bluuebunny/crossref_metadata_2025 huggingface dataset:
How does dynamic network capability operate? A moderated mediation analysis with NPD speed and firm age
Authors: Chen Yongjian (Ken) , Coviello Nicole , Ranaweera Chatura
Published: July 2020

Purpose

Systematic research examining the mechanisms that mediate the dynamic capability–performance relationship remains scarce. So too is research on the conditions under which these mechanisms might be influential. Accordingly, this study aims to build upon business network research to examine how a firm’s dynamic network capability (DNC) impacts firm performance, mediated by the speed of product reconfiguration (i.e. new product development [NPD] speed) and bounded by firm age.

Design/methodology/approach

The authors conduct moderated mediation analysis on survey data from small- and medium-sized manufacturing and technology firms in the USA. This study uses an initial survey and then a follow-up survey.

Findings

The findings support the general view that DNC is instrumental to firm performance, regardless of firm age. However, DNC operates differently for younger vs older firms. That is, DNC’s impact on the performance of younger firms is enabled by speeding up NPD, while much of the performance impact for older firms appears to be through alternative resource reconfiguration route(s). This study identifies the need to include a mediating variable such as resource reconfiguration to detect how DNC impacts performance.

Research limitations/implications

The model could include different dimensions of mediating resource reconfigurations, alternative boundary conditions and longer-term data.

Practical implications

This study provides managers with insight on how speed of product reconfiguration (in terms of NPD) operates in the DNC–performance relationship. It also helps them understand how this relationship changes in younger vs older firms.

Originality/value

To the best of the authors’ knowledge, this study is the first to provide empirical evidence on how DNC operates to influence performance in firms that are younger vs older.
The internal control manager and operational efficiency: evidence from Korea
Authors: Shin Hyejeong , Park Sorah
Published: July 2020

Purpose

This study aims to examine the relationship between the internal control manager attributes and the firms’ operational efficiency. The internal control manager designs and maintains the firms’ policies and procedures to certify the effectiveness of its internal control system.

Design/methodology/approach

The study is an empirical research based on a sample of public companies listed on the Korean Stock Exchange from year 2011 to 2015. The authors derive measures of operational efficiency using the data envelopment analysis tool.

Findings

This study shows that the operational efficiency increases with internal control managers’ task-related knowledge and diverse firm knowledge, consistent with human capital theory. Also, the results reveal that internal control managers, equity ownership has a curvilinear relationship with the operational efficiency, indicating that excessive managerial ownership can deteriorate the firm value.

Originality/value

While many studies have examined the association between the internal control system and financial reporting quality, this paper is differentiated from prior studies by focussing on the internal control managers’ personal attributes. This is important, as the internal control system is essentially built by internal control managers who are in charge. This study contributes to accounting literature by shedding light on the role of internal control managers in enhancing the firms’ operational efficiency.
Investment obstacles to sustainable development and competitiveness index
Authors: Alshubiri Faris
Published: July 2020

Purpose

This paper was aimed to develop better knowledge to show how obstacles impact Sustainable Development Goals (SDGs) in investment business on the global competitiveness index (GCI). This study was applied to six Gulf Cooperation Council (GCC) economies to analyse and classify investment obstacles in order to improve GCI and mitigate the obstacles to doing business.

Design/methodology/approach

This study used the 12 pillars of the GCI to classify six GCC countries and 15 factors of SDGs using data from 2008 to 2017. The data were collected from the International Monetary Fund and GCI reports from 2008 to 2018 on all six GCC countries: the UAE, Kuwait, Oman, Saudi Arabia, Bahrain and Qatar. The paper adopted equations to analyse the GCI, along with 15 obstacles to doing investment business. The paper used regression and correlation tests by two proxies: obstacles to SDGs as an independent variable and the GCI as a dependent variable.

Findings

The findings of this study focussed on the best classification of the GCI, which went to Qatar, whereas the lowest rank went to Oman. The major components of obstacles to doing investment business are restrictive labour regulations, access to financing and inefficient government bureaucracy factors. These obstacles stand in the way of achieving SDGs and delay the improvement of the competitive field. Hence, the results of the regression test show that there is a negative and statistically significant impact in Oman, Kuwait and the UAE between obstacles to doing business on the GCI at the significance levels of 1% and 5%. The Pearson correlation matrix is strong between obstacles to SDGs, as the same elements of the GCI also exist in these countries, at 55.2%, 75% and 55.5%, respectively.

Research limitations/implications

There are some limitations related to the study period being from 2008 to 2017. Before 2008, the GCI consisted of nine pillars rather than 12, and there were 14 problems rather than 15 related to doing investment business. Hence, this does not match with the period of this study. Furthermore, the reports after 2017 did not mention the problems of doing business, only analysing the GCI.

Practical implications

The results of the study highlight the strategic and practical aspects of GCC countries diagnosing the SDGs to know how to reduce obstacles to sustainable development, which can enhance investments by improving the GCI.

