bluuebunny/crossref_metadata_2025 huggingface dataset:
Reference intervals for biochemical analytes in transgender individuals on hormone therapy
Authors: Bezuidenhout Morné C , Conradie-Smit Marli , Dave Joel A , de Vries Elma , Ross Ian L , Zemlin Annalise E
Published: January 2022

Background

Hormone therapy in transgender individuals may impact processes that lead to changes in biochemical analytes, and therefore reference intervals. Currently, few reference interval studies are available for the transgender population. We determined biochemical reference intervals for transgender individuals receiving hormone therapy.

Methods

Our retrospective, laboratory-based, observational study included healthy transgender males ( N = 24) and transgender females ( N = 84) on hormone therapy. Various biochemical reference intervals were established for each cohort and compared to their cisgender counterparts.

Results

We detected significant differences in reference intervals for sodium, 139–142 mmol/L vs. 136–145 mmol/L when comparing transgender males (TM) with cisgender males (CM). The following significant changes in upper reference limits (URL) for TM versus CM were detected, ALP (URL: 96 U/L vs. 128 U/L), GGT (URL: 27 U/L vs. 67 U/L) and testosterone (URL: 46.7 nmol/L vs. 29.0 nmol/L), respectively. Moreover, when comparing transgender female (TF) to cisgender female (CF), significant differences in creatinine (URL: 117 μmol/L vs. 90 μmol/L), albumin (lower reference limit: 41 g/L, vs. 35 g/L), AST (URL: 50 U/L vs. 35 U/L), ALP (URL: 118 U/L vs. 98 U/L) and oestradiol (URL: 934 pmol/L vs. 213 pmol/L) were noted, respectively. Significantly higher LDL-C was observed for TM on hormone treatment, compared to baseline (2.9 mmol/L vs. 2.2 mmol/L, p <0.01).

Conclusions

Biochemical results for TM and TF receiving hormone therapy can be evaluated against our transgender-specific reference intervals for some analytes, while others can be compared to their identified gender reference intervals.
Hidden in (Virtual) Plain Sight: A Charter District’s Focus on Attendance During COVID-19
Authors: Childs Joshua , Grooms Ain , Mozley Mollie Purcell
Published: January 2022

COVID-19 placed a significant burden on urban students of color and their families. Changing environmental, community, and schooling factors influenced students’ ability and desire to attend school regularly. To ensure that students would attend school, district and school leaders were challenged with creating school environments and cultures that would promote attendance and overall safety. This case study of a charter school district in Texas highlights how organizational commitment by leaders and desire to get students to attend school during the pandemic, was pivotal as the school was transitioning during uncertain times. Interviews with district and school leaders revealed that supports, resources, and integration of technology helped to influence student attendance and helped to create plans for safely reopening.
Critical Essay: Wicked problems in the Age of Uncertainty
Authors: Grint Keith
Published: January 2022

We are, apparently, living in unprecedented times, an Age of Uncertainty, when wicked problems whirl all around as we struggle to cope with Covid-19, environmental catastrophe and the right-wing populism that threatens to unravel all kinds of international agreements. In this personal reflection, 15 years after I wrote an article on wicked problems and the social construction of leadership, I take a look back, and forward, to see whether there ever was an Age of Certainty when only tame problems temporarily troubled us, or whether our understanding of the world is itself a social construction, open to dispute and thus we have always lived in uncertain times. In the process of this evaluation, I consider whether collaborative leadership, often associated with wicked problems, is as ubiquitous and effective as some proponents make out, and if it isn’t, what this says about our ability to address such problems.
Business as service? Human Relations and the British interwar management movement
Authors: Maclean Mairi , Shaw Gareth , Harvey Charles
Published: January 2022

To what extent should business have an implication of service when its fundamental purpose is profit-seeking? We explore this issue through a contextually informed reappraisal of British interwar management thinking (1918–1939), drawing on rich archival material concerning the Rowntree business lectures and management research groups. Whereas existing literature is framed around scientific management versus human relations schools, we find a third pronounced, related theme: business as service. Our main contribution is to identify the origins in Britain of the discourse of corporate social responsibility in the guise of business as service. We show that this emerged earlier than commonly assumed and was imbued with an instrumental intent from its inception as a form of management control. This was a discourse emanating not from management theorists but from management practitioners, striving to put the corporate system on a sustainable footing while safeguarding the power, authority, and legitimacy of incumbent managerial elites.
Cinematic empire and nostalgia in Viceroy’s House and Victoria and Abdul
Authors: Pirzada Tehmina , Pirzadeh Saba
Published: January 2022

