bluuebunny/crossref_metadata_2025 huggingface dataset:
The Etiology, Clinical Features, and Severity of Anaphylaxis in Childhood by Age Groups
Authors: Turgay Yagmur Irem , Kulhas Celik Ilknur , Yilmaz Topal Ozge , Civelek Ersoy , Toyran Muge , Karaatmaca Betul , Kocabas Can Naci , Dibek Misirlioglu Emine
Published: January 2022

Introduction: Anaphylaxis is a severe, potentially fatal systemic hypersensitivity reaction with an acute onset. Etiology, clinical presentation, risk factors, comorbidities of pediatric anaphylaxis may vary depending on the age of the child. Objective: The aim of this study was to investigate the etiology, clinical features, management of anaphylaxis in infants, preschoolers, school-age children, and adolescents. Methods: The patients presenting with anaphylaxis between January 2015 and December 2018 in a single pediatric tertiary hospital were evaluated retrospectively. Demographic data, the triggers, sign-symptoms, severity, and the management of anaphylaxis were recorded. Results: 239 patients were included in the study, 62.3% of whom were boys. The median age was 6.7 (IQR 2.33–12.83) years. 23.8% of the patients were infants, 15.5% were preschoolers, 33.5% were school-age children, and 27.2% were adolescents. Anaphylaxis mostly occurred at home. The most common causative agents were foods (39.3%), drugs (30.1%), and venoms (15.9%) of all cases. Main food allergens were cow’s milk and hen’s eggs in infants, cow’s milk and tree nuts in preschoolers, and tree nuts and legumes in school-age children. Cases of drug-induced anaphylaxis (DIA) were recorded mostly with antibiotics (40.3%), followed by NSAIDs (23.6%). The primary trigger of anaphylaxis was foods in infants and preschoolers and drugs in school-age children and adolescents. There was no difference between age groups in terms of the system involved and severity. Severe anaphylaxis was more common with DIA. Adrenaline was used in 69.8% of all cases with no significant difference between age groups. Conclusion: Etiology and symptoms of anaphylaxis may differ between age groups. Raising awareness, educating patients and their parents on anaphylaxis and its management is essential.
Biomarkers for Locally Advanced Hepatocellular Carcinoma Patients Treated with Liver-Directed Combined Radiotherapy
Authors: Chung Seung Yeun , Kim Kyoung-Jin , Seong Jinsil
Published: January 2022

Introduction: In the era of biomarker-driven cancer therapy, robust biomarkers for hepatocellular carcinoma (HCC) have not been well-defined. In this hypothesis-generating study, we investigated biomarkers that can be incorporated to predict treatment outcomes in patients with locally advanced HCC who are administered liver-directed combined radiotherapy (LDCRT). Methods: Ninety-nine patients with HCC who were treated with conventional fractionation LDCRT between July 2016 and October 2018 were enrolled in this prospective single-arm study. Clinical outcomes and possible serum biomarkers, including soluble programmed cell death ligand-1 (sPD-L1), interleukin (IL)-10, IL-6, cell-free DNA (cfDNA), inter-alpha inhibitor H4, and interferon-gamma, were analyzed. The primary endpoint was disease progression, and additional endpoints were local failure-free rate, intrahepatic failure-free rate, and lung metastasis-free rate. Results: The median follow-up period was 18.7 months. The 1-year progression-free rate was 38.2%. Increasing baseline sPD-L1 per pg/mL, previous treatment history, protein induced by vitamin K absence-II >1,629 mAU/mL, and multiple tumors were the adverse factors for progression based on multivariate analysis. Survival tree analysis revealed three prognostic groups for progression, in which patients with multiple lesions and baseline sPD-L1 ≥41.07 pg/mL showed the worst outcomes. For dynamic changes in biomarker levels, sPD-L1 fold change and cfDNA fold-change values were unfavorable factors for progression. Conclusion: Baseline sPD-L1, sPD-L1 fold change, and cfDNA fold-change values showed the highest potential as biomarkers for predicting post-treatment progression after LDCRT in HCC patients. By incorporating clinical factors, these biomarkers may be useful for devising a biomarker-driven treatment paradigm in locally advanced HCC.
Orientation of the Atrial Septum to the Inferior Vena Cava May Contribute to the Persistent Patency of the Foramen Ovale
Authors: Pöyhönen Pauli , Kuusisto Jouni , Pirinen Jani , Räty Heli , Lehmonen Lauri , Paakkanen Riitta , Martinez-Majander Nicolas , Saeed Sahrai , Gerdts Eva , Putaala Jukka , Sinisalo Juha , Järvinen Vesa
Published: January 2022

