bluuebunny/crossref_metadata_2025 huggingface dataset:
Cloud adoption in Indian SMEs – an empirical analysis
Authors: Shetty Jayalaxmi Padmanabha , Panda Rajesh
Published: May 2022

Purpose

This study aims to empirically validate the determinants of cloud adoption in small and medium enterprises (SMEs) in India and examine its impact on their economic performance.

Design/methodology/approach

An integrated theoretical model interplaying technological, organizational and environmental aspects were applied for analyzing the variation in factors. Using data from 317 Indian SMEs, we have applied confirmatory factor analysis and structural equation modeling to test the hypotheses.

Findings

The results demonstrated that perceived usefulness, perceived ease of use, technology readiness, top management support and trust were the influencing drivers of cloud adoption in SMEs in India. Compared to previous studies, we did not find compatibility and competitive pressure as significant, suggesting that there was no single set of factors influencing technology adoption. Economic performance achieved by reduced transaction costs formed the basis of favorable adoption.

Research limitations/implications

The integrated model can provide space for new dimensions based on the category and geography of the SMEs. The paper does not address the supply-chain perspective of cloud adoption.

Practical implications

The study directs the firm owners to visualize business logic by creating a digital ecosystem. Further, the model guides the stakeholders, including cloud service providers, to contribute to the economic proficiency of the SMEs.

Originality/value

The paper empirically validates a model integrating both the drivers and consequences of cloud computing adoption as a unique study. Findings indicate that the usage of metrics such as return on investment and system efficiency form a part of the technology system approach.
Time will tell: psychological ownership, temporal focus and attitudes toward women as managers in Ethiopia
Authors: Delle Meba Tadesse , Segaro Ethiopia Legesse , Naldi Lucia
Published: May 2022

Purpose

This study aims to investigate the individual factors that directly and indirectly favor (or hinder) employees’ attitudes toward women in management. Two sides of psychological ownership (PO), promotion-focused and prevention-focused PO, are studied as having a direct effect on employees’ attitudes toward women in management. Past and future temporal focuses are examined as possible antecedents to the sides of PO, and as indirectly affecting employees’ attitudes toward women in management.

Design/methodology/approach

Survey questionnaires were collected from 230 MBA and related program students who were currently working and enrolled in one of six different universities in Ethiopia. Confirmatory factor analysis was applied to validate all measurement scales, and structural equation modeling was used to test the study hypotheses using Mplus software.

Findings

Employees with promotion-focused PO and employees with prevention-focused PO had a favorable and unfavorable attitude, respectively, toward women in management. In addition, a future temporal focus had a significant positive effect on promotion-focused PO, and a past temporal focus had a significant positive effect on prevention-focused PO. Overall, this mediation model showed that promotion-focused PO partially mediates the relationship between future temporal focus and attitudes toward equal opportunity for women managers, whereas prevention-focused PO fully mediates the negative relationship between past temporal focus and attitudes toward women in management.

Practical implications

This study provides new insight for organizations by showing how employees’ temporal focus explains their side of PO and how that affects their reaction toward women in management.

Originality/value

A new mechanism for revealing gender inequality in organizations is introduced. Moreover, the relationship between temporal focus and PO is discovered. This study is novel in providing an understanding of the antecedent to and effect of prevention-focused PO, which are largely overlooked in extant research.
Strategic brand innovation – an explorative study of up- and downstream brand innovation practices in SME wineries
Authors: Dreßler Marc , Paunovic Ivan
Published: May 2022

Purpose

The purpose of this paper is to explore brand innovation practices in small and medium enterprise (SME) wineries to found mid-range theory of brand innovation and to explain the interaction between upstream and downstream brand innovation during brand (re)launch.

Design/methodology/approach

This study deploys a qualitative research method. Data was collected through semi-structured telephone interviews with winery owners and managers from 20 German wineries. The approach explored both product and product line brands, organizational brands regarding upstream and downstream innovation and their mutual interaction.

Findings

The analyzed wineries provide evidence for up- and downstream brand innovation in the wine industry, thereby confirming previous findings that the wine industry is increasingly driven not only by tradition but also by innovation. The cases demonstrate that upscale SME wineries are able to distinguish between upstream and downstream innovation and integrate them in a meaningful way. Furthermore, the results point to the importance of team knowledge sharing and professional networks for successful upstream brand innovation, as well as social media for downstream brand innovation.

Originality/value

This paper presents a novel mid-range theory of brand innovation in winery SMEs, where resource constraints and a frugal approach to innovation demand for an integrated, hands-on approach.
Balanced spatial distribution of green areas creates healthier urban landscapes
Authors: Cirino Douglas William , Tambosi Leandro Reverberi , Mauad Thais , de Freitas Simone Rodrigues , Metzger Jean Paul
Published: May 2022

The benefits of green infrastructure on human well‐being in urban areas are already well‐established, with strong evidence of the positive effects of the amount and proximity to green areas. However, the understanding of how the spatial distribution and type of green areas affect health is still an open question.

Here, through a land sharing and sparing framework, we explore how different spatial configurations of green and built‐up areas and how different types of green areas can affect cardiovascular and respiratory hospitalizations in São Paulo city, Brazil.