The commercial viability of Gurinder Chadha’s Viceroy’s House (2017) and Stephen Frears’ Victoria and Abdul (2017) can be attributed to their effective use of heritage film elements to offer romanticized versions of British rule. Decoding the teleological intent behind these romanticized versions, this article contends that the chosen films promote nostalgia in response to the postimperial melancholia that Britain is experiencing in the contemporary period. Exploring the cinematic recreation of nostalgia, this article analyses the spatial, material, and racial aspects of Victoria and Abdul and Viceroy’s House. The spatial analysis highlights the cinematography used to depict heritage space to commemorate British tradition, the material examination focuses on colonial gifts of economic mobility and political emancipation bestowed on the colonized, and the racial analysis focuses on Muslim stereotyping through exoticism and animalization to reinforce British pride in civilizing the “inferior race”. An explication of these cinematic and narrative elements highlights the films’ invocation of nostalgia for an idealized past through a return to a closed epoch of empire that uncritically and dangerously reproduces ideologies of British cultural and racial superiority. Furthermore, this invocation of nostalgia works to glorify British historical origins and strengthen national cohesion in order to allay collective anxieties about the abject loss of the empire’s global recognition in the wake of Brexit.
Agents of transition or defenders of the status quo? Trade union strategies in green transitions
Authors: Kalt Tobias
Published: January 2022

Green transitions create major challenges to union power in carbon-intensive economies as well as opportunities for the renewal of union power. This research asks why sometimes unions oppose or delay green transitions while other times unions are more open to green transitions and may even become strong transition supporters. In drawing on the Power Resource Approach, I argue that unions are neither natural opponents nor supporters of green transitions but instead engage strategically with green transitions. Unions’ strategic choices to pursue oppositional, reactive, affirmative or transformative transition strategies is guided by an imperative to maintain or expand their power resources. The strategic choices unions make are influenced by several contextual conditions. In a comparative case study on coal transitions in South Africa and Germany, I identify the following contextual conditions: sectoral interests, organisational identity, internal structure, coalitions, political- and socio-economic environment, governance context and public discourse. Regarding each of these, I show how unions make strategic choices to protect or expand different power resources and become agents of transition or defenders of the status quo. This paper contributes to empirical research on drivers behind union transition strategies and offers an analytical framework to explain unions’ strategic choices in green transitions.
Electronic packaging cabinets simplified modeling, simulation, and experimental validation for systems engineering
Authors: Vargas José V C , Yang Sam , Ordonez Juan Carlos , Rigatti Luiz F , Peixoto Pedro H R , Balmant Wellington , Mariano Andre B
Published: January 2022

A simplified three-dimensional mathematical model for electronic packaging cabinets was derived from physical laws. Tridimensionality resulted from the domain division in volume elements (VEs) with uniform properties, each with one temperature, and empirical and theoretical correlations allowed for modeling their energetic interaction, thus producing ordinary differential equations (ODEs) temperatures versus time system. The cabinet (2048 mm × 1974 mm × 850 mm) thermal response with one heat source was measured. Data set 1 with a 1.6-kW power source was used for model adjustment by solving an inverse problem of parameter estimation (IPPE) having the cabinet internal average air velocities as adjustment parameters. Data set 2 obtained with a 3-kW power source validated model results. The converged mesh had a total of 7500 VE. The steady-state solution took between 16 and 19 s of CPU time to reach convergence and less than 3 min to obtain the 6500-s cabinet dynamic response under variable loading conditions, in an Intel CORE i7 computer. After validation, the model was used to study the impact of heat source height on system thermal response. Fundamentally, a sharp minimum junction temperature Tjct,min = 98.5 °C was obtained in the system hot spot at an optimal heat source height, which was 25.7 °C less than the highest calculated value within the investigated range (0.1 m < zjct < 1.66 m) for the 1.6-kW power setting, which characterizes the novelty of the research, and is worth to be pursued, no matter how complex the actual cabinet design may be.
Acquisition of cumulative conditioning effects on words: Spanish-speaking children’s [subject pronoun + verb] usage
Authors: Brown Esther L. , Shin Naomi
Published: January 2022

Child language acquisition research has provided ample evidence of lexical frequency effects. This corpus-based analysis introduces a novel frequency measure shown to significantly constrain adult language variation, but heretofore unexplored in child language acquisition research. Among adults, frequent occurrence of a form in a particular discourse context that conditions usage accumulates in memory over time and shapes the lexical representation of that form. This study contributes to the body of research on frequency effects in child language acquisition by testing whether such cumulative conditioning effects are also found among children, and, if so, at what age such effects appear. Specifically, the study investigates the influence of a distributional frequency measure (each verb form’s likelihood of use in a switch vs same-reference discourse context) on variable subject personal pronoun (SPP) expression ( N = 2227) in Spanish (e.g. yo voy ~ voy, both meaning ‘I go’) in the speech of 65 monolingual children in two age cohorts. Results reveal sensitivity to the contextual conditioning of discourse continuity (switch reference) among both the younger (6- and 7-year-olds) and older (8- and 9-year-olds) children in support of previous research. In addition, each verb’s likelihood of use in a switch-reference context significantly predicted the SPP use among the older children, but not the younger ones, suggesting that the cumulative effect of a probabilistic pattern takes time to emerge during childhood. The lexically specific accumulation in memory of contextual conditioning effects supports exemplar models of child language acquisition: each instance of use in discourse contributes to the lexical representation of that form and, over time, plays a role in the creation of morphosyntactic patterns during language development.
Evaluation of thermal comfort in mixed-mode buildings in temperate oceanic climates using American Society of Heating, Refrigeration, and Air Conditioning Engineers Comfort Database II
Authors: Gaffoor Mohamad Abdul , Eftekhari Mahroo , Luo Xiaoyan
Published: January 2022