Purpose: There is growing evidence that paradoxical embolism through patent foramen ovale (PFO) is a cause for cryptogenic stroke. However, it is still unclear why the foramen ovale fails to close after birth. We studied whether the 3D relations between the atrial septum (AS) and the inferior vena cava (IVC) are associated with PFO. Methods: We recruited 30 patients (18–49 years) with a first-ever cryptogenic stroke and 30 age- and sex-matched stroke-free controls. Using cardiac magnetic resonance, an approach to evaluate the 3D relations between the AS and the IVC was developed. The presence of interatrial right-to-left shunt was evaluated with transesophageal echocardiography (TEE) in patients and transcranial Doppler in controls. Results: Of 30 patients, 29 underwent successful TEE, of which 12 (41%) had a shunt. Patients with a shunt had a greater mean 3D angle (γ) between the atrial septal plane and the vector from the orifice of the IVC to the middle of the AS compared with patients without a shunt (45 ± 9° vs. 36 ± 8°, p = 0.017). Of 30 controls, 12 (40%) had a shunt and a greater mean γ compared with controls without a shunt (47 ± 8° vs. 37 ± 10°, p = 0.007). In a pooled analysis, 24 (41%) of 59 subjects with a shunt had a mean γ of 46 ± 9° compared with subjects without a shunt of 37 ± 9° (p < 0.001). Conclusions: More perpendicular orientation of the atrial septal plane to the orifice of the IVC is associated with PFO, possibly by directing the IVC flow to PFO.
Baseline QRS Area and Reduction in QRS Area Are Associated with Lower Mortality and Risk of Heart Failure Hospitalization after Cardiac Resynchronization Therapy
Authors: Marinko Sofia , Platonov Pyotr G. , Carlson Jonas , Borgquist Rasmus
Published: January 2022

Introduction: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure in selected patients. However, current guideline indications do not accurately predict individual prognosis with CRT, and up to 30% are nonresponders. Previous studies have shown that QRS area reduction following CRT is associated with improved survival. This study evaluates the incremental value of using QRS area derived from digital electrocardiogram (ECG) recordings, preoperatively and during CRT pacing. Methods: Medical records of 445 patients receiving CRT implants at a large-volume tertiary care center in Sweden were retrospectively evaluated. Digital ECG before and after CRT implantation were collected, and ECG parameters were analyzed in relation to a primary composite endpoint of heart failure hospitalization or death from any cause. Results: 147 patients (33%) reached the primary endpoint (93 deaths and 103 heart failure hospitalizations) over a median follow-up time of 2.7 years. A larger preimplant QRS area (HR, 0.89; [0.85–0.93]; p = <0.0001; adjusted HR, 0.93; [0.88–0.98]; p = 0.011) and a larger QRS area reduction (HR, 0.92; [0.88–0.96]; p = <0.0001; adjusted HR, 0.95; [0.90–0.99]; p = 0.042) postimplant correlated with a reduced risk of reaching the primary endpoint. This association was seen in patients with native left bundle branch block morphology, nonspecific intraventricular conduction delay, or paced ECG morphology but not in patients with right bundle branch block. Conclusion: Larger preimplant QRS area and QRS area reduction were associated with better clinical outcome following CRT in this retrospective material. This knowledge could help optimize patient selection and postoperative management.
Toward Evidence-Based Severity Assessment in Mouse Models with Repeated Seizures: (II.) Impact of Surgery and Intrahippocampal Kainate
Authors: Buchecker Verena , Koska Ines , Pace Claudia , Talbot Steven R. , Palme Rupert , Bleich Andre , Potschka Heidrun
Published: January 2022

Introduction: Chronic epilepsy models require neurosurgical procedures including depth electrode implants. The intrahippocampal kainate model is a frequently used chronic paradigm, which is based on chemoconvulsant administration and status epilepticus induction during the surgical procedure. This experimental approach raises the question of the extent to which this approach affects postsurgical recovery. In addition to the short- and long-term impact of the surgical intervention, a potential impact of highly frequent electrographic seizure events needs to be considered in the context of severity assessment. Methods: Various behavioral, biochemical, and telemetric parameters were analyzed in four experimental groups of mice: 1st naive, 2nd with transmitter implants, 3rd with transmitter and electrode implants, and 4th with transmitter implants, electrode implants, and kainate-induced status epilepticus. Results: During the early postsurgical phase, transmitter implants caused a transient impact on Mouse Grimace scores and intragroup increase of fecal corticosterone metabolites. Additional craniotomy was associated with an influence on total heart rate variability and fecal corticosterone metabolites. Heart rate and Irwin score increases as well as a prolonged increase in Mouse Grimace scores pointed to an added burden related to the induction of a nonconvulsive status epilepticus. Data from the chronic phase argued against a relevant influence of frequent electrographic seizures on behavioral patterns, fecal corticosterone metabolites, heart rate, and its variability. However, Irwin scores indicated long-term changes in some animals with increased reactivity, body tone, and Straub tail. Interestingly, selected behavioral and telemetric data from the early post-status epilepticus phase correlated with the frequency of electrographic seizure events in the chronic phase. Conclusion: In conclusion, our findings argue against the pronounced impact of highly frequent electrographic seizures on the well-being of mice. However, an increased level of nervousness in a subgroup of animals should be considered for handling procedures and refinement measures. In the early postsurgical phase, several parameters indicate an influence of the interventions with evidence that the nonconvulsive status epilepticus can negatively affect the recovery. Thus, the development and validation of refinement efforts should focus on this experimental phase. Finally, the datasets suggest that simple readout parameters may predict the long-term consequences of the epileptogenic insult. Respective biomarker candidates require further validation in the follow-up studies in models with subgroups of animals with or without epilepsy development.
Neuroticism, Worry, and Cardiometabolic Risk Trajectories: Findings From a 40‐Year Study of Men
Authors: Lee Lewina O. , Grimm Kevin J. , Spiro Avron , Kubzansky Laura D.
Published: January 2022

Background

Anxiety is linked to elevated risk of cardiometabolic disease onset, but the underlying mechanisms remain unclear. We examined the prospective association of 2 anxiety facets, neuroticism and worry, with cardiometabolic risk (CMR) trajectories for 4 decades.

