bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes in twin pregnancies
Authors: Schubert Julia , Timmesfeld Nina , Noever Kathrin , Behnam Susann , Vinturache Angela , Arabin Birgit
Published: November 2022

Introduction

To date, there have only been provisional recommendations about the appropriate gestational weight gain in twin pregnancies. This study aimed to contribute evidence to this gap of knowledge.

Material and methods

Using a cohort of 10 603 twin pregnancies delivered between 2000 and 2015 in the state of Hessen, Germany, the individual and combined impact of maternal body mass index and gestational weight gain on maternal and neonatal outcomes was analyzed using uni‐ and multivariable logistic regression models. The analysis used newly defined population‐based quartiles of gestational weight gain in women carrying twin pregnancies (Q1: <419.4 g/week [low weight gain], Q2–Q3: 419.4–692.3 g/week [optimal weight gain], Q4: >692.3 g/week [high weight gain]) and the World Health Organization body mass index classification.

Results

Pre‐pregnancy body mass index ≥25 kg/m2 was associated with significantly increased rates of cesarean deliveries (aOR1.2, 95% CI: 1.01–1.41) and pregnancy‐induced hypertensive disorders (aOR 1.53, 95% CI: 1.11–2.1) but not with any adverse neonatal outcome.

Perinatal mortality (aOR 2.23, 95% CI: 1.38–3.6), preterm birth (aOR 1.88, 95% CI: 1.58–2.25), APGAR′5 < 7 (aOR 1.61, 95% CI: 1.19–2.17) and admissions to the neonatal intensive care unit (aOR 1.6, CI: 1.38–1.85) were increased among women with low gestational weight gain. Rates of cesarean deliveries were high in both women with low (aOR 1.25, 95% CI: 1.05–1.48) and high gestational weight gain (aOR 1.17, 95% CI: 1.01–1.35). A high gestational weight gain was also associated with higher rates of hypertensive disorders in pregnancy (aOR 2.32, 95% CI: 1.79–3.02) and postpartum hemorrhage (aOR 1.72, 95%CI: 1.12–2.63). The risk of preterm birth, low Apgar scores and NICU admissions showed a converse linear relation with pre‐pregnancy body mass index in women with low gestational weight gain.

Conclusions

In twin pregnancies, nonoptimal weekly maternal weight gain seems to be strongly associated with maternal and neonatal adverse outcomes. Since gestational weight gain is a modifiable risk factor, health care providers have the opportunity to counsel pregnant women with twins and target their care accordingly. Additional research to confirm the validity and generalizability of our findings in different populations is warranted.
A social‐psychological examination of academic precarity as an organizational practice and subjective experience
Authors: Albayrak‐Aydemir Nihan , Gleibs Ilka Helene
Published: November 2022

Research and teaching conditions have, particularly for those who are junior or from disadvantaged backgrounds, deteriorated considerably over the years in the higher education sector. Unequal opportunities in access and advancement in careers have led to increasing levels of precarity in the higher education sector. Although the concept of precarity has been grasped in many other disciplines, the social‐psychological understanding of this concept remains unexplored. In this paper, we aim to develop a social‐psychological understanding of precarity to examine how identity dynamics and intergroup relations, as well as associated organizational controls, reinforce inequality regimes and power structures that create precarious conditions in academia. In doing so, we use social identity theory and system justification theory under an inequality regime framework. We argue that even though change towards equality and equity in academia should be possible, it is difficult to achieve this because of entrenched identity interests by power holders and the perceived legitimacy of the existing system. Therefore, academic precarity should be recognized both as a subjective experience and as an organizational practice to make inequalities more visible and decrease the perceptions of legitimacy—and to eventually achieve a fundamental positive transformation in academia.
Limited seed dispersal shapes fine‐scale spatial genetic structure in a Neotropical dioecious large‐seeded palm
Authors: Escobar Sebastián , Vigouroux Yves , Karubian Jordan , Zekraoui Leila , Balslev Henrik , Montúfar Rommel
Published: November 2022

Seed and pollen dispersal contribute to gene flow and shape the genetic patterns of plants over fine spatial scales. We inferred fine‐scale spatial genetic structure (FSGS) and estimated realized dispersal distances in Phytelephas aequatorialis, a Neotropical dioecious large‐seeded palm. We aimed to explore how seed and pollen dispersal shape this genetic pattern in a focal population. For this purpose, we genotyped 138 seedlings and 99 adults with 20 newly developed microsatellite markers. We tested if rodent‐mediated seed dispersal has a stronger influence than insect‐mediated pollen dispersal in shaping FSGS. We also tested if pollen dispersal was influenced by the density of male palms around mother palms in order to further explore this ecological process in large‐seeded plants. Rodent‐mediated dispersal of these large seeds occurred mostly over short distances (mean 34.76 ± 34.06 m) while pollen dispersal distances were two times higher (mean 67.91 ± 38.29 m). The spatial extent of FSGS up to 35 m and the fact that seed dispersal did not increase the distance at which male alleles disperse suggest that spatially limited seed dispersal is the main factor shaping FSGS and contributes only marginally to gene flow within the population. Pollen dispersal distances depended on the density of male palms, decreasing when individuals show a clumped distribution and increasing when they are scattered. Our results show that limited seed dispersal mediated by rodents shapes FSGS in P. aequatorialis, while more extensive pollen dispersal accounts for a larger contribution to gene flow and may maintain high genetic diversity.

