bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimorbidity and Readmissions in Older People with Acute Coronary Syndromes
Authors: Gudnadottir Gudny Stella , Gudnason Thorarinn , Wilhelmson Katarina , Ravn-Fischer Annica
Published: January 2022

Aims: This study aimed to examine the multimorbidity as well as the 30-day and 1-year readmission rates in a large, unselected cohort of elderly patients with acute coronary syndrome (ACS). Methods and Results: All patients ≥70 years hospitalized due to ACS during January 1, 2006, to December 31, 2013, and registered in the SWEDEHEART registry were included. In-hospital multimorbidity and disease burden were determined. Outcomes included 30-day and 1-year all-cause mortality, any readmission, and readmissions due to ACS, heart failure, ischaemic stroke or transient ischaemic attack (TIA), and bleeding events. Out of 80,176 patients, 25.6% had ST-elevation myocardial infarction (STEMI) and 74.4% non-ST-segment elevation ACS (NSTE-ACS). The mean age was 79.8 (±6.4 standard deviation) and 43.4% were women. Multimorbidity, or two chronic diseases, was present in 67.7%, thereof in 53.0% of STEMI patients and 72.7% of NSTE-ACS patients. In-hospital mortality was 7.0%. Of the 74,577 patients who survived to discharge, 24.6% were readmitted within 30 days and 59.5% were readmitted during the following year. Multimorbid patients had a higher risk of readmissions than those without multimorbidity. Multimorbid STEMI patients were admitted the following year in 56.2% of cases compared to 44.5% of STEMI patients without multimorbidity, adjusted odds ratio (OR) 1.35 (95% confidence interval: 1.26–1.45). Multimorbid patients with NSTE-ACS were readmitted in 63.4% of cases the following year compared with 49.1% of those without multimorbidity, adjusted OR 1.42 (1.35–1.50). More than half of the readmissions were due to cardiovascular causes (ACS, stroke, TIA, or heart failure) or bleeding events. Conclusions: Older people with ACS have a high multimorbidity burden and a high readmission rate both within 30 days and 1 year. Half of the readmissions were due to a cardiovascular event or a bleeding event. The presence of multimorbidity increases the risk of readmissions for patients with ACS. As hospital admissions are costly for the health care system and can include risks, especially for older patients, there may be opportunities in better risk stratifying this group at discharge for subsequent decrease in readmission rates.
Sexuality and Neurodegenerative Disease: An Unmet Challenge for Patients, Caregivers, and Treatment
Authors: Eshmawey Mohamed
Published: January 2022

Background: Many factors affect sexuality in the elderly such as dementia which is a common cause of inappropriate sexual behaviors. These behavioral disturbances are distressing, disruptive, and impair the care of the patient. Summary: The onset of dementia does not erase sexuality. Sexual expression can be an important aspect of well-being for older adults with dementia. This study gives a general overview about the relationship between sexuality and cognitive impairment. It starts with a general discussion of sexual aspects in the elderly. This is followed by research studies in this field including effects of dementia on sexual life, sexuality issues related to cognitive decline, inappropriate sexual behaviors in dementia patients, and sexuality in healthcare institutions. We discuss also ethical aspects in relation with sexuality and dementia. Finally, we show different approaches to treat inappropriate sexual behaviors. Key Messages: The discussion of sexuality in dementia raises many medical and ethical concerns. Inappropriate sexual behaviors are estimated to occur in about 7%–25% of demented patients. The question is how to address such a delicate subject and discuss it in an easy way without making the patient feel humiliated or mistreated. This narrative review reveals sexual problems and difficult questions encountered in daily practice with patients suffering from cognitive impairment.
Effect of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Dysglycemia, Insulin Resistance, and Dyslipidemia: a Temporal Causal Longitudinal Study
Authors: Agbaje Andrew O. , Barker Alan R. , Mitchell Gary F. , Tuomainen Tomi-Pekka
Published: January 2022

Background:

We investigated the temporal causal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression with the risk of dysglycemia, insulin resistance, and dyslipidemia.

Methods:

We included 3862, 17.7-year-old, participants from the Avon Longitudinal Study of Parents and Children, followed up for 7 years. cfPWV, cIMT, and fasting plasma samples were repeatedly measured. We computed homeostatic model assessment (HOMA) of insulin resistance and percent pancreatic beta-cell function. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models.

Results:

A higher cfPWV at 17.7 years was associated with higher insulin at age 24.5 years (odds ratio, 1.25 [CI, 1.08–1.44];
P
=0.003), which slightly attenuated after covariates adjustment. Higher cIMT at 17.7 years was associated with lower insulin (odds ratio, 0.06 [0.01–0.95];
P
=0.046) at 24.5 years, after covariate adjustments. In mixed-effect models, the 7-year progression in cfPWV (predictor) was directly associated with the increase in triglyceride (outcome). cIMT progression was associated with the 7-year increase in LDL (low-density lipoprotein), triglyceride, and glucose. In cross-lagged models, higher cfPWV at 17.7 years was associated with higher insulin (
β
=0.06, SE, 0.12,
P
=0.014), HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years. However, insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 17.7 years were not associated with cfPWV at 24.5 years. Higher cIMT at 17.7 years was associated with reduced insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years, but not vice versa. Higher glucose at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years only.