Originality/value

The current study measured and evaluated how to mitigate the obstacles to SDGs in the GCC countries. It is the first study to explain these obstacles in the GCC countries, which are characterised by their huge wealth that contributes significantly to global economic development.
An objective hermeneutic approach to qualitative validation
Authors: Borim-de-Souza Rafael , Travis Eric Ford , Munck Luciano , Galleli Bárbara
Published: July 2020

Purpose

Inspired by objective hermeneutics (Oevermann, 1984, 1996, 1999; Oevermannet al., 1979; Weller, 2010; Wohrab-Sahr, 2003) and qualitative validation (Adcock and Collier, 2001; Martis, 2006; Maxwell, 1992), the authors present this essay with the aim of proposing an objective hermeneutic approach to qualitative validation.

Design/methodology/approach

In order to develop this approach, the authors consider the contributions of Martis (2006) and Maxwell (1992) about theoretical–empirical validity, Adcock and Collier's propositions (2001) regarding the conceptualization and evaluation of phenomena through specific levels, tasks and stages of validation and the principles of objective hermeneutic interpretation proposed by Wohlrab-Sahr (2003).

Findings

Three main contributions are considered: theoretical–empirical validity (Martis, 2006; Maxwell, 1992); levels of validation – theoretical framework, systematized concept, indicators and results (Adcock and Collier, 2001); stages of validation – content validity, convergent validity and nomological validity (Adcock and Collier, 2001); and principles of objective hermeneutic interpretation – sequential interpretation, mental–experimental explanation of possible interpretations, preservation rule, literal character of interpretation, totality, reflection about knowledge used in the analysis and group of interpreters (Wohrab-Sahr, 2003). These contributions were related to establishing a framework that illustrates the proposed objective hermeneutic approach to qualitative validation.

Originality/value

The authors intend to offer to the scope of organization studies an alternative for validation, so that the voices of the researched can be heard. Furthermore, the authors seek to guide researchers as to how to respect and protect what is heard, in order to avoid any invasion of others' discourse.
Investor attention and market correction
Authors: Chen Zhongdong
Published: July 2020

Purpose

This study disentangles the investor-base effect and the information effect of investor attention. The former leads to a larger investor base and higher stock returns, while the latter facilitates the dissemination of information among investors and impacts informational trading.

Design/methodology/approach

Using positive volume shocks as a proxy for increased investor attention, this study evaluates the impacts of the investor-base effect and the information effect of investor attention on market correction following extreme daily returns in the US stock market from 1966 to 2018.

Findings

This study finds that the investor-base effect increases subsequent returns of both daily winner and daily loser stocks. The information effect leads to economically less significant return reversals for both the daily winner and daily loser stocks. These two effects tend to have economically more significant impacts on the daily loser stocks. The economic significance of these two effects is also related to firm size and the state of the stock market.

Originality/value

This study is the first to disentangle the investor-base effect and the information effect of increased investor attention. The evidence that the information effect facilitates the dissemination of new information and impacts stock returns contributes to the strand of studies on the impact of investor attention on market efficiency. This evidence also contributes to the strand of studies analyzing the impact of informational trading on stock returns. In addition, this study provides evidence for market overreaction and the subsequent correction. The results for up and down markets contribute to the literature on the investors' trading behavior.
Ambiguity aversion and experiential learning: implications for long-term savings decisions
Authors: Foltice Bryan , Rogers Rachel
Published: July 2020

Purpose

This paper evaluates potential methods for reducing ambiguity surrounding returns on equity to improve long-term savings decisions.

Design/methodology/approach

We evaluate 221 undergraduate students in the US and first assess the degree of ambiguity aversion exhibited by individuals in the sample population as they decide between a risky (known probability) option and ambiguous (unknown probability) option pertaining to their chances of winning $0 or $1 in a hypothetical lottery. Similarly, we test whether sampling historical return data through learning modules influences long-term decision making regarding asset allocation within a retirement portfolio.

Findings

Allowing participants to experience the underlying probability through sampling significantly influences behavior, as participants were more likely to select the ambiguous option after sampling. Here, we also find that participants who receive interactive learning modules – which require users to manually alter the asset allocation to produce a sample of historical return data based on the specific allocation entered in the model – increase their post-learning equity allocations by 10.1% more than individuals receiving static modules. Interestingly, we find no significant evidence of ambiguity aversion playing a role in the asset allocation decision.

Originality/value

We find that decision-making related to ambiguous and risky options can be substantially influenced by experiential learning. Our study supplements previous literature, providing a link between research on the effect of ambiguity on stock market participation and implementation of educational programs to improve the asset allocation decision for young adults.
Corporate social responsibility, innovation capability and firm performance: evidence from SME
Authors: Bahta Dawit , Yun Jiang , Islam Md Rashidul , Ashfaq Muhammad
Published: July 2020

Purpose

The purpose of this paper is to examine corporate social responsibility (CSR) and its effect on small and medium enterprises’ (SMEs) innovation capability and financial performance from the perspective of a developing country. It also aims to explore the role of innovation capability as a mediating factor in the linkage between CSR and SMEs’ financial performance.

Design/methodology/approach

A questionnaire was distributed among managers/owners of the sampled companies. Using a data set of 402 Eritrean firms and partial least squares structural equation modeling, direct and mediating effects were tested.

