bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pediatric Level III Trauma Center Experience With Dog Bite Injuries
Authors: Mattice Taylor , Schnaith Abigail , Ortega Henry W. , Segura Bradley , Kaila Rahul , Amoni Iluonose , Shanley Ryan , Louie Jeffrey P.
Published: September 2023

Dog bite injuries often present to Emergency Departments (ED), and between 2001 and 2003, approximately 4.5 million adults and children were injured. Injuries may range from puncture wounds to deep tissue lacerations or avulsions. Deaths have been described. Our objective was to describe dog bite injuries, the overall location of injuries, and need for vaccination among children who presented to a Pediatric ED designated as a level III trauma center with a robust facial surgical infrastructure. This was a 6-year retrospective study. Charts were identified by International Classification of Diseases, Tenth Revision ( ICD-10) codes for lacerations or injuries secondary to animal bites and accessing the hospital’s trauma database. Variables abstracted were age, sex, type of injury, location, need for antibiotics, immunization states and requirement of tetanus or rabies vaccine, disposition from ED to the operating room, home, or any in-patient unit. We excluded children older than 17 years of age and children who had a post-bite injury infection or injury not initially managed in our facility or medical system. The final cohort consisted of 152 children. The median age was 52 months and age ranged from 2 to 215 months. Children with a single bite injury were older when compared with those with numerous injuries, 81 and 62 months of age, respectively. Among young children, 75% of injuries occurred above the neck and 15.1% were managed in the operating room. Twenty-four percent of children required either a tetanus or rabies vaccination. Most dog bite injuries occurred to facial structures. Comprehensive care of dog victims included awareness of both dog and injured child vaccination status.
Hospital Portfolio Strategy and Patient Choice
Authors: Sunder Sarang , Thirumalai Sriram
Published: September 2023

Specialize? Diversify? Do patients care? The authors investigate the demand-side effects of a hospital's portfolio strategy, which entails decisions about the depth and breadth of its service offerings. Positing that both depth (focus) and breadth (related focus) signal expertise, the authors use both archival and experimental evidence to examine these effects. The archival study is based on Florida's State Inpatient Databases for 2006–2015 and spans all major departments in health care delivery. The empirical analysis exploits plausible exogenous variation from other health care markets and reveals that patient choice is positively influenced by a hospital's depth (focus) and breadth (related focus) of expertise in a department. Complementing the archival evidence, the authors also conducted online experiments to examine the signaling effects of hospital portfolio strategy on patient choice behavior. The results provide support for the idea that hospital portfolio strategy influences patients’ perceptions of hospital expertise in focal and related areas and, subsequently, their choice behavior. The authors also highlight potential synergistic effects between focus and related focus and heterogeneity in the effects across departments, payer types, and hospital profit status. These findings underscore the need for managers to adopt a targeted approach to portfolio decisions in health care.
Pixel-level pruning deep supervision UNet++ for detecting fabric defects
Authors: Zhang Erhu , Kang Xuejuan
Published: September 2023

Due to the complexity of fabric texture and the diversity of defect types, fabric defect detection is quite challenging. At present, fabric defect detection algorithms based on deep learning have achieved good detection results, but there are still some key issues to be solved. First, the existing network models remain unchanged once they have been built. When they are used to detect defects of different kinds of fabrics, the network model cannot be adjusted flexibly according to the characteristics of the fabrics, which reduces the efficiency of algorithm detection. Second, the imbalanced category of fabric defect samples makes model training more challenging. Moreover, the number of defective pixels is very small compared with the number of pixels in the whole image, which further increases the difficulty of fabric defect detection methods. To solve these problems, we propose a pixel-level pruning end-to-end deep supervision DSUNet++ architecture for fabric defect detection. The DSUNet++ architecture consists of an encoder, a decoder, and a series of cascade operations for fusing the detailed features of the shallow layer and the abstract features of the deep layer. The deep supervision is embedded into the outputs of different depths in the DSUNet++, which can prune the network reasonably according to the characteristics of different kinds of fabrics, so as to balance the depth, speed and precision of the network. Furthermore, the cross-entropy loss function weighted by the median frequency CEloss_MFB is introduced to overcome the problem of imbalanced fabric defect sample categories and detection rate decrease of small pixel defects. The experimental results show that the average detection rate of the method is 97.68% and 99.01% in the defect detection of raw fabric and patterned fabric, respectively.
Choice Overload in Tourism: Moderating Roles of Hypothetical and Social Distance
Authors: Park Sangwon , Eves Anita
Published: September 2023

The evolution of information and communication technology has enabled travelers to access abundant information and a wide range of available products/services that may satisfy their needs or wants. However, this phenomenon also poses a challenge to travelers who have to choose from an overwhelming collection of travel products. This situation, known as the paradox of choice, may have negative outcomes. This research tested the mechanism of relationships between choice set size and perceived responses to choice overload as affected by psychological distance. Results of multiple scenario-based experimental design studies indicated a negative influence of choice set size on the choice process (e.g., choice complexity/difficulty and task difficulty) in the context of tourism-related choices. This research demonstrated the moderating effects of hypothetical and social distances on the choice process. Therefore, it extended the theory of decision-making and provided important practical implications for tourism marketing.
Clinical Analysis of Supraclavicular Flaps for the Repair of the Pharyngeal Fistula
Authors: Jiao Cheng , Tao Ying , Zhu Bin , Chen Li , Yang Dandan , Guan Bing , Yu Aimin
Published: September 2023