Methods and Results

The sample comprised 1561 men from an ongoing adult male cohort. In 1975, healthy men (mean age, 53 years [SD, 8.4 years]) completed the Eysenck Personality Inventory‐Short Form neuroticism scale and a Worries Scale. Seven CMR biomarkers were assessed every 3 to 5 years. The CMR score was the number of biomarkers categorized as high‐risk based on established cut points or medication use. Using mixed effects regression, we modeled CMR trajectories over age and evaluated their associations with neuroticism and worry. Using Cox regression, we examined associations of neuroticism and worry with risk of having ≥6 CMR high‐risk biomarkers through 2015. CMR increased at 0.8 markers per decade from age 33 to 65 years, at which point men had an average of 3.8 high‐risk markers, followed by a slower increase of 0.5 markers per decade. Higher neuroticism (B=0.08; 95% CI, 0.02–0.15) and worry levels (B=0.07; 95% CI, 0.001–0.13) were associated with elevated CMR across time, and with 13% (95% CI, 1.03–1.23) and 10% (95% CI, 1.01–1.20) greater risks, respectively, of having ≥6 high‐risk CMR markers, adjusting for potential confounders.

Conclusions

By middle adulthood, higher anxiety levels are associated with stable differences in CMR that are maintained into older ages. Anxious individuals may experience deteriorations in cardiometabolic health earlier in life and remain on a stable trajectory of heightened risk into older ages.
Whose Wuxia and What Kind of Myth: A Wuxia Accompanying Text Perspective
Authors: Sun Jinyan , Han Dawei
Published: January 2022

Texts are the result of engravings in different social contexts, and they are culturally activated in different ways. The image of wuxia is formed by various accompanying texts sharing and participating in constructing a collection of wuxia narratives. By means of text-naming methods, authors, serialization of novels, film and television adaptations, criticism, and so forth, the image of wuxia operates in a continuous cycle that flows throughout texts that are gradually accumulated in the literary corpus. On this basis, it condenses and expresses a series of ideological discourses centred on topics such as gender and nation. These accompanying texts have diverse identities and play multiple roles in the cause of wuxia coming to be viewed as public heroes. They not only supply us with frameworks and positioning of wuxia novels but also provide cultural observations of society so as to participate in the construction of wuxia myths.
A review of Chelonian type specimens (order Testudines)
Authors: IVERSON JOHN B.
Published: January 2022

Type specimens are the cornerstones of modern taxonomy and systematics, and should be the starting point of any study of diversity, especially considering the increasing ability to sample them genetically.  However, no compilation of type material (beyond holotypes) exists for turtles (Order Testudines). This is the first attempt to locate and compile a list of all type specimens (holotypes, paratypes, syntypes, lectotypes, neotypes, etc.) for all described turtles, whether currently recognized or synonymized. A total of 1222 named taxa are included here (including synonyms), but only 875 of them (71.6%) have at least one identified type specimen (excluding neotypes and iconotypes). Part or all of the type series for another 102 taxa are considered lost. This list represents a 45-year search effort, and although still incomplete, should benefit current and future turtle systematicists, as well as direct ongoing efforts to locate type specimens still missing.
Redescription of Neocypridella fossulata (Daday, 1910) (Crustacea: Ostracoda) and description of a new subfamily
Authors: SAVATENALINTON SUKONTHIP
Published: January 2022

Neocypridella fossulata (Daday, 1910) is redescribed based on type material from the Daday collection (Hungarian Natural History Museum, Budapest). The major diagnostic characters of the genus are the ovate shape of the carapace in lateral view, with the left valve overlapping the right valve, the absence of marginal septa on the valve margins, the right valve anterior selvage not inwardly displaced, the presence of a Wouters’ organ on the first antenna, the divided penultimate segment of the second antenna, the markedly large β-seta on the mandibular palp, the subquadrate terminal segment of the maxillula palp, the divided penultimate segment of the second thoracopod with setae d1 and d2 both long, the slender caudal ramus and the slender caudal ramus attachment with thin dorsal and ventral branches. Neocypridella fossulata can be further characterized by the oblique carapace in frontal view, the two smooth bristles on the maxillula third endite and the thin and long Ga claw of the caudal ramus, which is c. 3/5 of the length of the ramus.