Abstract in Spanish is available with online material.
Notch pathway regulates osimertinib drug‐tolerant persistence in EGFR‐mutated non–small‐cell lung cancer
Authors: Takahashi Hirofumi , Sakakibara‐Konishi Jun , Furuta Megumi , Shoji Tetsuaki , Tsuji Kosuke , Morinaga Daisuke , Kikuchi Eiki , Kikuchi Junko , Noguchi Takuro , Hatanaka Kanako C. , Hatanaka Yutaka , Shinagawa Naofumi , Konno Satoshi
Published: November 2022

Osimertinib is a third‐generation epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitor (TKI) that has shown marked antitumor activity in patients with EGFR‐mutated non–small‐cell lung cancer (NSCLC). However, these effects are transient and most patients develop resistance. Reversible drug‐tolerant persister (DTP) cells are defined as a small subpopulation of cells with markedly reduced sensitivity and non‐genetic acquired resistance to EGFR‐TKIs. Notch is a transmembrane receptor that plays an important role in tumorigenesis. We previously reported that there is significant crosstalk between the Notch and EGFR pathways in NSCLC. Moreover, the Notch pathway is associated with resistance to previous‐generation EGFR‐TKIs. However, the role of Notch in osimertinib resistance is not fully understood. In this study, we evaluated whether Notch is involved in osimertinib resistance. We show that NOTCH1 and Notch target genes are upregulated in osimertinib DTP cells, and that the addition of a γ‐secretase inhibitor (GSI), a Notch inhibitor, impairs drug‐tolerant persistence in vitro and in vivo. Compared with osimertinib, combined GSI and osimertinib suppress phospho‐ERK partly by enhancing DUSP1 expression. Furthermore, Notch1 and HES1 were upregulated after EGFR‐TKI treatment in half of human EGFR‐mutated NSCLC tumor tissues. These results suggest that the combination of GSI and osimertinib may be a potential therapy for EGFR‐mutated NSCLC.
Aminoacylation‐defective bi‐allelic mutations in human EPRS1 associated with psychomotor developmental delay, epilepsy, and deafness
Authors: Jin Danni , Wek Sheree A. , Cordova Ricardo A. , Wek Ronald C. , Lacombe Didier , Michaud Vincent , Musier‐Forsyth Karin
Published: November 2022

Aminoacyl‐tRNA synthetases are enzymes that ensure accurate protein synthesis. Variants of the dual‐functional cytoplasmic human glutamyl‐prolyl‐tRNA synthetase, EPRS1, have been associated with leukodystrophy, diabetes and bone disease. Here, we report compound heterozygous variants in EPRS1 in a 4‐year‐old female patient presenting with psychomotor developmental delay, seizures and deafness. Functional studies of these two missense mutations support major defects in enzymatic function in vitro and contributed to confirmation of the diagnosis.
Marginal bone loss around dental implants: comparison between matched groups of bruxer and non‐bruxer patients: A retrospective case–control study
Authors: Bredberg Clara , Vu Camila , Häggman‐Henrikson Birgitta , Chrcanovic Bruno Ramos
Published: November 2022

Purpose

To compare marginal bone loss (MBL) around dental implants in a group of bruxers in relation to a matched group of non‐bruxers.

Methods

The present record‐based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö. Only implants not lost and with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow‐up were considered for inclusion. Univariate linear regression models and a linear mixed‐effects model were performed.

Results

Two hundred and four patients (104 bruxers, 100 non‐bruxers), with a total of 811 implants (416 in bruxers, 395 in non‐bruxers) were included in the study. The results of the linear mixed‐effects model suggested that bruxism, smoking, age, region of the jaws, implant diameter, and prosthesis type had a statistically significant influence on MBL over time. Individuals who are both bruxers and smokers showed greater MBL when compared to individuals who are either a bruxer or smoker, or neither (p < 0.001).

Conclusions

Bruxism is suggested to increase the risk of MBL over time, as well as higher age, smoking, and the combination of bruxism and smoking. Other factors that showed a correlation with increased MBL were implant diameter, region of the jaws, and prosthesis type, but it is not possible to draw robust conclusions for these factors, as the categories of these variables were very unbalanced.
Recurrence of diverticulitis after prophylactic sigmoidectomy: an underestimated problem?
Authors: Mathilde Aubert , Mege Diane , Monsinjon Marie , Giacca Massimo , Panis Yves
Published: November 2022

Aim

Several papers have been published about the risk of recurrence after an attack of diverticulitis treated conservatively. However, very few papers have been devoted to the risk of postoperative recurrence of diverticulitis (PRD) after prophylactic sigmoidectomy (PS). The aim of this work was to report the rate of PRD after PS and to assess possible risk factors for recurrence after surgery.

Method

All consecutive patients who underwent elective laparoscopic PS for diverticulitis between 2005 and 2019 were retrospectively included. PRD was assessed.