Objectives: We explored the value of supraclavicular flaps in repairing pharyngeal fistula. Methods: Patients treated with supraclavicular flaps were included. Data on preoperative radiotherapy, surgical modality, flap size, postoperative healing, and other clinical outcomes were collected. Techniques, indications, and postoperative complications after repairing with supraclavicular flaps were described. A total of 16 male patients aged 58 to 79 years were involved, including 10 cases of postoperative pharyngeal fistula after hypopharyngeal cancer, 5 cases of postoperative pharyngeal fistula after laryngeal cancer, and 1 case of postoperative pharyngeal fistula after laryngeal and esophageal cancer. In 12 patients, the pharyngeal fistula was repaired by double island folding of the supraclavicular flap; in the remaining 4 patients, the pharyngeal fistula was repaired by the supraclavicular flaps combined with the pectoralis major flaps. The supraclavicular flap was 6 to 8 cm in width and 6 to 15 cm in length. Results: One patient developed partial necrosis at the distal end of the flap, which was successfully treated with debridement and dressing. The flaps grew well in the remaining 15 patients. Among them, a patient with a postoperative pharyngeal fistula after hypopharyngeal carcinoma was implanted with radioactive particles for tumor recurrence at the esophageal entrance, and died in the 11th month after surgery. Conclusions: The supraclavicular flap can achieve excellent results in the repair of pharyngeal fistula.
Gender and Gender-Role Attitudes in Wage Negotiations: Evidence from an Online Experiment
Authors: Demirović Melisa , Rogers Jonathan , Robbins Blaine G.
Published: September 2023

Gender differences in wage negotiations have been offered as a popular explanation for why the gender gap in pay persists in the United States. In this study, we use data from an artificial wage negotiation experiment (N = 307) to examine the relationship between gender and wage negotiations and to test whether gender-role attitudes moderate this relationship. We find that gender-role attitudes moderate how gender influences the decision to negotiate, but not the outcomes of negotiations, and that forced negotiations do not lead to additional gains for women regardless of their gender-role attitudes. We conclude with a discussion of implications and directions for future research.
More severe initial manifestations and worse short-term functional outcome of intracerebral hemorrhage in the plateau than in the plain
Authors: Wang Xiaoyin , Sun Haochen , Wang Xian , Lan Jing , Guo Yong , Liu Weiguo , Cui Lili , Ji Xunming
Published: September 2023

Intracerebral hemorrhage (ICH) is one of the most devastating forms of stroke. However, studies on ICH at high altitude are insufficient. We aimed to compare the initial manifestations, imaging features and short-term functional outcomes of ICH at different altitudes, and further explore the effect of altitude on the severity and prognosis of ICH. We retrospectively recruited ICH patients from January 2018 to July 2021 from two centers at different altitudes in China. Information regarding to clinical manifestations, neuroimages, and functional outcomes at discharge were collected and analyzed. Association between altitude and initial severity, neuroimages, and short-term prognosis of ICH were also investigated. A total of 724 patients with 400 lowlanders and 324 highlanders were enrolled. Compared with patients from the plain, those at high altitude were characterized by more severe preliminary manifestations ( P < 0.0001), larger hematoma volume ( P < 0.001) and poorer short-term functional outcome ( P < 0.0001). High altitude was independently associated with dependency at discharge (adjusted P = 0.024), in-hospital mortality (adjusted P = 0.049) and gastrointestinal hemorrhage incidence (adjusted P = 0.017). ICH patients from high altitude suffered from more serious initial manifestations and worse short-term functional outcome than lowlanders. Control of blood pressure, oxygen supplementation and inhibition of inflammation may be critical for ICH at high altitude.
Lower middle cerebral artery blood velocity during low-volume high-intensity interval exercise in chronic stroke
Authors: Whitaker Alicen A , Waghmare Saniya , Montgomery Robert N , Aaron Stacey E , Eickmeyer Sarah M , Vidoni Eric D , Billinger Sandra A
Published: September 2023

High-intensity interval training (HIIE) may present unique challenges to the cerebrovascular system in individuals post-stroke. We hypothesized lower middle cerebral artery blood velocity (MCAv) in individuals post-stroke: 1) during 10 minutes of HIIE, 2) immediately following HIIE, and 3) 30 minutes after HIIE, compared to age- and sex-matched controls (CON). We used a recumbent stepper submaximal exercise test to determine workloads for high-intensity and active recovery. Our low volume HIIE protocol consisted of 1-minute intervals for 10 minutes. During HIIE, we measured MCAv, mean arterial pressure (MAP), heart rate (HR), and end tidal carbon dioxide (PETCO2). We assessed carotid-femoral pulse wave velocity as a measure of arterial stiffness. Fifty participants completed the study (25 post-stroke, 76% ischemic, 32% moderate disability). Individuals post-stroke had lower MCAv during HIIE compared to CON (p = 0.03), which remained 30 minutes after HIIE. Individuals post-stroke had greater arterial stiffness (p = 0.01) which was moderately associated with a smaller MCAv responsiveness during HIIE (r = −0.44). No differences were found for MAP, HR, and PETCO2. This study suggests individuals post-stroke had a lower MCAv during HIIE compared to their peers, which remained during recovery up to 30 minutes. Arterial stiffness may contribute to the lower cerebrovascular responsiveness post-stroke.
Do masks cover more than just a face? A study on how facemasks affect the perception of emotional expressions according to their degree of intensity
Authors: Thomas Pauline J. N. , Caharel Stéphanie
Published: September 2023