Findings

The result reveals that CSR has a positive and significant effect on the financial performance and innovation capability of SEMs. Besides, innovation capability has a positive and significant effect on the business performance of SMEs. The result also supports a partial mediation effect of innovation capability on the association between CSR and firm performance.

Practical implications

The findings from this research could enhance the awareness of the entrepreneurs, researchers and policymakers on CSR-SMEs’ relationship and help understand the importance of CSR as a crucial driver mechanism for companies to become more innovative and competitive.

Originality/value

By empirically examining the relationship between CSR, innovation capability and performance in SMEs, this study contributes to the ongoing scholarly discussion on the linkage between CSR and financial performance. Also, to the best of the authors’ knowledge, no other study investigated the mediating role of innovation capability on the link between CSR activities and firms’ financial performance in SMEs from a developing country perspective, making substantial contributions to research in terms of theory, practice and policy.
Placental growth factor in suspected preterm pre‐eclampsia: a review of the evidence and practicalities of implementation
Authors: Hurrell A , Beardmore‐Gray A , Duhig K , Webster L , Chappell LC , Shennan AH
Published: July 2020

Despite extensive research, the pathophysiology and prevention of pre‐eclampsia remain elusive, diagnosis is challenging, and pre‐eclampsia remains associated with adverse maternal and perinatal outcomes. Angiogenic biomarkers, including placental growth factor (PlGF) and soluble fms‐like tyrosine kinase 1 (sFlt‐1), have been identified as valuable biomarkers for preterm pre‐eclampsia, accelerating diagnosis and reducing maternal adverse outcomes by risk stratification, with enhanced surveillance for high‐risk women. PlGF‐based testing is increasingly being implemented in clinical practice in several countries. This review provides healthcare providers with an understanding of the evidence for PlGF‐based testing and describes the practicalities and challenges to implementation.

Tweetable abstract

Placental growth factor in pre‐eclampsia: evidence and implementation of testing.
Can vertically integrated health systems provide greater value: The case of hospitals under the comprehensive care for joint replacement model?
Authors: Machta Rachel M. , Reschovsky James , Jones David J. , Furukawa Michael F. , Rich Eugene C.
Published: July 2020

Objective

We aim to assess whether system providers perform better than nonsystem providers under an alternative payment model that incentivizes high‐quality, cost‐efficient care. We posit that the payment environment and the incentives it provides can affect the relative performance of vertically integrated health systems. To examine this potential influence, we compare system and nonsystem hospitals participating in Medicare's Comprehensive Care for Joint Replacement (CJR) model.

Data Sources

We used hospital cost and quality data from the Centers for Medicare & Medicaid Services linked to data from the Agency for Healthcare Research and Quality's Compendium of US Health Systems and hospital characteristics from secondary sources. The data include 706 hospitals in 67 metropolitan areas.

Study Design

We estimated regressions that compared system and nonsystem hospitals' 2017 cost and quality performance providing lower joint replacements among hospitals required to participate in CJR.

Principal Findings

Among CJR hospitals, system hospitals that provided comprehensive services in their local market had 5.8 percent ($1612) lower episode costs (P = .01) than nonsystem hospitals. System hospitals that did not provide such services had 3.5 percent ($967) lower episode costs (P = .14). Quality differences between system hospitals and nonsystem hospitals were mostly small and statistically insignificant.

Conclusions

When operating under alternative payment model incentives, vertical integration may enable hospitals to lower costs with similar quality scores.
Prediction of the development of islet autoantibodies through integration of environmental, genetic, and metabolic markers
Authors: Webb‐Robertson Bobbie‐Jo M. , Bramer Lisa M. , Stanfill Bryan A. , Reehl Sarah M. , Nakayasu Ernesto S. , Metz Thomas O. , Frohnert Brigitte I. , Norris Jill M. , Johnson Randi K. , Rich Stephen S. , Rewers Marian J.
Published: July 2020

Background

The Environmental Determinants of the Diabetes in the Young (TEDDY) study has prospectively followed, from birth, children at increased genetic risk of type 1 diabetes. TEDDY has collected heterogenous data longitudinally to gain insights into the environmental and biological mechanisms driving the progression to persistent islet autoantibodies.

Methods

We developed a machine learning model to predict imminent transition to the development of persistent islet autoantibodies based on time‐varying metabolomics data integrated with time‐invariant risk factors (eg, gestational age). The machine learning was initiated with 221 potential features (85 genetic, 5 environmental, 131 metabolomic) and an ensemble‐based feature evaluation was utilized to identify a small set of predictive features that can be interrogated to better understand the pathogenesis leading up to persistent islet autoimmunity.

Results

The final integrative machine learning model included 42 disparate features, returning a cross‐validated receiver operating characteristic area under the curve (AUC) of 0.74 and an AUC of ~0.65 on an independent validation dataset. The model identified a principal set of 20 time‐invariant markers, including 18 genetic markers (16 single nucleotide polymorphisms [SNPs] and two HLA‐DR genotypes) and two demographic markers (gestational age and exposure to a prebiotic formula). Integration with the metabolome identified 22 supplemental metabolites and lipids, including adipic acid and ceramide d42:0, that predicted development of islet autoantibodies.

