A Digital Tale of Two Cities—Observing the Dynamics of the Artificial Intelligence Ecosystems in Berlin and Sydney

In entrepreneurial ecosystems (EEs), geographical and contextual factors play a big role in shaping the knowledge bases for digital innovation. While cities around the world compete to be perceived as successful “tech startup hubs”, proactive urban strategies are needed to create knowledge spillovers into EEs. This study explores the evolution of artificial intelligence (AI) knowledge practices in the EEs of Berlin and Sydney by using knowledge-spillover theory of entrepreneurship. The study utilizes a bibliometric analysis of secondary data in combination with exploratory stakeholder interviews conducted for both cities. Findings underline the critical role of experimental knowledge in driving the momentum of the EEs and the supporting role of policies imprinting knowledge practices. The paper shows how the dynamics of EEs can be explored empirically and raises awareness of the role of specialised and integrated policies in determining a city’s overall success in building EEs

Bone pain and extremely low bone mineral density due to severe vitamin D deficiency in celiac disease

Case report A 29-year-old wheelchair-bound woman was presented to us by the gastroenterologist with suspected osteomalacia. She had lived in the Netherlands all her life and was born of Moroccan parents. Her medical history revealed iron deficiency, growth retardation, and celiac disease, for which she was put on a gluten-free diet. She had progressive bone pain since 2 years, difficulty with walking, and about 15 kg weight loss. She had a short stature, scoliosis, and pronounced kyphosis of the spine and poor condition of her teeth. Laboratory results showed hypocalcemia, an immeasurable serum25-hydroxyvitamin D level, and elevated parathyroid hormone and alkaline phosphatase levels. Spinal radiographs showed unsharp, low contrast vertebrae. Bone mineral density measurement at the lumbar spine and hip showed a T-score of -6.0 and -6.5, respectively. A bone scintigraphy showed multiple hotspots in ribs, sternum, mandible, and long bones. A duodenal biopsy revealed villous atrophy (Marsh 3C) and positive antibodies against endomysium, transglutaminase, and gliadin, compatible with active celiac disease. A bone biopsy showed severe osteomalacia but normal bone volume. She was treated with calcium intravenously and later orally. Furthermore, she was treated with high oral doses of vitamin D and a gluten-free diet. After a few weeks of treatment, her bone pain decreased, and her muscle strength improved. Discussion In this article, the pathophysiology and occurrence of osteomalacia as a complication of celiac disease are discussed. Low bone mineral density can point to osteomalacia as well as osteoporosis. © International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Systematic review: conservative treatments for secondary lymphedema

<p>Abstract</p> <p>Background</p> <p>Several conservative (i.e., nonpharmacologic, nonsurgical) treatments exist for secondary lymphedema. The optimal treatment is unknown. We examined the effectiveness of conservative treatments for secondary lymphedema, as well as harms related to these treatments.</p> <p>Methods</p> <p>We searched MEDLINE^®, EMBASE^®, Cochrane Central Register of Controlled Trials^®, AMED, and CINAHL from 1990 to January 19, 2010. We obtained English- and non-English-language randomized controlled trials or observational studies (with comparison groups) that reported primary effectiveness data on conservative treatments for secondary lymphedema. For English-language studies, we extracted data in tabular form and summarized the tables descriptively. For non-English-language studies, we summarized the results descriptively and discussed similarities with the English-language studies.</p> <p>Results</p> <p>Thirty-six English-language and eight non-English-language studies were included in the review. Most of these studies involved upper-limb lymphedema secondary to breast cancer. Despite lymphedema's chronicity, lengths of follow-up in most studies were under 6 months. Many trial reports contained inadequate descriptions of randomization, blinding, and methods to assess harms. Most observational studies did not control for confounding. Many studies showed that active treatments reduced the size of lymphatic limbs, although extensive between-study heterogeneity in areas such as treatment comparisons and protocols, and outcome measures, prevented us from assessing whether any one treatment was superior. This heterogeneity also precluded us from statistically pooling results. Harms were rare (< 1% incidence) and mostly minor (e.g., headache, arm pain).</p> <p>Conclusions</p> <p>The literature contains no evidence to suggest the most effective treatment for secondary lymphedema. Harms are few and unlikely to cause major clinical problems.</p