Conclusions:

Arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and insulin resistance in young adulthood.
Structure-function coupling as a correlate and potential biomarker of cognitive impairment in multiple sclerosis
Authors: Kulik Shanna D. , Nauta Ilse M. , Tewarie Prejaas , Koubiyr Ismail , van Dellen Edwin , Ruet Aurelie , Meijer Kim A. , de Jong Brigit A. , Stam Cornelis J. , Hillebrand Arjan , Geurts Jeroen J. G. , Douw Linda , Schoonheim Menno M.
Published: January 2022

Multiple sclerosis (MS) features extensive connectivity changes, but how structural and functional connectivity relate, and whether this relation could be a useful biomarker for cognitive impairment in MS is unclear. This study included 79 MS patients and 40 healthy controls (HCs). Patients were classified as cognitively impaired (CI) or cognitively preserved (CP). Structural connectivity was determined using diffusion MRI and functional connectivity using resting-state magnetoencephalography (MEG) data (theta, alpha1, and alpha2 bands). Structure-function coupling was assessed by correlating modalities, and further explored in frequency bands that significantly correlated with whole-brain structural connectivity. Functional correlates of short- and long-range structural connections (based on tract length) were then specifically assessed. Receiving operating curve analyses were performed on coupling values to identify biomarker potential. Only the theta band showed significant correlations between whole-brain structural and functional connectivity (rho = −0.26, p = 0.023, only in MS). Long-range structure-function coupling was stronger in CI patients compared to HCs (p = 0.005). Short-range coupling showed no group differences. Structure-function coupling was not a significant classifier of cognitive impairment for any tract length (short-range area under the curve (AUC) = 0.498, p = 0.976, long-range AUC = 0.611, p = 0.095). Long-range structure-function coupling was stronger in CI MS compared to HCs, but more research is needed to further explore this measure as biomarkers in MS.
Uncertainty in Integrated Assessment Modeling of Climate Change
Authors: Tavoni Massimo , Valente Giovanni
Published: January 2022

Integrated assessment models (IAMs) play a major role in the science and policy of climate change. Similarly to other widely used computational tools for addressing socially relevant problems, IAMs need to account for the key uncertainties characterizing processes and socio-economic responses. In the case of climate change, these are particularly complex given the very long-term nature of climate and the deep uncertainty characterizing technological and human systems. Here we draw from philosophical discussion of mathematical modeling of social problems and review the role of uncertainty in climate-economic modeling. In agreement with the literature, we highlight the crucial role of epistemic uncertainty in IAMs. We posit that the normative components of models, more than the physical and socio-techno-economic ones, are the most fraught by uncertainty and yet the least understood. We suggest a research agenda to explore uncertainties of evaluation frameworks, transcending the current implicit normativity of IAMs.
Are narcissistic CEOs good or bad for family firm innovation?
Authors: Rovelli Paola , Massis Alfredo De , Gomez-Mejia Luis R
Published: January 2022

Despite anecdotal evidence showing that some CEOs possess narcissistic personality traits, research on this individual characteristic is still lagging behind. Though the literature has established that narcissistic CEO traits may affect firm performance, it is not clear whether they act as constructive or destructing forces in family firms. This is particularly important given family firms’ attention towards the preservation of socioemotional wealth. A question thus arises: Can family firms benefit from narcissistic CEOs or should they avoid appointing individuals with this personality trait? Our analysis of unique data from Italian CEOs – collected through a survey and a psychometric test – reveals that CEO narcissism is lower in family firms, and among family CEOs. Nevertheless, in family firms, more narcissistic CEOs tend to exploit greater innovation opportunities by fostering higher top management teams strategic decision comprehensiveness. Our findings advance our understanding of narcissism in leadership positions, highlighting its importance for family firms’ innovation and providing meaningful contributions for research on CEO personality, family business and innovation, as well as for practitioners.
Validating the Vocabulary Learning Strategies Used by English as a Foreign Language University Students in Taiwan
Authors: Chou Mu-Hsuan
Published: January 2022

Vocabulary learning strategies have been frequently viewed as a practical tool to facilitate the acquisition of words and enhance comprehension and production in communication. Previous research suggests that vocabulary learning strategies are a multidimensional construct. This study attempts to validate a vocabulary learning strategies questionnaire using rigorous validation procedures. A questionnaire with 52 items from Gu (2018) was administered to 556 university students in Taiwan. Data were analyzed using exploratory factor analysis and confirmatory factor analysis with SPSS 23.0 and AMOS 23.0, respectively. The results showed that a validated short version of the questionnaire, comprising 33 items, can be used as a measurement tool to assess strategy use and be used when administration time is limited, or the assessment of vocabulary learning strategies is part of a larger number of variables. The second-order confirmatory factor analysis revealed that Activation, Visual and Auditory Encoding, Structure Encoding, Oral Repetition and Selective Attention were the top five important strategies related to vocabulary learning. Finally, the data revealed that it is possible to obtain plausible underlying constructs for a set of questionnaire items in exploratory factor analysis, while the discriminant and construct validity cannot be established in confirmatory factor analysis.
Catchment Profile of Large Cochlear Implant Centers in the United States
Authors: Nassiri Ashley M. , Holcomb Meredith A. , Perkins Elizabeth L. , Bucker Andrea L. , Prentiss Sandra M. , Welch Christopher M. , Andresen Nick S. , Valenzuela Carla V. , Wick Cameron C. , Angeli Simon I. , Sun Daniel Q. , Bowditch Stephen P. , Brown Kevin D. , Zwolan Teresa A. , Haynes David S. , Saoji Aniket A. , Carlson Matthew L.
Published: January 2022