A comprehensive understanding of occupant comfort in mixed-mode (MM) buildings is crucial for the design of MM buildings which are being proposed as a low-energy solution to combat the global warming without compromising comfort. Current comfort standards are mainly for naturally ventilated (NV) or air-conditioned (AC) buildings, and there is a significant gap in standards for MM buildings. With comfort databases playing a major role in the development of thermal comfort models, the recently published ASHRAE Global Thermal Comfort Database II is utilised, in this research, to investigate the thermal sensation and occupant’s behavioural adaptations in MM buildings in temperate oceanic climates and to develop an adaptive thermal comfort model based on the outdoor environmental conditions. The Fanger's PMV model was found to underpredict the actual thermal sensation of the occupants while the occupant adaptivity was found to be lower than that predicted by the adaptive models of Standard 55 and EN15251/EN 16798-1. Furthermore, based on the results of this study and the various impediments faced, recommendations are proposed for future comfort surveys so that more detailed and conclusive studies can be conducted for wider applications using open-source thermal comfort databases.

Good understanding of occupant comfort is necessary to reduce building energy consumption without compromising comfort. This article explores the use of ASHRAE Comfort Database II for determining occupant comfort in MM buildings in temperate oceanic climates and the limitations faced therein. A practical and publicly accessible database developed based on the recommendations from this study will improve thermal comfort models and enable better prediction of occupant comfort while improving energy efficiency substantially.
University-Industry Collaboration in a Cross-Border Iberian Regions
Authors: Mascarenhas Carla , Marques Carla , Ferreira João J. , Galvão Anderson
Published: January 2022

This study sought to understand how the differences in university-industry (U-I) dynamics in two cross-border regions act on their research and innovation performance. Surveys were administered to academics from research centres or units in Portugal’s Northern Region and Spain’s Castile and Leon. Data were also collected from the Community Innovation Survey (CIS2014) conducted in Portugal and Spain, to obtain a broader perspective on the topic and regions under analysis. A comparison could thus be made between the researchers’ perspective (i.e. micro) and the companies’ perspective that answered the CIS questionnaire (i.e. meso) on U-I collaboration dynamics. The questionnaires were analysed using Partial least squares structural equation modelling, and the data from CIS survey using logistic regression. The results show that U-I cooperation is associated with (i) time spent on research and development, (ii) budgets based on direct contracts with industries, (iii) companies’ location and (iv) incentives for collaboration. However, the researchers’ age and academic field are the only factors affecting which incentives for collaboration are significant. The results also reveal that U-I collaboration influences regions’ innovation profiles. These findings contribute to a fuller, more empirical understanding of U-I cooperation, demonstrating that encouragement of this type of collaboration can be a driver of innovation in any region. This article contributes in policy terms to a better understanding of the necessary incentives for both U-I collaboration and the internationalisation of this collaboration.
Gendered and Stratified Family Formation Trajectories in the Context of Latin American Migration, 1950 to 2000
Authors: Castro Torres Andrés F. , Gutierrez-Vazquez Edith Y.
Published: January 2022

The interdependence of migration and family formation has been studied extensively, but studies that consider the embeddedness of this interdependence within gender and class relations are less common. Most existing research on family and migration treats gender and social class as separate determinants of family events or transitions, instead of analyzing how the intersections of both shape full family formation trajectories, defined as all partnership and childbearing statuses throughout an individual life course. We overcome this gap by using an intersectionality framework to analyze trajectories of family formation and migration collected by the Mexican and Latin American Migration projects (1982–2016). Using retrospective information, we reconstruct full family formation and dissolution trajectories (i.e., individuals’ marital statuses and number of children born from ages 15 to 39) for 16,000 individuals and apply sequence and cluster analysis to define a six-category typology of ideal family formation trajectories. Next, we associate this typology with individuals’ sex, age at migration (domestic, international), and educational attainment as a way to measure individuals’ social class position. Our results suggest that the relationship between migration and typical family trajectories depends on the intersection of individuals’ social class and gender. Previous studies have neglected this intersection by overly focusing on the “average” migrant's experience. Migration research must acknowledge and account for migrants’ heterogenous experiences and pay more attention to how intersecting social categories mediate the relationship between migration and other demographic processes.
When Diaspora Politics Meet Global Ambitions: Diaspora Institutions Amid China's Geopolitical Transformations
Authors: Liu Jiaqi M.
Published: January 2022