Results

Three hundred and sixty four patients (199 men, mean age 54 ± 13 years) were included. Among these, 26 (7%) presented with 1.7 ± 1 (range 1–4) episodes of recurrence of diverticulitis after a mean delay of 44 ± 39 months (1 month–11 years) after surgery. Patients who presented with postoperative recurrence of diverticulitis were younger (46 ± 11 vs. 55 ± 13 years, p = 0.002) and more frequently had uncomplicated diverticulitis [15/26 (58%) vs. 97/338 (29%), p = 0.002] and more than two previous episodes before PS [17/26 (65%) vs. 132/338 (39%), p = 0.009] than patients without PRD. After multivariate analysis, two independent risk factors for PRD were identified: patients with more than two episodes before PS (OR = 3.3, 95% CI = 1.2–9, p = 0.005) and age < 50 years (OR = 4.5, 95% CI = 2–11, p = 0.001). If both factors were present, recurrence reached 18% (9/51).

Conclusion

Postoperative recurrence of diverticulitis is rare (7%) after PS for diverticulitis. Some patients (i.e. those with more than two episodes before PS and/or age <50 years) could be exposed to a higher risk of recurrence (up to 18%), making prophylactic surgery questionable in these patients.
Comparison of static and rolling logistic regression models on predicting invasive mechanical ventilation or death from COVID‐19—A retrospective, multicentre study
Authors: Engoren Milo , Pancaro Carlo , Yeldo Nicholas S. , Kerzabi Lotfi S. , Douville Nicholas
Published: November 2022

Introduction

COVID‐19 virus has undergone mutations, and the introduction of vaccines and effective treatments have changed its clinical severity. We hypothesized that models that evolve may better predict invasive mechanical ventilation or death than do static models.

Methods

This retrospective study of adult patients with COVID‐19 from six Michigan hospitals analysed 20 demographic, comorbid, vital sign and laboratory factors, one derived factor and nine factors representing changes in vital signs or laboratory values with time for their ability to predict death or invasive mechanical ventilation within the next 4, 8 or 24 h. Static logistic regression was constructed on the initial 300 patients and tested on the remaining 6741 patients. Rolling logistic regression was similarly constructed on the initial 300 patients, but then new patients were added, and older patients removed. Each new construction model was subsequently tested on the next patient. Static and rolling models were compared with receiver operator characteristic and precision‐recall curves.

Results

Of the 7041 patients, 534 (7.6%) required invasive mechanical ventilation or died within 14 days of arrival. Rolling models improved discrimination (0.865 ± 0.010, 0.856 ± 0.007 and 0.843 ± 0.005 for the 4, 8 and 24‐h models, respectively; all p < 0.001 compared with the static logistic regressions with 0.827 ± 0.011, 0.794 ± 0.012 and 0.735 ± 0.012, respectively). Similarly, the areas under the precision‐recall curves improved from 0.006, 0.010 and 0.021 with the static models to 0.030, 0.045 and 0.076 for the 4‐, 8‐ and 24‐h rolling models, respectively, all p < 0.001.

Conclusion

Rolling models with contemporaneous data maintained better metrics of performance than static models, which used older data.
A randomized, open‐label, two‐treatment crossover study to evaluate the effect of food on the pharmacokinetics of diazepam nasal spray in healthy adults
Authors: Rogawski Michael A. , Slatko Gary
Published: November 2022

Objective

The pharmacokinetics of oral diazepam are affected by food, but food‐effect studies have not been conducted for diazepam nasal spray because it is believed that most absorption occurs via the nasal mucosa. However, gastrointestinal side effects reported with nasal diazepam suggest that at least a portion of the drug may be absorbed enterally and thus subject to food effects. The objective of this study was to evaluate the possible effects of food on the pharmacokinetics of diazepam nasal spray in healthy adults.

Methods

This randomized, open‐label crossover study compared equal doses of diazepam nasal spray after an overnight fast and after a standardized high‐fat, high‐calorie breakfast. Each participant served as their own control, and there was a washout period of at least 21 days between treatments.

Results

Twenty‐four healthy adults enrolled in this study. Two participants withdrew consent, and two had pre‐dose diazepam concentrations that exceeded the protocol‐defined minimum after the washout period and were excluded from the final analysis population of 20 participants. Under fed conditions, the mean maximum plasma diazepam concentration was decreased by 48% (p < .0001) and the overall diazepam exposure during the first 4 h was reduced by 57% (p < .0001) compared with fasted conditions. The time to maximum plasma concentration was 4.0 h in the fed state compared with 2.0 h in the fasted state (p < .0001). At 2 h post‐dose, diazepam concentrations were ≥150 ng/mL for 100% of the participants when in the fasted state and 30% when in the fed state. Significantly more participants experienced adverse events under fasted conditions (83.3%) than under fed conditions (54.5%; p = .0340).

