bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Spheroids from Adipose-Derived Stem Cells Induce Calvarial Bone Production in a Xenogeneic Rabbit Model
Authors: Di Stefano Anna Barbara , Montesano Luigi , Belmonte Beatrice , Gulino Alessandro , Gagliardo Cesare , Florena Ada Maria , Bilello Giuseppa , Moschella Francesco , Cordova Adriana , Leto Barone Angelo A. , Toia Francesca
Published: December 2020

Calvarial defects can result from several causes. Tissue engineering hold the potential to restore native form and protective function. We have recently shown that stemness and differentiation ability of spheroids from adipose-derived stem cells (S-ASCs) promotes osteoblasts growth within Integra in a small vertebral lesion. In our study, we aimed to test osteogenic potential of S-ASCs in aiding regeneration of a calvarial defect. Groups containing Integra showed increased bone regeneration at the calvarial defect-Integra interface compared with the control group. In particular, S-ASC–derived osteoblasts group showed a superior calvarial remodeling than undifferentiated S-ASCs group. Clusters of ossification were observed in these both groups with enhanced microvasculature density and fibrosis. In conclusion, seeding of S-ASCs in dermal regeneration templates enhanced bone healing in a rabbit calvarial defect model. These findings could prompt the elective use of S-ASCs with enhanced multilineage differentiation potential for tissue engineering purposes.
Clinical Findings and Outcomes of Palatal Repair in 9 Patients With Van der Woude Syndrome
Authors: Allam Karam Ahmed , Haredy Mostafa Mamdoh
Published: December 2020

Introduction

Van der Woude syndrome (VWS), an autosomal dominant condition associated with clefts of the lip and/or palate and lower lip pits, is caused by mutations in interferon regulatory factor 6 gene. It is reported to be the most common syndromic cleft worldwide. This case series presents the phenotypic characteristics and treatment outcomes in a group of 9 patients diagnosed with VWS.

Methods

A retrospective review was performed on records of patients given a diagnosis of VWS presenting to the Department of Plastic Surgery of Sohag University between July 2009 and November 2019. Data analyses included age and sex of affected patients, type of the cleft, associated anomalies, presence of lower lip pits, and history of lower lip pits/cleft in the family and treatment outcomes.

Results

The study identified 9 patients (male = 2, female = 7). Age at first presentation ranged between 1 week and 7 years (mean = 1.3 years). Four patients had bilateral cleft lip and palate and 1 patient had unilateral cleft lip and palate (UCLP), whereas 4 patients had isolated cleft palate. Bilateral lower lip pits were presented in 8 patients, whereas the ninth patient has unilateral pit. Family history was positive in 3 patients. Most patients in this study developed after palatal repair speech problems with an increased rate of secondary surgical procedures needed for correction of velopharyngeal insufficiency.

Conclusions

All reviewed cases of VWS presented with lower lip pits and cleft palate with or without cleft lip. A positive family history of similar conditions was demonstrated in 33.3% of our patients. This study suggests an increased incidence of secondary palatal surgeries for velopharyngeal insufficiency in patients with VWS; this warrant further studies including control group of nonsyndromic cleft patients.
The Impact of Policy Reform on Utilization of Popular Reconstructive Procedures
Authors: Yesantharao Pooja S. , He Waverley , Shetty Pragna , Aravind Pathik , Quan Amy , Fadavi Darya , Aliu Oluseyi
Published: December 2020

Objectives

Medicaid beneficiaries systematically face challenges in accessing healthcare, especially with regard to specialty services like reconstructive surgery. This study evaluated the impact of 2 healthcare reform policies, Medicaid expansion and global hospital budgeting, on utilization of reconstructive surgery by Medicaid patients.

Methods

Utilization of reconstructive surgery by Medicaid patients in New Jersey (Medicaid expansion/no global budget), Maryland (Medicaid expansion/with global budgets), and Florida (no Medicaid expansion/no global budget) between 2012 and 2016 was compared using quasi-experimental, interrupted time-series modeling. Subgroup analyses by procedure type and urgency were also undertaken.