Through a case study of China, one of the largest emigration states and a rising global power, this article probes how a homeland state envisions diaspora politics amid geopolitical transformations. Drawing on historical, policy, and interview data, I argue that China's changing positioning toward Chinese emigrants, triggered by the state's geopolitical vicissitudes, has reshaped and repurposed diaspora institutions. I find that since the 2010s, China's diaspora policies have shifted away from soliciting diasporic support for domestic economic growth and national unification and toward liaising externally with migrants to expand Chinese soft power abroad. In consequence, diaspora institutions with more extensive overseas connections and flexible working experiences have taken precedence over formal state agencies specialized in domestic policymaking. This article makes two theoretical contributions to a multilevel understanding of diaspora politics as traversing simultaneously the domestic and global political fields. First, following neo-pluralism, I examine China's diaspora bureaucracy as composed of a diverse set of state entities with distinctive, or even contradictory, interests, orientations, and philosophies. These organizational variations shape diaspora institutions’ different strengths and fluctuating significance in China's shifting geopolitical strategies. Second, by situating emigrants and diaspora institutions in the macrohistorical framework of world politics, this article pushes research on diaspora politics into more profound dialog with world-systems theory. Rather than assuming an asymmetric interdependence between weaker emigration countries and hegemonic immigration countries, I demonstrate how an aspirational homeland state seeks to challenge this established world order and accomplish its geopolitical ascendancy through diaspora re-strategizing and institutional reshuffling.
Effects of control mechanisms on supply chain resilience and sustainability performance
Authors: Cui Li , Jin Ziyi , Li Ying , Wang Yating
Published: January 2022

Supply chain resilience (SCRES) plays an important role in dealing with disruptions in a highly turbulent business environment and has received a fair amount of attention from industry and academia. This study explores the relationships among control mechanisms (process, social, and outcome control), SCRES (proactive and reactive resilience), and sustainability performance (economic, environmental, and social performance). Structural equation modeling is used to analyze data collected from 322 Chinese manufacturing firms. This study finds that process control and social control have a positive impact on the two dimensions of SCRES, while outcome control has no significant impact on SCRES. Proactive and reactive resilience both have a significant positive impact on the three dimensions of sustainability performance. The results deepen the understanding of the enablers and performance of SCRES. They also provide managerial insights into how to use control mechanisms to build SCRES capability for sustainable development.

JEL Classification: M1
Effectiveness of Soy Methyl Ester-Polystyrene as a Concrete Protectant on Mitigating the Chemical Interaction between Cement Paste and Calcium Chloride
Authors: He Jialuo , Thway Thiha , Farnam Yaghoob
Published: January 2022

Concrete pavements and bridge decks suffer from severe deterioration caused by the application of chloride-based deicing salts (i.e., NaCl, CaCl2, and MgCl2) during winter. One of them is the formation of a destructive calcium oxychloride (CAOXY) phase caused by the chemical interaction between cement paste and CaCl2/MgCl2. By simulating the practical service conditions, this work investigated the formed CAOXY phase in cement paste exposed to CaCl2 solution and evaluated the performance of soy methyl ester-polystyrene (SME-PS) blend as a promising concrete protectant in mitigating the formation of CAOXY. With the surface treatment of SME-PS, cement paste showed less than 10% of the formed CAOXY phase in control cement paste after being exposed to CaCl2 solution for 28 days. In control cement paste, the amount of formed CAOXY at the exposed surface increased with the exposure time and some of the CAOXY phase formed in the cement paste exhibited a higher phase changing temperature. Moreover, a modified model based on Fick’s second Law was developed for predicting the CAOXY content in concrete with respect to the depth of the exposed surface. This model was verified by the comparison between the predicted values and the data obtained from a low-temperature differential scanning calorimetry (LT-DSC) test.
Study on the Liquid Centroid Positions of Elliptical Tank Trucks under Different Steering Conditions
Authors: He Lieyun , Lin Xinming
Published: January 2022

There is a certain gas phase space in the filling of tank trucks, and the position of the liquid center of mass in the tank will change when the tank truck is being steered, which affects the driving stability of the vehicle. Taking the elliptical cross section of the tank truck body as the research object and based on the quasi-static mechanical model, the exact algorithm model of liquid centroid positions in different steering conditions of tank trucks have been deduced. Then, taking centrifugal acceleration, the liquid filling ratio, and the tank shape and dimension as independent variables and the centroid coordinates as the dependent variables, respectively, and applying MATLAB to describe the change of the liquid centroid position, the liquid centroid position in the elliptical tank truck is described when the elliptical tank truck is being steered. The factors affecting the steering stability of the tank truck are also analyzed. The conclusion provides a theoretical basis for further research into the running stability of tank trucks, the optimization of a tank’s shape and size, the modeling of lateral sloshing mechanics, and the software algorithm for the reconstruction of tank truck accidents.
Herceptin-conjugated magnetic polystyrene-Agsbox nanoparticles as a theranostic agent for breast cancer
Authors: Karahaliloğlu Zeynep , Kilicay Ebru , Hazer Baki
Published: January 2022