                The morphology of Neocypridella is compared with related taxa and the taxonomic position of the genus is discussed. This revealed that Neocypridella cannot be assigned to any of the extant subfamilies in the Cyprididae. Therefore, a new subfamily, Neocypridellinae subfam. nov., is erected.
An Unintended Consequence of Product Upgrades: How Upgrades Can Make Current Consumers Feel Left Behind
Authors: Jung Wonsuk , Peck Joann , Palmeira Mauricio , Kim Kyeongheui
Published: January 2022

In today’s advanced economies, consumers are constantly exposed to an increasing number of upgraded products. This research examines consumer response to a brand's launching of an upgraded product and identifies the consumer's ownership status of a previous version of the product as a key dimension that can influence their reaction. Contrary to common intuition, the research demonstrates that while the release of an upgraded product is received positively by nonowners of a previous version, this is not always the case for owners. The authors propose that owners respond unfavorably because the new upgrade increases perceived distance between the owners and the brand as the brand progresses forward with the enhanced products. That is, when the new product replaces an existing product the consumers own, consumers perceive that the brand is moving away from them. This negative effect of an upgrade is attenuated if the owners are provided with an extra source of connection to the brand. The authors investigate this phenomenon in five studies and discuss the implications of their findings.
Prevalence of polypharmacy and risk of potential drug-drug interactions among hospitalized patients with emphasis on the pharmacokinetics
Authors: Georgiev Kaloyan D. , Hvarchanova Nadezhda , Stoychev Elitsa , Kanazirev Branimir
Published: January 2022

Background:

Both polypharmacy and potential drug-drug interactions (pDDIs), especially those at the pharmacokinetic level, are common in hospitalized patients and are associated with adverse effects and failure of therapy;

Objective:

The aim of the present study is to investigate retrospectively the prevalence of polypharmacy and the risk of potential pharmacokinetic drug-drug interaction among hospitalized patients;

Methods:

The medical documentation of hospitalized patients in the unit of internal diseases at the hospital “St Marina” in Varna, Bulgaria for a period of six months (January–July 2016) was retrospectively reviewed. Lexicomp® Drug Interaction software was used for the detection of pDDI. Descriptive statistic and logistic regression were used for data analysis;

Results:

In this study, 294 patients out of 510 (57%) were selected with polypharmacy. The number of detected potential pharmacokinetic DDIs (pPKDDIs) was only 216 (or 12,4%), but almost 40% of patients with polypharmacy were exposed to at least one pPKDDIs. The most common pPKDDIs occur at the biotransformation level – 78 (36,1%), and the most common enzyme form that is involved in these interactions is cytochrome 3A4 (44 or 20,4%). The number of prescribed medications (>7) was found to increase the possibility of having pDDIs (OR 25.535, 95% CI 12.529 to 52.042; p = <0.001) and pPKDDIs (OR 5.165, 95% CI 3.430 to 7.779; p = <0.001) as well;

Conclusion and Relevance:

Caution should be taken in patients taking more than seven drugs and careful assessment of the pPKDDIs should be made. When such interactions are detected, they need to be properly evaluated and managed.
Sovereignty and trading states: denuclearization in Belarus, Kazakhstan, South Africa, and Ukraine
Authors: Bourdais Park JeongWon , Chung DaHoon
Published: January 2022

The paper explores the cases of denuclearized countries, namely Belarus, Kazakhstan, South Africa, and Ukraine and primarily intends to answer the questions of how (process), why (reasons for denuclearization), and for what (benefits and gains) did these four countries abandon their strategically advantageous nuclear arsenals. For conceptual analysis, ‘a trading state’ is employed, for they commonly faced the imminent need of guaranteeing state sovereignty and the influence of changing security dynamics. The four cases exhibit both generalizable commonality and distinctive experience in the process of denuclearization. They demonstrate that two mutually-reinforcing forces, ‘global-scale structural change in world politics’ and ‘pressure for regime creation or change’, interactively led to the final decision to enact complete denuclearization, albeit not effortlessly. Furthermore, unveiling the differences in the process of denuclearization – in terms of resistance, negotiation tools and leverage, stage of nuclear development, domestic-grown technology, internal justification for legitimacy – helps to clarify the gains and benefits received in return for denuclearization. Shedding light on these four countries, under pressure from nuclear weapons states, complements conventional realism-leaning interpretations of nuclear politics and offers policy insights to understand countries with nuclear ambition in contemporary world politics.
When Do Greedy Entrepreneurs Exhibit Unethical Pro-Organizational Behavior? The Role of New Venture Team Trust
Authors: Tacke Friedrich , Knockaert Mirjam , Patzelt Holger , Breugst Nicola
Published: January 2022

Greed is an excessive form of self-interest that leads individuals to pursue material wealth and immaterial desires with little or no concern for the well-being of others. While the literature suggests that greed results in managers acting unethically, a situational strength perspective suggests that this may not always be the case. Therefore, this paper aims at understanding how the new venture context, particularly the role of a team member's affective and cognitive trust in the new venture team, shapes the manifestation of greed in entrepreneurs’ unethical pro-organizational behavior—behavior that allows new venture team members to advance their ventures despite the violation of social norms. Consistent with our theorizing, we find that new venture team members’ affective and cognitive trust in their teams shape the relationship between greed and unethical pro-organizational behavior in opposing ways. Particularly, higher levels of greed are more likely to be connected to unethical pro-organizational behavior when a member's affective trust in the team is high and cognitive trust in the team is low. Our study offers implications for the entrepreneurship and management literatures, alongside implications for practice.
Why (not) be a music teacher? Exploring pre-service music teachers’ sources of concern regarding their future profession
Authors: Mateos-Moreno Daniel
Published: January 2022