Emotional facial expressions convey crucial information in nonverbal communication and serve as a mediator in face-to-face relationships. Their recognition would rely on specific facial traits depending on the perceived emotion. During the COVID-19 pandemic, wearing a facemask has thus disrupted the human ability to read emotions from faces. Yet, these effects are usually assessed across studies from faces expressing stereotypical and exaggerated emotions, which is far removed from real-life conditions. The objective of the present study was to evaluate the impact of facemasks through an emotion categorization task using morphs ranging from a neutral face and an expressive face (anger, disgust, fear, happiness, and sadness) (from 0% neutral to 100% expressive in 20% steps). Our results revealed a strong impact of facemasks on the recognition of expressions of disgust, happiness, and sadness, resulting in a decrease in performance and an increase in misinterpretations, both for low and high levels of intensity. In contrast, the recognition of anger and fear, as well as neutral expression, was found to be less impacted by mask-wearing. Future studies should address this issue from a more ecological point of view with the aim of taking concrete adaptive measures in the context of daily interactions.
Feasibility of a Multi-Component Strengths-Building Intervention for Caregivers of Persons With Heart Failure
Authors: Abshire Saylor Martha , Pavlovic Noelle , DeGroot Lyndsay , Peeler Anna , Nelson Katie E. , Perrin Nancy , Gilotra Nisha A. , Wolff Jennifer L. , Davidson Patricia M. , Szanton Sarah L.
Published: September 2023

Caregivers of persons with heart failure (HF) navigate complex care plans, yet support strategies often focus solely on meeting the needs of patients. We conducted a randomized waitlist control trial ( N = 38) to test the feasibility and gauge initial effect size of the Caregiver Support intervention on quality of life, caregiver burden, and self-efficacy among HF caregivers. The intervention includes up to five remote, nurse-facilitated sessions. Components address: holistic caregiver assessment, life purpose, action planning, resources, and future planning. Caregivers were 93.3% female, 60% White, and 63.3% spouses. Average age was 59.4. Participants who completed the intervention reported high satisfaction and acceptability of activities. Between-group effect sizes at 16 and 32 weeks suggest improvement in quality of life (mental health) (.88; 1.08), caregiver burden (.31; .37), and self-efficacy (.63; .74). Caregivers found Caregiver Support acceptable and feasible. Findings contribute evidence that this intervention can enhance caregiver outcomes. Clinicaltrials.gov Identifier NCT04090749.
Developing an extended producer responsibility system for solid waste management in Jordan using multi-criteria decision-making approach
Authors: Abu-Qdais Hani , Al-Saleh Marwan
Published: September 2023

To move from a traditional end of pipe approach into a more sustainable solid waste management system, the Jordanian Government has recently passed a set of new regulations The National Solid Waste Management Strategy has put a road map to encourage circular economy practices. One of the considered policy instruments is the adoption of the extended producer responsibility (EPR). The current study aimed to adopt a multi-criteria decision-making method to select the most convenient EPR structure within the Jordanian context. The study used analytical hierarchy process (AHP) and fuzzy AHP (FAHP) techniques to select the suitable type of producer responsibility organization (PRO) structure. A four-level hierarchy model was constructed with 4 criteria, 10 sub-criteria and 3 PRO alternatives. The analysis revealed that the legal and administrative criteria is the most important one (0.47) followed by environmental criteria (0.22), whereas the least important ones were socio-economic (0.17) and technical criteria (0.13). The most preferable PRO alternative was found to be PRO with profit. There were slight differences between all weight values under AHP and FAHP. Despite the availability of several laws, there is a need to develop the legal and administrative framework to enable the adoption of EPR in Jordan. Research should be the first step in the process of EPR system design. None of the previous studies conducted used the AHP and FAHP in assessing and selecting the EPR systems.
A computational fluid dynamics model to estimate local quantities in firebrand char oxidation
Authors: Banagiri Shrikar , Meadows Joseph , Lattimer Brian Y
Published: September 2023

