bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rare manifestation of a large stenosing gastrointestinal tumor caused by Mycobacterium tuberculosis in a previously healthy man from Austria
Authors: Shao Guangyu , Chitechi Bakari , Demireli Gamze , Ornig Karoline , Neuböck Matthias J. , Heldt Sven , Mandl Michael , Paar Christian , Winkler Markus , Lamprecht Bernd , Salzer Helmut J. F. 
Published: October 2021

Summary
Background
Gastrointestinal tuberculosis (TB) is a rare manifestation in low TB-incidence countries such as Austria. It is usually seen in immunocompromised patients or in migrants being more susceptible for extrapulmonary disease manifestations.

Case description
We report a very rare manifestation of severe gastrointestinal TB in a 49-year-old previously healthy man from Upper Austria. Endoscopy showed a large tumor mass obstructing about 2/3 of the lumen of the cecum. Positron emission tomography/computed tomography scan revealed not only a high metabolic activity in the tumor mass, but also active pulmonary lesions in both upper lung lobes. Bronchial secretion showed acid-fast bacilli in the microscopy and polymerase chain reaction was positive for M. tuberculosis complex. Phenotypic resistance testing showed no resistance for first-line anti-TB drugs. Treatment with isoniazid, rifampicin, pyrazinamide and ethambutol was initiated. Based on therapeutic drug monitoring, the standard treatment regime was adapted to rifampicin high dose. TB treatment was well tolerated and the patient achieved relapse-free cure one year after the end of treatment.

Conclusion
Gastrointestinal involvement mimicking an intestinal tumor is a very rare TB manifestation in previously healthy Austrians. However, it should be kept in mind due to increasing migration from countries with higher rates of extrapulmonary TB and due to an increasing number of immunocompromised patients. TB telephone consultations can support medical professionals in the diagnosis and the management of complex TB patients. TB management is currently at a transitional stage from a programmatic to personalized management concept including therapeutic drug monitoring or biomarker-guided treatment duration to achieve relapse-free cure.
Identity-Related Factors Protect Well-Being Against Stigma for Transgender and Gender Non-Conforming People
Authors: Doyle David Matthew , Begeny Christopher T. , Barreto Manuela , Morton Thomas A. 
Published: October 2021

AbstractRelatively little is known about identity-related resilience factors associated with well-being among transgender and gender non-conforming (TGNC) people. Drawing upon theory on stigma-related stress and resilience and work examining group identification as a buffer against discrimination, the aim of the current study was to model perceived discrimination, transgender identification, and gender identity affirmation as predictors of well-being for TGNC people. We also tested whether the positive association between gender identity affirmation and well-being might be explained by the benefits affirmation has for individual self-concept clarity. Participants were 105 TGNC individuals (42% transgender male, 39% transgender female, 19% other gender non-conforming [e.g., non-binary]) recruited through online forums and support groups in the UK and North America who completed an online survey including self-report measures of key constructs. Results from structural equation models demonstrated that: (1) experiences of discrimination were associated with lower well-being overall, but having a stronger transgender identity moderated this association; (2) after adjustment for discrimination and transgender identification, experiences of gender identity affirmation were independently associated with greater well-being for TGNC people. Secondary analyses demonstrated that gender identity affirmation was linked to well-being through reinforcing a strong, internalized sense of clarity about individual self-concept. Results are discussed in terms of the implications for TGNC health and well-being, particularly with regard to the need for supportive, identity-affirming social environments.
A Polygenic Approach to Understanding Resilience to Peer Victimisation
Authors: Armitage Jessica M. , Wang R. Adele H. , Davis Oliver S. P. , Haworth Claire M. A. 
Published: October 2021

AbstractPrevious studies suggest an individual’s risk of depression following adversity may be moderated by their genetic liability. No study, however, has examined peer victimisation, an experience repeatedly associated with mental illness. We explore whether the negative mental health outcomes following victimisation can be partly attributed to genetic factors using polygenic scores for depression and wellbeing. Among participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), we show that polygenic scores and peer victimisation are significant independent predictors of depressive symptoms (n=2268) and wellbeing (n=2299) in early adulthood. When testing for interaction effects, our results lead us to conclude that low mental health and wellbeing following peer victimisation is unlikely to be explained by a moderating effect of genetic factors, as indexed by current polygenic scores. Genetic profiling is therefore unlikely to be effective in identifying those more vulnerable to the effects of victimisation at present. The reasons why some go on to experience mental health problems following victimisation, while others remain resilient, requires further exploration, but our results rule out a major influence of current polygenic scores.
The Role of Atmospheric Stability and Turbulence in Offshore Wind-Farm Wakes in the German Bight
Authors: Platis Andreas , Hundhausen Marie , Lampert Astrid , Emeis Stefan , Bange Jens 
Published: October 2021