Objective

To characterize the catchment area and patient profile of large cochlear implant (CI) centers in the United States.

Study Design

Multi‐institutional retrospective case series.

Setting

Tertiary referral CI centers.

Methods

Patients who underwent CI surgery at 7 participating CI centers between 2015 and 2020 were identified. Patients’ residential zip codes were used to approximate travel distances and urban vs rural residential areas.

Results

Over the 6‐year study period (2015‐2020), 6313 unique CI surgical procedures occurred (4529 adult, 1784 pediatric). Between 2015 and 2019, CI procedures increased by 43%. Patients traveled a median 52 miles (interquartile range, 21‐110) each way; patients treated at rural CI centers traveled greater distances vs those treated at urban centers (72 vs 46 miles, P <. 001). Rural residents represented 61% of the patient population and traveled farther than urban residents (73 vs 24 miles, P <. 001). Overall, 91% of patients lived within a 200‐mile radius of the institution, while 71% lived within a 100‐mile radius. In adults, multiple regression analysis redemonstrated an association between greater travel distances and (1) older age at the time of CI and (2) residential rural setting (both P <. 001, r2 = 0.2).

Conclusions

While large CI centers serve geographically dispersed populations, most patients reside within a 200‐mile radius. Strategies to expand CI utilization may leverage remote programming, telemedicine, and strategic placement of new centers and satellite clinics to ameliorate travel burden.
Significance of very-low-voltage coagulation plus coverage with polyglycolic acid sheet after bullectomy for primary spontaneous pneumothorax
Authors: Shigefuku Shunsuke , Takahashi Hidenobu , Ito Maki , Kajiwara Naohiro , Ohira Tatsuo , Ikeda Norihiko
Published: January 2022

Background

The purpose of this study was to clarify the efficacy of the combination of low-voltage coagulation plus staple line coverage with a polyglycolic acid sheet after bullectomy for primary spontaneous pneumothorax to prevent a postoperative recurrence.

Methods

A total of 143 patients who underwent bullectomy for primary spontaneous pneumothorax between January 2014 and December 2019 were enrolled in this study. We classified the patients into two groups based on additional procedures after bullectomy, namely, low-voltage coagulation for the margin of the staple line plus coverage with a polyglycolic acid sheet (Group A) and staple line coverage with a polyglycolic acid sheet alone (Group B). We evaluated perioperative factors and recurrence-free survival after surgery in the two groups.

Results

Nine patients in Group B developed postoperative recurrences. In contrast, there was no postoperative recurrence in Group A. According to the Kaplan–Meier curves, the 2-year recurrence-free survival rates of the patients were 100% and 90.3%, in Group A and Group B, respectively. The log-rank test showed a significant difference between the two groups ( p = 0.031).

Conclusion

Low-voltage coagulation for the margin of a staple line plus coverage with a polyglycolic acid sheet is a useful option as an additional technique after bullectomy for primary spontaneous pneumothorax to prevent a postoperative recurrence.
Cognition and protest in democratic and authoritarian regimes, 1981–2020
Authors: Lavrinenko Olga
Published: January 2022

Whereas most theories of why the masses protest in democratic and authoritarian regimes involve some psychological or ‘cognitive’ element, major theories that include them (a) de-emphasize the structural conditions and (b) posit an explicit structure and cognition model but lack data to test its propositions across nations and time. This article synthesizes cognition-themed theories of democratic culture, political process theory’s cognitive liberation, and the structural cognitive model’s incentives. I test this synthetic theory in a specific way: that democratization and social spending interact with cognition in terms of external political efficacy and support for equitable economic redistribution to increase protest potential. I employ a three-level cross-national time-series model on the World Values Survey/European Values Study integrated dataset (1981–2020), consisting of democratic and authoritarian-leaning countries. I find that the three cognitive theories are complementary and that the interaction of structural changes with micro-level cognition has nuanced associations with protest potential.
The prevalence and incidence of HIV in the ART era (2006–2016) in North West Tanzania
Authors: Mosha Neema R , Todd Jim , Mukerebe Crispin , Marston Milly , Colombe Soledad , Clark Benjamin , Beard James , Mtenga Baltazar , Slaymaker Emma , Boerma Ties , Zaba Basia , Urassa Mark
Published: January 2022

Background

Sub-Saharan countries bear a disproportionate percentage of HIV infections and HIV-related deaths despite the efforts to strengthen HIV prevention and treatments services, including ART. It is important to demonstrate how these services have contributed to reducing the epidemic using available population data.