Firebrand burning is a complex phenomenon that is influenced by several parameters which are difficult to fully explore experimentally. Computational fluid dynamics models capable of predicting local quantities are essential for accurate prediction of char oxidation in firebrands. This article presents a computational fluid dynamics model to estimate firebrand mass loss, diameter change, and surface temperature during char oxidation. The model was validated using previously conducted wind tunnel experiments. These experiments were conducted for firebrands of two different aspect ratios, which were arranged in three different configurations (single, horizontal array, and vertical array), and for four different wind speeds (0.5, 1, 1.5, and 2 m/s). The computational fluid dynamics results were compared with a previous 1 D model. In all the test cases, the computational fluid dynamics model predicted the physical phenomena with significantly improved accuracy compared to a 1 D model. The char oxidation model presented in this article can be coupled with other models to study firebrand generation and trajectory, biomass pyrolysis, fluidized bed reactors, and coal combustion.
Concordance of Posttraumatic Stress Disorder Symptoms Assessed via Retrospective Report Versus Experience Sampling Methods in Community Women Experiencing Intimate Partner Violence
Authors: Kiefer Reina , Schick Melissa R. , Newberger Noam G. , Ferguson Jewelia J. , Raudales Alexa M. , Sullivan Tami P. , Weiss Nicole H.
Published: September 2023

Posttraumatic stress disorder (PTSD) is one of the most prominent negative health consequences that women experiencing intimate partner violence (IPV) may develop. However, research on PTSD among women experiencing IPV has largely relied on retrospective reporting methods, which are vulnerable to bias and may consequently misrepresent PTSD symptoms. This study evaluated the concordance between PTSD symptoms assessed via retrospective self-report and experience sampling methods (ESM), which involve repeated within-day sampling of experiences in near real-time and in natural environments. Community women ( N = 134) experiencing IPV ( Mage = 40.7, 30.4% Black) responded to ESM surveys three times a day for 30 days and then completed a follow-up interview. Retrospective self-report of PTSD symptoms, which were assessed during the follow-up interview, were compared to ESM reports of PTSD symptoms. Retrospective reports of PTSD symptoms were significantly different from PTSD symptoms reported during the ESM period, but most closely resembled peak PTSD symptoms. Notably, retrospective reports of PTSD symptoms were significantly different, with a very large effect size, from average PTSD symptoms reported during the ESM period. Discordance scores were significantly negatively associated with the number of days on which any IPV occurred, suggesting that as the frequency of IPV experiences increased, differences between retrospective PTSD symptoms and each ESM symptom pattern decreased. This study provides an important contribution to the literature by highlighting meaningful differences in PTSD symptoms assessed via retrospective self-report versus ESM and the role of IPV context. Findings emphasize the importance of utilizing ESM in PTSD research with women experiencing IPV.
Studies on interfacial shear strength of pineapple leaf fibre from agro-waste reinforced polypropylene composites: Influence of fibre length and carding parameters
Authors: Rahman Habibur , Rana Sohel , Das Apurba , Alagirusamy Ramasamy
Published: September 2023

This work investigates the potential utilisation of the agro-waste pineapple leaf fibre (PALF) as a green reinforcement in polypropylene (PP) composites. Generally, chemical treatment is used to clean the scratched PALF, and the effluents of those chemicals are discharged into nature. A new mechanical approach (carding) was used in this work to remove the remaining extraneous substances from the scratched and sun-dried PALF instead of using any chemical treatment. The percentage of sticky fibres and dust content decreased, and fibre breakage increased with the increasing number of carding passages. The individualized fibre properties were also influenced by the number of carding passages. The carding process reduced the diameter of PALF due to removal of extraneous materials. The tensile properties of raw PALF improved significantly until the fourth carding passage and further increase in the number of passages did not show any significant influence on the tenacity and modulus. Scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR) confirmed the elimination of hemicellulose along with other gummy and waxy substances from the individualized PALF due to the carding action. The crystallinity % also increased after the carding process due to the removal of amorphous substances. As the reinforcement-matrix interfacial shear strength (IFSS) strongly influences the physico-mechanical properties of composites, IFSS of carded PALF reinforced finer and coarser PP fibre micro-bonded composites was also studied using the single fibre pull-out test (SFPT). Among different composites, the fourth carding passed PALF-reinforced finer PP fibre micro-bonded composite showed the highest IFSS. Additionally, the load- extension curves and SEM images of the tensile pulled-out surface were investigated to study the interfacial adhesion between PALF and PP micro-droplets. The increased surface roughness of PALF due to the carding action resulted in an improvement in the IFSS of PALF-reinforced PP micro-bonded composites.
Significant Publications on Infectious Diseases Pharmacotherapy in 2022
Authors: Teran Nicholas , Buckley Valerie , Britt Rachel S. , Ikwuagwu Judy , Thomas Jamie L. , Zaki Amir , Olson Kelsey , Stramel Stefanie ,   on behalf of the Houston Infectious Diseases Network
Published: September 2023

