The Use of Cognitive Factors for Explaining Entrepreneurship

‘What makes an entrepreneur?’ This is an important question for many researchers in the past three decades. Although this is a fundamental question, research usually find incomplete and uncertain answers to this research question. Thus, it is of imperative importance to study novel factors that may explain entrepreneurship better. Therefore, this thesis takes entrepreneurship as a starting point to investigate the associations with two new potential cognitive factors, viz., neurocognitive measures on the one hand and self-reported psychiatric symptoms and individual differences on the other hand. Chapter 1 introduces how the five chapters fit in the conceptual model this thesis builds upon and discusses its main motivation and contribution. Chapter 2 and 3 examine the internal consistency and functional significance of important neurocognitive measures. The results provide guidelines for future research and suggest that more research is needed to fully understand what these neurocognitive measures reflect. Chapter 4 and 5 investigate the association between attention-deficit/hyperactivity (ADHD) symptoms and entrepreneurial choice and orientation. The findings suggest that there is a positive association that is primarily driven by hyperactivity symptoms. Finally, Chapter 6 studies the association between present and future temporal focus and entrepreneurial orientation in a sample of solo self-employed individuals. The results suggest that for these individuals a future focus is more important compared to present focus for the entrepreneurial orientation and that a focus on both temporal foci simultaneously comes at the expense of their entrepreneurial orientation. Taken together, this thesis presents initial results associating new potential cognitive factors that may explain entrepreneurship and opens up ample room for research in this direction

Internal consistency of event-related potentials associated with cognitive control: N2/P3 and ERN/Pe

Recent studies in psychophysiology show an increased attention for examining the reliability of Event-Related Potentials (ERPs), which are measures of cognitive control (e.g., Go/No-Go tasks). An important index of reliability is the internal consistency (e.g., Cronbach's alpha) of a measure. In this study, we examine the internal consistency of the N2 and P3 in a Go/No-Go task. Furthermore, we attempt to replicate the previously found internal consistency of the Error-Related Negativity (ERN) and Positive-Error (Pe) in an Eriksen Flanker task. Healthy participants performed a Go/No-Go task and an Eriksen Flanker task, whereby the amplitudes of the correct No-Go N2/P3, and error trials for ERN/Pe were the variables of interest. This study provides evidence that the N2 and P3 in a Go/No-Go task are internally consistent after 20 and 14 trials are included in the average, respectively. Moreover, the ERN and Pe become internally consistent after approximately 8 trials are included in the average. In addition guidelines and suggestions for future research are discussed

The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment

Attention-deficit/hyperactivity (ADHD) symptoms have been associated with the decision to become self-employed. Although these symptoms are generally regarded as disadvantageous, there may also be a bright side. To our knowledge, however, there has been no systematic, epidemiological evidence to support this claim. This paper examines the association between ADHD symptoms and self-employment in a population-based sample from the STAGE cohort of the Swedish Twin Registry (N = 7208). For replication, we used a sample of Dutch students who participated in the Global University Entrepreneurial Spirit Students’ Survey (N = 13,112). In the Swedish sample, we found a positive association with self-employment for both general ADHD symptoms [odds ratio (OR) 1.13; 95 % confidence intervals (CI) 1.04–1.23] and hyperactivity symptoms [OR 1.19; 95 % CI 1.08–1.32], whereas no association was found for attention-deficit symptoms [OR 0.99; 95 % CI 0.89–1.10]. The positive association between hyperactivity and self-employment was replicated in the Dutch student sample [OR 1.09; 95 % CI 1.03–1.15]. Our results show that certain aspects of ADHD, in particular hyperactivity, can have a bright side, as they are positively associated with self-employment

A nationwide overview of 1-year mortality in cardiac arrest patients admitted to intensive care units in the Netherlands between 2010 and 2016

Aim: Worldwide, cardiac arrest (CA) remains a major cause of death. Most post-CA patients are admitted to the intensive care unit (ICU). The aim of this study is to describe mortality rates and possible changes in mortality rates in patients with CA admitted to the ICU in the Netherlands between 2010 and 2016. Methods: In this study, we included all adult CA patients registered in the National Intensive Care Evaluation (NICE) regist

In-hospital cardiovascular events after liver transplantation: predictors and long-term outcome

Introduction: Liver transplantation has emerged as a successful therapy for end-stage liver disease. However, cardiovascular mortality is the leading cause of fatality in the postoperative period. The aim of this study was to reveal the prevalence and identify risk factors of early cardiovascular events (CVEs). Methods: We performed a retrospective study of all consecutive patients who underwent a primary liver transplantation from 1986 to 2017 (n = 916). We investigated the occurrence of in-hospital CVEs, their predictors, and short- and long-term outcome. Results: The prevalence of CVEs was 11%. The adjusted analysis showed that higher age (OR 1.06, 95% CI 1.03–1.09), higher MELD score (OR 1.04, 95% CI 1.01–1.07 CI) and sinus tachycardia at time of screening (OR 3.12, 95% CI 1.45–6.72) we

The effect of therapeutic drug monitoring of beta-lactam and fluoroquinolones on clinical outcome in critically ill patients: The DOLPHIN trial protocol of a multi-centre randomised controlled trial