Methods

We estimated the prevalence and incidence rates from a cohort running over 23 years in Magu District, Mwanza Region-North West Tanzania. Adults 15 years and over who were residents of the Kisesa observational HIV cohort study between 2006 and 2016 were eligible for inclusion. Survival analysis was used to calculate person-time at risk, incidence rates and 95% confidence intervals (CIs). Cox regression models were used for the risk factor analyses disaggregated by sex and age group.

Results

The HIV prevalence in the sero-surveys decreased from 7.2% in 2006/07 to 6.6% in 2016, with a notable decrease of over 50% for both men and women aged 15–24 years. The incidence rate for HIV was estimated to be 5.5 (95% CI 4.6–6.6) per 1,000 person-years in women compared to 4.6 (95% CI 3.5–5.8) in men, with a decrease over time. Despite the availability of ART services, the uptake is still small.

Conclusions

New infections are still occurring, with high HIV incidence in individuals aged below 45 years. With new guidelines and the 95-95-95 UNAIDS target, prevalence and incidence must be adequately assessed. In addition, there is a need for additional efforts to assess the impact of HIV/AIDS prevention programmes and intervention services, especially in these areas where resources are limited.
Optimal maintenance planning with special emphasis on deterioration process and vessel routing for offshore wind systems
Authors: Chou Shuo-Yan , Pham Xuan Loc , Nguyen Thi Anh Tuyet , Yu Tiffany Hui-Kuang
Published: January 2022

Maintenance cost contributes a large portion in total life-cycle cost of offshore wind systems and improves the efficiency of maintenance activities that has emerged as an effective solution in enhancing cost-effectiveness of offshore wind energy. This study proposes a mathematical model to determine the optimal maintenance schedules, by highlighting the deterioration process of offshore wind systems and accounting the optimal vessel routing of maintenance activities, maintenance cost therefore could be shifted to an optimal level. Firstly, reliability of each component is precisely analyzed with respect to the effect of previous maintenance activities. Then, an optimal individual maintenance schedule and a grouping maintenance schedule in daily manner are established based on reliability analysis and opportunity cost consideration. Finally, an optimal maintenance schedule approach accounting vessel routing is apparently presented to optimize the transportation cost of maintenance activities. Numerous influential factors such as system reliability, weather condition, maintenance resource, maintenance duration, production loss cost, and vessel related issues are deliberately examined to enhance the robustness and efficiency of the proposed approach. The experimental results investigating four different scenarios demonstrate that by applying the proposed approach, number of maintenance activity is lowered down, maintenance duration and vessel travelling distance are also significantly reduced in the range of 43.86% - 52.77%, and 52.90% - 58.35%, respectively. Therefore, the economic benefit on maintenance cost could be achieved in an interval of 15.15% - 23.25% by selecting the optimal maintenance schedule.
The digitalisation of service work: A comparative study of restructuring of the banking sector in the United Kingdom and Luxembourg
Authors: Kornelakis Andreas , Kirov Vassil , Thill Patrick
Published: January 2022

The article compares the process of digitalisation and outcomes from work restructuring in two banks from the United Kingdom and Luxembourg. The banking sectors in both countries have been challenged by digitalisation pressures such as online and mobile banking, pressures from ‘Fintech’ banks, and the automation of back-office operations. Yet, the adjustment paths in the two countries differed. In Luxembourg, there is an adjustment via limited lay-offs, and increased training and reskilling; however, in the United Kingdom, the main outcomes revolve around branch downsizing and offshoring of employment. These outcomes are explained by differences in institutional supports for collective voice institutions, as well as the role of the state. The findings demonstrate that the embedded employment relations’ institutions and actors have shaped distinct paths of adjustment to digitalisation; and show how the impact of technology on work is neither deterministic nor unidirectional.
Congenital cytomegalovirus infection after maternal primary infection in a patient with systemic lupus erythematosus: A case report and literature review
Authors: Nakamura Eri , Isoda Kentaro , Kotani Takuya , Hiramatsu Yuri , Wada Yumiko , Fujiki Youhei , Fujita Daisuke , Takeuchi Tohru
Published: January 2022

Background

Management of infectious complications in pregnant women receiving immunosuppressive therapy for systemic lupus erythematosus (SLE) is important. Maternal infection with cytomegalovirus (CMV) often causes congenital CMV infection in the foetus. Thus far, there are only few reports on congenital CMV infection after maternal reactivation in patients with SLE. We report the first case of congenital CMV infection after maternal primary infection in a patient with SLE.