Purpose: To provide summarization of the most significant infectious diseases (ID) pharmacotherapy articles published in peer-reviewed literature in 2022. Summary: Members of the Houston Infectious Diseases Network (HIDN) nominated notable articles providing significant contributions to ID pharmacotherapy in 2022. Article nominations included those pertaining to general ID, as well as those including coronavirus disease 2019 (COVID-19), and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy. A total of 71 articles were nominated by HIDN. Members: 68 articles pertaining to general ID pharmacotherapy and 3 articles focusing on HIV/AIDS. To aid selection of the most these most notable articles of 2022, a survey was created and distributed to members of the Society of Infectious Diseases Pharmacists (SIDP). Of the 153 SIDP members who participated in the survey, there were 128 recorded votes for the top 10 general ID pharmacotherapy articles and 30 votes recorded for the top HIV/AIDS article. The most notable publications are summarized. Conclusion: Post pandemic significant advances in antimicrobial stewardship and infectious disease states continues to occur in a world recently focused on the coronavirus disease 2019 (COVID-19) global pandemic. Continuous growth in publication of ID-related articles over the past year lends towards the aims of this review to aid clinicians in remaining current on key practice-changing ID pharmacotherapy publications from 2022.
Shaping corporate social responsibility standards in the global economy: Chinese industry guidelines for responsible mineral supply chains
Authors: Chen Si
Published: September 2023

Between 2014 and 2023, the China Chamber of Commerce of Metals, Minerals & Chemicals Importers & Exporters (known by its acronym CCCMC) developed a set of corporate social responsibility guidelines which aim to steer Chinese outward mining investment toward a socially responsible model. This article presents an in-depth analysis of these voluntary industry-specific corporate social responsibility guidelines. The article also unfolds the less visible processes in which a Chinese industry association proactively engages with the dynamics of multi-level governance of corporate social responsibility in global mineral supply chains. While focusing on the rising role of the CCCMC, the article takes a ‘multi-level and actor-centred’ approach to understand the development of corporate social responsibility standards in the global economy. The article finds that CCCMC guidelines are inspired by and infused with pre-existing corporate social responsibility standards, especially international standards. Furthermore, it showcases the CCCMC’s continuing follow-up measures to implement the guidelines and increase recognition from other actors in global mineral supply chains. In particular, the article finds that the CCCMC has taken substantive measures to formulate and implement applicable labour standards in global mineral supply chains.
Food insecurity and depressive symptoms among young people living with HIV in Eastern Zambia
Authors: Shangani Sylvia , Masa Rainier , Zimba Mathias , Zimba Gilbert , Operario Don
Published: September 2023

Background: Mental health problems are common among people living with HIV/AIDS and contribute to poor HIV-related outcomes, including AIDS-related mortality. We examined the association between severe food insecurity and depressive symptoms in young people living with HIV (YPLH) in Zambia. Methods: We sampled 120 youth living with HIV aged 18–21 years in the Eastern Province of Zambia. Household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS). Mental health was assessed using the Children's Depression Inventory-Short Form. We fitted linear regression models to assess whether food insecurity is associated with depressive symptoms. Results: The mean age was 19 years, and 63% were female. Overall, 43% were severely food insecure. After adjusting for sociodemographic variables and other confounders, severely food insecure participants were more likely to report depressive symptoms (β = 0.81, 95% Confidence Interval [CI] 0.07–1.55) and engagement in sex work (β = 1.78, 95% CI 0.32–3.25). Conclusion: Almost half of the sample reported severe food insecurity which was associated with depressive symptoms. Interventions aimed at improving food insecurity may have beneficial effects on mental health and HIV outcomes among young people living with HIV in resource-limited settings.
Haploidentical Natural Killer Cell Therapy as an Adjunct to Stem Cell Transplantation for Treatment of Refractory Acute Myeloid Leukemia
Authors: Kulkarni Uday , Arunachalam Arun Kumar , Palani Hamenth Kumar , Nair Reeshma Radhakrishnan , Balasundaram Nithya , Venkatraman Arvind , Korula Anu , Selvarajan Sushil , Lionel Sharon , Balasubramanian Poonkuzhali , Maddali Madhavi , Abraham Aby , George Biju , Mathews Vikram
Published: September 2023

Refractory acute myeloid leukemia (AML), defined as failure of two cycles of induction therapy at diagnosis or of one cycle at relapse, represents a subgroup with poor outcomes. Haploidentical natural killer cell (NK) therapy is a strategy that is being explored in refractory malignancies. Historically, at our center, patients with refractory AML have been treated with cytoreductive therapy (fludarabine + cytosine + granulocyte colony-stimulating factor ± idarubicin or mitoxantrone + etoposide) followed by 1-week rest and then reduced-intensity transplant with fludarabine + melphalan. We used the same backbone for this trial (CTRI/2019/02/017505) with the addition of CD56-positive cells from a family donor infused 1 day after the completion of chemotherapy. CD56-positive selection was done using a CliniMACS Prodigy system (Miltenyi Biotec, Bergisch Gladbach, Germany) followed by overnight incubation in autologous plasma with 2 micromolar arsenic trioxide and 500 U/mL of interleukin-2. From February 2019, 14 patients with a median age of 29 years (interquartile range [IQR]: 16.5–38.5) were enrolled in this trial. Six were females. Six had primary refractory AML while eight had relapsed refractory AML. The median CD56-cell dose infused was 46.16 × 106/kg (IQR: 25.06–70.36). One patient withdrew consent after NK cell infusion. Of the 13 patients who proceeded to transplant, five died of immediate post-transplant complications while two did not engraft but were in morphologic leukemia-free state (both subsequently died of infective complications after the second transplant). Of the remaining six patients who engrafted and survived beyond 1 month of the transplant, two developed disease relapse and died. The remaining four patients are alive and relapse free at the last follow-up (mean follow-up duration of surviving patients is 24 months). The 2-year estimated overall survival for the cohort was 28.6% ± 12.1% while the treatment-related mortality (TRM) with this approach was 38.5% ± 13.5%. Haploidentical NK cell therapy as an adjunct to transplant is safe and needs further exploration in patients with AML. For refractory AML, post-transplant NK infusion and strategies to reduce TRM while using pre-transplant NK infusion merit exploration.
How Does Human, Financial and Social Capital Affect a Firm’s Performance? Evidence from Handloom Enterprises in Assam
Authors: Dey Bijoy Kumar , Paul Ujjwal Kanti , Das Gurudas , Mathur Tanuj
Published: September 2023