Results

During the study period, the likelihood of Medicaid patients using reconstructive surgery significantly increased in expansion states (Maryland: 0.3% [95% confidence interval = 0.17% to 0.42%] increase per quarter, P < 0.001; New Jersey: 0.4% [0.31% to 0.52%] increase per quarter, P = 0.004) when compared with Florida (nonexpansion state). Global budgeting did not significantly impact overall utilization of reconstructive procedures by Medicaid beneficiaries. Upon subgroup analyses, there was a greater increase in utilization of elective procedures than emergent procedures by Medicaid beneficiaries after Medicaid expansion (elective: 0.9% [0.8% to 1.3%] increase per quarter, P = 0.04; emergent/urgent: 0.2% [0.1% to 0.4%] increase per quarter, P = 0.02). In addition, Medicaid expansion had the greatest absolute effect on breast reconstruction (1.0% [95% confidence interval = 0.7% to 1.3%] increase per quarter) compared with other procedure types.

Conclusions

Medicaid expansion increased access to reconstructive surgery for Medicaid beneficiaries, especially for elective procedures. Encouragingly, although cost-constrictive, global hospital budgeting did not limit longitudinal utilization of reconstructive surgery by Medicaid patients, who are traditionally at higher risk for complications/readmissions.
Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries
Authors: El-Gammal Tarek Abdalla , El-Sayed Amr , Kotb Mohammed M. , Abdel-Hamid Usama Farghaly , El-Gammal Yousif Tarek
Published: December 2020

Introduction

In brachial plexus injuries, useful recovery of arm function has been documented in most patients after phrenic nerve transfer after variable follow-up durations, but there is not much information about long-term functional outcomes. In addition, there is still some concern that respiratory complications might become manifest with aging. The aim of this study was to report the outcome of phrenic nerve transfer after a minimum follow-up of 5 years.

Patients and Methods

Twenty-six patients were reviewed and evaluated clinically. Age at surgery averaged 25.2 years and follow-up averaged 9.15 years.

Results

Shoulder abduction and external rotation achieved by transfer of phrenic to axillary nerve (or posterior division of upper trunk), combined with spinal accessory to suprascapular nerve transfer, were better than that achieved by transfer of phrenic to suprascapular nerve, combined with grafting the posterior division of upper trunk from C5, 52.3 and 45.5 degrees versus 47.5 and 39.4 degrees, respectively. There was no difference in abduction when the phrenic nerve was transferred directly to the posterior division of upper trunk or to the axillary nerve using nerve graft. Elbow flexion (≥M3 MRC) was achieved in 5 (83.3%) of 6 cases. Elbow extension M4 MRC or greater was achieved in 4 (66.6%) of 6 cases. All patients, including those who exceeded the age of 45 years and those who had concomitant intercostal nerve transfer, continued to have no respiratory symptoms.

Conclusions

The long-term follow-up confirms the safety and effectiveness and of phrenic nerve transfer for functional restoration of shoulder and elbow functions in brachial plexus avulsion injuries.
A Comparative Study of Nail Fold Approach and Microscopic Nail Bed Approach in the Surgical Treatment of Subungual Exostosis
Authors: Kusuhara Hirohisa , Itani Yoshihito , Isogai Noritaka , Sueyoshi Yu
Published: December 2020

Subungual exostosis is a benign tumor that occurs under the nail plate of the distal phalanx and causes nail deformity and pain. There are many reports of recurrence and postoperative nail deformity, and the surgical approach needs to be reassessed. Two typical surgical approaches are from the nail fold and the nail bed. Here, we compare 2 surgical approaches for subungual exostosis that were performed in our department. Twenty-three cases of subungual exostosis were treated between 2010 and 2019; 12 cases were treated by the nail fold approach and 11 by the microscopic nail bed approach. The nail fold approach resulted in not only scarring but also nail deformities, such as onychodystrophy. There were 2 (18.2%) cases of recurrence. In the microscopic nail bed approach, there was no case of recurrence. It was possible to preserve the thinned nail bed by dissecting under a microscope, and the thinned nail bed did not become necrotic in any cases. To solve postoperative nail deformity and a high recurrence rate, sufficient resection and meticulous surgical procedure on the nail bed and nail matrix are essential. The microscopic nail bed approach satisfied both of these criteria and was considered to be a useful method for subungual exostosis.
Three-Dimensional Computer-Assisted Orthognathic Surgery
Authors: Ho Cheng-Ting , Denadai Rafael , Lin Hsiu-Hsia , Lo Lun-Jou
Published: December 2020

Purpose

Three-dimensional (3D) computer-aided planning has truly revolutionized orthognathic surgery (OGS) treatment, but no study has compared the traditional hybrid and full 3D digital planning models. This study compared these virtual planning models in the treatment of asymmetric maxillomandibular disharmony.

