 different centers with inflammatory dermatosis showing ultrasonography‐detected calcium depositions was retrospectively reviewed.

Results

Dystrophic calcinosis represented 86.2%, calciphylaxis 8.6%, and metastatic calcinosis 5.2%. Three different sonographic patterns of calcium deposition were found: 1) thin hyperechoic bands, parallel to the surface of the epidermis, generating a strong and wide posterior acoustic shadow; 2) hyperechoic spots or lumps with a narrow acoustic shadow; and 3) a linear hyperechoic band parallel to the walls of a blood vessel with also a narrow acoustic shadow. The predominant pattern in metastatic calcifications was type 1, in dystrophic calcifications type 2, and in calciphylaxis type 3. In dystrophic calcinosis, cutis deposits were longer and wider than in calciphylaxis (P < .05).

Conclusion

New data on inflammatory dermatoses with calcium deposition may be useful for the diagnosis and monitoring of calcium deposits and could avoid the performance of more invasive tests, such as a skin biopsy.
Composite Hydrogels of Alkyl Functionalized Gellan Gum Derivative and Hydroxyapatite/Tricalcium Phosphate Nanoparticles as Injectable Scaffolds for bone Regeneration
Authors: Pitarresi Giovanna , Palumbo Fabio Salvatore , Fiorica Calogero , Bongiovì Flavia , Martorana Annalisa , Federico Salvatore , Chinnici Cinzia Maria , Giammona Gaetano
Published: November 2021

An alkyl functionalized gellan gum derivative is here used to produce hydrogels containing hydroxyapatite and tricalcium phosphate nanoparticles as injectable nanostructured scaffolds for bone regeneration. The amphiphilic nature of the polysaccharide derivative along with its thermotropic behavior and ionotropic crosslinking features make possible to produce injectable bone mimetic scaffolds that can be used to release viable cells and osteoinductive biomolecules. The influence of different nanoparticles concentration on the rheological and physicochemical properties of the injectable systems is studied. It is found that the presence of inorganic nanoparticles reinforces the 3D hydrated polymeric networks without influencing their injectability but improving the physicochemical properties of ionotropic crosslinked hydrogels produced with two different curing media. Preliminary cytocompatibility tests performed with murine preosteoblast cells revealed that gellan gum based hydrogels can safely encapsulate viable cells. Loading and release experiments for dexamethasone and stromal cell‐derived factor‐1 demonstrate the drug delivery features of the obtained injectable systems.
Popping the Champagne
Authors: Wich Scott
Published: November 2021

No image captures the celebration of the end of another year as much as a frosty bottle of champagne set against a backdrop of celebration and revelry. New Years' Eve toasts are a common bond for individuals, coming together, to be optimistic about the future. Every December, thousands of bottles of champagne ring in optimism for the new year.
Weighted Hardy–Sobolev inequality and global existence result of thermoelastic system on manifolds with corner‐edge singularities
Authors: Koozehgar Kalleji Morteza
Published: November 2021

This article concerns with the thermoelastic corner‐edge‐type system with singular potential function on a wedge manifold with corner singularities. First, we introduce weighted p‐Sobolev spaces on manifolds with corner‐edge singularities. Then, we prove the corner‐edge‐type Sobolev inequality, Poincar
inequality and Hardy inequality and obtain some results about the compactness of embedding maps on the weighted corner‐edge Sobolev spaces. Finally, as an application of these results, we apply the potential well theory and the Faedo–Galerkin approximations to obtain the global weak solutions for the thermoelastic corner‐edge‐type system 1.1.
Black Freedom, Black Markets: Notes on New Orleans Black Masking Indian Tradition
Authors: Perry Marc D.
Published: November 2021

This article explores some of the complexities between Black beauty, alterities of Black possibility, and oppositional refusal on one hand, and Black vulnerability—if not expendability—on the other as lived among members of New Orleans Black Masking Indian community vis‐à‐vis the city’s tourist‐driven cultural economy. At center sits a dichotomy of Blackness that figures some African American New Orleanians as commercially assimilable and therefore valued Black subjects, and those otherwise deemed un‐assimilable and hence ultimately dispensable. Amid such bifurcated economies of desire/disposability generative of a kind of “contractual Blackness,” some Black Masking members craft entrepreneurial strategies through which local African American cultural traditions serve as currencies that afford entry to a raced marketplace otherwise largely inaccessible. While such creative agencies suggest a critical foregrounding of Black subjects rather than simple objects of market consumption, they also appear to underscore some of the ambiguities, if not enduring vulnerabilities of Black refusal and its liberatory promise amid the current moment.
Relationship between public sector reforms and culture: The implementation of NPM‐related performance management reforms in a collectivist and risk averse culture
Authors: Ugyel Lhawang
Published: November 2021