This article examines how human, financial and social capital affects the performance of handloom enterprises in the Indian state of Assam. The study employs a random sample of 340 handloom micro-entrepreneurs from Assam’s three districts. Tobit model and the hierarchical regression have investigated the link between a firm’s performance and human, financial and social capital. The results reveal that human, financial and social capital positively affects the performance of handloom firms. Aside from these, the study found that firm performance is positively influenced by innovation and the use of technology. Finally, some policy implications are provided based on the findings.
The limits to upgrading and value capture in R&D global value chains: Indian and Chinese contract R&D firms in the integrated circuit design and pharmaceutical global value chains
Authors: Fuller Douglas B , Ramirez Paulina
Published: September 2023

This article analyzes the interaction between lead firms and Chinese and Indian contract research and development (R&D) firms in integrated circuit (IC) and chemistry-based pharmaceutical global value chains (GVCs) in order to delineate what factors influenced the upgrading and value capture outcomes of these contract R&D firms in the two sectors. There are five main findings. First, the two sectors differed significantly in terms of the upgrading of contract R&D firms’ activities and capabilities. More upgrading was found in chemistry-based pharmaceuticals than in ICs. Second, in both industries, lead firms utilized a range of strategies to control and limit upgrading and value capture by contract R&D firms. Third, level of R&D uncertainty (risk) and lead firms’ level of market access control informed the strategies of lead firms. Lead firms generally adopted strategies to limit upgrading by contract R&D firms except in two situations: where R&D risk was high so that lead firms wished to offload costly risks onto contract R&D firms and where lead firms had significant market access control to limit value capture by upgrading contract R&D firms. Fourth, the strategies to limit upgrading included minimizing the flow of information possible in modular linkages and discouraging IP development by contract R&D firms. Fifth, the lead firm strategies to limit value capture included limiting upgrading and thus any associated potential value capture, enhancing lead firm bargaining leverage, and controlling market access via established market channels and continual engagement with regulatory agencies in relevant markets.
Sparsentan: A First-in-Class Dual Endothelin and Angiotensin II Receptor Antagonist
Authors: Chiu Ada W. , Bredenkamp Nina
Published: September 2023

Objective:

To provide an overview of the guidelines on the management of immunoglobulin A nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS), review the evidence for sparsentan, and discuss its place in therapy.

Data Sources:

A literature search was conducted using MEDLINE, EMBASE, and clinicaltrials.gov using the search terms “sparsentan” and “RE-021” up to the end of Jun 2023.

Study Selection and Data Extraction:

English studies were included if they evaluated the pharmacology, pharmacokinetics, efficacy, and safety of sparsentan in human subjects. Information from the Food and Drug Administration (FDA) and manufacturer’s monograph were also extracted.

Data Synthesis:

In comparison with irbesartan, sparsentan reduced urine protein-to-creatinine ratio (UPCR) in both IgAN (−49.8% vs −15.1% at interim 36 weeks) and FSGS (−44.8% vs −18.5% at 8 weeks). Hypotension and edema were the most common adverse events in the sparsentan groups. Hepatotoxicity appears to be comparable between sparsentan and irbesartan in short-term results.

Relevance to Patient Care and Clinical Practice in Comparison With Existing Drugs:

Sparsentan provides a new option for patients with IgAN who are otherwise at high risk of progressive kidney disease. Continued FDA approval is dependent on long-term study results on renal function decline and safety.

Conclusion:

Sparsentan reduces proteinuria in IgAN and FSGS, and has expedited approval by the FDA for IgAN in patients at risk of rapid disease progression, generally at urine protein-to-creatinine ratio (UPCR) ≥1.5 g/g. Interim results from PROTECT and results from DUET showed promise for improving proteinuria in IgAN and FSGS. Long-term renal function benefit and safety data are pending.
Reluctant cooptation: The legislative recruitment of the private sector into Russia’s dominant party, 2015–2020
Authors: Mikhasev Timofei , Golosov Grigorii V
Published: September 2023