There is a global shortage of music teachers, and this deficit is continually growing. While there is a considerable body of research on the sources of concern, attrition, stress and burnout for practising teachers, studies investigating the perspective of pre-service music teachers instead are comparatively rarer. This gap in the literature is problematic, considering its relevance to the development of teacher education programmes and the prevention of discouragement and unrealistic expectations among teachers-to-be. Based on the case of pre-service music teachers from a Swedish university, this research investigates the challenging aspects of the profession through qualitative means. While the results cannot be directly extrapolated to other contexts, the insights gained in this case study expand the theoretical knowledge in the field by identifying seven main categories as sources of concern, of which the aspects that are typically inherent to the profession were dominant (e.g. assessing students, teaching groups of students, etc.). Moreover, the findings reveal differences among the views of pre-service and in-service music teachers that may influence career development. Finally, I provide implications to prevent discouragement among pre-service music teachers based on the results of the case under study.
Effect of continuous deep sedation on survival in the last days of life of cancer patients: A multicenter prospective cohort study
Authors: Yokomichi Naosuke , Yamaguchi Takuhiro , Maeda Isseki , Mori Masanori , Imai Kengo , Shirado Naito Akemi , Yamaguchi Takashi , Terabayashi Toru , Hiratsuka Yusuke , Hisanaga Takayuki , Morita Tatsuya
Published: January 2022

Background:

Continuous deep sedation is ethically controversial with respect to whether it shortens a patient’s life.

Aim:

To examine whether continuous deep sedation shortens patient survival from the day of Palliative Performance Scale decline to 20 (PPS20).

Design:

A part of a multicenter prospective cohort study (EASED study).

Setting/participants:

We recruited consecutive adult patients with advanced cancer admitted to 23 participating palliative care units in 2017 in Japan. We compared survival from PPS20 between those who did and did not receive continuous deep sedation. Continuous deep sedation was defined as the continuous administration of sedative medication with the intention to keep a patient continuously unconscious to alleviate otherwise uncontrollable symptoms, but the dose of sedatives was adjusted to achieve adequate symptom relief for each patient. The propensity score-weighting method was used to control for potential confounders, and five sensitivity analyses were performed.

Results:

A total of 1926 patients were enrolled. Patients discharged alive were excluded, and we analyzed 1625 patients of whom 156 (9.6%) received continuous deep sedation. Median survival from PPS20 of 1625 patients was 81 h (95% CI: 77–88). The RASS scores decreased to ⩽−4 was 66% at 24 h. Continuous deep sedation was not associated with a significant survival risk (adjusted hazard ratio: 1.06, 95% CI: 0.85–1.33). All sensitivity analyses, including continuous deep sedation defined as the RASS score was ⩽−4 achieved the essentially the same results.

Conclusions:

Continuous deep sedation with careful dose adjustment was not associated with shorter survival in the last days of life in patients with advanced cancer.
Waiting for the market? Microinsurance and development as anticipatory marketization
Authors: Bernards Nick
Published: January 2022

This article traces experiments aimed at promoting wider adoption of ‘microinsurance’ – small, simplified insurance policies targeting the poorest. Microinsurance is a central element of a wider turn towards the promotion of ‘resilience’ in global development. The development of commercial markets for microinsurance, however, has failed to meet the expectations of promoters. This article traces the ways that the diverse donor agencies, professional organizations and philanthropic organizations involved in the promotion of microinsurance have responded to these failures, primarily by seeking to articulate basic data infrastructures that might make possible profitable insurance operations. These activities are described as a kind of ‘anticipatory marketization’ – experiments seeking to prepare the ground for the emergence of markets for risk management, thus far without much success. Where microinsurance has often been described in terms of ‘financialization’, this article suggests that there are important political dynamics at play that have been overlooked. Efforts to develop markets for microinsurance, and the persistent focus on troubleshooting and re-engineering those markets in the face of failure, are not driven directly by finance capital. Rather, they reflect fraught efforts to articulate modes of social protection not requiring substantial redistribution.
When Do Work-Family Policies Work? Unpacking the Effects of Stigma and Financial Costs for Men and Women
Authors: Thébaud Sarah , Pedulla David S.
Published: January 2022

Work-family policies—such as parental leave and flextime—can help to facilitate gender equality in workplaces and in families. But policy use is typically low, varies significantly from one workplace to another, and is often more prevalent among women than men. Extant research suggests that flexibility stigma—workplace norms that penalize workers for utilizing policies that facilitate non-work demands—as well as the financial costs associated with policy use, contribute to this pattern. However, previous studies have been largely correlational in nature, and have had difficulty assessing how these factors may interact with one another to shape gendered patterns of policy use. In this study, we offer novel causal traction on this set of issues. Using an original, population-based survey experiment, we examine how the salience of flexibility stigma and financial costs affect men's and women's intentions to use work-family policies. We find that these factors exert a large direct effect on men's and women's intentions to use work-family policies. Moreover, the gender gap in parental leave use intentions is large in workplace contexts with high flexibility stigma and high financial costs, but this gap narrows significantly under more favorable conditions. Findings point to the importance of organizational contexts and policy design in shaping work-family policy use and, in turn, gender inequality.
Annual Mammographic Screening Reduces the Risk of Interval or Higher Stage Invasive Breast Cancers Among Postmenopausal Women in the Ontario Breast Screening Program
Authors: Blackmore Kristina M , Chiarelli Anna M , Mirea Lucia , Mittmann Nicole , Muradali Derek , Rabeneck Linda , Done Susan J
Published: January 2022