AbstractAirborne meteorological in situ measurements as well as stationary measurements at the offshore masts FINO1 and FINO3 in the German Bight are evaluated in order to examine the hypothesis that the wake dissipation downstream of large offshore wind farms depends on atmospheric stability. A long-term study of the mast data for the years 2016 and 2017 demonstrates a clear dependence of stability on the wind direction. Stable conditions are predominantly expected during southerly winds coming from the land. The analysis of various stability and turbulence criteria shows that the lapse rate is the most robust parameter for stability classification in the German Bight, but further implies that stability depends on the measurement height. A near-surface (0 to 30 m), predominantly convective, layer is present and more stable conditions are found aloft (55 to 95 m). Combing the stability data with the airborne measurements of the offshore wind-farm wakes reveals the trend of a correlation between longer wake lengths and an increase in the initial wind-speed deficit downwind of a wind farm with stronger thermal stability. However, the stability correlation criteria with the wake length downstream of the four investigated wind farms, Godewind, Amrumbank West, Meerwind Süd/Ost, and Nordsee Ost, contain large variance. It is assumed that the observed scattering is due to the influence of the wind-farm architecture and temperature inversions around hub height. These, however, are crucial for the classification of stability and illustrate the complexity of a clear stability metric.
Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data
Authors: Kwon Osung , Na Wonjun , Hur Jaehee , Kim Ju Hyeon , Jun Tae Joon , Kang Hee Jun , Lee Hojoon , Kim Young-Hak 
Published: October 2021

Abstract
Purpose
To estimate the risk of recurrent cardiovascular events in a real-world population of very high-risk Korean patients with prior myocardial infarction (MI), ischemic stroke (IS), or symptomatic peripheral artery disease (sPAD), similar to the Further cardiovascular OUtcomes Research with proprotein convertase subtilisin–kexin type 9 Inhibition in subjects with Elevated Risk (FOURIER) trial population.

Methods
This retrospective study used the Asan Medical Center Heart Registry database built on electronic medical records (EMR) from 2000 to 2016. Patients with a history of clinically evident atherosclerotic cardiovascular disease (ASCVD) with multiple risk factors were followed up for 3 years. The primary endpoint was a composite of MI, stroke, hospitalization for unstable angina, coronary revascularization, and all-cause mortality.

Results
Among 15,820 patients, the 3-year cumulative incidence of the composite primary endpoint was 15.3% and the 3-year incidence rate was 5.7 (95% CI 5.5–5.9) per 100 person-years. At individual endpoints, the rates of deaths, MI, and IS were 0.4 (0.3–0.4), 0.9 (0.8–0.9), and 0.8 (0.7–0.9), respectively. The risk of the primary endpoint did not differ significantly between recipients of different intensities of statin therapy. Low-density lipoprotein cholesterol (LDL-C) goals were only achieved in 24.4% of patients during the first year of follow-up.

Conclusion
By analyzing EMR data representing routine practice in Korea, we found that patients with very high-risk ASCVD were at substantial risk of further cardiovascular events in 3 years. Given the observed risk of recurrent events with suboptimal lipid management by statin, additional treatment to control LDL-C might be necessary to reduce the burden of further cardiovascular events for very high-risk ASCVD patients.
Global scenarios of residential heating and cooling energy demand and CO2 emissions
Authors: Mastrucci Alessio , van Ruijven Bas , Byers Edward , Poblete-Cazenave Miguel , Pachauri Shonali 
Published: October 2021