Case presentation

A 19-year-old Japanese primigravida with SLE received treatment with prednisolone 3 mg/day and azathioprine 75 mg/day at conception. At 7 weeks of gestation, she suddenly developed fever and had decreased white blood cell and platelet counts and elevated aspartate aminotransferase and alanine aminotransferase levels. These clinical findings led to a diagnosis of SLE exacerbation. The prednisolone dose was increased to 15 mg/day, and hydroxychloroquine (200 mg/day) was administered. Consequently, all clinical findings normalised at 12 weeks. At 19 weeks, foetal ultrasound findings revealed oligohydramnios, brain hypoplasia, ventriculomegaly and hyperechogenic bowel. Maternal serological test results indicated increased CMV-specific IgG and IgM levels, low IgG avidity (26%), and positive CMV antigenemia. The foetus was diagnosed with symptomatic congenital CMV infection transmitted from the maternal primary infection. After counselling about the severe prognosis of the foetus, the mother decided to terminate her pregnancy and underwent artificial abortion at 21 weeks.

Discussion

The foetus of a mother with SLE who is receiving immunosuppressive therapy may be at increased risk of transmission and aggravation of congenital CMV infection; thus, preventive management and screening for congenital CMV infection during pregnancy are recommended for such patients. Maternal CMV infection shows clinical findings similar to those of SLE exacerbation, and careful differential diagnosis by maternal serological evaluation and foetal ultrasound scans is required.
A style for every age: A stylometric inquiry into crosswriters for children, adolescents and adults
Authors: Haverals Wouter , Geybels Lindsey , Joosen Vanessa
Published: January 2022

In the field of children’s literature studies, much attention has been devoted to investigating differences between children’s and adult literature. Works of crosswriters, authors who write for both readerships in different works, are an excellent source for this research. This article applies stylometry, the computational method of analysing style, to the oeuvres of 10 Dutch and English crosswriters to trace potential differences in their individual style and similarities between the authors. The analyses also take into account the age of the intended reader (as listed in the paratext) and the publication date, to study the influence these aspects have on writing style. Four case studies zoom in on a specific author or age category of the intended readership to study general tendencies as well as outliers. The results from the stylometric analyses are complemented with peritextual information about the author’s view on style and writing for readerships of different ages. The main conclusion drawn from the case studies is that the style of the texts usually correlates more strongly with the age of the intended reader than with the time period in which it was written. Young adult literature clusters more closely with adult literature. The style associated with a younger readership is distinct in the oeuvres of most authors studied in this article and even transcends the differences between authors.
Rapid identification of the storage age of dried tangerine peel using a hand-held near infrared spectrometer and machine learning
Authors: Zhang Xin , Gao Zhangming , Yang Yinglin , Pan Shaowei , Yin Jianwei , Yu Xiangyang
Published: January 2022

Dried tangerine peel is a Chinese medicine with high medicinal value. The storage age is an important indicator of its medicinal value, so it is very significant to accurately identify the storage age of dried tangerine peel. Traditional physical and chemical analysis methods can be used to achieve this goal, but these methods are limited by their operability and convenience. Near infrared (NIR) spectroscopy and machine learning have excellent performance in the rapid detection of food and pharmaceutical samples. This study investigated the novel application of integrating a hand-held NIR spectrometer combined with machine learning to rapidly and accurately identify the storage age of Xinhui dried tangerine peel. Savitzky–Golay convolution smoothing, standard normal variate (SNV), first derivative, and second derivative pretreatments were employed to preprocess spectral data. Principal component analysis (PCA) was used to reduce the spectral data dimensions and obtain the characteristic spectral variables of each sample. Support vector machine (SVM) and k-nearest neighbor were applied to establish the qualitative discriminant models. The SNV-PCA-SVM model discriminant accuracy was 99.60% in the validation set and was 96.50% in the test set, showing excellent generalization performance. The results indicated that the method of using a hand-held NIR spectrometer combined with machine learning could be applied to rapidly identify the storage age of Xinhui dried tangerine peel. This is a promising and economical hand-held NIR spectroscopic method for assuring the dried tangerine peel age on-site.
Challenging the entrepreneurial discourse around women home-based workers’ empowerment
Authors: Huq Afreen , Delaney Annie , Debney Ben
Published: January 2022

This article explores dominant entrepreneurship discourse and practice surrounding informal women home-based workers, and their relationship to goals of individual empowerment. We argue that conventional neoliberal entrepreneurship discourse conflates empowerment and performativity, linking the capacity of women to develop greater agency with their incorporation into an economic regime with predetermined roles, labelled ‘empowerment’. Applying a critical lens, we analyse the development discourse on entrepreneurship and economic performativity in these terms – looking to understand the characteristics of empowerment concerning home-based workers in Bangladesh working for a fair-trade organisation and a domestic garment supply chain. We argue that the conflation of empowerment and performativity serves the convenience of neoliberal ideology rather than the empowerment needs of those to whom such discourses are applied. To complement our critique, based on the empowerment literature, we develop a conceptual framework of empowerment and agency encompassing individual and collective agency, considering these in light of the relationship between performativity and social reproduction. Coupling a more nuanced understanding of empowerment to the critique of the entrepreneurial discourse, as applied to women home-based workers, provides a theoretical contribution to the empowerment and entrepreneurial discourse literature.
Countries Manufacturing Pharmaceuticals for the US Market: A 10-Year Analysis of Public Data
Authors: Hatton Randy C. , Leighton Greg , Englander Libbe
Published: January 2022

Background:

Concerns about strategic supplies and quality have increased the scrutiny of the countries where US pharmaceuticals are made.