As performance management reforms gain traction worldwide, their implementation, however, has demonstrated mixed results. This trend is visible in the manner countries have adopted and implemented New Public Management (NPM)‐related public sector reforms that are based on the neo‐classical and business models of organisation and management. Experiences in various countries demonstrate that the inherent individualistic aspects of NPM‐related performance management do not suit the context of countries with a collective culture. The introduction of a series of NPM‐related performance management reforms introduced to Bhutan’s civil service over the last 15 years explores the relationship between public sector reforms and culture. This article highlights the challenges faced in the implementation of performance management reforms in Bhutan’s collectivist and risk averse culture. Bhutan’s experience in the implementation of NPM‐related reforms provide an insightful lesson for other countries with similar culture and context.
US emergency department visits for acute harms from over‐the‐counter cough and cold medications, 2017–2019
Authors: Mital Rohan , Lovegrove Maribeth C. , Moro Ruth N. , Geller Andrew I. , Weidle Nina J. , Lind Jennifer N. , Budnitz Daniel S.
Published: November 2021

Background and Purpose

Characterization of emergency department (ED) visits for acute harms related to use of over‐the‐counter cough and cold medications (CCMs) by patient demographics, intent of CCM use, concurrent substance use, and clinical manifestations can help guide prevention of medication harms.

Methods

Public health surveillance data from the National Electronic Injury Surveillance System‐Cooperative Adverse Drug Event Surveillance project were used to estimate numbers and population rates of ED visits from 2017 to 2019.

Results

Based on 1396 surveillance cases, there were an estimated 26 735 (95% CI, 21 679‐31 791) US ED visits for CCM‐related harms annually, accounting for 1.3% (95% CI, 1.2–1.5%) of all ED visits for medication adverse events. Three fifths (61.4%, 95% CI, 55.6–67.2%) of these visits were attributed to non‐therapeutic CCM use (nonmedical use, self‐harm, unsupervised pediatric exposures). Most visits by children aged <4 years (74.0%, 95% CI, 59.7–88.3%) were for unsupervised CCM exposures. Proportion hospitalized was higher for visits for self‐harm (76.5%, 95% CI, 68.9–84.2%) than for visits for nonmedical use (30.3%, 95% CI, 21.1–39.6%) and therapeutic use (8.8%, 95% CI, 5.9–11.8%). Overall, estimated population rates of ED visits for CCM‐related harms were higher for patients aged 12–34 years (16.5 per 100 000, 95% CI, 13.0–20.0) compared with patients aged <12 years (5.1 per 100 000, 95% CI, 3.6–6.5) and ≥ 35 years (4.3 per 100 000, 95% CI, 3.4–5.1). Concurrent use of other medications, illicit drugs, or alcohol was frequent in ED visits for nonmedical use (61.3%) and self‐harm (75.9%).

Conclusions

Continued national surveillance of CCM‐related harms can assess progress toward safer use.
Cooperative deterministic learning and formation control for underactuated USVs with prescribed performance
Authors: He Shude , Dong Chao , Dai Shi‐Lu , Zou Tao
Published: November 2021

In this article, we aim to address the problem of cooperative learning from adaptive neural formation control for a group of underactuated unmanned surface vehicles (USVs) with modeling uncertainties, where the formation errors are subject to prescribed performance constraints. A coordinate transformation is introduced to overcome the difficulties caused by off‐diagonal system matrix. Under limited communication range, the connectivity preservation as well as collision avoidance among the initial connected vehicles are achieved by guaranteeing the intervehicle distances converge to small neighborhoods of the desired distance. Meanwhile, the convergence of bearing angles to small neighborhoods of desired bearing angles avoids the possible controller singularity problem arising from underactuation and achieves the predefined formation shape. The prescribed performance constraints are imposed on the formation errors to improve the transient and steady‐state performances. Using the deterministic learning theory, the modeling uncertainties are locally accurately identified/learned by the localized radial basis function (RBF) neural networks (NNs) along the union of all vehicles' state orbits in a cooperative way. The learned knowledge is stored in constant RBF networks and is reutilized to develop experience‐based formation control protocol to improve the control performance including reduction of the computational burden. Simulations are carried out to verify the effectiveness of the proposed formation controllers.
A group‐sequential randomized trial design utilizing supplemental trial data
Authors: Kotalik Ales , Vock David M. , Hobbs Brian P. , Koopmeiners Joseph S.
Published: November 2021