Methods

Young adult patients with an asymmetric skeletal class III deformity who underwent 3D computer-aided 2-jaw OGS using hybrid (alginate dental impression, 2D cephalometric tracings, manual-guided stone model surgery, occlusion setup, and splint fabrication; n = 30) or full digital (laser-scanned dentition, 3D cephalometric tracings, virtual-based occlusion setup and surgery, and computer-generated surgical splint; n = 30) planning models were consecutively recruited. Preoperative and postoperative 3D cephalometric analyses (dental relation, skeletal assessments based on sagittal and frontal views, and soft tissue evaluations) were adopted for intragroup and intergroup comparisons. Postoperative patient-perceived satisfaction with facial appearance was also recorded.

Results

Both hybrid and full digital planning groups had significant (all P < 0.05) improvements after surgery with respect to facial convexity, incisor overjet, and frontal symmetry parameters. The full 3D digital planning-based OGS treatment had similar (all P > 0.05) 3D cephalometric-derived outcomes (preoperative, postoperative, and treatment-induced change data) and patient-perceived outcomes compared with the traditional hybrid 3D planning method.

Conclusions

For the decision-making process in selecting the planning model, multidisciplinary teams could consider additional parameters such as patient comfort, storage needs, convenience for data reuse, overall planning time, availability, and costs.
Effect of Radiation Therapy on Microsurgical Deep Inferior Epigastric Perforator Flap Breast Reconstructions
Authors: Prantl Lukas , Moellhoff Nicholas , von Fritschen Uwe , Giunta Riccardo , Germann Guenter , Kehrer Andreas , Thiha Aung , Ehrl Denis , Zeman Florian , Broer Peter Niclas , Heidekrueger Paul Immanuel
Published: December 2020

Introduction

Breast reconstruction with autologous tissue is a state-of-the art procedure. Several patient-related factors have been identified with regard to the safety and efficacy of these reconstructions. The presented study investigates the impact of prereconstruction radiation on outcomes of deep inferior epigastric perforator (DIEP) free-flap breast reconstructions using largest database available in Europe.

Materials and Methods

Between 2011 and 2019, 3926 female patients underwent 4577 DIEP flap breast reconstructions in 22 different German breast cancer centers. The cases were divided into a no-radiation (NR) and a radiation (R) group, according to radiation status before reconstruction. Groups were compared with regard to surgical complications and free-flap outcome.

Results

Overall, there was no significant difference between the groups regarding the rate of total flap loss [1.9% (NR) vs 2.1% (R), P = 0.743], partial flap loss [0.9% (NR) vs 1.5 (R), P = 0.069], and revision surgery [vascular revision: 4.4% (NR) vs 4.1% (R), P = 0.686; wound revision: 7.6% (NR) vs 9.4% (R), P = 0.122]. However, the patients had a significantly higher risk of developing wound healing disturbances at the recipient site [1.2% (NR) vs 2.1% (R), P = 0.035] and showed significantly longer hospitalization {8 [SD, 8.4 (NR)] vs 9 [SD, 15.4 {R}] days, P = 0.006} after prereconstruction radiation.

Conclusions

Our findings suggest that DIEP flap reconstruction after radiation therapy is feasible. Women with a history of radiation therapy should, however, be informed in detail about the higher risk for wound healing disturbances at the recipient site.
Inframammary Fold Approach for Second-stage Operation in Expander—Implant Breast Reconstruction
Authors: Min Kyunghyun , Jeon Dong Nyeok , Han Hyun Ho , Kim Eun Key , Eom Jin Sup
Published: December 2020

Background and Objectives

Despite expander-based breast reconstruction being used as a reliable reconstruction method, implant removal due to wound dehiscence and infection still occurs in 0.5% to 15% of cases. This study aimed to compare the outcomes of the new inframammary fold (IMF) incision approach with previous incision in second-stage operation of expander-based 2-stage breast reconstruction.

Methods

Patients who underwent expander-based 2-stage breast reconstruction between February 2014 and May 2019 were included. After expander inflation, patients undergoing second-stage reconstruction were divided into the previous incision and IMF incision groups and their outcomes were compared. Propensity score matching analysis was performed to compare postoperative 1-year results.

Results

The previous incision and IMF incision groups comprised 79 and 31 patients, respectively. There were no intergroup differences in general demographics or intraoperative data, except for total inflation volume (426.87 ± 102.63 mL in the previous incision group and 375.48 ± 94.10 mL in the IMF incision group, P = 0.017). Wound dehiscence occurred in 12 and 0 cases in the previous and IMF incision groups, respectively (P = 0.018). Implant removal was performed due to dehiscence in 9 cases (8.18%) and 0 cases (0%) in the previous and IMF incision groups, respectively (P = 0.049). In 1-to-1 propensity score matching analysis, the IMF incision group showed better results at 1-year follow-up (odds ratio: 0, 95% confidence interval: 0–1.09; P = 0.063).