Purpose: In the Ontario Breast Screening Program (OBSP) annual screening improved breast cancer detection for women 50–74 years with a family/personal history compared to biennial, while detection was equivalent for women screened annually for mammographic density ≥75%. This study compares the risk of interval or higher stage invasive cancers among postmenopausal women screened annually vs biennially by age and estrogen use. Methods: A retrospective design identified 4247 invasive breast cancers diagnosed among concurrent cohorts of women 50–74 screened in the OBSP with digital mammography between 2011 and 2014, followed until 2016. Polytomous logistic regression estimated the risk of interval or higher stage breast cancers by age and estrogen use between women screened annually because of first-degree relative with breast or ovarian cancer or personal history of ovarian cancer, or mammographic density ≥75%, and those screened biennially. Results: The risk of interval vs screen-detected cancers was significantly reduced in women screened annually for family/personal history (OR=.64; 95%CI:0.51–.80), particularly those 60–74 years (OR=.59; 95%CI:0.45–.77) or not currently using estrogen (OR=.66; 95%CI:0.52–.83) compared to those screened biennially. The risk of stage II–IV vs stage I tumors was also lower in women 60–74 years screened annually for family/personal history (OR=.79; 95%CI:0.64–.97) and in those screened annually for mammographic density ≥75% currently using estrogen (OR=.51; 95%CI:0.26–1.01) compared to women screened biennially. Conclusion: Postmenopausal women at increased risk screened annually had equivalent or reduced risks of interval or higher stage invasive breast cancers than those screened biennially, further supporting risk-based screening in this population.
Patients Diagnosed with Multisystem Inflammatory Syndrome in Children Have Persistent Neurologic, Sleep, and Psychiatric Symptoms After Hospitalization
Authors: Enner Stephanie , Shah Yash D. , Ali Aaqil , Cerise Jane E. , Esposito Justin , Rubin Lorry , Subramony Anupama , Kothare Sanjeev
Published: January 2022

Background: Acute neurological complications from COVID-19 have been reported in both pediatric and adult populations. Chronic symptoms after recovery have been reported in adults and can include neuropsychiatric and sleep symptoms. Persistent symptoms in children with the multisystem inflammatory syndrome in children (MIS-C) have not been studied. Methods: We conducted a single-center retrospective chart review and cross-sectional survey of patients diagnosed with MIS-C. Patients and parents were surveyed on symptoms before the COVID-19 pandemic, upon admission, and 23 weeks (interquartile range 20-26 weeks) after discharge. Age and gender-matched patients requiring intensive care unit (ICU) care for status asthmaticus were surveyed as a control group. Results: In this cohort of 47 patients, 77% reported neurological, 60% psychiatric, and 77% sleep symptoms during hospitalization. Prior to hospitalization, 15% reported neurological, 0% psychiatric, and 7% sleep symptoms. Eighteen (50%) of the 36 patients who had neurological symptoms during hospitalization continued to have symptoms on follow-up (odds ratio [OR] = ∞, p = .003]). Similarly, 16 (57%) of 28 patients with psychiatric symptoms reported persistence at follow-up (OR = 5.00; p = .02). Fifteen (42%) of the 18 patients reporting sleep disturbance during hospitalization had persistence on follow-up (OR = 1.9; p = .49). The aggregate of neurological, psychiatric, and sleep symptoms during admission and at follow-up was significantly higher for MIS-C patients requiring ICU care when compared to the control group ( p = .01). Conclusions: In this cohort of patients with MIS-C, a majority of patients reported new-onset neuropsychiatric and sleep symptoms. Almost half of these patients had persistent symptoms on a follow-up survey.
“I Wish he Were Dead.” The Experience of Loss among Young Arab-Bedouin Women in Polygamous Families
Authors: Alhuzail Nuzha Allassad
Published: January 2022

This article presents the sense of loss of young Arab-Bedouin women in Israel who grew up in polygamous families. Polygamy is widespread in Israel's Arab-Bedouin population, although state law explicitly prohibits it. Tradition and custom allow a man to marry more than one woman, and Islam does not forbid it. Polygamy has many ramifications for women, children, and society in general.

The data were gathered in semi-structured, in-depth interviews with 30 young women, ages 18 to 22, whose fathers took a second wife in the last five years and moved to a separate home with the new wife. The women interviewed were so distressed they sought therapeutic help. Among the many findings is the profound sense of loss: of fathering, of love and attention, and of family.