Significance

This study in healthy volunteers demonstrated that food significantly decreases and delays the absorption of diazepam dosed via nasal spray. Patients using diazepam nasal spray after eating may obtain diazepam concentrations that are below those needed for seizure control.
Classification of open source software bug report based on transfer learning
Authors: Zhifang Liao , Kun Wang , Qi Zeng , Shengzong Liu , Yan Zhang , Jianbiao He
Published: November 2022

Currently, the feature richness of text encoding vectors in the bug report classification model based on deep learning is limited by the size of the domain dataset and the quality of the text. However, it is difficult to further enrich the features of text encoding vectors. At the same time, most existing bug report classification methods ignore the submitter's personal information. To solve these problems, we construct nine personal information characteristics of bug report submitters in GitHub by survey. Then, we propose a GitHub bug report classification method named personal information fine‐tuning network (PIFTNet) based on transfer learning and the submitter's personal information. PIFTNet transfers the general text feature vectors in bidirectional encoder representation from transformers (BERT) to the domain of bug report classification by fine‐tuning the pre‐training parameters in BERT. It also combines the text characteristics and the characteristics of the submitter's personal information to construct the classification model. In addition, we propose a two‐stage training method to alleviate the catastrophic changes in the pre‐training parameters and loss of the initially learned knowledge caused by direct training of PIFTNet. We verify the proposed PIFTNet on the dataset extracted from GitHub and empirical results prove the effectiveness of PIFTNet.
Biochemical and crystallographic assessments of the effect of 4,6‐O‐disulfated disaccharide moieties in chondroitin sulfate E on chondroitinase ABC I activity
Authors: Watanabe Ippei , Miyanaga Akimasa , Hoshi Hirotaka , Suzuki Kiyoshi , Eguchi Tadashi
Published: November 2022

O‐sulfated N‐acetyl‐d‐galactosamine (GalNAc) residues in chondroitin sulfate (CS) play a crucial role in chondroitinase ABC I (cABC‐I) activity. CSA containing mainly 4‐O‐monosulfated GalNAc was a good substrate for the enzyme, but not CSE containing mainly 4,6‐O‐disulfated GalNAc [GalNAc(4S,6S)]. Each CS isomer exhibits structural heterogeneity; CSE has di‐sulfated disaccharide units and mono‐sulfated disaccharide units. Disaccharide composition analysis of digested products revealed that mono‐sulfated disaccharide units in CSE contributed to the enzyme reactivity. Although enough substrate (CSA) was present in mixtures of CSA and CSE for reaction, the reactivity was reduced depending on the amount of CSE in the mixture. These results suggested that CSE is not only resistant to enzyme digestion but also attenuates enzyme activity. To understand the mechanism of action, crystallography of cABC‐I in complex with unsaturated CSE‐disaccharide, ΔDi‐(4,6)S, was performed. Both 4‐O‐ and 6‐O‐sulfate groups in ΔDi‐(4,6)S interact with Arg500, suggesting that there was a greater interaction between ΔDi‐(4,6)S and Arg500 than between mono‐sulfated disaccharides and Arg500. Besides, this interaction attenuated enzyme activity by interfering with a function of Arg500, which is the charge neutralization of the carboxy group of D‐glucuronic acid (GlcA) residues in CS. When interacting with the CSE‐disaccharide unit [GlcAβ1‐3GalNAc(4S,6S)] in CS, cABC‐I cannot interact with other CS‐disaccharide units until it has digested the CSE‐disaccharide unit. The low reactivity of cABC‐I with CSE is attributable to two suggested factors: (a) resistance of E‐units in CSE molecules to digestion by cABC‐I, and (b) tendency of E‐units in CSE molecules to attenuate cABC‐I activity.
Characterization of a glycoside hydrolase endolysin from Acinetobacter baumannii phage AbTZA1 with high antibacterial potency and novel structural features
Authors: Premetis Georgios E. , Stathi Angeliki , Papageorgiou Anastassios C. , Labrou Nikolaos E.
Published: November 2022

The classification of Acinetobacter baumannii by WHO as ‘priority 1’ antibiotic‐resistant pathogen underlines the urgent need for novel antimicrobial agents towards this pathogen. In this work, screening of the A. baumannii phage AbTZA1 genome allowed the identification of a putative endolysin (AbLys1, EC3.2.1.17) that belongs to the glycoside hydrolase family 24 (GH24). The sequence of AbLys1 was cloned, expressed in E. coli and purified. The lytic activity and specificity of AbLys1 were evaluated against a range of Gram‐positive and Gram‐negative human pathogens. AbLys1 was found to display a high selectivity towards A. baumannii. Kinetic analysis was carried out to characterize the dependence of its lytic activity on pH. The enzyme shows its maximal activity at pH values 7–8. The structure of AbLys1 was determined by X‐ray crystallography to 1.82 Å resolution. The overall structure revealed two helical domains: a small, antenna‐like, N‐terminal domain and a larger C‐terminal domain with six α‐helices and a β‐hairpin. Both the antenna‐like and β‐hairpin regions contain short sequences (AMseq1 and AMseq2) with predicted antimicrobial activity. Engineering studies revealed a key role of AMseq1 and AMseq2 on the enzyme's lytic activity towards A. baumannii cells but not towards purified peptidoglycan. This suggests that both sequences affect the destabilization of the outer membrane, thus providing access of the catalytic domain to the peptidoglycan. In addition, the deletion of AMseq1 enhanced the enzyme stability, whereas the deletion of AMseq2 diminished it. The results suggest that AbLys1 is a promising new enzybiotic with efficient lytic and antimicrobial activity.
Paradox versus paradigm: A disconnect between understanding and management of freshwater cyanobacterial harmful algae blooms
Authors: Bramburger Andrew J. , Filstrup Christopher T. , Reavie Euan D. , Sheik Cody S. , Haffner Gordon Douglas , Depew David C. , Downing John A.
Published: November 2022

Freshwater cyanobacterial harmful algae blooms (cHABs) are a major threat to human and environmental health and are increasing globally in frequency and severity. To manage this threat in a timely manner, science must focus on increasing our ability to predict the growth and toxigenicity of specific taxa of cyanobacteria.