Conclusions

The IMF approach is a safe method for replacing the expander with an implant, with lower incidence of wound dehiscence and implant explantation.
Long-Term Photogrammetric- and Panel Assessment‐Based Outcome Study of Staged Reconstructive Approach for Hypertelorism Correction
Authors: Chuang Kai-Ti , Denadai Rafael , Yong Jin-Han , Chou Pang-Yun , Chen Yu-Ray
Published: December 2020

Background

The surgical management of hypertelorism is challenging for plastic surgeons, and limited long-term outcome data are available. The purpose of this long-term study was to report a single-surgeon experience with a staged reconstructive protocol for hypertelorism correction.

Methods

This retrospective study reviewed the records of patients with hypertelorism who were surgically managed by a single surgeon between 1978 and 2000. Bone (orbital box osteotomy and orthognathic surgery) and soft tissue (rhinoplasty and epicanthoplasty) surgeries were performed based on a patient-specific surgical protocol. Included patients were divided into a childhood group and an adolescence or adulthood group according to their age at orbital repositioning (≤12 and >12 years, respectively). Patients were invited for clinical interviews in February 2020 to evaluate whether requests for revision surgery had been made. The photogrammetric analysis–based hypertelorism index was calculated at preoperative and long-term postoperative times. Satisfaction with the long-term outcome was judged by both surgical professionals and laypeople.

Results

In total, 14 patients with hypertelorism of different etiologies were included, with no request for revision surgery during an average follow-up of 29 years. The preoperative hypertelorism index was higher than the long-term postoperative evaluation (all, P < 0.05) for both childhood and adolescence or adulthood groups. Intergroup comparison revealed no significant difference for the hypertelorism index and panel assessment–based satisfaction with long-term outcome analysis (all, P > 0.05).

Conclusions

Considering the complexity and wide spectrum of clinical presentation of soft tissue and bone deformities in hypertelorism and current outcomes, the surgical approach to these patients should be staged and individualized for achievement of a balanced result between functional (orbital, occlusion, and psychosocial) and aesthetic parameters.
Flap Repair Technique for Soft Tissue Defects of the Hand
Authors: Zhao Fengjing
Published: December 2020

Repair for the soft tissue defects of hand has been a major challenge of hand or reconstructive surgery. A lot of flaps are used, free or pedicle flap, but there are no comprehensive description of these flaps. In this article, we retrospectively reviewed the repair technique of the fingertip defect, palmar or dorsal defect of the hand, by using different flaps in 14 cases, between June 2010 and December 2014, and the advantages and limitation of each flap are simply stated. We have shown a lot of surgical pictures, with a small amount of text, providing a wide range of ideas for the surgeon to freely choose an easy and effective method for his own technology. Overall, these approaches are simple, safe, and effective for repairing the soft tissue defect of the hand.
Bisphosphonate-Related Osteonecrosis of the Jaw
Authors: Chien Hsin-I , Chen Lee-Wei , Liu Wen-Chung , Lin Cheng-Ta , Ho Yen-Yi , Tsai Wei-Hsuan , Yang Kuo-Chung
Published: December 2020

Objectives

Antiresorptive agents for bone pain were widely used to treat patients with advanced osteoporosis, multiple myeloma, and bone metastatic cancer. In recent years, however, bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been a rare but major complication of this therapy. Most patients with BRONJ undergo dental procedures during treatment with antiresorptive agents. However, BRONJ may also occur spontaneously. This study reports 13 BRONJ patient cases at Kaohsiung Veterans General Hospital, Taiwan, and their related treatments. We also compare patients with cancer with patients with osteoporosis in treatment outcomes.

Methods

Thirteen symptomatic patients with BRONJ were reviewed between 1985 and 2018 at Kaohsiung Veterans General Hospital. We included patients at advanced stage who were hospitalized for infection control of osteonecrosis of the jaw and excluded asymptomatic patients at stage 0 and stage 1. Four multiple myeloma, 3 patients with bone metastatic breast cancer and 6 patients with advanced osteoporosis (average ages, 63.57 ± 14.54 years in cancer patients and 79.5 ± 9.31 years in osteoporosis patients; average drug durations, 25.86 ± 27.23 months in cancer patients and 58.33 ± 23.87 months in osteoporosis patients; average follow-up times, 22.71 ± 14.46 months in cancer patients and 28.08 ± 36.35 months in osteoporosis patients) were included.