Background: Critically ill patients undergo extensive physiological alterations that will have impact on antibiotic pharmacokinetics. Up to 60% of intensive care unit (ICU) patients meet the pharmacodynamic targets of beta-lactam antibiotics, with only 30% in fluoroquinolones. Not reaching these targets might increase the chance of therapeutic failure, resulting in increased mortality and morbidity, and antibiotic resistance. The DOLPHIN trial was designed to demonstrate the added value of therapeutic drug monitoring (TDM) of beta-lactam and fluoroquinolones in critically ill patients in the ICU. Methods: A multi-centre, randomised controlled trial (RCT) was designed to assess the efficacy and cost-effectiveness of model-based TDM of beta-lactam and fluoroquinolones. Four hundred fifty patients will be included within 24 months after start of inclusion. Eligible patients will be randomly allocated to either study group: the intervention group (active TDM) or the control group (non-TDM). In the intervention group dose adjustment of the study antibiotics (cefotaxime, ceftazidime, ceftriaxone, cefuroxime, amoxicillin, amoxicillin with clavulanic acid, flucloxacillin, piperacillin with tazobactam, meropenem, and ciprofloxacin) on day 1, 3, and 5 is performed based upon TDM with a Bayesian model. The primary outcome will be ICU length of stay. Other outcomes amongst all survival, disease severity, safety, quality of life after ICU discharge, and cost effectiveness will be included. Discussion: No trial has investigated the effect of early TDM of beta-lactam and fluoroquinolones on clinical outcome in critically ill patients. The findings from the DOLPHIN trial will possibly lead to new insights in clinical management of critically ill patients receiving antibiotics. In short, to TDM or not to TDM? Trial registration: EudraCT number: 2017-004677-14. Sponsor protocol name: DOLPHIN. Registered 6 March 2018. Protocol Version 6, Protocol date: 27 November 2019

Heterologous ad26.COV2.S prime and mRNA-based boost COVID-19 vaccination regimens: the SWITCH trial protocol

Immunogenetics and cellular immunology of bacterial infectious disease

Association between Clinical Frailty Scale score and hospital mortality in adult patients with COVID-19 (COMET): an international, multicentre, retrospective, observational cohort study

Background During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe.Methods This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS1-3), mildly frail (CFS4-5), or frail (CFS6-9). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities).Findings Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR(55-77)]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS6-9 vs CFS1-3 odds ratio [OR] 2.71 [95% CI 2.04-3.60], p= 65 years: CFS6-9 vs CFS1-3 OR 2.90 [2.12-3.97], p<0.0001 and CFS4-5 vs CFS1-3 OR 1.64 [1.20-2.25], p=0.0020). In patients younger than 65 years, an increased hospital mortality risk was only observed in frail patients (CFS6-9 vs CFS1-3 OR 2.22 [1.08-4.57], p=0.030; CFS4-5 vs CFS1-3 OR 1.08 [0.48-2.39], p=0.86). Frail patients had a higher incidence of admission to intensive care than fit patients (CFS6-9 vs CFS1-3 OR 1.54 [1.21-1.97], p=0.0010), whereas mildly frail patients had a lower incidence than fit patients (CFS4-5 vs CFS1-3 OR 0.71 [0.55-0.92], p=0.0090). Among patients younger than 65 years, frail patients had an increased incidence of admission to intensive care (CFS6-9 vs CFS1-3 OR 2.96 [1.98-4.43], p<0.0001), whereas mildly frail patients had no significant difference in incidence compared with fit patients (CFS4-5 vs CFS1-3 OR 0.93 [0.63-1.38], p=0.72). Among patients aged 65 years and older, frail patients had no significant difference in the incidence of admission to intensive care compared with fit patients (CFS6-9 vs CFS1-3 OR 1.27 [0.92-1.75], p=0.14), whereas mildly frail patients had a lower incidence than fit patients (CFS4-5 vs CFS1-3 OR 0.66 [0.47-0.93], p=0.018).Interpretation The results of this study suggest that CFS score is a suitable risk marker for hospital mortality in adult patients with COVID-19. However, treatment decisions based on the CFS in patients younger than 65 years should be made with caution. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Pathophysiology, epidemiology and therapy of agein

Immunogenicity and reactogenicity of vaccine boosters after Ad26.COV2.S priming

BACKGROUND The Ad26.COV2.S vaccine, which was approved as a single-shot immunization regimen, has been shown to be effective against severe coronavirus disease 2019. However, this vaccine induces lower severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein (S)-specific antibody levels than those induced by messenger RNA (mRNA)-based vaccines. The immunogenicity and reactogenicity of a homologous or heterologous booster in persons who have received an Ad26. COV2.S priming dose are unclear.METHODSIn this single-blind, multicenter, randomized, controlled trial involving health care workers who had received a priming dose of Ad26.COV2.S vaccine, we assessed immunogenicity and reactogenicity 28 days after a homologous or heterologous booster vaccination. The participants were assigned to receive no booster, an Ad26. COV2.S booster, an mRNA-1273 booster, or a BNT162b2 booster. The primary end point was the level of S-specific binding antibodies, and the secondary end points were the levels of neutralizing antibodies, S-specific T-cell responses, and reactogenicity. A post hoc analysis was performed to compare mRNA-1273 boosting with BNT162b2 boosting.RESULTSHomologous or heterologous booster vaccination in 434 participants resulted in higher levels of S-specific binding antibodies, neutralizing antibodies, and T-cell responses than a single Ad26.COV2.S vaccination. The increase in binding antibodies was significantly larger with heterologous regimens that included mRNA-based vaccines than with the homologous booster. The mRNA-1273 booster was most immunogenic and was associated with higher reactogenicity than the BNT162b2 and Ad26.COV2.S boosters. Local and systemic reactions were generally mild to moderate in the first 2 days after booster administration.CONCLUSIONSThe Ad26.COV2.S and mRNA boosters had an acceptable safety profile and were immunogenic in health care workers who had received a priming dose of Ad26. COV2.S vaccine. The strongest responses occurred after boosting with mRNA-based vaccines. Boosting with any available vaccine was better than not boosting.Immunogenetics and cellular immunology of bacterial infectious disease