Recent molecular research has revealed striking genomic and metabolic diversity among the many morphologically indistinguishable sub‐species and strains of cyanobacteria. Assemblage‐level molecular metabolic capability surveys promise to improve our ability to predict cyanobacterial responses to environmental forcing, but many of these cutting‐edge techniques are not widely available or cost‐effective enough to be employed in routine monitoring programmes to support management decisions. Taxonomic ambiguity, cryptic functional specialisation, incongruence between genomic capability and phylogeny, and genomic flexibility impose severe challenges to our ability to ascribe autecological attributes at a level of taxonomic resolution that is attainable under current management strategies (i.e. Linnaean species). This lack of knowledge prohibits reliable predictions of species' responses to environmental stressors.

Cyanobacterial species comprise consortia of metabolically diverse, morphologically indistinct strains that span a range of ecological specialisation. Under current, broadly applied taxonomic concepts, these species functionally embody a generalist ecological strategy—persisting and/or proliferating where other specialised competitors are negatively impacted.

We postulate that within current management frameworks, characterising of cyanobacterial species as competing generalists, as well as considering abundance trajectories of well‐characterised, non‐cyanobacterial specialist phytoplankton will generate more scalable, mechanistic, and management‐relevant insight into increasing cHAB frequency and severity in suitable time frames.

Here we recommend that cHAB management considers the competitive framework of phytoplankton communities, including cyanobacteria, wherein diverse environmental changes lead to deterministic responses by readily identifiable, documented specialist taxa. Characterising these changes in community structure will quantify the relative importance of altered stressors and resource availability that can be exploited by metabolically flexible cyanobacteria.
Global diversity patterns of larger benthic foraminifera under future climate change
Authors: Förderer Esther‐Meena , Rödder Dennis , Langer Martin R.
Published: November 2022

Global warming threatens the viability of tropical coral reefs and associated marine calcifiers, including symbiont‐bearing larger benthic foraminifera (LBF). The impacts of current climate change on LBF are debated because they were particularly diverse and abundant during past warm periods. Studies on the responses of selected LBF species to changing environmental conditions reveal varying results. Based on a comprehensive review of the scientific literature on LBF species occurrences, we applied species distribution modeling using Maxent to estimate present‐day and future species richness patterns on a global scale for the time periods 2040–2050 and 2090–2100. For our future projections, we focus on Representative Concentration Pathway 6.0 from the Intergovernmental Panel on Climate Change, which projects mean surface temperature changes of +2.2°C by the year 2100. Our results suggest that species richness in the Central Indo‐Pacific is two to three times higher than in the Bahamian ecoregion, which we have identified as the present‐day center of LBF diversity in the Atlantic. Our future predictions project a dramatic temperature‐driven decline in low‐latitude species richness and an increasing widening bimodal latitudinal pattern of species diversity. While the central Indo‐Pacific, now the stronghold of LBF diversity, is expected to be most pushed outside of the currently realized niches of most species, refugia may be largely preserved in the Atlantic. LBF species will face large‐scale non‐analogous climatic conditions compared to currently realized climate space in the near future, as reflected in the extensive areas of extrapolation, particularly in the Indo‐Pacific. Our study supports hypotheses that species richness and biogeographic patterns of LBF will fundamentally change under future climate conditions, possibly initiating a faunal turnover by the late 21st century.
Auditor‐provided non‐audit services and perceived audit quality: Evidence from the cost of equity and debt capital
Authors: Friedrich Christian , Quick Reiner , Schmidt Florian
Published: November 2022

There is an ongoing debate among regulators and researchers about concerns that the provision of non‐audit services (NAS) to audit clients may impair audit quality by reduced independence. In this context, there can be different perspectives on audit quality. Given recent regulatory changes in the European Union (EU) aimed to improve investor confidence in audited financial statements, it is critical to understand the association of NAS and audit quality perceptions by investors before and after the regulation. We investigate whether NAS affect shareholder and lender perceptions of audit quality, measured by the cost of debt and equity capital. For a sample of German firms, we find significant positive associations of NAS with both cost of debt and cost of equity. Other assurance and consultancy services drive this effect. We do not find this effect in the pre‐regulation period, but in the transition period when the regulation was passed but NAS restriction did not yet apply. In the post‐regulation period, it only persists for lenders. Thus, the EU regulation may have increased (or inadequately created) independence concerns for shareholders and lenders and curbed these concerns for shareholders only.
Investigating the clinical decision‐making of nursing students using high‐fidelity simulation, observation and think aloud: A mixed methods research study
Authors: Abdulmohdi Naim , Mcvicar Andrew
Published: November 2022

Aims

The aim of this study was to investigate nursing students' clinical decision‐making by using high‐fidelity simulation of a deteriorated patient scenario.

Design

A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection.