Definitive clinical trials are resource intensive, often requiring a large number of participants over several years. One approach to improve the efficiency of clinical trials is to incorporate historical information into the primary trial analysis. This approach has tremendous potential in the areas of pediatric or rare disease trials, where achieving reasonable power is difficult. In this article, we introduce a novel Bayesian group‐sequential trial design based on Multisource Exchangeability Models, which allows for dynamic borrowing of historical information at the interim analyses. Our approach achieves synergy between group sequential and adaptive borrowing methodology to attain improved power and reduced sample size. We explore the frequentist operating characteristics of our design through simulation and compare our method to a traditional group‐sequential design. Our method achieves earlier stopping of the primary study while increasing power under the alternative hypothesis but has a potential for type I error inflation under some null scenarios. We discuss the issues of decision boundary determination, power and sample size calculations, and the issue of information accrual. We present our method for a continuous and binary outcome, as well as in a linear regression setting.
Analysis of Decisive Structural Parameters and Acidic Property of Zeolites for Gas‐Phase Alkylation of Benzene with Ethylene
Authors: Zhai Yunping , Wang Youju , Chen Junwen , Liang Shihang , Wang Yongrui , Luo Yibin , Shu Xingtian
Published: November 2021

The effects of the zeolite structure and acidic property on the activity and selectivity in gas‐phase alkylation of benzene with ethylene were investigated using TUN, IMF, *SFV and MFI with different structures and Si/Al2 ratios. The channels of TUN and IMF provide both higher selectivity to ethylation (ethylbenzene and di‐ethylbenzene) and lower xylene selectivity compared to MFI with slightly smaller pore diameter in which the pore diffusion limitations are suffered. The activity is mainly controlled by zeolite channel architecture. The higher activity and selectivity are obtained using modified TUN and modified IMF with suitable density of Brønsted acidity in a well‐defined channel structure sterically constrained for heavy by‐products. It is shown that the activity and selectivity increase with increasing pore diameter of three‐dimensional 10 ring channel structure, while the rule is not valid for *SFV.
Recent Progress on Emerging Transparent Metallic Electrodes for Flexible Organic and Perovskite Photovoltaics
Authors: Zhang Di , Alami Abdul Hai , Choy Wallace C. H.
Published: November 2021

The rapid development of smart and wearable electronics calls for revolutionizing optoelectronics to become flexible, lightweight, and affordable. To meet these demands in photovoltaic devices, that is, solar cells, it is essential to develop mechanically flexible transparent electrodes over the conventional rigid ones while features such as low‐temperature procedures, stability, solution process, and/or low cost are highly desired and often required. Moreover, the optoelectronic properties of an electrode must not be compromised in an operational flexible cell. Despite the considerable challenges, various bendable transparent electrodes for solar cells have emerged in recent years. Particularly, transparent electrodes based on metallic materials are especially attractive as metal offers excellent conductivity and their formation processing is generally mature and commercially viable. This work aims to provide an overview of the recent development of metal‐based transparent electrodes for flexible organic and perovskite photovoltaics. After the introduction, metallic materials for the transparent electrodes including nanowires, meshes/grids, and films are discussed. The procedures and protocols for cell flexibility testing are summarized, before highlighting recent progress on fully functional, high‐efficiency flexible organic and perovskite solar cells using these transparent metallic electrodes. Finally, the challenges and outlook of the research field are discussed.
A large scale parallel fluid‐structure interaction computing platform for simulating structural responses to a detonation shock
Authors: Zhang Sen , Guo Xiao‐Wei , Li Chao , Liu Yi , Fan Sijiang , Zhao Ran , Yang Canqun
Published: November 2021