Objective:

To examine the locations of manufacturers of brand name, biological, and generic drugs over 10 years.

Methods:

This longitudinal descriptive study used publicly available data from US government Web sites, including the Food and Drug Administration (FDA) Drug Establishments list, FDA National Drug Code Directory, FDA Orange Book, FDA Purple Book, and the National Institutes of Health DailyMed Drug Labels. These data were collected from 2011 to 2020.

Results:

Brand name drug manufacturing in the United States and Europe decreased from 89% in 2011 to 79% in 2020. Biological manufacturing in the United States decreased, while that in Western European countries increased; 100% of biological manufacturing was done in the United States or Europe in 2011 and decreased to 93% by 2020. Generic manufacturing in India increased from 21% to 51%, while US manufacturing decreased from 52% to 35% from 2011 to 2020. These analyses were limited to publicly available data, and the results could be affected by the accuracy and completeness of the data.

Conclusions and relevance:

Brand name drugs and biologicals are primarily made in the United States and Europe. Generic drugs are increasingly made in India, but the United States remains a major supplier. If the country of origin for pharmaceuticals is important, these findings support supply chain concerns for generic drugs. We recommend that product containers and official labeling prominently include the manufacturer and location for active pharmaceutical ingredients and finished dosage forms.
Ado-trastuzumab emtansine associated spider telangiectasia
Authors: Gursoy Pınar , Acar Ayda , Acikalin Taner
Published: January 2022

Introduction

Breast cancer is the most common cancer in women. Human epidermal growth factor receptor 2 (HER2) positivity rate is 20% and generally has a poor prognosis. Ado-trastuzumab emtansine (T-DM1) is an antibody–drug conjugate consisting of HER2 target monoclonal antibody trastuzumab and microtubule inhibitor emtansine. The most common side effects are fatigue, diarrhea, anemia, and it is generally a safe and tolerable agent.

Case report

In our case, we reported our patient who developed mucosal and cutaneous telangiectasia after T-DM1 treatment and who had a complete response in metastases after skin lesions.

Management and Outcome

While no side effects were observed during the use of T-DM1 for HER2 positive disease, nose bleeding and spider telangiectasia on the skin developed in the 9th month of the treatment. In these lesions, which did not require any treatment, no regression was observed during T-DM1 treatment.

Discussion

We think that T-DM1, which was detected with a low incidence of skin toxicity in studies, may form telangiectatic lesions due to vascular dilatation through emtansine, and therefore care should be taken in the treatment of T-DM1.
Bilateral lipid keratopathy with rheumatic fever in siblings
Authors: Richa Dhiman , Meena Lakshmipathy , Jyotirmay Biswas
Published: January 2022

Purpose

To report two unusual cases of lipid keratopathy in siblings with rheumatic fever and positive anti-phospholipid antibodies.

Methods

Clinical and histopathological examination along with complete systemic work-up was done after taking appropriate consent from the patients. A serum lipid profile showed elevated cholesterol and low-density lipoproteins. Systemic history revealed both the siblings were on treatment for rheumatic fever. A complete blood profile showed positive anti-phospholipid antibodies in one of them.

Results

Penetrating keratoplasty was performed in both cases one year apart. Histopathological examination showed lipid filled macrophages distributed throughout the corneal stroma. No episode of recurrence was noted in the follow-up period of three years.

Conclusion

These two cases highlight the importance of a thorough family history and a full systemic work-up in a patient with bilateral symmetrical lipid keratopathy. The co-existence of rheumatic fever and anti-phospholipid syndrome has been studied in literature but, their presence along with lipid keratopathy has not been previously described. It requires further research whether they have an association or it was just an incidental finding.
In with the old, out with the new! The more we keep pushing for theoretical novelty, the less informative entrepreneurship theory will become
Authors: Brinkerink Jasper
Published: January 2022

Field-wide editorial expectations for each entrepreneurship study to offer new and interesting theoretical insights or explanations discourage entrepreneurship scholars to conduct the type of research needed to secure a replicable, generalizable, and thereby useful knowledge base. I address the paradoxical – yet predictable – long-term consequences of the relentless push for theoretical novelty on the ultimate informativeness of entrepreneurship theory, and ask the entrepreneurship research community to consider our collective and individual responsibilities in improving the systematic empirical scrutiny to which we subject our field’s core assumptions.
Secure performance analysis and pilot spoofing attack detection in cell-free massive MIMO systems with finite-resolution ADCs
Authors: Zhang Xianyu , Qiao Xiaoqiang , Liang Tao , An Kang
Published: January 2022