Sharing/sparing indicators were selected as the main explanatory factors in the control of all groups of diseases. Land sharing appeared as a favourable spatial condition to prevent cardiovascular hospitalization, while land sparing and arboreal vegetation were relevant to reduce hospitalization by lower respiratory diseases.

For upper respiratory diseases, forests seem to provide a disservice, once they were associated with increased rates of hospitalization by respiratory allergies causes.

Considering that hospitalization rates and severity of cardiovascular diseases are substantially higher than those of upper respiratory ones, dense vegetation tends to provide more services than disservices. The land sharing configuration, which is characterized by green areas spread throughout the urban network (in streets, gardens, small squares or parks), should lead to higher exposure and use of the benefits of green areas, which may then explain the greater prevention of cardiovascular diseases.

These novel results indicate that a more balanced distribution of green areas across built‐up areas creates healthier urban spaces, and thus can be used as an urban planning strategy to leverage the health benefits provided by green infrastructure.

Policy implications. Aiming to reduce hospitalizations by cardiovascular and pulmonary causes, urban planning should promote the spreading of green areas across the cities, in order to increase daily contact with natural attributes, giving preference to distribution over total quantity of green in urban landscape.
Audit Implications of Non‐GAAP Reporting
Authors: HALLMAN NICHOLAS J. , SCHMIDT JAIME J. , THOMPSON ANNE M.
Published: May 2022

We investigate whether non‐GAAP reporting affects the audit process and thereby the quality of the related financial statements. First, we provide evidence that auditors in numerous countries, including the United States and the United Kingdom, rely to varying degrees on non‐GAAP profit before tax as a benchmark for determining quantitative materiality. Then, using Premium Listed companies on the London Stock Exchange, we document that U.K. auditor reliance on non‐GAAP materiality benchmarks often results in a higher quantitative materiality amount and can lower audit quality. Although U.K. auditors appear skeptical of managers’ more aggressive non‐GAAP adjustments, auditors adopt more of management's low‐quality adjustments when auditor independence is weaker. In sum, our results suggest that non‐GAAP reporting can indirectly affect investors by reducing the rigor of the financial statement audit.
On criticism, human resource management and civility
Authors: Brewster Chris
Published: May 2022

If you are interested in people as a subject, even if you are interested in them only as an aspect of the effective managing of organisations, you are likely to be more aware of the impact of your actions and reactions on others, and therefore more likely to be civil. But perhaps we still need to keep the issue of civility in our minds as we write our papers and our emails, review others' work and aim to develop a new generation of researchers.
A needs–supplies fit perspective on employee perceptions of HR practices and their relationship with employee outcomes
Authors: Van Beurden Jeske , Van Veldhoven Marc , Van de Voorde Karina
Published: May 2022

This study explores the employees' views on the effectiveness of HR practices for their job performance, drawing from a needs–supplies (N–S) fit approach. Findings based on 465 employees show a positive association between the N–S fit of present HR practices (i.e., employees perceiving supplied practices as needed) and engagement and proactive behaviour. The N–S fit of absent HR practices (i.e., employees indicating they do not need the non‐offered practices) is positively associated with engagement and negatively with proactive behaviour. Additionally, proactive behaviour and engagement are higher when employees experience present practices as effective and absent practices as irrelevant for their functioning. Also, these outcomes are higher when employees experience supplied practices as effective while missing essential practices, than when the supplied practices are ineffective and absent practices are irrelevant. Organisations can use this approach to revisit HR practices that waste organizational resources and introduce HR practices that improve employee functioning.
Protein restriction and branched‐chain amino acid restriction promote geroprotective shifts in metabolism
Authors: Trautman Michaela E. , Richardson Nicole E. , Lamming Dudley W.
Published: May 2022

The proportion of humans suffering from age‐related diseases is increasing around the world, and creative solutions are needed to promote healthy longevity. Recent work has clearly shown that a calorie is not just a calorie—and that low protein diets are associated with reduced mortality in humans and promote metabolic health and extended lifespan in rodents. Many of the benefits of protein restriction on metabolism and aging are the result of decreased consumption of the three branched‐chain amino acids (BCAAs), leucine, isoleucine, and valine. Here, we discuss the emerging evidence that BCAAs are critical modulators of healthy metabolism and longevity in rodents and humans, as well as the physiological and molecular mechanisms that may drive the benefits of BCAA restriction. Our results illustrate that protein quality—the specific composition of dietary protein—may be a previously unappreciated driver of metabolic dysfunction and that reducing dietary BCAAs may be a promising new approach to delay and prevent diseases of aging.
A’uwẽ (Xavante) Sacred Food Plants: Maize and Wild Root Vegetables
Authors: Welch James R.
Published: May 2022