Results

Seven patients were defined as having stage 3 (53.8%) and 6 as having stage 2 (46.2%) medication-related osteonecrosis of the jaw, according to the American Association of Oral and Maxillofacial Surgeons classification. The complete response rate with totally healed mucosa was 61.5%. Four cancer patients received free fibular flap (FFF) reconstruction with a high complete response rate (100%). All of them had a relatively better performance status, and the average age was also younger than osteoporosis patients.

Conclusion

Free fibular flap with a high complete response rate may improve pain relief and infection control for patients with BRONJ. Younger age is seemed to be a great indicator for FFF, but poor self-care ability (Eastern Cooperative Oncology Group status >3) is not suitable for these surgical treatments.
Are Backyard Waterslides as Dangerous as Public Waterslides: A Review of 1,823 Head and Neck Injuries
Authors: Lee Kevin C. , Stanbouly Dani , Chuang Sung-Kiang
Published: December 2020

The purpose of this study was to describe the characteristics and compare the severity of head and neck injuries between public and backyard waterslides. This was a 20-year cross-sectional study of the National Electronic Injury Surveillance System. Injuries from waterslides were included in this study if they involved the head, face, eyeball, mouth, neck, or ear. Patient and injury characteristics were compared by the type of waterslide using chi-squared and independent sample tests. A total of 1823 injury reports were identified (39.8% backyard waterslides and 60.2% public waterslides). The mean age at the time of injury was 13.2 years, and the majority of patients were white (74.2%) males (55.1%). The most common primary diagnoses were laceration (28.4%) and internal organ injury (27.2%). A greater proportion of backyard injuries involved the head (P < 0.01) and resulted in concussions (P < 0.01) or fractures (P = 0.04). The overall admission rate from the ED was 3.5%, and no fatalities were noted. There were no significant differences in admission rates between injuries from backyard and public slides. Fatal or serious head and neck injuries appear to be uncommon with waterslide injuries. Backyard waterslides pose a greater likelihood of cranial injury, and this may relate to differences in riding habits between public and private waterslides.
Accessory Cranial Suture Leading to Abnormal Head Shape
Authors: Leach Garrison A. , Kurnik Nicole M. , Bristol Ruth E. , Singh Davinder J.
Published: December 2020

Accessory cranial sutures have been described in the literature and are most commonly associated with the parietal bone. These sutures are typically identified incidentally and there have been no reported cases of accessory cranial sutures leading to abnormal head shape.

The authors present the case of a 3-month-old patient with multiple congenital anomalies and an accessory parietal suture leading to abnormal head shape. The patient was successfully treated with cranial orthotic therapy. To our knowledge, this is the first reported case of an accessory cranial suture leading to abnormal head shape.
HIF-1α and Hypoxia Responsive Genes are Differentially Expressed in Leukocytes From Survivors and Non-Survivors Patients During Clinical Sepsis
Authors: Ferreira Bianca Lima , Leite Giuseppe Gianini Figueirêdo , Brunialti Milena Karina Colo , Assuncao Murillo , Azevedo Luciano Cesar Pontes , Freitas Flávio , Salomao Reinaldo
Published: December 2020

Hypoxia inducible factor 1 alpha (HIF-1α) is linked to the metabolic and immune alterations in septic patients. Stabilization of HIF-1α by hypoxia or inflammation promotes the expression of several genes related to glycolytic metabolism, angiogenesis, coagulation, cell proliferation, and apoptosis. Here, we analyzed public available blood transcriptome datasets from septic patients and evaluated by PCR array the expression of HIF-1α and other hypoxia responsive genes in peripheral blood mononuclear cells from patients with sepsis secondary to community acquired infections. Samples were collected at intensive care unit admission (D0, n=29) and after 7 days follow-up (D7, n = 18); healthy volunteers (n = 10) were included as controls. Hypoxia and glycolysis were among the top scored molecular signatures in the transcriptome datasets. PCR array showed that 24 out of 78 analyzed genes were modulated in septic patients compared with healthy volunteers; most of them (23/24) were downregulated at admission. This same pattern was observed in surviving patients, while non-survivors presented more upregulated genes. EGLN1, EGLN2, and HIF1AN, inhibitors of HIF-1α activation were downregulated in patients, regardless of the outcome, while HIF-1α and other target genes, such as PDK1 and HMOX1, expression were higher in non-survivors than in survivors, mainly at D7. Non-survivor patients also presented a higher SOFA score and lower PaO2/FiO2 ratio. Our results indicate a differential modulation of hypoxia pathway in leukocytes between septic patients who survived and those who did not survive with an increased intensity at D7, which is possibly influenced by disease severity and may affect the immune response in sepsis.
Umbilical Hernia Repair in Cirrhotic Patients With Ascites: A Systemic Review of Literature
Authors: Guo Chenchen , Liu Quanguo , Wang Yong , Li Junsheng
Published: December 2020