In this article, the secure communication in cell-free massive multiple-input multiple-output system with low-resolution analog-to-digital converters is investigated in the presence of an active eavesdropper. Specifically, in this article, the deterioration caused by the analog-to-digital converter imperfections on the accuracy of the channel estimation and secure transmission performance is studied. Besides, the additive quantization noise model is utilized to analyze the impacts of the low-resolution analog-to-digital converters. The minimum mean square error channel estimation results show that there is a nonzero floor caused by the coarse analog-to-digital converters. Then, the closed-form expressions for both the legitimate users achievable ergodic rate and the information leakage to the eavesdropper are derived, respectively. Moreover, tight approximated ergodic secrecy rate expression is also presented with respect to analog-to-digital converters quantization bits, number of antennas, pilot power, and so on. To degrade the impacts of the pilot spoofing attack, an active attack detection approach based on random matrix theory is proposed which can only be operated at one access point. Simulation results are provided to corroborate the obtained results and analyze the impacts of various parameters on system secrecy performance. Also, the superiority of the proposed active attacks detection method is confirmed via simulation results.
Towards a Taxonomy of Collective Emotions
Authors: Thonhauser Gerhard
Published: January 2022

This paper distinguishes collective emotions from other phenomena pertaining to the social and interactive nature of emotion and proposes a taxonomy of different types of collective emotion. First, it emphasizes the distinction between collective emotions as affective experiences and underpinning mechanisms. Second, it elaborates on other types of affective experience, namely the social sharing of emotion, group-based emotions, and joint emotions. Then, it proposes a working definition of collective emotion via a minimal threshold and four structural features. Finally, it develops a taxonomy of five types of collective emotion: emotional sharing, emotional contagion, emotional matching, emotional segregation, and emotional fusion.
Hypercalcemia associated with dysgerminoma and elevation of calcitriol: A case report and review of the literature
Authors: Hara Natsuko , Suwanai Hirotsugu , Abe Hironori , Yakou Fumiyoshi , Ishikawa Takuya , Urayama Munehiro , Nagai Takeshi , Nagao Toshitaka , Shikuma Jumpei , Miwa Takashi , Suzuki Ryo , Odawara Masato
Published: January 2022

We report on the case of a patient with dysgerminoma, a rare germ cell tumor, which showed hypercalcemia with an elevation of 1α,25-dihydroxycholecalciferol (calcitriol). A 27-year-old nulliparous woman presented with hypercalcemia during the examination of a right ovarian tumor with an elevation of calcitriol, lactate dehydrogenase, and alkaline phosphatase. Fractional excretion of calcium was elevated, and intact parathyroid hormone was suppressed. After undergoing right salpingo-oophorectomy, the patient’s serum calcium and calcitriol returned to the normal range within a week. A literature search was conducted on the topic by reviewing databases for dysgerminoma showing hypercalcemia. We identified 14 patients from the literature and performed a pooled analysis, including the results of our case. However, most cases lack data that can help investigate the potential association between parathyroid hormone, parathyroid hormone-related protein, calcitriol, and phosphorus in hypercalcemia. Thus, more case reports that include additional information are required to fully elucidate the mechanism of hypercalcemia associated with dysgerminoma.
The Thick Machine: Anthropological AI between explanation and explication
Authors: Munk Anders Kristian , Olesen Asger Gehrt , Jacomy Mathieu
Published: January 2022

According to Clifford Geertz, the purpose of anthropology is not to explain culture but to explicate it. That should cause us to rethink our relationship with machine learning. It is, we contend, perfectly possible that machine learning algorithms, which are unable to explain, and could even be unexplainable themselves, can still be of critical use in a process of explication. Thus, we report on an experiment with anthropological AI. From a dataset of 175K Facebook comments, we trained a neural network to predict the emoji reaction associated with a comment and asked a group of human players to compete against the machine. We show that a) the machine can reach the same (poor) accuracy as the players (51%), b) it fails in roughly the same ways as the players, and c) easily predictable emoji reactions tend to reflect unambiguous situations where interpretation is easy. We therefore repurpose the failures of the neural network to point us to deeper and more ambiguous situations where interpretation is hard and explication becomes both necessary and interesting. We use this experiment as a point of departure for discussing how experiences from anthropology, and in particular the tension between formalist ethnoscience and interpretive thick description, might contribute to debates about explainable AI.
The Effect of Physical Environment Risk Factors on Vehicle Collisions Severity Involving Child-Pedestrians in Malaysia
Authors: Darus Nur Shaeza , Borhan Muhamad Nazri , Ishak Siti Zaharah , Ismail Rozmi , Mohd. Razali Siti Fatin , Yunin Nor Aznirahani Mhd , Hamidun Rizati
Published: January 2022