Due to the intrinsic nature of multi‐physics, it is prohibitively complex to design and implement a simulation software platform for study of structural responses to a detonation shock. In this article, a partitioned fluid‐structure interaction computing platform is designed for parallel simulating structural responses to a detonation shock. The detonation and wave propagation are modeled in an open‐source multi‐component solver based on OpenFOAM and blastFoam, and the structural responses are simulated through the finite element library deal.II. To capture the interaction dynamics between the fluid and the structure, both solvers are adapted to preCICE. For improving the parallel performance of the computing platform, the inter‐solver data is exchanged by peer‐to‐peer communications and the intermediate server in conventional multi‐physics software is eliminated. Furthermore, the coupled solver with detonation support has been deployed on a computing cluster after considering the distributed data storage and load‐balancing between solvers. The 3D numerical result of structural responses to a detonation shock is presented and analyzed. On 256 processor cores, the speedup ratio of the simulations for a detonation shock reach 178.0 with 5.1 million of mesh cells and the parallel efficiency achieve 69.5%. The results demonstrate good potential of massively parallel simulations. Overall, a general‐purpose fluid‐structure interaction software platform with detonation support is proposed by integrating open source codes. And this work has important practical significance for engineering application in fields of construction blasting, mining, and so forth.
Acquisition strategy factors related to faster defense acquisitions
Authors: Etemadi Amir , Kamp John
Published: November 2021

The Department of Defense is experimenting with rapid acquisition strategies intended to deliver new capabilities in 2–5 years. There are few historical examples of programs achieving such cycle times – the duration from program start to initial operational capability within such short durations. This paper summarizes recent research between strategy decisions during program development and eventual program durations. Regression models are developed providing initial estimates of program schedule durations and growth from a few planning decisions. Program offices may use similar models and relationships as part of setting realistic program schedule expectations.
Epistemologische Neupositionierungen. Alexander Mitscherlich zwischen „naturwissenschaftlicher Methodik“, Psychoanalyse und Psychosomatischer Medizin
Authors: Dörre Steffen
Published: November 2021

Anhand von Alexander Mitscherlichs Plädoyers für eine Psychosomatische Medizin werden dessen epistemologische Neupositionierungen in den 1940er, 1950er und 1960er Jahren untersucht. Sie eröffnen den Blick auf die Auseinandersetzung von Psychiatern, Internisten und Psychotherapeuten um valides und handlungsrelevantes Wissen in der Nachkriegszeit. Zentral war für Mitscherlich ein Krankheitsverständnis, das der Subjektivität der Patienten einen festen Platz zuwies. Damit verbunden war eine kontinuierliche Kritik an statistischen Verfahren zur Validierung von Einzelbefunden und Hypothesen. Gezeigt wird, wie anpassungsfähig Mitscherlich mit seiner Kritik an einer naturwissenschaftlich orientierten Methodik in der Medizin war, wenngleich er die ursprüngliche Stoßrichtung trotz aller Wandlungen aufrechterhielt.
Methodological development for the optimisation of electricity cost in cement factories: the use of artificial intelligence in process variables
Authors: Parejo Guzmán Manuel , Navarrete Rubia Benito , Mora Peris Pedro , Alfalla-Luque Rafaela
Published: November 2021

Cement factories require large amounts of energy. 70% of the variable cost goes to energy—33% to kiln thermal energy and 37% to electrical energy. This paper represents the second stage of a broader research study which aims at optimising electricity cost in a cement factory by means of using artificial intelligence. After an analysis of the different tools that could be highly useful for the optimisation of electricity cost, for which a systematic review of the literature and surveys and an expert panel of 42 professionals in the cement sector were carried out, a methodology was developed in order to reduce electricity cost by optimising not only different variables of the production process, but also regulated electricity costs and electricity market costs. Artificial neural networks and genetic algorithms will be the tools to be used in this methodology, which can be applied to any cement plant in the world, and, by extension, to any electro-intensive consumer. The innovation of this research work is based on the use of a methodology that not only combines two different variables at the same time—process variables and regulated prices—but also makes use of artificial intelligence tools techniques.
Patient-reported outcomes during repetitive oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy for isolated unresectable colorectal peritoneal metastases in a multicenter, single-arm, phase 2 trial (CRC-PIPAC)
Authors: Lurvink Robin J. , Rovers Koen P. , Wassenaar Emma C. E. , Bakkers Checca , Burger Jacobus W. A. , Creemers Geert-Jan M. , Los Maartje , Mols Floortje , Wiezer Marinus J. , Nienhuijs Simon W. , Boerma Djamila , de Hingh Ignace H. J. T.
Published: November 2021

Background

CRC-PIPAC prospectively assessed repetitive oxaliplatin-based pressurized intraperitoneal aerosol chemotherapy (PIPAC-OX) as a palliative monotherapy (i.e., without concomitant systemic therapy in between subsequent procedures) for unresectable colorectal peritoneal metastases (CPM). The present study explored patient-reported outcomes (PROs) during trial treatment.