AbstractBuildings account for 36% of global final energy demand and are key to mitigating climate change. Assessing the evolution of the global building stock and its energy demand is critical to support mitigation strategies. However, most global studies lack granularity and overlook heterogeneity in the building sector, limiting the evaluation of demand transformation scenarios. We develop global residential building scenarios along the shared socio-economic pathways (SSPs) 1–3 and assess the evolution of building stock, energy demand, and CO2 emissions for space heating and cooling with MESSAGEix-Buildings, a modelling framework soft-linked to an integrated assessment framework. MESSAGEix-Buildings combines bottom-up modelling of energy demand, stock turnover, and discrete choice modelling for energy efficiency decisions, and accounts for heterogeneity in geographical contexts, socio-economics, and buildings characteristics.Global CO2 emissions for space heating are projected to decrease between 34.4 (SSP3) and 52.5% (SSP1) by 2050 under energy efficiency improvements and electrification. Space cooling demand starkly rises in developing countries, with CO2 emissions increasing globally by 58.2 (SSP1) to 85.2% (SSP3) by 2050. Scenarios substantially differ in the uptake of energy efficient new construction and renovations, generally higher for single-family homes, and in space cooling patterns across income levels and locations, with most of the demand in the global south driven by medium- and high-income urban households. This study contributes an advancement in the granularity of building sector knowledge to be assessed in integration with other sources of emissions in the context of global climate change mitigation and sustainable development.
Psychomotor learning theory informing the design and evaluation of an interactive augmented reality hand hygiene training app for healthcare workers
Authors: Lacey Gerard , Gozdzielewska Lucyna , McAloney-Kocaman Kareena , Ruttle Jonathan , Cronin Sean , Price Lesley 
Published: October 2021

AbstractHand hygiene is critical for infection control, but studies report poor transfer from training to practice. Hand hygiene training in hospitals typically involves one classroom session per year, but psychomotor skills require repetition and feedback for retention. We describe the design and independent evaluation of a mobile interactive augmented reality training tool for the World Health Organisation (WHO) hand hygiene technique. The design was based on a detailed analysis of the underlying educational theory relating to psychomotor skills learning. During the evaluation forty-seven subjects used AR hand hygiene training over 4 weeks. Hand hygiene proficiency was assessed at weekly intervals, both electronically and via human inspection. Thirty eight participants (81%) reached proficiency after 24.3 (SD = 17.8) two-minute practice sessions. The study demonstrated that interactive mobile applications could empower learners to develop hand hygiene skills independently. Healthcare organizations could improve hand hygiene quality by using self-directed skills-based training combined with regular ward-based assessments.
Determinants of blood and saliva lead concentrations in adult gardeners on urban agricultural sites
Authors: Bramwell Lindsay , Morton Jackie , Harding Anne-Helen , Lin Nan , Entwistle Jane 
Published: October 2021

AbstractSoil Pb concentrations at urban agriculture sites (UAS) commonly exceed recommended safe levels. There is a lack of evidence regarding uptake of Pb by gardeners using such sites for food crops. Our study aimed to elucidate whether gardening in soil with raised Pb levels results in Pb body burdens of concern to health, and to assess confounding factors influencing Pb body burden. Our cross-sectional case study measured Pb in saliva and blood of UAS gardeners (n = 43), soil and produce samples from their UAS, and home tap water. Blood and saliva Pb concentrations were compared with those from non-UAS gardener controls (n = 29). A health risk threshold of 5 µg dL−1 blood Pb level (BLL) was selected in keeping with international guidance. Detailed surveys investigated individuals’ anthropometrics and potential Pb exposures from diet, and historic and everyday activities. Saliva was not found to be a suitable biomarker of adult Pb exposure in this context. Predictors of higher BLLs were being older, being male and eating more root vegetables and shrub fruit. Eating more green vegetables predicted a lower BLL, suggesting a protective effect against Pb uptake. UAS gardeners’ BLLs (geometric mean 1.53; range 0.6–4.1 µg dL−1) were not significantly higher (p = 0.39) than the control group (geometric mean 1.43; range 0.7–2.9 µg dL−1). All BLLs were below 5 µg dL−1 except one resulting from occupational exposure. Having paired the UAS gardeners with closely matched controls, we found Pb in UAS soils (with range 62–1300 mg kg−1from common urban sources) unlikely to pose an additional risk to adult health compared to their neighbours who did not access UAS. As such, other Pb sources may be the dominant factor controlling BLL.
Understanding entropy
Authors: Nelson Peter G. 
Published: October 2021