This study is aimed at investigating the association between child-pedestrian severity levels of collisions and physical environmental variables. The outcome of this study could be applied to road safety intervention for improving engineering modifications related to children pedestrians. The retrospective analysis was carried out using 6-year data from Royal Malaysia Police records from the years 2009 to 2014. Multinomial logit modeling (MNL) was applied. The results demonstrated that the injury severity of the collisions is related to road geometry, road surface material, road surface condition, traffic system, road marking, traffic control type, lighting condition, speed limit, time of collision, type of location, and land use characteristics. Specifically, fatal injury collisions are significantly increased by t/y intersection; concrete and earth-road surfaces; two-way traffic and dual carriageways; posted speed limits of 70 to 90 km/h; time of collision: 0 to 0659 hours (early morning) and 0700 to 0959 hours (morning); lighting conditions, including dark without street light, and dark with street light; and control type involving police. Meanwhile, cross intersections’ posted speed limits of 80 km/h to 90 km/h and the time of collision from 0 to 0659 hours (early morning) and 1900 to 2459 hours (night), significantly increased serious injury collisions. Notably, the findings revealed the importance of more in-depth studies on physical environmental features that relate to child-pedestrians’ severity level of collisions. This is essential for improvements to physical environmental designs by policymakers. Thus, policymakers and stakeholders can utilize the findings to further improve the physical environment through structure and design.
Neonatal Urinary Tract Infection and Renal Nodular Lesion: A Rare Case of Xanthogranulomatous Pyelonephritis
Authors: Morais Catarina Granjo , Gomes Sara , Fragoso Ana Catarina , Coelho Janine , Jardim Joana , Barreira João Luís , Pinto-Carvalho Irene , Pinto Helena
Published: January 2022

Xanthogranulomatous pyelonephritis (XPN) is an uncommon variant of chronic pyelonephritis with a poorly understood pathogenesis and a challenging diagnosis. It is rare in pediatric patients, particularly in the neonatal period. We report the case of an 18-day-old female neonate admitted to the emergency room due to macroscopic hematuria and poor feeding. Urinalysis revealed leukocyturia and she was initially admitted under the clinical suspicion of acute pyelonephritis. Renal ultrasound and magnetic resonance imaging (MRI) revealed a progressive nodular lesion in the middle third of the left kidney. Given the suspicion of renal abscess or neoplasm, the patient was transferred to our tertiary hospital. Urinary catecholamines and tumor markers had normal values. Percutaneous kidney biopsy confirmed XPN. Posterior computed tomography scan excluded extension to neighboring structures. A conservative management with systemic antibiotic therapy was decided. She completed 7 weeks of systemic antibiotic therapy (ampicillin and cefotaxime) with progressive reduction of lesion size and posterior calcification. Follow-up at 3 years was uneventful. The lipid profile and study of neutrophil function were normal. Voiding cystourethrography excluded vesicoureteral reflux. The authors intend to highlight the importance of a high index of suspicion of XPN to allow preoperative diagnosis. Histopathological assessment is mandatory to confirm XPN and exclude other entities mimicked by focal and unilateral progressive disease. There are only a few published cases of optimal clinical evolution solely with broad-spectrum antibiotics; however, this may allow a beneficial nephron-sparing approach in selected patients.
Understanding the Cheerleader as an Orthopaedic Patient: An Evidence-Based Review of the Literature
Authors: Xu Amy L. , Beck Jennifer J. , Sweeney Emily A. , Severson Megan N. , Page A. Stacie , Lee R. Jay
Published: January 2022

Cheerleading is a highly popular youth sport in the United States and has been increasingly recognized in recent years for its athleticism and competitive nature. The sport has changed dramatically since its inception. When the sport of cheerleading was first developed, its primary purpose was to entertain crowds and support other athletes. Today, cheerleaders are competitive athletes themselves. Cheerleaders, most of whom are in the pediatric age group, and their parents commonly approach orthopaedic surgeons and sports medicine physicians with questions regarding the risks associated with participation in the sport. Appropriate clinical guidance is especially important for athletes returning to the sport after an injury. However, unlike other popular sports (eg, football, basketball, and volleyball), the intricacies of cheerleading are not well-known to those outside the sport, including many health care providers. Previous studies have reported on the epidemiological patterns of injuries associated with cheerleading and how such aesthetic sports affect the body, finding that fractures and concussions are prevalent and that catastrophic injuries are more common than in most other sports. Here, we provide an evidence-based discussion of 10 pertinent topics regarding cheerleading and its risks to the musculoskeletal system. The purpose of this review is to provide a comprehensive resource for orthopaedic surgeons and sports medicine physicians who care for these athletes.
Diversity and Inclusion or Tokens? A Qualitative Study of Black Women Academic Nurse Leaders in the United States
Authors: Iheduru-Anderson Kechi , Okoro Florence O. , Moore Shawana S.
Published: January 2022

Severe under-representation of Black women academic nurse leaders persists in United States higher education, and a major research gap still exists regarding experiences of these leaders, and facilitators of and barriers to their success. Our objective was to examine how race and gender influence how Black women academic nurse leaders’ function in their leadership positions, how they are perceived by their peers, and how their perception of race, gender, class, and power influences diversity, equity, and inclusion initiatives in the workplace. Critical race theory was used as a guiding theory, and the study design involved narrative inquiry followed by thematic analysis. Four overarching themes with four sub-themes were revealed: (a) Paying a personal price for authenticity, (b) Being the only one is hard even when you are in charge, (c) The illusion of diversity and inclusion while trying to survive, and (d) Focusing on building and sustaining diversity, equity, and inclusion. Implications for nursing education including instituting training for faculty in anti-racist pedagogy and requiring nursing programs to meet inclusivity metrics for approval and accreditation.