Methods

Twenty‐three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to ‘think aloud’ during and after the simulation. The students were audio‐video recorded and observations were collected by the researcher.

Results

There was a significant moderate increase in the ‘deduction’ and ‘analysis’ sub‐scale scores and overall test score, suggestive of improved analytical decision‐making processes through the simulation experience. Think‐aloud and observation data identified that students predominantly applied ‘forward’ reasoning during the simulated ‘patient's’ deterioration, focusing mainly on cue acquisition. ‘Backward’ reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem.

Conclusion

Students learn different clinical decision‐making skills during the simulation compared to what they learn from debriefing. Using observation and think‐aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision‐making process.
Epidemiological study of capillary malformation among 7299 infants under 1 year of age in China
Authors: Yu Lei , Qin Kun , Deng Xianming , Yao Xiaojian , Deng Yuhong , He Wanying , Liu Qi‐wen , Tang Yichun , Yang Hong , Wang Zhengyuan , Zhu Zhaohua , Zhang Tangde
Published: November 2022

Background

Capillary malformation (CM) is the most common vascular malformation. Large scale studies on its incidence and risk factors are limited in China.

Objective

Our study aimed to investigate the incidence of CM in Chinese infants and to evaluate its potential risk factors.

Methods

A cross‐sectional study, including 7299 infants (aged < 1 year) were collected by a self‐administered questionnaire. Independent‐samples T tests or χ2 tests and multivariable logistic models were used to examine the potential risk factors for CM.

Results

The incidences of salmon patches and port‐wine stains (PWSs) were 9.10% and 0.80%, respectively. In analyses, male sex (OR: 1.32, 95% CI: 1.12–1.55) and birth hypoxia (OR: 5.61, 95% CI: 4.39–7.16) were risk factors for salmon patches. Birth hypoxia (OR: 12.58, 95% CI: 7.26–21.79) and pregnancy‐induced hypertension syndrome (PIH; OR: 3.66, 95% CI: 1.49–8.99) were associated with a higher risk of PWSs.

Conclusion

This epidemiological study had the largest sample size of infants with CM in the world thus far, which updated its incidence in Chinese infants and found the potential risk factors for CM.
Drying kinetics of guabiju pulp (Myrcianthes pungens): Mass transfer parameters, mathematical modeling and evaluation of bioactive compounds
Authors: Bombana Vanessa Barbieri , Fischer Bruno , Oro Carolina Elisa Demaman , Rigo Diane , Polina Caroline Chies , Franco Denti Andressa , Gonçalves Tiago dos Santos , Steffens Clarice , Cansian Rogério Luis , Toniazzo Backes Geciane , Junges Alexander
Published: November 2022

This work aimed to estimate the mass transfer parameters of guabiju pulp under different temperatures of drying, modeling the kinetic curves using Fick's second law and the Lewis, Henderson–Pabis, Page, Modified Page, Logarithmic and Midilli models and to evaluate their biological properties and color. Guabiju pulp were dried at 313.15–373.15 K. The drying rate decreases over time, showing an exponential behavior with a significant influence of the operating temperature. Values of the effective diffusivity coefficient (Deff) between 1.578 and 10.755 × 10−9 m2 s−1were observed, with an activation energy of 30.77 kJ mol−1and an Arrhenius factor of 1962 × 10−4 m2 s−1. All models used showed good fit quality parameters (coefficient of determination—R2(>0.9521), sum of squared error—SSE (<0.0049), root mean square error—RMSE (<0.0699) and chi‐square test—X2(<0.0052)). The Midilli model showed the smallest deviations in relation to the experimental data. The values of the mass transfer constant (k6) ranged from 0.00036 to 0.01232 for the Midilli model. The best results for antioxidant activity, phenolic compounds and flavonoids were obtained at 353.15 K. The dehydrated guabiju pulp can be considered promising for human consumption and for food supplementation due to its biological activities, since the phenolic compounds act as pigments, flavor precursors and natural antioxidants.

Practical applications

Drying systems have proved to be an important strategy for the conservation of natural resources. However, they still lack studies by society. In line with drying systems, the kinetic modeling of the data allows simulating and optimizing the process, reaching the maximum potential of the process and making the process viable, reducing losses and errors and increasing product quality, facilitating industrial implementation and scale‐up. Thus, studies on the drying of guabiju pulp (Myrcianthes pungens) help to understand the process. Considering that the fruit has bioactive compounds and can be used in a certain product within the pharmaceutical, chemical or food industry.
Comparison of the effect of ultrasound and microwave on the functional properties and in vitro digestibility of normal maize starch and potato starch
Authors: Zhou Yihan , Wang Meng , Wang Luyu , Liu Lingling , Wu Yanwen , Ouyang Jie
Published: November 2022

This study aimed to compare the effects of ultrasound and microwave, single or dual treatments, on the functional and in vitro digestive properties of normal maize starch and potato starch. The solubility, water and oil absorption capacity, and the freeze–thaw stability of both starches increased after treatment, and these functional properties of potato starch negatively correlated with relative crystallinity and positively correlated with damaged starch content. Meanwhile, the dual modification sequence showed a significant effect on the solubility, syneresis, and in vitro digestibility of potato starch. Under the single treatment of microwave, the content of resistant starch increased while that of rapidly digestible starch decreased, which might be due to the formation of the amylose–lipid complex by microwave treatment. However, the ultrasound treatment and dual treatment increased the starch digestibility, probably due to the loosening of the internal structure of starch by ultrasound. The utilization of dual ultrasound and microwave modification showed a prospective industrial application in the modification of starch.