Intersectionality theory was used to explain the particular vulnerability of these young women. Israel has no targeted treatment programs or interventions for adolescent girls in polygamous families, and this may harm their chances of successfully negotiating adolescence. Targeted treatment is recommended. The findings apply to social work in any country where polygamy exists.
Leveraging from Racism: A Dual Structural Advantages Perspective
Authors: Muzanenhamo Penelope , Chowdhury Rashedur
Published: January 2022

Drawing on the autobiography of an immigrant Black African female scholar, we introduce and conceptualize the notion of dual structural advantages that racism potentially affords elite White male academics. These hegemonic scholars enjoy two types of possible advantage. First, as gatekeepers to a racist academic system, powerful White male scholars protect their interests by epistemically excluding the ‘Other’ from knowledge production. Second, these hegemonic agents ironically utilize racism as a hermeneutical resource for ‘impactful’ research output, grounded in progressive, anti-racist theorizations in collaboration with Black male scholars. Such work is disseminated and perpetuated through elite academic outlets, thus substantially leveraging the agents’ careers and university rankings. Foregrounding double advantages in debates on racial equality accentuates the necessity of changing the agential practices of elite White male scholars in order to transform racist institutions.
Assessment of antidiabetic effect of 4-HIL in type 2 diabetic and healthy Sprague Dawley rats
Authors: Singh Pragati , Ishteyaque Sharmeen , Prajapati Ramanand , Yadav Karan Singh , Singh Rupali , Kumar Akhilesh , Sharma Sharad , Narender Tadigoppula , Mugale Madhav Nilakanth
Published: January 2022

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia and insulin resistance. 4-hydroxyisoleucine (4-HIL) is a non-proteinogenic amino acid isolated from the fenugreek seeds and has enormous pharmacological activities. The present study was undertaken to investigate the antihyperglycemic effect of 4-HIL in streptozotocin (STZ)-induced diabetic rats. Moreover, its toxicity was evaluated in vitro and in vivo employing human embryonic kidney cells (HEK-293) and healthy rats, respectively. In experiment 1, STZ-induced diabetic male rats were subjected to an oral treatment of 4-HIL (100 mg/kg), while experiment 2 deals with the effects of 4-HIL on healthy male and female rats following oral administration. The treatment (experiment 1) declined the elevated blood glucose level, feed intake, and increased body weight(s). Additionally, blood glucose impairment was improved as observed by OGTT and IPGT tests. Pancreatic histopathology revealed mild changes in the 4-HIL group. Moreover, experiment 2 showed increased body weight, normal blood glucose levels (male—106.06 ± 7.49 mg/dl and female—100.06 ± 14.69 mg/dL), hematological parameters, and histopathological profiles in the treatment group. 4-HIL did not affect the viability of HEK-293 cells, and no signs of toxicity were observed in healthy rats. Therefore, the study concludes that 4-HIL has potential antihyperglycemic activity without any toxic effects.
Methylation patterns of the CDKN2B and CDKN2A genes in an indigenous population exposed to pesticides
Authors: Paredes-Céspedes Diana M , Bernal-Hernández Yael Yvette , Herrera-Moreno José Francisco , Rojas-García Aurora Elizabeth , Medina-Díaz Irma Martha , González-Arias Cyndia A , Barrón-Vivanco Briscia Socorro
Published: January 2022

The INK4 -ARF locus includes the CDKN2B and CDKN2A genes and is functionally relevant in the regulation of both cell proliferation and senescence. Studies have reported modifications of DNA methylation in this locus by exposure to environmental contaminants including pesticides; however, until now, specific methylation profiles have not been reported in genetically conserved populations exposed to occupational pesticides. The aim of this study was to determine the methylation profiles of the CDKN2B and CDKN2A genes in a genetically conserved population exposed to pesticides. A cross-sectional and analytical study was carried out in 190 Huichol indigenous persons. Information related to pesticide exposure, diet and other variables were obtained through the use of a structured questionnaire. Blood and urine samples were collected for methylation test and dialkylphosphates (DAP) determination, respectively. DNA methylation was measured by the pyrosequencing of bisulfite-treated DNA and DAP concentrations by gas chromatography-tandem mass spectrometry (GC/MS). The most frequent metabolite in the population was dimethylthiophosphate. The farmer group presented a higher methylation percentage of CDKN2B than the non-farmer group, but no differences in CDKN2A were observed between groups. A positive correlation between methylation of CpG site 3 of CDKN2B and time working in the field was observed in the farmer group. An association between methylation percentage of CDKN2B and age was also observed in the non-farmer group. These results suggest that pesticide exposure and exposure time in Huichol indigenous individuals could modify the methylation pattern of the CDKN2B gene.
Entrepreneurial Self-efficacy and Financial and Calculation Skills Can Shape Different Profiles of Venture Intentions
Authors: Ruiz-Dotras Elisabet , Lladós-Masllorens Josep
Published: January 2022

The complexity of finances and access to financial markets is one of the main challenges facing an entrepreneur. However, not many studies examine the effect of financial skills on entrepreneurial intentions. Our research describes venture intentions, considering motivations, contextual factors and personal traits in different clusters, based on the strong sense of entrepreneurial self-efficacy and the levels of financial literacy and numeracy skills. Results demonstrate that financial and numeracy skills and self-efficacy shape different profiles of potential entrepreneurs. The study shows that social motivations exert a favourable impact on entrepreneurial intentions only for those who firmly believe in their abilities or have high financial and numeracy skills. For those without outstanding skills or high self-efficacy, contextual factors play a key role in the decision to launch a new venture.
Transition to Sustainable Growth in South Korea: Investment and Trade under Uncertainty
Authors: Jang Tae-Seok , Oh Sehwan
Published: January 2022