Breast cancer is a malignant tumor, which has derived from cells of the breast. Further, a relatively rapid metastasis, and resistance development against all the conventional drug combinations are major clinical issues in breast cancer patients as well as limitations like toxicity, genetic mutation, and metastasis make difficult the use of conventional therapy methods such as chemotherapy, radiotherapy, and local surgery. Therefore, considering the urgent needs, and high death rate in breast cancer cases, the development of new diagnosis and treatment regimens which diagnosed at the early stage and protected normal tissues required for clinical applications. Recently, the combination of tumor diagnosis and treatment within a single platform is a novel perspective, and magnetic nanoparticles are potential candidate owing to their low toxic effect, biocompatibility, biological degradability, superior magnetic properties, and targeting ability to overcome the problems of conventional diagnosis and therapy techniques. Considering these restrictions and requirements, the goal of this research was to investigate the potential of an innovative theranostic agent, which is soybean oil-based polystyrene (PS)-g-soybean oil graft copolymer containing AgNPs (PS-Agsbox) for treatment and MRI-based diagnosis of cancer. Herein, we designed targeted magnetic PS-Agsbox nanoparticles carrying thymoquinone (TQ) that is known for its anticancer potential against breast cancer, and herceptin (HER), which is to bind to the HER2 receptor protein on the surface of HER2-positive tumor cells, and acts by blocking the effects of it. We have successfully demonstrated selective binding, effective uptake of HER-conjugated magnetic PS-Agsbox nanoparticles into MDA-MB-231 (human breast carcinoma cells, a HER2-underexpressing cell line) and SKBR-3 (human breast cancer cells, a HER2-overexpressing breast cancer cell line) cell lines while no effect against L929 (mouse fibroblast cell line). Moreover, the magnetic resonance (MRI) properties of HER-conjugated magnetic PS-Agsbox nanoparticles were also confirmed.
An Evaluation of the Methodological Underpinnings of a Laboratory Paradigm for the Study of Sexual Violence
Authors: Angelone D. J. , Mitchell Damon , Yucel Ebru , Davis Kelly Cue , George William H.
Published: January 2022

Ethically constructed laboratory paradigms can provide behaviorally based opportunities to study sexual violence as an addition to questionnaires. One such paradigm invites male participants to watch and show sexual materials to a female confederate as an analog of sexual perpetration. However, there has been inconsistency in the confederate’s presentation, such that she either expresses a dislike of sexual material or her preferences are omitted. Some researchers have also questioned whether an expressed dislike is analogous to an expressed nonconsent. As such, the primary goal of the current study was to determine whether confederate expressions of dislike, nonconsent, or the omission of a preference, differentially affect male participants’ behavior within a well-established paradigm. That is, we attempted to clarify the appropriate methodology for future researchers (i.e., the validity of the paradigm) and determine the impact of such a situational manipulation on laboratory-based sexual violence. Participants were 276 adult men, who were randomly assigned to one of three conditions: (1) dislike, (2) nonconsent, or (3) said nothing (the omission of a preference) and then asked to show a brief video clip to the female confederate who expressed these preferences. Overall, exposure to experimental condition predicted sexual video-showing over and above that of social desirability, hostile sexism (HS), and sexual violence history, suggesting that situational variables can play a significant role in laboratory-based sexual violence. Greater HS was associated with greater likelihood of sexual video-showing in the nonconsent condition relative to the dislike condition. Sexual video-showing was most frequent in the said nothing condition. In sum, researchers should be mindful of the confederate expression (or lack thereof) of preferences for sexual materials when using the sexual imposition paradigm.
Niche Diversity Predicts Personality Structure Across 115 Nations
Authors: Durkee Patrick K. , Lukaszewski Aaron W. , von Rueden Christopher R. , Gurven Michael D. , Buss David M. , Tucker-Drob Elliot M.
Published: January 2022

The niche-diversity hypothesis proposes that personality structure arises from the affordances of unique trait combinations within a society. It predicts that personality traits will be both more variable and differentiated in populations with more distinct social and ecological niches. Prior tests of this hypothesis in 55 nations suffered from potential confounds associated with differences in the measurement properties of personality scales across groups. Using psychometric methods for the approximation of cross-national measurement invariance, we tested the niche-diversity hypothesis in a sample of 115 nations ( N = 685,089). We found that an index of niche diversity was robustly associated with lower intertrait covariance and greater personality dimensionality across nations but was not consistently related to trait variances. These findings generally bolster the core of the niche-diversity hypothesis, demonstrating the contingency of human personality structure on socioecological contexts.
On the ambivalence of preferences for income redistribution: A research note
Authors: Dallinger Ursula
Published: January 2022