Methods

In this single-arm phase 2 trial in two tertiary centers, patients with isolated unresectable CPM received 6-weekly PIPAC-OX (92 mg/m2). PROs (calculated from EQ-5D-5L, and EORTC QLQ-C30 and QLQ-CR29) were compared between baseline and 1 and 4 weeks after the first three procedures using linear mixed modeling with determination of clinical relevance (Cohen’s D ≥ 0.50) of statistically significant differences.

Results

Twenty patients underwent 59 procedures (median 3 [range 1–6]). Several PROs solely worsened 1 week after the first procedure (index value − 0.10, p < 0.001; physical functioning − 20, p < 0.001; role functioning − 27, p < 0.001; social functioning − 18, p < 0.001; C30 summary score − 16, p < 0.001; appetite loss + 15, p = 0.007; diarrhea + 15, p = 0.002; urinary frequency + 13, p = 0.004; flatulence + 13, p = 0.001). These PROs returned to baseline at subsequent time points. Other PROs worsened 1 week after the first procedure (fatigue + 23, p < 0.001; pain + 29, p < 0.001; abdominal pain + 32, p < 0.001), second procedure (fatigue + 20, p < 0.001; pain + 21, p < 0.001; abdominal pain + 20, p = 0.002), and third procedure (pain + 22, p < 0.001; abdominal pain + 22, p = 0.002). Except for appetite loss, all changes were clinically relevant. All analyzed PROs returned to baseline 4 weeks after the third procedure.

Conclusions

Patients receiving repetitive PIPAC-OX monotherapy for unresectable CPM had clinically relevant but reversible worsening of several PROs, mainly 1 week after the first procedure.

Trial registration

Clinicaltrials.gov: NCT03246321; Netherlands trial register: NL6426.
Burden of depression and anxiety disorders per disease codes in patients with lymphoma in Germany
Authors: Tilch Marie-Kristin , Galle Peter R. , Schattenberg Jörn M. , Kostev Karel , Labenz Christian
Published: November 2021

Purpose

The aim of this study was to explore the incidence of depression and anxiety disorder diagnoses in a large German cohort of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) diagnoses in comparison to patients without cancer over a 10-year time frame.

Methods

Patients with HL (n=687) and NHL (n=4130) were matched to cohorts without a cancer diagnosis (n=687 and 4130) by age, sex, and yearly consultation frequency. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between lymphoma, separated into HL and NHL, and both depression and anxiety disorders was investigated using Cox regression models.

Results

We compared 687 patients with HL with 687 matched non-cancer individuals and 4130 patients with NHL with 4130 matched non-cancer individuals. Within 10 years of the index date, 24.0% of patients with HL and 22.3% of patients with NHL were diagnosed with depression. Anxiety disorders were diagnosed in 6.7% and 5.3% of patients with HL and NHL, respectively. On regression analyses, HL (HR 2.30, 95% CI 1.65–3.21, p<0.001) and NHL (HR 2.09, 95% CI 1.81–2.41, p<0.001) were positively associated with incident depression. The HR for anxiety disorders was 1.64 (95% CI 1.24–2.16, p<0.001) in patients with NHL, while HL was not associated with incident anxiety disorders (HR 1.21, 95% CI 0.71–2.07, p<0.478).

Conclusion

Lymphoma constitutes a risk factor for emerging depression and anxiety disorders. Following the diagnosis of lymphoma, screening and strategies to prevent the occurrence of these diseases seem warranted.
A Plea for the Comprehensiveness of the Category of Moral “Luck”
Authors: Zaborowski Robert
Published: November 2021

The aim of this paper is to improve our understanding of the category of moral “luck”. In current debate most often only specific cases of moral “luck” are taken into account. Such restrictions, however, involving a fragmentary picture of moral "luck", are introduced without any rationale for them. In this paper I look for a formal comprehensiveness of the category of moral “luck”. I consider three factors each of which is developed in two scenarios. These are (i) whether the agent’s action is nasty or nice, (ii) whether the agent’s intention is confirmed or contradicted by her action, and (iii) whether the agent’s action is preceded by her intention or the lack thereof. I explore eight scenarios which are a mark of the intricacy of the category of moral “luck” otherwise ignored in the literature. After an assessment of their structure I arrive at new distinctions. The upshot is a rather complex set of correlations between several cases of moral “luck” with a variety of kinds and shades.