In lowland South America, sacred food plants have taken an ethnographic back seat to psychotropic plants. Yet, such foods are often central to local understandings of mythology, healing, ceremony, and spiritual well‐being. In this article, I elucidate the sacred nature of two kinds of food plants that occupy special sociocultural spaces among the A’uwẽ (Xavante) in Central Brazil: cultivated maize and collected root vegetables. Although these are not the only sacred food plants in A’uwẽ society, they are iconic because they are considered uniquely appropriate gifts during certain ceremonial and ritual events. I also explore how I conducted research about ceremonial ethnobotanical topics in a society that considers most sacred and spiritual knowledge privileged. Both sacred plant foods highlighted here continue to be commonly given as presents expressing gratitude to others during popular ceremonial occasions, thereby maintaining them in the collective consciousness as integral components of contemporary social life.
Bedaquiline exposure in pregnancy and breastfeeding in women with rifampicin‐resistant tuberculosis
Authors: Court Richard , Gausi Kamunkhwala , Mkhize Buyisile , Wiesner Lubbe , Waitt Catriona , McIlleron Helen , Maartens Gary , Denti Paolo , Loveday Marian
Published: May 2022

Aims

We aimed to explore the effect of pregnancy on bedaquiline pharmacokinetics (PK) and describe bedaquiline exposure in the breast milk of mothers treated for rifampicin‐resistant tuberculosis (TB), where there are no human data available.

Methods

We performed a longitudinal PK study in pregnant women treated for rifampicin‐resistant TB to explore the effect of pregnancy on bedaquiline exposure. Pharmacokinetic sampling was performed at 4 time‐points over 6 hours in the third trimester, and again at approximately 6 weeks postpartum. We obtained serial breast milk samples from breastfeeding mothers, and a single plasma sample taken from breastfed and nonbreastfed infants to assess bedaquiline exposure. We used liquid chromatography–tandem mass spectrometry to perform the breast milk and plasma bedaquiline assays, and population PK modelling to interpret the bedaquiline concentrations.

Results

We recruited 13 women, 6 of whom completed the ante‐ and postpartum PK sampling. All participants were HIV‐positive on antiretroviral therapy. We observed lower ante‐ and postpartum bedaquiline exposures than reported in nonpregnant controls. Bedaquiline concentrations in breast milk were higher than maternal plasma (milk to maternal plasma ratio: 14:1). A single random plasma bedaquiline and M2 concentration was available in 4 infants (median age: 6.5 wk): concentrations in the 1 breastfed infant were similar to maternal plasma concentrations; concentrations in the 3 nonbreastfed infants were detectable but lower than maternal plasma concentrations.

Conclusion

We report low exposure of bedaquiline in pregnant women treated for rifampicin‐resistant TB. Bedaquiline significantly accumulates in breast milk; breastfed infants receive mg/kg doses of bedaquiline equivalent to maternal doses.
Exact-Corrected Confidence Interval for Risk Difference in Noninferiority Binomial Trials
Authors: Hawila Nour , Berg Arthur
Published: May 2022

A novel confidence interval estimator is proposed for the risk difference in noninferiority binomial trials. The proposed confidence interval, which is dependent on the prespecified noninferiority margin, is consistent with an exact unconditional test that preserves the type-I error and has improved power, particularly for smaller sample sizes, compared to the confidence interval by Chan and Zhang. The improved performance of the proposed confidence interval is theoretically justified and demonstrated with simulations and examples. An R package is also distributed that implements the proposed methods along with other confidence interval estimators.
Nonparametric Estimation of the Causal Effect of a Stochastic Threshold-Based Intervention
Authors: van der Laan Lars , Zhang Wenbo , Gilbert Peter B.
Published: May 2022

Identifying a biomarker or treatment-dose threshold that marks a specified level of risk is an important problem, especially in clinical trials. In view of this goal, we consider a covariate-adjusted threshold-based interventional estimand, which happens to equal the binary treatment–specific mean estimand from the causal inference literature obtained by dichotomizing the continuous biomarker or treatment as above or below a threshold. The unadjusted version of this estimand was considered in Donovan et al.. Expanding upon Stitelman et al., we show that this estimand, under conditions, identifies the expected outcome of a stochastic intervention that sets the treatment dose of all participants above the threshold. We propose a novel nonparametric efficient estimator for the covariate-adjusted threshold-response function for the case of informative outcome missingness, which utilizes machine learning and targeted minimum-loss estimation (TMLE). We prove the estimator is efficient and characterize its asymptotic distribution and robustness properties. Construction of simultaneous 95% confidence bands for the threshold-specific estimand across a set of thresholds is discussed. In the Supporting Information, we discuss how to adjust our estimator when the biomarker is missing at random, as occurs in clinical trials with biased sampling designs, using inverse probability weighting. Efficiency and bias reduction of the proposed estimator are assessed in simulations. The methods are employed to estimate neutralizing antibody thresholds for virologically confirmed dengue risk in the CYD14 and CYD15 dengue vaccine trials.
Application of an infrared thermography-based model to detect pressure injuries: a prospective cohort study
Authors: Jiang Xiaoqiong , Wang Yu , Wang Yuxin , Zhou Min , Huang Pan , Yang Yufan , Peng Fang , Wang Haishuang , Li Xiaomei , Zhang Liping , Cai Fuman
Published: May 2022

Background

It is challenging to detect pressure injuries at an early stage of their development.

Objectives

To assess the ability of an infrared thermography (IRT)-based model, constructed using a convolution neural network, to reliably detect pressure injuries.

Methods

A prospective cohort study compared validity in patients with pressure injury (n = 58) and without pressure injury (n = 205) using different methods. Each patient was followed up for 10 days.