Conclusions

The majority (86%) of metabolites that predicted development of islet autoantibodies belonged to three pathways: lipid oxidation, phospholipase A2 signaling, and pentose phosphate, suggesting that these metabolic processes may play a role in triggering islet autoimmunity.
Mortality and HRQoL in ICU patients with delirium: Protocol for 1‐year follow‐up of AID‐ICU trial
Authors: Mortensen Camilla B. , Poulsen Lone M. , Andersen‐Ranberg Nina C. , Perner Anders , Lange Theis , Estrup S Stine , Ebdrup Bjørn H. , Egerod Ingrid , Rasmussen Bodil S. , Hästbacka Johanna , Caballero Jesús , Citerio Giuseppe , Morgan Matthew P.G. , Samuelson Karin , Mathiesen Ole
Published: July 2020

Background

Intensive care unit (ICU)‐acquired delirium is frequent and associated with poor short‐ and long‐term outcomes for patients in ICUs. It therefore constitutes a major healthcare problem. Despite limited evidence, haloperidol is the most frequently used pharmacological intervention against ICU‐acquired delirium.

Agents intervening against Delirium in the ICU (AID‐ICU) is an international, multicentre, randomised, blinded, placebo‐controlled trial investigates benefits and harms of treatment with haloperidol in patients with ICU‐acquired delirium. The current pre‐planned one‐year follow‐up study of the AID‐ICU trial population aims to explore the effects of haloperidol on one‐year mortality and health related quality of life (HRQoL).

Methods

The AID‐ICU trial will include 1000 participants. One‐year mortality will be obtained from the trial sites; we will validate the vital status of Danish participants using the Danish National Health Data Registers. Mortality will be analysed by Cox‐regression and visualized by Kaplan‐Meier curves tested for significance using the log‐rank test. We will obtain HRQoL data using the EQ‐5D instrument. HRQoL analysis will be performed using a general linear model adjusted for stratification variables. Deceased participants will be designated the worst possible value.

Results

We expect to publish results of this study in 2022.

Conclusion

We expect that this one‐year follow‐up study of participants with ICU‐acquired delirium allocated to haloperidol vs. placebo will provide important information on the long‐term consequences of delirium including the effects of haloperidol. We expect that our results will improve the care of this vulnerable patient group.
Occupancy patterns of an apex avian predator across a forest landscape
Authors: Cisterne Adam , Crates Ross , Bell Phil , Heinsohn Rob , Stojanovic Dejan
Published: July 2020

Apex predators are integral parts of every ecosystem, having top‐down roles in food web maintenance. Understanding the environmental and habitat characteristics associated with predator occurrence is paramount to conservation efforts. However, detecting top order predators can be difficult due to small population sizes and cryptic behaviour. The endangered Tasmanian masked owl (Tyto novaehollandiae castanops) is a nocturnal predator with a distribution understood to be associated with high mature forest cover at broad scales. With the aim to gather monitoring data to inform future conservation effort, we trialled an occupancy survey design to model masked owl occurrence across ~800 km2in the Tasmanian Southern Forests. We conducted 662 visits to assess masked owl occupancy at 160 sites during July–September 2018. Masked owl site occupancy was 12%, and estimated detectability was 0.26 (±0.06 SE). Cumulative detection probability of masked owls over four visits was 0.7. Occupancy modelling suggested owls were more likely to be detected when mean prey count was higher. However, low detection rates hindered the development of confident occupancy predictions. To inform effective conservation of the endangered Tasmanian masked owl, there is a need to develop novel survey techniques that better account for the ecology of this rare, wide‐ranging and cryptic predator. We discuss the potential to combine novel census approaches that exploit different aspects of masked owl ecology to obtain more robust and detailed data.
Role of testosterone in cognition and mobility of aging men
Authors: Kaufman Jean‐Marc , Lapauw Bruno
Published: July 2020

Background

Cognitive decline and impairment of physical performance and mobility are age‐related clinical problems with major negative impact on quality of life of elderly men. In how far the decline of testosterone production contributes to these problems in older men and whether testosterone therapy can contribute to slow down, prevent, or reverse their development remains subjects of debate.

Objectives

This narrative review presents the current knowledge on association of sex steroid status with cognitive decline and impairment of physical function and mobility in elderly men and on the effects of testosterone therapy on cognition and on physical performance and mobility in elderly men.

Materials and Method

The review is based on electronic database searches with primary focus on evidence from larger prospective observational studies and from controlled randomized trials, respectively.

Results

In most observational studies, testosterone levels do not predict cognitive decline or development of Alzheimer's disease. In randomized trials, testosterone therapy did not significantly affect cognition in men with low or low‐to‐normal serum testosterone, regardless of whether they have preexisting cognitive impairment. Overall, observational data indicate that the usually moderate decline of androgen exposure in older men cannot fully account for the parallel decline of physical performance and mobility. Trials of testosterone therapy in older men with low or low‐normal serum testosterone, whether they were generally healthy or suffered from physical function impairments, either did not show any effect on mobility and physical performance or showed limited effects of uncertain clinical relevancy.