AbstractA new way of understanding entropy as a macroscopic property is presented. This is based on the fact that heat flows from a hot body to a cold one even when the hot one is smaller and has less energy. A quantity that determines the direction of flow is shown to be the increment of heat gained (q) divided by the absolute temperature (T). The same quantity is shown to determine the direction of other processes taking place in isolated systems provided thatqis determined by the state (s) of the system. Entropy emerges as the potent energy of a system [Σ(qs/T)], the potency being determined by 1/T. This is shown to tie in with the statistical mechanical interpretation of entropy. The treatment is shorter than the traditional one based on heat engines.
Characteristics Associated with Homeless Pregnant Women in Columbus, Ohio
Authors: Ervin Emma , Poppe Barbara , Onwuka Amanda , Keedy Hannah , Metraux Stephen , Jones Leslie , Sandel Megan , Kelleher Kelly 
Published: October 2021

Abstract
Introduction
The effects of homelessness on pregnant women are substantial. We aim to identify key characteristics of a group of women identified as homeless and pregnant in order to understand their history of housing, family composition, health, and demographics as a first step for future intervention.

Methods
We present cross-sectional survey data on a sample of 100 women reporting homelessness and pregnancy in the prior year in Columbus, Ohio, identified through social service and housing not for profit agencies. Our analysis uses data collected from a survey of health behaviors, housing, employment status, and demographics. Continuous measures are described with means and standard deviations, and categorical variables are described with percentages.

Results
The majority (81%) of the women identified as African American. Over 95% of the women were single, and 74 women reported a prior pregnancy. Almost half of the women reported being behind on rent at least one time in the last 6 months, and 43% indicated that they had lived in more than three places in the last year. Approximately 34% of the sample reported cigarette use during pregnancy, while 12% and 30% reported alcohol and illicit drug use, respectively.

Discussion
Women who were pregnant and experiencing homelessness in our study reported a multitude of complex and severe problems ranging from high rates of substance use, longstanding housing insecurity and financial stress. Programs hoping to successfully support women will need to address a variety of service needs while recognizing the resilience of many women.
Justification and the knowledge-connection
Authors: Hirvelä Jaakko 
Published: October 2021

AbstractI will present a novel account of justification in terms of knowledge on which one is justified in believingpjust in case one could know thatp. My main aim is to unravel some of the formal properties that justification has in virtue of its connection to knowledge. Assuming that safety is at least a necessary condition for knowledge, I show that justification (1) doesn’t iterate trivially; (2) isn’t a luminous condition; (3) is closed under a certain kind of multi-premise closure principle, but; (4) surprisingly one can nevertheless believe with justification a set of claims that’s jointly inconsistent. This last feature allows for a rather satisfying solution to the preface paradox. Finally, I contrast my account with other knowledge-first accounts of justification.
Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population
Authors: Teni Fitsum Sebsibe , Gerdtham Ulf-G. , Leidl Reiner , Henriksson Martin , Åström Mimmi , Sun Sun , Burström Kristina 
Published: October 2021

Abstract
Purpose
This study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden.

Methods
Based on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders.

Results
In total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained.

Conclusion
EQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects.
Charisma and Democracy: Max Weber on the Riddle of Political Change in Modern Societies
Authors: T. Magalhães Pedro 
Published: October 2021

AbstractThe elite theory of Max Weber has recently been rediscovered by political scientists and political theorists who have sought to explore both the heuristic and the normative potential of plebiscitary leader democracy. Notwithstanding the merits of this wave of studies, this paper argues that attention should be shifted from Weber's context-specific defence of plebiscitary leadership in post-WWI Germany to his broader conception of charisma as an attempt to grasp the enigma of significant social and political change. Contemporary democratic theory, this paper contends, can fruitfully draw on Weber to sink into the antinomies and ambiguities of a transformative democratic politics.
Celebrity Politics and Democratic Elitism
Authors: Archer Alfred , Cawston Amanda 
Published: October 2021

AbstractIs there good reason to worry about celebrity involvement in democratic politics? The rise of celebrity politicians such as Donald Trump and Vladimir Zelensky has led political theorists and commentators to worry that the role of expertise in democratic politics has been undermined. According to one recent critique (Archer et al. 2020), celebrities possess a significant degree of epistemic power (the power to influence what people believe) that is unconnected to appropriate expertise. This presents a problem both for deliberative and epistemic theories of democratic legitimacy, which ignore this form of power, and for real existing democracies attempting to meet the standards of legitimacy set out by these theories. But do these critiques apply to democratic elitism? In this paper, we argue that recognition of celebrity epistemic power in fact represents a valuable resource for supporting the legitimacy and practice of democratic elitism, though these benefits do come with certain risks to which elite theories are particularly vulnerable.