Results

The optimal cut-off values of the IRT-based model were 0·53 for identifying tissue damage 1 day before visual detection of pressure injury and 0·88 for pressure injury detection on the day visual detection is possible. Kaplan–Meier curves and Cox proportional hazard regression model analysis showed that the risk of pressure injury increased 13-fold 1 day before visual detection with a cut-off value higher than 0·53 [hazard ratio (HR) 13·04, 95% confidence interval (CI) 6·32–26·91; P < 0·001]. The ability of the IRT-based model to detect pressure injuries [area under the receiver operating characteristic curve (AUC)lag 0 days, 0·98, 95% CI 0·95–1·00] was better than that of other methods.

Conclusions

The IRT-based model is a useful and reliable method for clinical dermatologists and nurses to detect pressure injuries. It can objectively and accurately detect pressure injuries 1 day before visual detection and is therefore able to guide prevention earlier than would otherwise be possible.

What is already known about this topic?  Detection of pressure injuries at an early stage is challenging.Infrared thermography can be used for the physiological and anatomical evaluation of subcutaneous tissue abnormalities.A convolutional neural network is increasingly used in medical imaging analysis.

What does this study add?  The optimal cut-off values of the IRT-based model were 0·53 for identifying tissue damage 1 day before visual detection of pressure injury and 0·88 for pressure injury detection on the day visual detection is possible.Infrared thermography-based models can be used by clinical dermatologists and nurses to detect pressure injuries at an early stage objectively and accurately.
Cytocentrifugation – a perfect circle?
Authors: Glencross Hedley David
Published: May 2022

Cytocentrifugation as a method for slide preparation has been in use for over 50 years, providing a straightforward method of concentrating a (near) monolayer of cells into a discrete circle on a slide. Although the method is simple in its application, achievement of consistently good results requires a significant amount of skill and judgement to be exercised, and as a result, in some scenarios, cytocentrifugation is being replaced by liquid‐based cytology prepared slides more regularly. Cytocentrifugation though, provides the cytologist with a wider range of options and opportunities for ancillary testing that remain a cornerstone of a cytological diagnosis.
Reform complementarities and growth: Evidence and mechanisms
Authors: Tarabar Danko , Pantuosco Louis J.
Published: May 2022

When reforms of different policy areas are said to be complementary, the presence of one reformed area bolsters the effectiveness of reform of the other. We use the five areas of the Economic Freedom of the World (EFW) index over 2000–2017 to test for the impact of reform complementarities on real per capita income growth in up to 131 countries. Using a novel index for complementarity (Braga De Macedo & Oliveira‐Martins, 2008, Econ. Transit.), we find robust evidence that pursuing broader reform packages is associated with an increase in annual growth by about 1.2%. Further analysis shows that the effect of complementarities operates largely through its positive impact on domestic investment.
Accidental oral bleeding in a dementia patient taking anticoagulants: A case report
Authors: Yamada Miki , Suzuki Kyoko , Iijima Yosuke , Hino Shunsuke , Kaneko Takahiro , Horie Norio
Published: May 2022

Introduction

Identifying the causes of accidental oral bleeding can be difficult in patients with dementia. The aim of this study was to highlight the effectiveness of multidisciplinary consultation, which proved extremely useful in investigating the cause of bleeding in this case.

Case presentation

An 86‐year‐old woman on anticoagulants who had been admitted to a geriatric facility experienced repeated oral bleeding of unknown cause, initially attributed to periodontitis.

Conclusion

Along with anticoagulant use, a multidisciplinary consultation attributed the bleeding to the use of a spoon at mealtimes and possible scratching at the wound by the patient with her fingers.
Does difference between label and actual potency of factor VIII concentrate affect pharmacokinetic‐guided dosing of replacement therapy in haemophilia A?
Authors: Goedhart Tine M.H.J. , Bukkems Laura H. , van Moort Iris , Spence Colin C. , Zwaan Michel C. , de Maat Moniek P.M. , Mathôt Ron A.A. , Cnossen Marjon H. ,   for the OPTI‐CLOT study group and SYMPHONY consortium
Published: May 2022

Background

To account for interindividual variability in the pharmacokinetics (PK) of factor concentrates, PK‐guided dosing is increasingly implemented in haemophilia patients. Calculations are based on provided label potency, but legislation allows a potency difference of ±20% between label and actual potency. It is unknown if these differences affect PK guidance.

Aim

Explore the effects of potency differences on individual factor VIII (FVIII) PK parameters and the prediction of FVIII trough levels of dosing regimens.

Methods

We analyzed individual preoperative PK profiling data from severe and moderate haemophilia A patients included in the OPTI‐CLOT randomized controlled trial. Label and actual potency were compared, with data on potency provided by pharmaceutical companies. For both potencies, individual PK parameters were estimated and concentration‐time curves were constructed by nonlinear mixed‐effects modelling. Finally, we explored the effect of both the identified and the maximum legislated potency difference on predicted FVIII trough levels infused in a low and high dose regimen.

Results

In 45/50 included patients, actual potency was higher than its label potency. The median potency difference was 6.0% (range ‐9.2% to 18.4%) and resulted in varying individual PK parameter estimates but practically identical FVIII concentration‐time curves. As expected, predicted FVIII trough levels were linearly correlated to the actual dose.