Discussion and Conclusions

The whole of the evidence tends to downplay the role of sex steroid status in the decline of cognitive function and impairment of physical function and mobility in older men. Based on the available evidence, prevention or treatment of cognitive decline or of impairment of mobility and physical function are not valid indications for testosterone treatment in older men with low or low‐to‐normal serum testosterone levels.
Predictive values of initial semi‐quantitative assessment of relative afferent pupillary defect for neovascularization in central retinal vein occlusion
Authors: Ducloyer Jean‐Baptiste , Bensaber Sonia , Khanna Raoul Kanav , Cochard Catherine , Lebreton Olivier , Le Meur Guylène , Lebranchu Pierre , Arsene Sophie , Weber Michel
Published: July 2020

Purpose

To measure the predictive values of relative afferent pupillary defect (RAPD) assessed semi‐quantitatively, and visual acuity (VA) at onset of central retinal vein occlusion (CRVO), for neovascularization.

Methods

Retrospective analysis of the TROXHEMO trial that included patients with CRVO within 30 days after the onset. Inclusion criteria were as follows: semi‐quantitative RAPD assessment at diagnosis and/or at one month. RAPD was ‘severe’ if ≥ 0.9 log. Exclusion criteria were as follows: prophylactic panretinal photocoagulation (PRP) before neovascularization.

Results

Among the 119 patients enrolled in the main centre, 101 were analysed. 26 had a neovascular complication during the twelve months of follow‐up: rubeosis (19), glaucoma (7) and posterior neovascularization (15). The mean time to onset of a neovascular complication was 4.7 months (1 to 12, median 3 months). All the patients who had a neovascular complication had RAPD at first examination or at one month (negative predictive value (NPV) = 100%) but the positive predictive value (PPV) was low (31%, 95% CI [21%; 42%]). The association ‘severe RAPD or VA < 35 letters (ETDRS) at inclusion or at one month’ was the best compromise between PPV (53%, [39%; 68%]) and NPV (96%, [92%; 100%]).

Conclusion

To predict neovascularization, RAPD should be routinely evaluated with filters: the risk of neovascular complication is (a) almost nil if there is no RAPD, (b) very low if there is no severe RAPD and if VA is higher than 35 letters, and (c) higher than 50% if RAPD is ≥ 0.9 log or if VA is less than 35 letters.
Randomised clinical trial: significant biochemical and colonic transit effects of the farnesoid X receptor agonist tropifexor in patients with primary bile acid diarrhoea
Authors: Camilleri Michael , Nord Sara Linker , Burton Duane , Oduyebo Ibironke , Zhang Yiming , Chen Jin , Im Koeun , Bhad Prafulla , Badman Michael K. , Sanders David S. , Walters Julian R. F.
Published: July 2020

Background

In primary bile acid diarrhoea, feedback by farnesoid X receptor (FXR) and fibroblast growth hormone 19 (FGF19) on hepatic bile acid production is impaired.

Aims

To evaluate the safety, mechanisms and efficacy of negative feedback by FXR activation with tropifexor, a non‐bile acid FXR agonist, in patients with primary bile acid diarrhoea.

Methods

In this double‐blind, multicentre, randomised, cross‐over study, patients received tropifexor 60 µg or placebo once daily for 14 days in each of two treatment periods. Primary objectives included tropifexor safety and tolerability, and on stool frequency and form. Other assessments included pharmacokinetic and pharmacodynamic measures, biochemical markers and gastrointestinal transit.

Results

Twenty patients (tropifexor 60 µg/placebo [N = 10]; placebo/tropifexor 60 µg [N = 10]) were enrolled. Adverse event rates were lower with tropifexor vs placebo (52.9% vs 73.7%). No patient had pruritus during tropifexor intake. There were no significant differences in stool frequency, stool form or loperamide use between treatments. Tropifexor increased FGF19 and decreased 7α‐hydroxy‐4‐cholesten‐3‐one (C4) levels for up to 8 h. Plasma tropifexor concentrations peaked at 5 hours post‐dose on days 1 and 12. At day 12, tropifexor caused reduction in peak total bile acid concentration (33%, P = 0.032) and exposure (36%, P = 0.005). Moreover, tropifexor showed a significant increase in ascending colon half‐emptying time (P = 0.036).

Conclusions

Tropifexor 60 µg once daily had acceptable safety and tolerability. Changes in FGF19 and C4 showed effective target engagement; however, higher doses may be required to observe stool frequency changes. Slowing of ascending colon emptying suggests therapeutic potential of tropifexor in patients with primary bile acid diarrhoea.