This study examines major challenges for the Korean economy since East Asia has undergone significant transitions with the emergence of China in the 2000s. Because the transition has created uncertainties in the economy, South Korea has been exposed to a high degree of international competition in the turbulence of regional integration. We first employed structural vector autoregression to provide the impulse response of investment to various economic shocks, revealing the effects of structural changes and competition on industry. Furthermore, we identified the reasons behind low investment in South Korea over the past two decades. Second, as a proxy for structural change in the economy, we addressed the effects of extraneous shocks on the Korean economy by considering industry competitiveness. The results indicate that heightened uncertainty and export demands have shaped the dynamics of the Korean economy. In particular, the overall competitiveness of South Korea’s merchant trade in major products such as mobile phones, automobiles, ships and optics has weakened due to intensifying competition and increasing overseas production. These changes suggest that South Korea needs to revise its economic development strategy, which has been largely driven by exports. To address the diverse challenges faced by the Korean economy, we highlighted the importance of indigenous dynamism for sustainable growth.
Integration duties in the European Union: Four models
Authors: Ganty Sarah
Published: January 2022

Integration is becoming increasingly important in law, due to the growing involvement of the legislative, executive and judicial powers at European, national, regional and local levels. This phenomenon concerns third-country nationals and EU citizens, despite the fundamentally different legal regimes applicable to these groups. In this article, I discuss the expansion of integration duties and the different legal mechanisms which they are based on. I propose four conditions- and obligations-based integration models likely to be found in EU law and national laws: the symbolic model, the meritocratic model, the activation model and the selective model. From a legal perspective, identifying these integration mechanisms is essential for assessing compliance with fundamental rights and EU law. Moreover, such a typology is likely to help researchers, policy-makers and the public obtain a better sense of how the conception of integration evolves in our societies and in the legal field in particular. I conclude by briefly sketching a common trend which I observed throughout the four models: they are imbued with a strong socioeconomic dimension hindering the socioeconomically underprivileged categories.
Are national football federation bodies governed by public law? Setting the boundaries of EU Public Procurement directives
Authors: Torre de Silva Víctor
Published: January 2022

Sports federations, being private associations, have traditionally awarded their contracts regardless of EU Public Procurement directives. The Court of Justice of the European Union has recently given its first ruling on this issue: Federazione Italiana Giuoco Calcio, judgment of 3 February 2021. This article intends to summarize and comment on this decision, a preliminary reference requested by the Italian Council of State. The Court of Justice of the European Union has stated that, if the sports federations depend on any state authority, namely the Italian National Olympic Committee, they should comply with the Public Procurement directives. This might increase transparency, although it could add structure and length to contract award procedures, above certain economic value. The judgment affirms that Italian sports federations have been established for the specific purpose of meeting needs in the general interest, not having an industrial or commercial character, but is less clear regarding whether they are subject to management supervision from the Italian National Olympic Committee. The Court of Justice of the European Union defers the final decision on dependency to the Italian court, thus giving little guidance to other Member States.
The Coherence Challenge Between Policy Makers and School Leaders: Exploring a National Pedagogical Reform
Authors: Bros Eliana , Schechter Chen
Published: January 2022

Purpose

It has been suggested that coherency between primary stakeholders involved in an educational reform is a key determinant of its success. The “Meaningful Learning Reform” is defined as an open reform, serving as a bottom-up solution to promote school autonomy. This reform allows school leaders to exercise considerable discretion regarding the broad policy’s goals of reaching 21st century learning skills in public schools. The purpose of this study is to examine the variations in perceptions of policy makers and principals while implementing this generally outlined “Meaningful Learning Reform.”

Methodology

In this qualitative phenomenological study, interviews were conducted with principals ( N = 30), that were involved in the implementation of the reform examined, and policy makers ( N = 2) that served as national initiators of the reform.

Findings

The data analysis of the stakeholders conveys the coherency of interpretations in three main themes: (a) misalignments in the nature of reform’s meaning—including differences in the perceptions of the name given to the reform, the reform’s purpose, and its foundation tenets; (b) contradictions regarding the authority leading the reform—various outlooks regarding the direction of the leading authority; and (c) difficulties in the process of implementation—including initiation and implementation phases of the reform.

Originality/Value

The exploration of the variations of interpretations between policy makers and principals contributes to a deeper understanding of coherency in the educational context. The data provides new insights regarding the dynamics between top-down and bottom-up leadership while implementing a generally outlined pedagogical reform.
A Rare Case of Glial Choristoma Arising from the Vomer in Association with Cleft Palate
Authors: Varshini K Amrutha , Desai Anil , Sahana BA , Kumar Niranjan
Published: January 2022

Heterotopic neuroglial tissue represents normal glial tissue in an abnormal location distant from the central nervous system. It is a rare congenital condition and the majority of these lesions are diagnosed at birth or early childhood. We report a rare case scenario of a growth arising from the vomer associated with cleft palate. The origin of a glial choristoma from the midline of the nasal cavity in association with a cleft palate has not been reported in the literature. Complete surgical excision was performed prior to palatoplasty with no postoperative complications or evidence of recurrence.