Conclusion

It is not necessary to take potency differences into account when applying PK guidance of FVIII concentrates in haemophilia A patients. However, when the patient is switched to another FVIII batch after PK‐guided dosing, trough levels may deviate ±20% from calculations based on label dose.
Quantification of the relationship between desmopressin concentration and Von Willebrand factor in Von Willebrand disease type 1: A pharmacodynamic study
Authors: Heijdra Jessica M. , Cloesmeijer Michael E. , de Jager Nico C.B. , Leebeek Frank W.G. , Kruip Marieke H.J.A. , Cnossen Marjon H. , Mathôt Ron A.A. ,   for the OPTI‐CLOT/ To WiN study group and SYMPHONY consortium
Published: May 2022

Introduction

Desmopressin can be used to prevent bleeding in von Willebrand disease (VWD), but the relationship between desmopressin and von Willebrand factor activity (VWF:Act) has yet to be quantified.

Aim

To quantify the relationship between desmopressin dose, its plasma concentration and the VWF:Act response in type 1 VWD patients.

Methods

Forty‐seven VWD patients (median age 25 years, IQR: 19–37; median body weight 71 kg, IQR: 59–86) received an IV desmopressin dose of .3 mcg/kg. In total, 177 blood samples were available for analysis. We developed an integrated population pharmacokinetic‐pharmacodynamic (PK‐PD) model using nonlinear mixed effect modelling. Subsequently, we performed Monte Carlo simulations to investigate the efficacy of the current dosing regimen.

Results

A one‐compartment PK model best described the time profile of the desmopressin concentrations. In the PD turnover model, the relationship between desmopressin plasma concentration and release of VWF:Act from the vascular endothelium was best described with an Emax model. Typically, VWF:Act increased 452% with an EC50 of .174 ng/ml. Simulations demonstrated that after .3 mcg/kg desmopressin intravenously, >90% patients with a VWF:Act baseline of ≥.20 IU/mL attain a VWF:Act >.5 IU/ml up to ≥4 h after administration. A capped dose of 30 mcg was sufficient in patients weighing over 100 kg.

Conclusion

The relationship between desmopressin and VWF:Act was quantified in a PK‐PD model. The simulations provide evidence that recently published international guidelines advising an intravenous desmopressin dose of .3 mcg/kg with a capped dose of 30 mcg > 100 kg gives a sufficient desmopressin response.
Safety of intramuscular COVID‐19 vaccination in patients with haemophilia
Authors: Tiede Andreas , Leise Hendrik , Horneff Silvia , Oldenburg Johannes , Halimeh Susan , Heller Christine , Königs Christoph , Holstein Katharina , Pfrepper Christian
Published: May 2022

Background

Guidelines recommend that patients with haemophilia should preferably receive vaccination subcutaneously. COVID‐19 and other vaccines, however, are only licenced for intramuscular application.

Aims

To assess the safety of intramuscular COVID‐19 vaccination in patients living with haemophilia.

Methods

Part A of this prospective observational study enrolled consecutive patients with haemophilia A (HA) and B (HB) of all ages and severities and assessed injection site bleeding and other complications within 30 days of vaccination. Part B enrolled patients providing informed consent for detailed data collection including medication and prophylaxis around the time of vaccination. Logistic regression was performed to assess potential risk factors for bleeding.

Results

Four hundred and sixty‐one patients were enrolled into part A. The primary endpoint injection site bleeding occurred in seven patients (1.5%, 95% confidence interval .7–3.1%). Comprehensive analysis of 214 patients (404 vaccinations, part B) revealed that 97% of patients with severe haemophilia had prophylaxis before vaccination, either as part of their routine prophylaxis or using additional doses. 56% and 30% of patients with moderate and mild haemophilia, respectively, received prophylaxis before vaccination. Among the seven bleeds recorded, three occurred when intramuscular vaccination was done without prophylaxis (odds ratio 12).

Conclusions

This is the first prospective study reporting on the safety of intramuscular vaccination in haemophilia. The rate of injection site bleeding was low in mild haemophilia, and in moderate and severe haemophilia if patients received factor prophylaxis.
A community jury study exploring the public acceptability of using risk stratification to determine eligibility for cancer screening
Authors: Dennison Rebecca A. , Boscott Rachel A. , Thomas Rae , Griffin Simon J. , Harrison Hannah , John Stephen D. , Moorthie Sowmiya A. , Morris Stephen , Rossi Sabrina H. , Stewart Grant D. , Thomas Chloe V. , Usher‐Smith Juliet A.
Published: May 2022

Introduction

Using risk stratification to determine eligibility for cancer screening is likely to improve the efficiency of screening programmes by targeting resources towards those most likely to benefit. We aimed to explore the implications of this approach from a societal perspective by understanding public views on the most acceptable stratification strategies.

Methods

We conducted three online community juries with 9 or 10 participants in each. Participants were purposefully sampled by age (40–79 years), sex, ethnicity, social grade and English region. On the first day, participants were informed of the potential benefits and harms of cancer screening and the implications of different ways of introducing stratification using scenarios based on phenotypic and genetic risk scores. On the second day, participants deliberated to reach a verdict on the research question, ‘Which approach(es) to inviting people to screening are acceptable, and under what circumstances?’ Deliberations and feedback were recorded and analysed using thematic analysis.