Cooptation is one of the most efficient strategies employed by authoritarian regimes and their leaders in order to survive in power. In most of these regimes, dominant pro-government parties serve as important tools of cooptation in general and of legislative recruitment, as one of its forms, in particular. The main thesis of this study is that cooptation is selective. When contrasted to the social sectors that are directly linked to the state, the private sector will be at a relative disadvantage, resulting in a smaller scope of cooptation. To test this thesis empirically, we build several hypotheses based on our expectations regarding the effects of electoral rules on candidate selection, and then test these hypotheses against the data from 82 regional legislative elections held in Russia in 2015–2020. The analysis confirms our main thesis and clarifies several findings previously reported in the literature on business and politics in Russia.
Co-creation and societal impact: Toward a generic framework for research impact assessment
Authors: Gerke Daria-Maria , Uude Katrin , Kliewe Thorsten
Published: September 2023

Academia focuses on the interplay of Higher Education Institutions and external stakeholders. In this context, academia is concerned with the societal impact and impact created in interactions with external stakeholders; the latter is often referred to as impact co-creation. There is agreement that the related processes leading to an impact are complex and multi-dimensional. However, academics disagree on how the ultimate, wider impact of research should be measured. This study seeks to conceptualize societal impact through the lens of value co-creation, arguing that societal impact is best conceptualized as the uptake of research. Based on this, we developed a generic research impact assessment framework to facilitate evaluations and enable cross-sector learning. This study contributes to academia by providing an overarching understanding of impact creation, including wider research impact, and offers the perspective that any research project involving stakeholders to a certain extent, also entails co-production.
Theory building from qualitative evaluation
Authors: Guenther John , Falk Ian , Cole Michael J.
Published: September 2023

This article argues that not only is theory building from qualitative evaluation possible, but ought to be considered as a desirable product and utilisation of evaluators’ work. Based on three case studies, the authors show how theory building can work, and why it can be important and useful. Theory building is seldom considered an impact-producing product from evaluation. Theory in evaluation is typically limited to ‘evaluation theory’ as a way of explaining why and how different approaches to evaluation work. Theory is also used to inform programme design and ‘theory of change’. The literature seldom suggests that evaluations can be used to build theory in social sciences. The argument presented in this article builds on literature of ‘theories of evaluation use’ to suggest that theorising is a form of knowledge utilisation arising from well-constructed, open-ended evaluation questions, and conceptual use of findings and recommendations.
Identification of human hexahydrocannabinol metabolites in urine
Authors: Schirmer Willi , Auwärter Volker , Kaudewitz Julia , Schürch Stefan , Weinmann Wolfgang
Published: September 2023

Hexahydrocannabinol (HHC) is a cannabinoid that has been known since 1940 but has only recently found its way into recreational use as a psychoactive drug. HHC has been used as a legal alternative to tetrahydrocannabinol (THC) in many countries, but first countries already placed it under their narcotic substances law. Our aim was to evaluate a reliable analytical method for the proof of HHC consumption by LC-MS/MS and GC-MS. We identified the two epimers of HHC and metabolites after HHC consumption by two volunteers (inhalation by use of a vaporizer and oral intake). LC-HR-MS/MS, LC-MS/MS and GC-MS with literature data (EI-MS spectra of derivatives) and reference compounds - as far as commercially available - were used for metabolite identification. Phase-II-metabolites (glucuronides) of HHC and OH-HHC were found in urine samples with LC-HR-MS/MS and LC-MS/MS. The main metabolite was tentatively identified with GC-MS as 4'OH-HHC (stereochemistry on C9 and C4' unknown). Another major side-chain hydroxylated metabolite found by LC-MS/MS could not be unambiguously identified. Both epimers of 11-OH-HHC were found in considerable amounts in urine. (8 R, 9 R)-8-OH-HHC was identified as a minor metabolite with GC-MS and LC-MS/MS. While (9 S)-HHC was found in urine after oral intake and inhalation of HHC, the more psychoactive epimer (9 R)-HHC was only found in urine after inhalation. Several other minor metabolites were detected but not structurally identified. We found that after oral or inhalative consumption the urinary main metabolites of a diastereomeric mixture of HHC are different from the respective, major Δ9-THC metabolites (11-OH-Δ9-THC and 11-nor-9-carboxy-Δ9-THC). Although a sensitive LC-MS/MS and GC-SIM-MS method were set-up for the reference compounds (9 R)-11-nor-9-carboxy-HHC and (9 S)-11-nor-9-carboxy-HHC, these oxidation products were not detected in urine with these techniques. To further increase sensitivity, a GC-MS/MS method was developed, and the 11-nor-9-carboxy metabolites of HHC were confirmed to be present as minor metabolites.
Adult learners’ perceptions of distance education
Authors: Åkerfeldt Anna , Bergdahl Nina , Hrastinski Stefan
Published: September 2023