ClinicalTrials.gov number: NCT02713243.
Statistical inference for natural language processing algorithms with a demonstration using type 2 diabetes prediction from electronic health record notes
Authors: Egleston Brian L. , Bai Tian , Bleicher Richard J. , Taylor Stanford J. , Lutz Michael H. , Vucetic Slobodan
Published: July 2020

The pointwise mutual information statistic (PMI), which measures how often two words occur together in a document corpus, is a cornerstone of recently proposed popular natural language processing algorithms such as word2vec. PMI and word2vec reveal semantic relationships between words and can be helpful in a range of applications such as document indexing, topic analysis, or document categorization. We use probability theory to demonstrate the relationship between PMI and word2vec. We use the theoretical results to demonstrate how the PMI can be modeled and estimated in a simple and straight forward manner. We further describe how one can obtain standard error estimates that account for within‐patient clustering that arises from patterns of repeated words within a patient's health record due to a unique health history. We then demonstrate the usefulness of PMI on the problem of predictive identification of disease from free text notes of electronic health records. Specifically, we use our methods to distinguish those with and without type 2 diabetes mellitus in electronic health record free text data using over 400 000 clinical notes from an academic medical center.
Preoperative detection of Vesical Imaging‐Reporting and Data System (VI‐RADS) score 5 reliably identifies extravesical extension of urothelial carcinoma of the urinary bladder and predicts significant delayed time to cystectomy: time to reconsider the need for primary deep transurethral resection of bladder tumour in cases of locally advanced disease?
Authors: Del Giudice Francesco , Leonardo Costantino , Simone Giuseppe , Pecoraro Martina , De Berardinis Ettore , Cipollari Stefano , Flammia Simone , Bicchetti Marco , Busetto Gian Maria , Chung Benjamin I. , Gallucci Michele , Catalano Carlo , Panebianco Valeria
Published: July 2020

Objectives

(I) To determine Vesical Imaging‐Reporting and Data System (VI‐RADS) score 5 accuracy in predicting locally advanced bladder cancer (BCa), so as to potentially identify those patients who could avoid the morbidity of deep transurethral resection of bladder tumour (TURBT) in favour of histological sampling‐TUR prior to radical cystectomy (RC). (II) To explore the predictive value of VI‐RADS score 5 on time‐to‐cystectomy (TTC) outcomes.

Patients and Methods

We retrospectively reviewed patients’ ineligible or refusing cisplatin‐based combination neoadjuvant chemotherapy who underwent multiparametric magnetic resonance imaging (mpMRI) of the bladder prior to staging TURBT followed by RC for muscle‐invasive BCa. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated for VI‐RADS score 5 vs. score 2–4 cases to assess the accuracy of mpMRI for extravesical BCa detection (≥pT3). VI‐RADS score performance was assessed by receiver operating characteristics curve analysis. A Κ statistic was calculated to estimate mpMRI and pathological diagnostic agreement. The risk of delayed TTC (i.e. time from initial BCa diagnosis of >3 months) was assessed using multivariable logistic regression model.

Results

A total of 149 T2–T4a, cN0–M0 patients (VI‐RADS score 5, n = 39 vs VI‐RADS score 2–4, n = 110) were examined. VI‐RADS score 5 demonstrated sensitivity, specificity, PPV and NPV, in detecting extravesical disease of 90.2% (95% confidence interval [CI] 84–94.3), 98.1% (95% CI 94–99.6), 94.9% (95% CI 89.6–97.6) and 96.4% (95% CI 91.6–98.6), respectively. The area under the curve was 94.2% (95% CI 88.7–99.7) and inter‐reader agreement was excellent (Κinter 0.89). The mean (SD) TTC was 4.2 (2.3) and 2.8 (1.1) months for score 5 vs 2–4, respectively (P < 0.001). VI‐RADS score 5 was found to independently increase risk of delayed TTC (odds ratio 2.81, 95% CI 1.20–6.62).

Conclusion

The VI‐RADS is valid and reliable in differentiating patients with extravesical disease from those with muscle‐confined BCa before TURBT. Detection of VI‐RADS score 5 was found to predict significant delay in TTC independently from other clinicopathological features. In the future, higher VI‐RADS scores could potentially avoid the morbidity of extensive primary resections in favour of sampling‐TUR for histology. Further prospective, larger, and multi‐institutional trials are required to validate clinical applicability of our findings.
Lightning‐caused disturbance in the Peruvian Amazon
Authors: Gora Evan M. , Yanoviak Stephen P.
Published: July 2020

We surveyed seven lightning strike sites in the northern Peruvian Amazon. An average of 17.3 trees were damaged per strike; large trees (> 60 cm diameter) were disproportionately affected. The results contribute to a growing body of evidence that lightning is an important agent of disturbance pantropically.

Abstract in Spanish is available with online material.
Perceived discrimination in health services and preventive dental attendance in Brazilian adults
Authors: Junior Orlando Luiz do Amaral , Menegazzo Gabriele Rissotto , Fagundes Maria Laura Braccini , de Sousa Jailson Lopes , Tôrres Luisa Helena do Nascimento , Giordani Jessye Melgarejo do Amaral
Published: July 2020

Objectives

It is evident that discriminatory attitudes affect different dimensions of personal life, including health. This study aimed to verify the association between perceived discrimination in health services and preventive dental attendance in Brazilian adults.