Results

Across the juries, the principle of risk stratification was generally considered to be an acceptable approach for determining eligibility for screening. Disregarding increasing capacity, the participants considered it to enable efficient resource allocation to high‐risk individuals and could see how it might help to save lives. However, there were concerns regarding fair implementation, particularly how the risk assessment would be performed at scale and how people at low risk would be managed. Some favoured using the most accurate risk prediction model whereas others thought that certain risk factors should be prioritized (particularly factors considered as non‐modifiable and relatively stable, such as genetics and family history). Transparently justifying the programme and public education about cancer risk emerged as important contributors to acceptability.

Conclusion

Using risk stratification to determine eligibility for cancer screening was acceptable to informed members of the public, particularly if it included risk factors they considered fair and when communicated transparently.

Patient or Public Contribution

Two patient and public involvement representatives were involved throughout this study. They were not involved in synthesizing the results but contributed to producing study materials, co‐facilitated the community juries and commented on the interpretation of the findings and final report.
Qualitative and quantitative aspects of child‐directed parental talk and the relation to 2‐year‐old's developing vocabulary
Authors: Sundqvist Annette , Koch Felix‐Sebastian , Söderberg Mimmi , Barr Rachel , Heimann Mikael
Published: May 2022

Although prior research has independently linked vocabulary development with toddlers' media usage, parental mental state talk (MST), and parent–child conversational turn‐taking (CTT), these variables have not been investigated within the same study. In this study, we focus on associations between these variables and 2‐year‐old's (N = 87) vocabulary. Child vocabulary and digital media use were measured through online questionnaires. We took a multimethod approach to measure parents' child‐directed talk. First, we used a home sound environment recording (Language ENvironment Analysis technology) to estimate parents' talk (CTT). Second, parents narrated a picture book, the Frog story, to assess the parent's MST. There was a negative association between how much children watched video content and their vocabulary. However, parents reported that they frequently co‐viewed and engaged with the child and media. The negative association first displayed between the amount of video content viewed and the child's developing vocabulary was fully mediated by the parents' qualitative and quantitative talk as measured by MST and CCT, respectively. We propose that the parent relative level of MST and CTT also occurs when parents engage with the child during media use.
Potassium content is the main driver for salinity tolerance in sweet potato before tuber formation
Authors: Mondal Shimul , Rahaman Ebna Habib Md Shofiur , Asch Folkard
Published: May 2022

Sweet potato (Ipomoea batatas L.) is mostly grown in Asia, which accounts for 86% of global production. However, its production is under threat by salinity. Little is known about genotypic responses to salinity in sweet potato. Phenotypic responses or physiological processes linked to salt tolerance that could be developed into a reliable screening tool to assist breeding have not yet been developed for sweet potato. In a hydroponic cultivation system, 12 contrasting sweet potato genotypes were subjected to 0, 50, 100 and 150 mM root zone salinity (RZS). Genotypic thresholds for dry matter accumulation and the genotypic slopes for additional dry matter reduction when the RZS increased beyond the genotypic threshold were determined. Sodium, chlorine and potassium (K) were determined from above‐ground biomass and correlated with the genotypic thresholds found. Genotypic threshold levels were linearly negatively correlated with the difference in tissue K content at 75 mM RZS and the tissue K content at control levels. Based on the genotypic ability to retain high tissue potassium levels under increasing RZS, we propose a screening tool based on these experimental data that can distinguish between salt‐tolerant and salt‐sensitive genotypes and indicate the potential yield level of the sweet potato genotypes.
Anguilla sp. diseases diagnoses and treatments: The ideal methods at the crossroads of conservation and aquaculture purposes
Authors: Parchemin Christelle , Tapissier‐Bontemps Nathalie , Sasal Pierre , Faliex Elisabeth
Published: May 2022

Anguilla anguilla, A. japonica and A. rostrata are the most fished and consumed eel species. However, these species are Critically Endangered, Endangered and Endangered, respectively. A combination of factors is thought to be responsible for their decline including fisheries, climate change, habitat destruction, barriers to migration, pollution and pathogens. Among them, viruses, bacteria and parasites are causing weakening of wild eels and serious economic losses for fishermen and eel farmers. Early detection of pathogens is essential to provide appropriate responses both for conservation reasons and to limit economic losses. Classic diagnosis approaches are time consuming and invasive and usual treatments, for example, antipathogenic substances are becoming obsolete because of pathogen resistance and environmental impact problems. The need for early and non‐invasive diagnostic methods as well as effective and environmentally friendly treatments has increased. Vaccine development and diet supplementation have known a growing interest since their use could allow prevention of diseases. In this review, we summarize the main pathogens—viruses, bacteria and parasites—of the three northern temperate eel species, the methods used to detect these pathogens and the different treatments used. We discussed and highlighted the need for non‐invasive, rapid and efficient detection methods, as well as effective and environmentally friendly treatments for both conservation and aquaculture purposes.
Nurses’ substance use disorder in disciplinary procedures: A retrospective document analysis
Authors: Luurila Katrimaija , Kangasniemi Mari , Hult Marja , Häggman‐Laitila Arja
Published: May 2022

Aim and objectives

To describe nurses with substance use disorder (SUD) in authority disciplinary actions.