Increased income inequality, and policies that can limit its further growth, are an important issue for citizens, politicians and the media. Numerous empirical studies have measured political support for redistributive policies by asking whether the government should equalize gaps between rich and poor. They try to discover whether ‘redistributive’ policies are supported by public opinion and are therefore politically feasible. This research note argues that the standard instrument measures diffuse support for more equality, but gives rather vague hints if this support is transformed into a political mandate for redistributive programmes. With regard to the way in which the political demand for state redistribution to reduce income inequality has been raised so far, methodological critique and innovation is largely lacking. This article therefore tests the validity of the standard item. It argues that the conventional measurement only captures a general ‘inclination’ towards the idea of equality. However, since the item phrasing is unspecific, other orientations confound the answers, so that ultimately the predictive power in terms of political behaviour is low. The standard item measures egalitarian preferences with inconsistence. This limits its reliability, so that hardly any conclusions can be drawn regarding voting for left parties or support for redistributive programmes.
Antiphospholipid syndrome–mediated acute cerebrovascular diseases and long-term outcomes
Authors: García-Grimshaw Miguel , Posadas-Pinto Diego Rubén , Jiménez-Ruiz Amado , Valdés-Ferrer Sergio Iván , Cadena-Fernández Arturo , Torres-Ruiz José Jiram , Barrientos-Guerra José Domingo , Amancha-Gabela Margarita , Chiquete Erwin , Flores-Silva Fernando Daniel , Cantú-Brito Carlos
Published: January 2022

Objectives

The antiphospholipid syndrome (APS) is an autoimmune disease associated with thrombotic and non-thrombotic neurologic manifestations. APS is classified as primary (PAPS) or secondary (SAPS) when it co-exists with another autoimmune disease. We aim to describe the spectrum of acute cerebrovascular disease among patients with APS, their differences between stroke subtypes, and long-term functional outcomes.

Methods

Retrospective cohort study including adult (≥18 years) patients with APS followed in the stroke clinic of a tertiary-care reference center for autoimmune diseases in Mexico from 2009 to 2019.

Results

We studied 120 cases; 99 (82.5%) women; median age 43 years (interquartile range 35–52); 63.3% with SAPS. Demographics, comorbidities, and antiphospholipid antibodies (aPL) positivity were similar between APS type and stroke subtypes. Amongst index events, we observed 84 (70%) acute ischemic strokes (AIS), 19 (15.8%) cerebral venous thromboses (CVT), 11 (9.2%) intracerebral hemorrhages (ICH), and six (5%) subarachnoid hemorrhages (SAH). Sixty-seven (55.8%) were known patients with APS; the median time from APS diagnosis to index stroke was 46 months (interquartile range 12–96); 64.7% of intracranial hemorrhages (ICH or SAH) occurred ≥4 years after APS was diagnosed (23.5% anticoagulation-related); 63.2% of CVT cases developed before APS was diagnosed or simultaneously. Recurrences occurred in 26 (22.8%) patients, AIS, in 18 (69.2%); intracranial hemorrhage, in eight (30.8%). Long-term functional outcomes were good (modified Rankin Scale ≤2) in 63.2% of cases, during follow-up, the all-cause mortality rate was 19.2%.

Conclusion

We found no differences between stroke subtypes and APS types. aPL profiles were not associated with any of the acute cerebrovascular diseases described in this cohort. CVT may be an initial thrombotic manifestation of APS with low mortality and good long-term functional outcome.
A comparison of various aggregation functions in multi-criteria decision analysis for drug benefit–risk assessment
Authors: Menzies Tom , Saint-Hilary Gaelle , Mozgunov Pavel
Published: January 2022

Multi-criteria decision analysis is a quantitative approach to the drug benefit–risk assessment which allows for consistent comparisons by summarising all benefits and risks in a single score. The multi-criteria decision analysis consists of several components, one of which is the utility (or loss) score function that defines how benefits and risks are aggregated into a single quantity. While a linear utility score is one of the most widely used approach in benefit–risk assessment, it is recognised that it can result in counter-intuitive decisions, for example, recommending a treatment with extremely low benefits or high risks. To overcome this problem, alternative approaches to the scores construction, namely, product, multi-linear and Scale Loss Score models, were suggested. However, to date, the majority of arguments concerning the differences implied by these models are heuristic. In this work, we consider four models to calculate the aggregated utility/loss scores and compared their performance in an extensive simulation study over many different scenarios, and in a case study. It is found that the product and Scale Loss Score models provide more intuitive treatment recommendation decisions in the majority of scenarios compared to the linear and multi-linear models, and are more robust to the correlation in the criteria.
Can the Post-COVID FDI Boost the Indian Economy?
Authors: Jaswal Isha , Badri Narayanan G  , Jain Shanu
Published: January 2022