Methods

This cross‐sectional study used secondary data from the 2013 National Health Survey (PNS), a representative survey of the Brazilian population. The response rate was 91.9%, with 60,202 adults agreeing to complete the oral health self‐perception questionnaire. Data were analysed using the software STATA 14.0. A descriptive sample analysis was conducted that considered sample weight as well as an association between health discrimination and factors associated with preventive dental attendance through Poisson regression models.

Results

Adjusted analysis demonstrated that, regarding the reasons that led to discrimination, lack of money, social class and type of working occupation showed a negative association with preventive dental attendance.

Conclusion

Our findings show that discrimination perpetuates health inequities. Those with worse social conditions need more assistance as they struggle with discrimination and end up going for a check‐up after the disease is established or advanced. Preventive care, which could change the health condition of the disadvantaged population, is often a reality only for those less vulnerable.
Evaluating the outcomes of genetic rescue attempts
Authors: Robinson Zachary L. , Bell Donovan A. , Dhendup Tashi , Luikart Gordon , Whiteley Andrew R. , Kardos Marty
Published: July 2020

Augmenting gene flow is a powerful tool for the conservation of small, isolated populations. However, genetic rescue attempts have largely been limited to populations at the brink of extinction, in part due to concerns over negative outcomes (e.g., outbreeding depression). Increasing habitat fragmentation may necessitate more proactive genetic management. Broader application of augmented gene flow will, in turn, require rigorous evaluation to increase confidence and identify pitfalls in this approach. To date, there has been no assessment of best monitoring practices for genetic rescue attempts. We used genomically explicit, individual‐based simulations to examine the effectiveness of common approaches (i.e., tests for increases in fitness, migrant ancestry, heterozygosity, and abundance) for determining whether genetic rescue or outbreeding depression occurred. Statistical power to detect the effects of gene flow on fitness was high (≥0.8) when effect sizes were large, a finding consistent with those from previous studies on severely inbred populations. However, smaller effects of gene flow on fitness can appreciably affect persistence probability but current evaluation approaches fail to provide results from which reliable inferences can be drawn. The power of the metrics we examined to evaluate genetic rescue attempts depended on the time since gene flow and whether gene flow was beneficial or deleterious. Encouragingly, the use of multiple metrics provided nonredundant information and improved inference reliability, highlighting the importance of intensive monitoring efforts. Further development of best practices for evaluating genetic rescue attempts will be crucial for a responsible transition to increased use of translocations to decrease extinction risk.
Pediatric Pharmacokinetics and Dose Predictions: A Report of a Satellite Meeting to the 10th Juvenile Toxicity Symposium
Authors: van Groen Bianca D. , Pilla Reddy Venkatesh , Badée Justine , Olivares‐Morales Andrés , Johnson Trevor N. , Nicolaï Johan , Annaert Pieter , Smits Anne , de Wildt Saskia N. , Knibbe Catherijne A. J. , de Zwart Loeckie
Published: July 2020

On April 24, 2019, a symposium on Pediatric Pharmacokinetics and Dose Predictions was held as a satellite meeting to the 10th Juvenile Toxicity Symposium. This symposium brought together scientists from academia, industry, and clinical research organizations with the aim to update each other on the current knowledge on pediatric drug development. Through more knowledge on specific ontogeny profiles of drug metabolism and transporter proteins, integrated into physiologically‐based pharmacokinetic (PBPK) models, we have gained a more integrated understanding of age‐related differences in pharmacokinetics (PKs), Relevant examples were presented during the meeting. PBPK may be considered the gold standard for pediatric PK prediction, but still it is important to know that simpler methods, such as allometry, allometry combined with maturation function, functions based on the elimination pathway, or linear models, also perform well, depending on the age range or the mechanisms involved. Knowledge from different methods and information sources should be combined (e.g., microdosing can reveal early read‐out of age‐related differences in exposure), and such results can be a value to verify models. To further establish best practices for dose setting in pediatrics, more in vitro and in vivo research is needed on aspects such as age‐related changes in the exposure‐response relationship and the impact of disease on PK. New information coupled with the refining of model‐based drug development approaches will allow faster targeting of intended age groups and allow more efficient design of pediatric clinical trials.
PRAME expression in melanocytic proliferations with intermediate histopathologic or spitzoid features
Authors: Raghavan Shyam S. , Wang Jennifer Y. , Kwok Shirley , Rieger Kerri E. , Novoa Roberto A. , Brown Ryanne A.
Published: July 2020

Background

PRAME (PReferentially expressed Antigen in MElanoma) has shown utility in distinguishing melanoma from benign melanocytic lesions, but knowledge of its expression pattern in intermediate melanocytic and spitzoid proliferations is limited.

Methods

Immunohistochemical expression of PRAME was examined in 112 melanocytic proliferations with intermediate histopathologic or spitzoid features.

Results

Any intensity of nuclear PRAME staining in at least 60% of lesional melanocytes was determined as the best threshold for diffuse staining in this cohort. Nearly all non‐spitzoid melanomas (23/24; 95.8%) demonstrated diffuse PRAME expression. PRAME was completely negative in 95.6% (43/45) of mitotically‐active nevi, traumatized nevi, nevi with persistent/recurrent features, and dysplastic nevi. Most Spitz nevi (15/20) and atypical Spitz tumors (10/13) entirely lacked PRAME expression. One Spitz nevus, one atypical Spitz tumor, and one spitzoid melanoma (1/2) demonstrated diffuse PRAME expression.