Weaning practices in phenylketonuria vary between health professionals in Europe

Background: In phenylketonuria (PKU), weaning is considered more challenging when compared to feeding healthy infants. The primary aim of weaning is to gradually replace natural protein from breast milk or standard infant formula with solids containing equivalent phenylalanine (Phe). In addition, a Phe-free second stage L-amino acid supplement is usually recommended from around 6 months to replace Phe-free infant formula. Our aim was to assess different weaning approaches used by health professionals across Europe. Methods: A cross sectional questionnaire (survey monkey (R)) composed of 31 multiple and single choice questions was sent to European colleagues caring for inherited metabolic disorders (IMD). Centres were grouped into geographical regions for analysis. Results: Weaning started at 17-26 weeks in 85% (n=81/95) of centres, > 26 weeks in 12% (n=11/95) and 26 weeks. First solids were mainly low Phe vegetables (59%, n=56/95) and fruit (34%, n=32/95). A Phe exchange system to allocate dietary Phe was used by 52% (n=49/95) of centres predominantly from Northern and Southern Europe and 48% (n=46/95) calculated most Phe containing food sources (all centres in Eastern Europe and the majority from Germany and Austria). Some centres used a combination of both methods. A second stage Phe-free L-amino acid supplement containing a higher protein equivalent was introduced by 41% (n=39/95) of centres at infant age 26-36 weeks (mainly from Germany, Austria, Northern and Eastern Europe) and 37% (n=35/95) at infant age > 1y mainly from Southern Europe. 53% (n=50/95) of centres recommended a second stage Phe-free L-amino acid supplement in a spoonable or semi-solid form. Conclusions: Weaning strategies vary throughout European PKU centres. There is evidence to suggest that different infant weaning strategies may influence longer term adherence to the PKU diet or acceptance of Phe-free L-amino acid supplements; rendering prospective long-term studies important. It is essential to identify an effective weaning strategy that reduces caregiver burden but is associated with acceptable dietary adherence and optimal infant feeding development.Peer reviewe

Early feeding practices in infants with phenylketonuria across Europe

Background: In infants with phenylketonuria (PKU), dietary management is based on lowering and titrating phenylalanine (Phe) intake from breast milk or standard infant formula in combination with a Phe-free infant formula in order to maintain blood Phe levels within target range. Professionals use different methods to feed infants with PKU and our survey aimed to document practices across Europe. Methods: We sent a cross sectional, survey monkey (R) questionnaire to European health professionals working in IMD. It contained 31 open and multiple-choice questions. The results were analysed according to different geographical regions. Results: Ninety-five centres from 21 countries responded. Over 60% of centres commenced diet in infants by age 10 days, with 58% of centres implementing newborn screening by day 3 post birth. At diagnosis, infant hospital admission occurred in 61% of metabolic centres, mainly in Eastern, Western and Southern Europe. Breastfeeding fell sharply following diagnosis with only 30% of women still breast feeding at 6 months. 53% of centres gave pre-measured Phe-free infant formula before each breast feed and 23% alternated breast feeds with Phe-free infant formula. With standard infant formula feeds, measured amounts were followed by Phe-free infant formula to satiety in 37% of centres (n = 35/95), whereas 44% (n = 42/95) advised mixing both formulas together. Weaning commenced between 17 and 26 weeks in 85% centres, >= 26 weeks in 12% and <17 weeks in 3%. Discussion: This is the largest European survey completed on PKU infant feeding practices. It is evident that practices varied widely across Europe, and the practicalities of infant feeding in PKU received little focus in the PKU European Guidelines (2017). There are few reports comparing different feeding techniques with blood Phe control, Phe fluctuations and growth. Controlled prospective studies are necessary to assess how different infant feeding practices may influence longer term feeding development.Peer reviewe

Exploring the Knowledge Spillovers of a Technology in an Entrepreneurial Ecosystem – The Case of Artificial Intelligence in Sydney

New knowledge presents opportunities for commercial value and can hence be a critical asset for entrepreneurial ecosystems. In particular, general purpose technologies are major drivers of entrepreneurship, thus, a nuanced understanding on technological knowledge and its spillovers among actors within an entrepreneurial ecosystem (EE) is warranted. Using knowledge-spillover-based strategic entrepreneurship theory, we propose to observe knowledge spillovers through the assessment of the knowledge bases of a technology in an EE. To do so, this paper proposes to use three key sources of knowledge: publications reflecting the emerging knowledge base, patents representing the realized knowledge base, and startups showing the experimental knowledge base. This paper uses secondary data sources such as Web of Science and applies the method of bibliometrics to illustrate how an assessment is carried out in practice by evaluating the artificial intelligence (AI) knowledge bases in Sydney from 2000 to 2018. The findings are summarized with an illustration of the evolution of the key actors and their activities over time in order to indicate the key strengths and weaknesses in Sydney’s AI knowledge among the different bases. Contrary to expectations from the high potential of knowledge spillovers from a general purpose digital technology such as AI, the paper shows that apparent knowledge spillovers are yet highly limited in Sydney. Even though Sydney has a strong emerging knowledge base, the realized knowledge base seems weak and the experimental knowledge base is slowly improving. That observation itself verifies the need to take strategic actions to facilitate knowledge spillovers within EEs. After the implications for theory and policy makers are discussed, suggestions for further studies are proposed