Ever since the liberation of trade policies in India, Foreign Direct Investments (FDI) has been crucial in the growth of the economy, both at the macro as well as sector level. The association between FDI and economic growth is an area of interest globally. The investment decisions are affected by several national and international events that add to the volatility of the number of inflows. COVID-19 pandemic severely impacted the intensity of FDI inflows. But the strong resilience by our government manifested in crucial policy reforms and proactive decision-making minimized the impact. This article examines the potential impact of FDI on crucial macroeconomic variables using the Computable General Equilibrium (CGE) Model. Introducing the policy shock of $90 billion into the model, an increase of 5.68% per annum in GDP is estimated. Findings indicate that the impact of FDI shall be favourable to a large number of sectors mainly metals, construction, motor vehicle, computers, and electronics in terms of increased output, exports, and employment opportunities. The study offers logical implications for the policymakers to continue strengthening their moves to attract FDI.
Decision-Support Needs of Caregivers Considering Hospice Enrollment for a Family Member With Dementia
Authors: Schlag Karen Elizabeth , Britt Katherine Carroll , Kwak Jung , Burrows David Ray , Fry Liam
Published: January 2022

Background: There are few evidence-based interventions to support the growing number of family caregivers of persons living with advanced dementias (PWADs) in surrogate decision-making roles. This study identifies needs for decision support among family caregivers considering hospice enrollment for PWADs, in order to better inform efforts for decision support. Method: Individual and focus group interviews were conducted with caregivers (n = 13) and healthcare professionals (n = 14). Directed content analysis was used to identify and organize themes that emerged from interview transcripts. Results: Analysis revealed 2 themes concerning PWAD caregivers’ hospice-related decision-support needs: (1) detailed and practical information about hospice and (2) discussions clarifying meaning around quality of life (QOL) for PWADs. Caregivers needed to know when they should consider hospice, what treatments would be stopped, what services would help caregivers, and what costs would be involved. Caregivers varied in their perceptions of what it might mean for a PWAD to have QOL at the end of life and whether or not hospice would enhance it. Discussion: This study’s findings underscore the importance of decision-support tools and patient- and family-centered education for PWADs and caregivers about the trajectory of dementia and end-stage symptoms, along with practical information for hospice care planning and discussions addressing end of life values.
Dysregulation of Biomarkers of Hemostatic Activation and Inflammatory Processes are Associated with Adverse Outcomes in Pulmonary Embolism
Authors: Darwish Iman , Fareed Jawed , Brailovsky Yevgeniy , Hoppensteadt Debra , Slajus Brett , Bontekoe Emily , De Stefano Frank , Reed Trent , Darki Amir
Published: January 2022

Introduction

The pathophysiology of pulmonary embolism (PE) represents complex, multifactorial processes involving blood cells, vascular endothelium, and the activation of inflammatory pathways. Platelet (P), endothelial (E), and leukocyte (L)-selectin molecules may play an important role in PE pathophysiology. We aimed to profile the biomarkers of inflammation, including selectins in PE patients, and compare them to healthy individuals.

Materials and methods

100 acute PE patients and 50 controls were included in this case control study. ELISA methods were used to quantify levels of selectins, inflammatory, and hemostatic biomarkers.

Results

In PE patients, levels of selectin molecules as compared to controls convey increased P-selectin levels (95 ng/mL vs 40 ng/mL, p < .0001) and decreased L-selectin levels (1468 ng/mL vs 1934 ng/mL, p < .0001). Significant correlations were found between selectins and Plasminogen Activating Inhibitor-1 (PAI-1), Tumor Necrosis Factor-a (TNFa), and D-dimer. Fold change between selectins and controls is compared to other biomarkers, illustrating degrees of change comparable to TNFa, alpha-2-antiplasmin, and microparticles. L-selectin levels are inversely associated with all-cause-mortality in PE patients, (p = .040).

Conclusion

These studies suggest that various thrombo-inflammatory biomarkers are elevated in PE patients. Furthermore, L-selectin levels are inversely associated with mortality outcomes.
Rivaroxaban with Aspirin Versus Aspirin for Peripheral Arterial Disease and Intermittent Claudication. Rationale and Design of the COMPASS CLAUDICATION Trial
Authors: Ramacciotti Eduardo , Agati Leandro Barile , Volpiani Giuliano Giova , Brito Karen Falcão , Ribeiro Camilla Moreira , Aguiar Valéria Cristina Resende , Ramacciotti Lorenzo Storino , Paganotti Alexia , Pereira Felipe Menegueti , Caffaro Roberto Augusto , Fioranelli Alexandre , Krakauer Rogério , Rached Heron Rhydan Saad , Wolosker Nelson , Anand Sonia S. , Eikelboom John W. , Lopes Renato Delascio
Published: January 2022

Background

The COMPASS trial demonstrated that in patients with peripheral arterial disease, the combination of rivaroxaban and aspirin compared with aspirin reduces the risk of major adverse limb events, but it is not known whether this combination can also improve symptoms in patients with intermittent claudication. The primary objective of this study is to evaluate the effect of the combination on claudication distance.

Study design

Eighty-eight patients with intermittent claudication will be randomized to receive rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily or aspirin 100 mg once daily for 24 weeks. The primary outcome is the change in claudication distance from the baseline to 24 weeks, measured by 6 min walking test and treadmill test. The primary safety outcome is the incidence of major bleeding and clinically relevant non-major bleeding according to the International Society on Thrombosis and Hemostasis criteria.