Conclusions

Although diffuse PRAME expression is generally limited to malignant melanoma, benign Spitz nevi and atypical Spitz tumors can infrequently express diffuse PRAME. PRAME immunohistochemistry can be useful in the evaluation of atypical melanocytic proliferations with intermediate histopathologic features but should be interpreted with caution in the setting of spitzoid neoplasms.
A Study on Operational Risk and Credit Portfolio Risk Estimation Using Data Analytics*
Authors: Chen Rongda , Wang Ze , Yang Liu , Ng Chi To , Cheng T.C.E.
Published: July 2020

In this article we consider operational risk and use data analytics to estimate the credit portfolio risk. Specifically, we consider situations in which managers need to make the optimal operational decision on total provision for risk to hedge against the potential risk in the entire supply chain. We build a new structural credit model integrated with data analytics to analyze the joint default risk of credit portfolio. Our model enables the decision maker to better assess the risk of a supply chain, so that they could determine the optimal operational decisions with total provision for risk, and react in a timely manner to economic and environmental changes. We propose an efficient simulation method to estimate the default probability of the credit portfolio with the risk factors having the multivariate t‐copula. Moreover, we develop a three‐step importance sampling (IS) method for the t‐copula credit portfolio risk measurement model to achieve an accurate estimation of the tail probability of the credit portfolio loss distribution. We apply the Levenberg–Marquardt algorithm to estimate the mean‐shift vector of the systematic risk factors after the probability measure change. Besides, we empirically examine the changes in the credit portfolio risks of 60 listed Chinese firms in different industries using our proposed method. The results show that our model can help the decision maker make the optimal operational decisions with total provision for risk, which hedges against the potential risk in the entire supply chain.
Insulin glargine/lixisenatide fixed‐ratio combination (iGlarLixi) compared with premix or addition of meal‐time insulin to basal insulin in people with type 2 diabetes: A systematic review and Bayesian network meta‐analysis
Authors: Home Philip , Blonde Lawrence , Kalra Sanjay , Ji Linong , Guyot Patricia , Brulle‐Wohlhueter Claire , Murray Erin , Shah Roshan , Sayre Toby , Shaunik Alka
Published: July 2020

Aim

To assess the efficacy and safety of iGlarLixi, a fixed‐ratio combination of insulin glargine 100 U/mL and lixisenatide, relative to premix insulin and other insulin options through network meta‐analysis.

Methods

A systematic literature search identified randomized controlled trials (RCTs) comparing iGlarLixi, premix insulin or basal insulin (BI) in combination with meal‐time insulin, in people inadequately controlled with BI. Eligible RCTs were compared using Bayesian network meta‐analysis.

Results

Eight RCTs, some open‐label, involving 3538 participants, with a study duration of 24‐30 weeks were included. The estimated difference in HbA1c reduction with iGlarLixi compared with premix insulin was −0.50%‐units (95% credible interval: −0.93 to −0.06) with 98% probability of iGlarLixi being superior to premix. Estimates for iGlarLixi versus meal‐time + BI (thrice‐daily meal‐time insulin + basal) and basal‐plus (once‐daily meal‐time insulin + BI) were −0.35 (−0.89 to +0.13)%‐units and −0.68 (−1.18 to −0.17)%‐units with probabilities of real difference of 94% and 99%, respectively. Safety outcome analysis suggested that iGlarLixi had lower rates of both confirmed and documented symptomatic hypoglycaemia compared with premix insulin (probabilities of 85% and 93%, respectively) and lower weight gain (probability 98%).

Conclusions

iGlarLixi showed similar or improved efficacy and safety versus other intensification choices from BI included in this study, providing a clinically relevant treatment option in people with type 2 diabetes not well controlled on BI.
The Potential Impact of COVID‐19 on Student Learning and How Schools Can Respond
Authors: Wyse Adam E. , Stickney Eric M. , Butz David , Beckler Amanda , Close Catherine N.
Published: July 2020

There is no denying the impact that the coronravirus disease (COVID‐19) outbreak has had on many aspects of our lives. This article looks at the potential impact of COVID‐19 on student learning as schools abruptly morphed into virtual learning environments using data from several instructional, practice, and assessment solutions offered by Renaissance. First, three hypothetical learning scenarios are considered using normative data from Star assessments to explore the potential impact on reading and math test performace. Next, data on Focus Skills are used to highlight which grades may have missed the most foundational math and reading content if instruction was stopped or reduced. Last, data from two of Renaissance's practice tools are used to evaluate whether students were practicing key skills following school closures. The article concludes that academic decline will likely occur but may be tempered by the increased use of practice tools; effects may look different for math and reading; and may impact grades and schools differently. As such, schools may need to leverage decision‐making frameworks, such as the Multi‐tiered Systems of Support/Response‐to‐Intervention (MTSS/RTI) framework, more than ever to identify needs and target instruction where it matters most when school begins in fall 2020.