Unraveling the dynamics of immigrant engineers` full-utilization in Australia

The study aims to improve our understanding of the full-utilization of immigrant engineers by answering three research questions: (1) what are the economic and social costs of the under-utilization of immigrant engineers, (2) what factors determine immigrant engineers’ employment, and (3) what might be potential solutions to tackle with their under-utilization? We adopt the intersectionality theory to observe a rich set of social factors influential in immigrant engineers’ under-utilization by using 188 surveys and 14 interviews of immigrant engineers living in Australia. The paper concludes with the findings’ theoretical and policy implications, followed by suggestions for future studies

Understanding The Relationship Between Smart Cities And Entrepreneurial Ecosystems: The Case Of Sydney

Smart city literature is overdrawn with discussions on public services such as transportation while there is a need to broaden the analysis to understand the very rich dynamics of cities. In this chapter, the goal is to focus on the rise of technology-based entrepreneurs in cities who are creating emerging digital technologies. Cities have been a popular unit of analysis for technological development and economic activities due to their high dependency on immediate local context factors. Nowadays, transformation of cities into “smart” have increased their role further – both for economic value and for technological growth. This paper aims to expand the smart city concept to an ecosystem approach where cities become hubs of digital technologies. By combining the previous literature on entrepreneurship and digital technologies within a particular urban context, this paper discusses how smart cities could be a solid base to build digital entrepreneurship ecosystems for sustainable, liveable and competitive cities. In particular, the paper provides a case study for Sydney by illustrating the interactions between smart cities and digital entrepreneurship ecosystems in practice. The chapter ends with a summary of findings and implications for both policy makers and digital entrepreneurs

Efficacy of pneumatic compression and low-level laser therapy in the treatment of postmastectomy lymphoedema: A randomized controlled trial

PubMedID: 19164399Objective: To compare the long-term efficacy of pneumatic compression and low-level laser therapies in the management of postmastectomy lymphoedema. Design: Randomized controlled trial. Setting: Departmentof Physical Medicine and Rehabilitation of Cukurova University, Turkey. Subjects: Forty-seven patients with postmastectomy lymphoedema were enrolled in the study. Interventions: Patients were randomly allocated to pneumatic compression (group I, n = 24) and low-level laser (group II, n = 23) groups. Group I received 2 hours of compression therapy and group II received 20 minutes of laser therapy for four weeks. All patients were advised to perform daily limb exercises. Main measures: Demographic features, difference between sum of the circumferences of affected and unaffected limbs (?C), pain with visual analogue scale and grip strength were recorded. Results: Mean age of the patients was 48.3 (10.4) years. ?C decreased significantly at one, three and six months within both groups, and the decrease was still significant at month 12 only in group II (P = 0.004). Improvement of group II was greater than that of group I post treatment (P = 0.04) and at month 12 after 12 months (P = 0.02). Pain was significantly reduced in group I only at posttreatment evaluation, whereas in group II it was significant post treatment and at follow-up visits. No significant difference was detected in pain scores between the two groups. Grip strength was improved in both groups, but the differences between groups were not significant. Conclusions: Patients in both groups improved after the interventions. Group II had better long-term results than group I. Low-level laser might be a useful modality in the treatment of postmastectomy lymphoedema. © 2009 Sage Publications

Musculoskeletal complaints and quality of life after open heart surgery [Açik kalp operasyonu sonrasi kas-i·skelet si·stemi· yakinmalari ve yaşam kali·tesi·]

There is a tremendous increase in the number of cardiac operations correlating the technical advances in the last years. The aim of this study is to investigate about the musculoskeletal complaints and the health status of patients after open heart surgery. 154 patients enrolled the study, 62.3% had coronary artery by pass grafting, 32.4% had valve replacement. Detailed physical examination with laboratory and radiological evaluations were performed. Health related quality of life was assessed with the SF-36 Health Status Questionnaire (SF-36) and the scores of the patients were compared with age and gender comparable healthy individuals. In the patient group, 11 adhesive capsulitis (%7.1), 9 postthoracotomy pain syndrome (%5.8), 3 myofascial pain syndrome (2%), 2 fibromyalgia syndrome (%13) and 2 polymyalgia rheumatica (%1.3) were determined in the postoperative period. According to New York Heart Association (NYHA) functional classification, 92.9% of patients were in class 1 or 2. Significant relationship was found between NYHA functional class and physical function scale of SF-36 (r=-0.66, p<0.01). Although the scores of social functioning and role limitations due to emotional problems were similar in patient and control group, scores of general health perceptions, physical functioning, limitations due to physical problems, bodily pain, mental health and vitality were found significantly lower (p<0.05). It was concluded that some musculoskeletal complaints independent of cardiac pathologies might be observed after open heart surgery and the quality of life of these patients are lower than that of normal population in many aspects