Background

Nurses with SUD risk patient safety. Research evidence on the identification of nurses’ SUD and related management procedures is currently sparse.

Design

Retrospective document analysis of decisions related to SUD in nurses’ disciplinary actions.

Method

Decisions on nurses (N = 171) made by the Finnish National Supervisory Authority for Welfare and Health in Finland during 2007–2016 were used as data. An electronic extraction sheet was developed for data collection including variables (N = 34), of which 18 were analysed in this study with descriptive statistical methods and chi‐squared statistics. The study reported in accordance with the STROBE checklist for cross‐sectional studies.

Results

The mean age of the nurses was 43 years (SD 8.7). The most mentioned reasons for notifications leading to disciplinary actions were substance abuse with working while intoxicated and drug theft. The most mentioned intoxicants used were medicines and alcohol. On average, the first disciplinary decision was given at 6.4 months (SD 3.9) and the final decision was given at 17.9 months (SD 13.1). The most common decision was restriction of the right to practice.

Conclusion

The results supported findings from previous decades and different continents, showing similar trends are prevalent globally and continue today. In future studies, countries’ registers of nurses with SUD could be used to clarify the profile of nurses and develop appropriate procedures. Qualitative studies could be conducted to investigate to shed light on concealment of the phenomenon.

Relevance to clinical practice

There is a need for early identification, intervention and referral to treatment as well as effective protocols for reducing nurses’ risks of disciplinary actions related to SUD. It is important to be aware of the signs and symptoms of SUD and training for this is needed.
Implementing a resistance training programme for patients on short daily haemodialysis: A feasibility study
Authors: Ribeiro Heitor S. , Cunha Vinícius A. , Dourado Gustavo Í. , Duarte Marvery P. , Almeida Lucas S. , Baião Victor M. , Inda‐Filho Antônio J. , Viana João L. , Nóbrega Otávio T. , Ferreira Aparecido P.
Published: May 2022

Background

Kidney failure patients receiving haemodialysis experience protein‐energy wasting, muscle mass loss and physical function impairment. Intradialytic exercise interventions seem to modify these features, but they are often not implemented as a clinical routine.

Objective

To investigate the feasibility of implementing a supervised intradialytic resistance training programme as a clinical routine for patients receiving short daily haemodialysis.

Design

A prospective longitudinal study.

Participants

Eighteen patients in a supervised intradialytic resistance training programme for 8 months.

Measurements

It consisted of a warm‐up, lower‐ and upper‐limb resistance exercises and a cool‐down. Patients performed the resistance training during the first half of haemodialysis, twice a week, supervised by exercise physiologists and physiotherapists. The feasibility was assessed by the total and partial adherences, the reasons for refusing or for not exercising and the intradialytic complications.

Results

From a total of 953 potential exercise sessions, 759 were performed, with a 79.6% adherence rate. In the first 9 weeks, the adherence rate was 86.6% and the lowest rate was in the 19–27 weeks (73.5%). The main intradialytic complication during exercise sessions was hypotension (n = 31; 4.1%). The highest number of complications was reported during the first 9 weeks (n = 27; 9.1%). The main reasons for refusing or for not performing the intradialytic exercise sessions were clinical complications previous to exercise time (n = 63; 32.5%) and self‐reported indisposition (n = 62; 32.0%).

Conclusions

The intradialytic resistance training programme, supervised by exercise physiologists and physiotherapists, had very low complications, achieved a high long‐term adherence rate and showed to be feasible as a clinical routine for patients receiving short daily haemodialysis.
Medicare accountable care organization characteristics associated with participation in 2‐sided risk
Authors: Zhu Xi , Huang Huang , MacKinney A. Clinton , Ullrich Fred , Mueller Keith
Published: May 2022

Purpose

To examine the associations of accountable care organization (ACO) characteristics with the likelihood of participation in 2‐sided risk tracks in the Medicare Shared Savings Program (SSP).

Methods

CMS ACO Public Use Files and Provider‐Level Research Identifiable Files were used to trace Medicare ACOs’ participation in the SSP between 2012 and 2020 and measure ACO characteristics, including size, rurality of the service area, affiliation with supporting organizations, program experience, and performance. Logistic regression and survival analysis were used to test the associations between ACO characteristics and the probability of ACOs initially participating in or subsequently switching to 2‐sided risk tracks.

Findings

Among the 624 Medicare SSP ACOs that started between 2012 and 2017, 26 participated in 2‐sided risk tracks in their initial contracts and 95 switched to 2‐sided risk tracks subsequently. ACO characteristics were not significantly associated with the probability of participating in 2‐sided risk tracks in initial contracts. ACO size, affiliation with supporting organizations, and performance were positively associated with the likelihood of switching to 2‐sided risk. Rural ACOs were less likely to switch to 2‐sided risk than their urban counterparts.