Research informing adult education teachers’ didactic practices in distance education is scarce. Approaching the adult learner’s perspectives on how distance education is perceived is key to informing future initiatives. This study explores adult learners’ perception of distance education, concentrating on aspects such as, social presence, course structure, and perceived learning and satisfaction. A survey was distributed to teachers ( n = 78) in five schools organising adult distance education. Findings show that teacher accessibility and course structure correlated positively with social presence and perceived learning and satisfaction. Overall, adult learners are satisfied with their distance teaching. A challenge facing adult distance education is to create a sense of social presence despite the high demand for flexibility. Thus, we explored learner perceptions of benefits and challenges in distance education and structured these into social, cognitive, spatio-temporal, emotional, and technical dimensions. Findings reveal that one challenge in the social dimension was a lack of connection with peers, and a benefit in the cognitive dimension referred to autonomy and self-regulation. These findings are important as educational institutions and policymakers may strive for high flexibility, which in turn may lead to lower group cohesion and a lack of social presence.
Impact of Bileaflet Mechanical Mitral Valve Orientation on Pannus Overgrowth
Authors: Duman Zihni Mert , Apaydın Zinar , Can İsa , Kaplan Mustafa Can , Buğra Abdül Kerim , Timur Barış , Bayram Muhammed , Karakurt Seda Tükenmez , Güler Gamze Babür , Kadiroğulları Ersin , Onan Burak
Published: September 2023

Objective:

Pannus overgrowth is a chronic inflammatory process that can cause valve dysfunction and threaten the durability of prosthetic valves. Bileaflet mechanical mitral valve can be implanted in either an anatomical (parallel to the anatomical axis) or nonanatomical (perpendicular or oblique to the anatomical axis) orientation. The effect of the rotational orientation of the bileaflet mechanical mitral valve on excessive pannus enlargement is unknown. The present study compared the effect of bileaflet mechanical mitral valve orientation on pannus overgrowth.

Methods:

The study included patients who underwent bileaflet mechanical mitral valve replacement for rheumatic mitral valve stenosis. The pannus formation was confirmed by reexamining all transesophageal echocardiography images in the picture archiving and communication systems between May 2017 and April 2021. The primary aim of this study was the development of pannus overgrowth. Patients were divided into 2 groups based on their implantation orientation of the bileaflet mechanical mitral valve.

Results:

Pannus overgrowth was found in 26 patients (56.5%) in the anatomical orientation group and 71 patients (74.7%) in the nonanatomical orientation group ( P = 0.03). Anatomical orientation reduced the development of pannus overgrowth (odds ratio [OR] = 0.39, P = 0.04), and double left heart valve replacement increased the development of pannus overgrowth (OR = 2.73, P = 0.04).

Conclusions:

Pannus overgrowth was less common in bileaflet mechanical mitral valves implanted in the anatomical orientation.
Construction of grid color mixture model of seven primary-color and modified Stearns-Noechel color matching algorithm for color prediction of full-color-gamut rotor melange yarn
Authors: Zhu Wenshuo , Xue Yuan , Chen Yourong , Wang Yaojun , Shi Huanqiang
Published: September 2023

In this paper, the full-color-gamut grid color mixture model containing 601 grid points is constructed by ternary double coupling blending of seven primary-color fibers, and the spinning method of full-color-gamut melange yarn is given by combining with three-channel NC rotor spinning technology. A modified S-N color prediction model was constructed by selecting 55 uniformly distributed grid points for yarn and fabric production from the full-color-gamut grid color mixture model as samples for solving the reflectance conversion coefficients. On this basis, the method of predicting the color value of a melange yarn based on its primary-color fiber composition and blending ratio and predicting the primary-color fiber composition and blending ratio based on the color value of a melange yarn using the parameters of the nearest sample grid point is proposed, and six samples with different blending ratios in six color mixing regions of the full-color-gamut grid color mixture model are designed for validation. The results showed that the average color difference between the predicted color and the actual color of the melange yarn is 1.15, the predicted primary-color fiber composition of the melange yarn is consistent with the actual composition, and the average error between the predicted blending ratio and the actual blending ratio is 3.95%. The method proposed in this paper can effectively predict the color value and blending ratio of melange yarn.
Ultrasound Investigation of the Radial Nerve’s Superficial Branch: Reducing the Risk of K-Wire Insertion Damage in Distal Radius Fractures
Authors: Hamada Tomo , Tada Kaoru
Published: September 2023

Background:

Kirschner wire (K-wire) insertion during surgery for distal radius fractures carries a risk of damaging the radial nerve’s superficial branch. In this prospective study, we investigated the relationship between the radial nerve’s superficial branch and the radius using ultrasound to minimize risk.

Methods:

We collected data from 101 healthy volunteers (202 limbs; 51 men; mean age: 40.6 years). We ultrasonographically assessed the courses of the radial nerve’s dorsal and superficial palmar branches at 0, 1, 2, and 3 cm proximal to the radial styloid process tip. The positional relationship between the radial nerve’s superficial branch and the radius was determined by splitting the radius’s ultrasound map into 4 sections (R1-R4) from the palmar side. The section containing the dorsal and palmar branch midpoints was determined for each height.

Results:

In many limbs, the dorsal branch tended to wrap from the proximal palmar to the distal dorsal side at 1 to 2 cm proximal to the radial styloid process tip. In approximately 90% of limbs, the palmar branch ran along the radius’s palmar side rather than the radial surface.

Conclusions:

A small incision enabling direct view may be the best approach for avoiding nerve damage when the superficial branch is less than or equal to 2 cm proximal to the tip of the radial styloid process. Inserting the K-wire from the dorsal side of the radius may be safer for more proximal locations. We recommend a preoperative ultrasound examination to determine the course of the superficial branches of the radial nerve in each patient.