Practical applications

Ultrasound and microwave treatment, single or dual, have been widely used to study their effects on the physicochemical properties of starch. However, there is little information on the comparison of functional properties and in vitro digestibility of maize starch (A‐type crystalline) and potato starch (B‐type) by dual modification of ultrasound and microwave. The results showed that the functional properties of both starches improved after treatment, and the dual modification sequence showed a significant effect. The in vitro digestibility of starch decreased after microwave treatment, but increased after ultrasound treatment and dual treatment. We believe that the food industry can utilize the results of this study in the modification of starch with specific functional properties.
Shareholder litigation and toxic releases
Authors: Do Trung K. , Vo Xuan Vinh , Le Tuan‐Vinh
Published: November 2022

We examine the environmental impact of the staggered adoption of universal demand laws by 23 U.S. states between 1989 and 2005. Universal demand laws impede derivative lawsuits and thus undermine shareholder oversight of corporate environmental performance. We find that weakened litigation rights for shareholders are positively associated with the release of toxic chemicals by firms. The effect is stronger for firms with weak governance, and environmental mismanagement by firms after the passage of the laws lead to poorer financial performance. Overall, our findings imply that derivative lawsuits by shareholders are not frivolous, as is often asserted. Rather, they act as an effective mechanism of corporate governance.
Caregiver knowledge of obstructive sleep apnoea in Down syndrome
Authors: Giménez S. , Tapia I. E. , Fortea J. , Levedowski D. , Osorio R. , Hendrix J. , Hillerstrom H.
Published: November 2022

Background

Down syndrome (DS) population has a very high prevalence of obstructive sleep apnoea (OSA), but this remains underdiagnosed. Hence, we aimed to evaluate caregiver's knowledge of OSA and related sociodemographic factors that could contribute to OSA screening patterns in this population.

Methods

An online survey though the LuMind IDSC Foundation focused on OSA diagnosis, treatments and the number of sleep studies performed. Data were compared between subjects born before and after the American Academy of Pediatrics (AAP) recommendations for OSA screening.

Results

Of the caregivers, 724 (parents 96.3%), responded to the survey. The median [interquartile (IQR)] age of the subjects with DS was 12 [20;7] years. The majority (84.3%) had sleep apnoea diagnosis, and half of them were initially referred for a sleep study due to disturbed sleep symptoms. Only 58.7% of the responders were aware of the AAP recommendations. This was linked to higher socioeconomic and/or educational level and to an earlier OSA diagnosis. The median (IQR) age of OSA diagnosis was lowered after the AAP guidelines publication compared with before its publication (3 [4;2] years vs. 10 [18;5] years, P < 0.000). Adenotonsillectomy (81.9%) and continuous positive airway pressure (61.5%) were the most commonly prescribed treatments. Few had discussed other new therapies such as hypoglossal nerve stimulation (16.0%). Only 16.0% of the subjects repeated the sleep study to monitor OSA with ageing, and 30.2% had to wait more than 4 years between studies.

Conclusions

This study reinforces the need to improve OSA knowledge of caregivers and clinicians of individuals with DS to promote an earlier diagnosis and optimal treatment of OSA in this population.
Are health insurers in multiple lines of business less profitable? An examination of scope economies in health insurance
Authors: Born Patricia , Cook Amanda , Sirmans Tice , Yang Charles
Published: November 2022

In markets where companies can offer multiple products or services, production costs may decline, and profitability may increase as business scope expands. Using a sample of health insurers from 2015 to 2018 with data reported in the annual NAIC Supplemental Health Care Exhibit, we test whether scope economies exist among health insurers. We evaluate the relationship between scope and four profitability metrics—the medical loss ratio, the expense ratio, the underwriting profit ratio, and a profit efficiency measure obtained using a data envelopment analysis technique. We test two competing hypotheses from prior literature on scope economies in insurance. The strategic focus hypothesis states performance is higher for insurers that specialize in one line of business. The conglomeration hypothesis states performance is higher for insurers that operate in multiple lines of business. Our results provide evidence in support of the strategic focus hypothesis among US health insurers.
Expanding the Horizontal Call: A Typology of Social Influence on the Call to Ministry
Authors: Johnston Erin , Eagle David
Published: November 2022

This research examines the social actors and interactions that facilitate seminary students' sense of calling. Drawing from 36 in‐depth interviews with first year Masters of Divinity students, we introduce six ideal typical social others who play a formative role in the early stages of a call to ministry: instigators, exemplars, interpreters, affirmers, challengers, and codiscerners. Together, these findings demonstrate that the call to ministry, while deeply personal, emerges through social interactions that facilitate and make plausible a person's sense of calling and that sustain it over time. Extending Richard Pitt's conceptualization of the “horizontal call,” this paper argues that social others help evoke and solidify—not merely legitimate—a personal sense of call. This research also highlights differences in the social structuring of call by gender. Despite considerable gains in the ordination of women, we find that many still face obstacles to experiencing and embracing a call to ministry.
The effectiveness of video training in improving intensive care nurses' knowledge about brain death identification
Authors: Deniz İsmail , Ayhan Hatice
Published: November 2022

Background

Because patients diagnosed with brain death in intensive care units constitute a potential cadaveric donor group for organ transplantation, intensive care units are potential donor sources. Nurses who closely monitor the patient collaborate with medical personnel in the recognition and early diagnosis of brain death. Nurses also have an important role in supporting the patient's family. Therefore, it is very important for nurses to know the diagnostic criteria for brain death.