Conclusions

Small and rural ACOs are less prepared to transition into 2‐sided risk swiftly.
Genomics analysis of Lactobacillus paracasei SLP16
Authors: Zhao X. , Hu R. , Liu Y. , He Y. , Li S. , Yang J. , Zhou J. , Zhang J.
Published: May 2022

Lactobacillus paracasei SLP 16 was obtained from liquor cellar mud, and it was analysed by genome sequencing on Illumina Hiseqq platform. Then the biological information of L. paracasei SLP16 was analysed by ExPasy (website), and the toxin safety of the strain SLP 16 was analysed by PSI/PHI in the virulence factor database VFDB. Through the second-generation DNA sequencing platform technology, the whole genome information of L. paracasei SLP16 was obtained, which showed that the genome size of the strain SLP 16 was 2·65 mol l−1, and the GC content of the strain SLP 16 was 46·9%. And a total of 3131 genes were detected, including 3067 genes encoding protein and 63 genes encoding RNA. Whole genome analysis showed that L. paracasei SLP16 had five coding genes of F0F1-ATPase, four coding genes of Na+/H+ antiporter and three coding genes of A-ATPase, which were closely related to the acid tolerance of lactic acid bacteria (LAB). Whole genome analysis of L. paracasei SLP16 showed that SLP 16 had only one CFA synthetic coding gene, and no important BSH coding gene; however, it had F0F1-ATPase, Na+/H+ antiporter and several two-component regulatory systems, and which were related to bile salt tolerance of LAB. Safety evaluation in L. paracasei SLP16 showed that it did not have the virulence factor coding gene related to toxin. Common antibiotic sensitivity tests showed that L. paracasei SLP16 was resistant to compounds such as sulfamethoxazole, ciprofloxacin, gentamicin and lincomycin. In summary, L. paracasei SLP16 had coding genes closely related to acid tolerance and bile salt tolerance, and no coding gene of virulence factors related to toxins, and few kinds of resistant antibiotics. Therefore, whole genome analysis showed that L. paracasei SLP16 was a safe probiotic strain that can be safely applied.
Discovery of a novel type IIb RelBE toxin‐antitoxin system in Mycobacterium tuberculosis defined by co‐regulation with an antisense RNA
Authors: Dawson Clinton C. , Cummings Jason E. , Starkey Julie M. , Slayden Richard A.
Published: May 2022

Toxin‐antitoxin loci regulate adaptive responses to stresses associated with the host environment and drug exposure. Phylogenomic studies have shown that Mycobacterium tuberculosis encodes a naturally expanded type II toxin‐antitoxin system, including ParDE/RelBE superfamily members. Type II toxins are presumably regulated exclusively through protein–protein interactions with type II antitoxins. However, experimental observations in M. tuberculosis indicated that additional control mechanisms regulate RelBE2 type II loci under host‐associated stress conditions. Herein, we describe for the first time a novel antisense RNA, termed asRelE2, that co‐regulates RelE2 production via targeted processing by the Mtb RNase III, Rnc. We find that convergent expression of this coding‐antisense hybrid TA locus, relBE2‐asrelE2, is controlled in a cAMP‐dependent manner by the essential cAMP receptor protein transcription factor, Crp, in response to the host‐associated stresses of low pH and nutrient limitation. Ex vivo survival studies with relE2 and asrelE2 knockout strains showed that RelE2 contributes to Mtb survival in activated macrophages and low pH to nutrient limitation. To our knowledge, this is the first report of a novel tripartite type IIb TA loci and antisense post‐transcriptional regulation of a type II TA loci.
Two Magnaporthe appressoria‐specific (MAS) proteins, MoMas3 and MoMas5, are required for suppressing host innate immunity and promoting biotrophic growth in rice cells
Authors: Gong Ziwen , Ning Na , Li Zhiqiang , Xie Xin , Wilson Richard A. , Liu Wende
Published: May 2022

In the devastating rice blast fungus Magnaporthe oryzae, six Magnaporthe appressoria‐specific (MAS) proteins are encoded by MoGAS1, MoGAS2 and MoMAS3–MoMAS6. MoGAS1 and MoGAS2 were previously characterized as M. oryzae virulence factors; however, the roles of the other four genes are unknown. Here, we found that, although the loss of any MAS gene did not affect appressorial formation or vegetative growth, ∆Momas3 and ∆Momas5 mutant strains (but not the others) were reduced in virulence on susceptible CO‐39 rice seedlings. Focusing on ∆Momas3 and ∆Momas5 mutant strains, we found that they could penetrate host leaf surfaces and fill the first infected rice cell but did not spread readily to neighbouring cells, suggesting they were impaired for biotrophic growth. Live‐cell imaging of fluorescently labelled MoMas3 and MoMas5 proteins showed that during biotrophy, MoMas3 localized to the apoplastic compartment formed between fungal invasive hyphae and the plant‐derived extra‐invasive hyphal membrane while MoMas5 localized to the appressoria and the penetration peg. The loss of either MoMAS3 or MoMAS5 resulted in the accumulation of reactive oxygen species (ROS) in infected rice cells, resulting in the triggering of plant defences that inhibited mutant growth in planta. ∆Momas3 and ∆Momas5 biotrophic growth could be remediated by inhibiting host NADPH oxidases and suppressing ROS accumulation. Thus, MoMas3 and MoMas5 are novel virulence factors involved in suppressing host plant innate immunity to promote biotrophic growth.