The COMPASS CLAUDICATION trial will provide high-quality evidence regarding the effect of the combination of rivaroxaban and aspirin on claudication distance in patients with peripheral arterial disease.
A case of severe vasculitis after FLOT chemotherapy in a patient with metastatic gastric cancer who received multiple line chemotherapy
Authors: Hendem Engin , Korkmaz Mustafa , Uğraklı Muzaffer , Karakurt Eryılmaz Melek , Karaağaç Mustafa , Araz Murat , Artaç Mehmet
Published: January 2022

Introduction

Leukocytoclastic vasculitis is a histopathological term describing vasculitis in which the inflammatory infiltrate in small vessels consists of neutrophils. Although FLOT is given perioperatively in locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma, it has recently become a popular treatment option for metastatic cancers. In this case report, we present a case of FLOT-induced LCV.

Case Report

We present a 52-year-old patient with metastatic gastric adenocarcinoma treated with FLOT. The patient developed necrotizing vasculitis in the lower extremity after 5 cycles of FLOT.

Management & Outcome

After discontinuation of the FLOT regimen, the necrotizing morbid LCV gradually regressed with steroid therapy.

Discussion

To the best of our knowledge, our case is the first case of LCV that developed after FLOT chemotherapy. The clinical appearance of the patient, occurrence after chemotherapy, erythematous rash developing on bilateral lower extremities, and palpable purpuric vasculitis made us suspect. We found a potential relationship between FLOT and vasculitis according to the Naranjo scale (score 4 + ).
Use of enfortumab vedotin in an HIV-positive patient with urothelial carcinoma
Authors: Azizi Armon , Houshyar Roozbeh , Mar Nataliya
Published: January 2022

Introduction

Enfortumab vedotin is an antibody-drug conjugate used in patients with pretreated advanced urothelial carcinoma. Patients with human immunodeficiency virus were excluded from clinical trials conducted with this agent. Efficacy and safety of enfortumab vedotin has not been established in this patient population.

Case report

A patient with a long-standing diagnosis of human immunodeficiency virus and an undetectable viral load on antiretroviral therapy was diagnosed with metastatic upper tract urothelial carcinoma. Following disease progression on platinum-based chemotherapy and pembrolizumab, he was initiated on therapy with enfortumab vedotin.

Management & outcome

The patient developed significant toxicity shortly after initiation of enfortumab vedotin. His treatment was subsequently changed to docetaxel chemotherapy and he developed similar significant toxicity. Upon changing his antiretroviral therapy regimen, he was rechallenged with enfortumab vedotin and was able to tolerate it without dose-limiting toxicity, ultimately achieving a partial treatment response.

Discussion

This case describes use of enfortumab vedotin in a patient with human immunodeficiency virus, which has not previously been reported. It also underscores the importance of careful medication reconciliation in patients receiving enfortumab vedotin and antiretroviral therapy.
The Parkland Mass Shooting and the Path to Intended Violence: A Case Study of Missed Opportunities and Avenues for Future Prevention
Authors: Schildkraut Jaclyn , Cowan Rebecca G. , Mosher Tessa M.
Published: January 2022

The 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida reignited a discourse about safety and prevention that often follows such tragedies. Using a case study approach, we analyze the events leading up to the shooting (via official records from law enforcement and the shooting’s review commission) to identify missed opportunities for intervention, de-escalation, and ultimately prevention. The Path to Intended Violence model is employed to highlight the perpetrator’s escalating behaviors from grievance through the attack itself. The lessons learned then are utilized to offer recommendations for schools and communities seeking to prevent similar mass violence attacks.
Knowledge and practice towards glaucoma among glaucoma patients at University of Gondar Tertiary Eye Care and Training Center
Authors: Anbesse Dereje Hayilu , W. Gessesse Girum
Published: January 2022

Background

For better treatment outcome, exploring the knowledge of glaucoma and practices among glaucomatous patients is much more important.

Objective

The aimed of this study was to determine the knowledge and self-care practice and their associated factors towards glaucoma and its medications among glaucoma patients.

Methods

Cross section design study was conducted between May and July, 2017. The data was collected from glaucoma patients. Descriptive statistics was done to summarize socio demography data and associated factors with good knowledge and good practice were determined using binary logistic regression. Statistically significant variables were generated by considering p-value < 0.05.

Results

A total of 360 glaucoma patients were participated in this survey. The median age of the participant was 65 years. About 177 (49.25%) (95%CI: 43.9, 54.4) had good knowledge and a total of 197 or 54.7% (95%CI: 49.4, 59.7) had good practice about glaucoma and its medical treatments. The factors such as residence, marital status, educational status and stages of glaucoma of study participants were independently associated with having good knowledge. With respect to practice, educational status, duration of glaucoma, laterality and frequency of follow up were significantly associated with practice status of study participants.

Conclusion

In this study among glaucoma patients in a tertiary hospital, only half of patients have good knowledge about the disease and good practice pattern. Those with urban residence, higher education status and advanced stage of glaucoma were more likely to have good knowledge.