Aim

The aim of this study was to compare the effectiveness of theoretical education and video‐assisted education in equipping intensive care nurses to recognize brain death.

Study Design

A randomized, experimental study was conducted between February and May 2020 with a total of 50 intensive care nurses, split into 25 in the video‐assisted training group and 25 in the theoretical training group. In study, intensive care nurses were given a theoretical training and video‐assisted training on brain death criteria. One group was trained theoretically and the other group used a video showing criteria for brainstem reflexes (pupil assessment, spontaneous breathing, corneal reflex, retching and coughing assessments) and deep tendon reflexes in a simulated patient, supported by animation. The data were collected before, immediately after and 3 months after the training using the Brain Death Criteria Knowledge Test, the Brain Death Case Test, and the Training Effectiveness Evaluation Form. The independent samples t‐test, Mann–Whitney U test, Friedman test, Wilcoxon test, and Chi‐square test were used for statistical analysis of data.

Results

It was found that the knowledge scores of both groups immediately after training and 3 months after training were higher than before the training (p < .001). However, the post‐training knowledge scores of the video‐assisted training group were significantly higher than those of the theoretical training group (p = .011).

Conclusions

To enable intensive care nurses to identify brain death, video‐assisted training with a simulated patient is recommended, as is repeating the training at regular intervals.

Relevance to Clinical Practice

The simulated patient video‐assisted training method can be used for in‐service training to provide intensive care nurses with the ability to identify brain death. The training may be repeated at regular intervals (e.g., every 3 months) to increase nurse recall.
Direct nitrogen, phosphorus and carbon exchanges between Mucoromycotina ‘fine root endophyte’ fungi and a flowering plant in novel monoxenic cultures
Authors: Hoysted Grace A. , Field Katie J. , Sinanaj Besiana , Bell Christopher A. , Bidartondo Martin I. , Pressel Silvia
Published: November 2022

Most plants form mycorrhizal associations with mutualistic soil fungi. Through these partnerships, resources are exchanged including photosynthetically fixed carbon for fungal‐acquired nutrients. Recently, it was shown that the diversity of associated fungi is greater than previously assumed, extending to Mucoromycotina fungi. These Mucoromycotina ‘fine root endophytes’ (MFRE) are widespread and generally co‐colonise plant roots together with Glomeromycotina ‘coarse’ arbuscular mycorrhizal fungi (AMF). Until now, this co‐occurrence has hindered the determination of the direct function of MFRE symbiosis.

To overcome this major barrier, we developed new techniques for fungal isolation and culture and established the first monoxenic in vitro cultures of MFRE colonising a flowering plant, clover. Using radio‐ and stable‐isotope tracers in these in vitro systems, we measured the transfer of 33P, 15N and 14C between MFRE hyphae and the host plant.

Our results provide the first unequivocal evidence that MFRE fungi are nutritional mutualists with a flowering plant by showing that clover gained both 15N and 33P tracers directly from fungus in exchange for plant‐fixed C in the absence of other micro‐organisms.

Our findings and methods pave the way for a new era in mycorrhizal research, firmly establishing MFRE as both mycorrhizal and functionally important in terrestrial ecosystems.
Scan of physical activity policy actions in Europe: Lessons learned from populating the MOVING database
Authors: Oldridge‐Turner Kate , Kokkorou Margarita , Vlad Ioana , Klepp Knut‐Inge , Rutter Harry , Helleve Arnfinn , Fanian Diva , Sing Fiona , O'Mara Jennifer , Mitrou Giota , Wiseman Martin , Allen Kate
Published: November 2022

Adequate levels of physical activity are important for population health. Policy databases can track, monitor, and compare the development and implementation of physical activity policy actions and are populated by different methods. The new MOVING database, developed through the Confronting Obesity: Co‐creating Policy with Youth (CO‐CREATE) project, collates governmental policy actions designed to increase physical activity and is populated by an in‐depth scan of implemented national policy actions.

This paper presents lessons learned from conducting the policy scan across 27 European countries. Policy actions were identified using a structured search protocol from preselected sources, assessed against pre‐specified inclusion criteria and verified by an in‐country expert. 625 eligible national implemented policy actions were identified.

Challenges included policy actions falling out of scope, a lack of available information on policy actions, difficulty in identifying policy actions using specific search terms, and increased resource requirements for translation of policy actions into English. The scan indicated improvements, which informed protocol modifications.

Identifying the challenges and opportunities around conducting a policy scan is necessary to understand and assess the reliability, validity, and utility of a policy database. The policy scan will help to deliver a comprehensive picture of physical activity policy actions across Europe.