Background:

Umbilical hernia is a common abdominal complication in cirrhotic patients. The incidence of umbilical hernias can be up to 20% in the presence of ascites. However, there is no consensus regarding the optimal management of umbilical hernias in cirrhotic patients. The purpose of this study is to review the management of umbilical hernias in cirrhotic patients with ascites.

Methods:

A search of the available literature in English since 1980 was performed using PubMed, the Cochrane Library, and a search of relevant journals and reference lists. The search terms included “umbilical hernia,” “ascites,” “cirrhosis,” and any derivatives of these terms, and the literature search identified all the relevant publications.

Results:

Thirty-three relevant articles published in the language of English were identified. Fourteen studies involved the management of refractory ascites in cirrhotic patients. Twenty-four studies included cirrhotic patients receiving elective or emergency surgery. Because of much lower morbidity and mortality in elective surgery than in emergency surgery, many authors advocated early elective repair of uncomplicated umbilical hernias in cirrhotic patients. Of these, 2 studies described laparoscopic umbilical hernioplasty, with a significant lower morbidity and hernia recurrence than open repair. Fifteen studies described the use of prosthetic mesh umbilical hernia repair in cirrhotic patients, which was associated with minimal wound-related morbidity and markedly lower recurrences.

Conclusions:

Our results indicate that early elective repair of uncomplicated umbilical hernias is recommended in cirrhotic patients with tolerable hepatic functional reserve or when the expected time for liver transplantation is >3 months. Umbilical hernias are supposed to be corrected in the process of liver transplantation, provided that patients could have a better prospect to be transplanted within 3 months. Control of ascites is a crucial part to successful outcomes of umbilical hernia repair. Large volume paracentesis, concomitant peritoneovenous shunting with herniorrhaphy and transjugular intrahepatic portosystemic shunting can be applied to control refractory ascites. Emergency repair of umbilical hernias is indicated in cirrhotic patients with ascites when complications develop.
How does cluster location and intellectual capital impact entrepreneurial success within high-growth firms?
Authors: Temouri Yama , Pereira Vijay , Muschert Glenn W. , Ramiah Vikash , Babula Michael
Published: December 2020

Purpose

The purpose of this paper is to examine the role of intellectual capital and knowledge management in the entrepreneurial success of firms through a research model which is subsequently tested empirically.

Design/methodology/approach

The paper utilises the knowledge-based perspective to formulate three sets of hypotheses which the authors subsequently test in the empirical analysis on data derived from the Orbis database, which includes over 1-million data points from approximately 240,000 firms across 174 geographic subdivisions of economic regions in 14 European countries, from 2010 to 2013. The analysis utilises probit model regressions on the likelihood of becoming a high-growth firms (HGF), in the presence of a number of control factors including firm age, firm size, tangible assets, foreign ownership, competitiveness (via Herfindahl index), return on assets, industry sector and country location.

Findings

Findings from our analysis suggest that investments in intangible assets and generating patents from research and development (R&D) efforts is positively related to the likelihood of becoming a HGF. In addition, cluster membership seems to be a positive influence on becoming a HGF, however the moderating impact of intangible investments and patents is less clear in clusters.

Research limitations/implications

The authors highlight the mixed effects from cluster membership and the beneficial impact from intellectual capital and knowledge management in achieving high growth firm status.

Originality/value

The authors derive and test our research model, which outlines the interrelationship of the various factors leading to firms becoming high-growth firms. The results suggest that there may be further fruitful ground for future investigation in the intersections of knowledge management and intellectual capital concepts within entrepreneurial contexts.
Water availability rather than temperature control soil fauna community structure and prey–predator interactions
Authors: Aupic‐Samain Adriane , Baldy Virginie , Delcourt Ninon , Krogh Paul Henning , Gauquelin Thierry , Fernandez Catherine , Santonja Mathieu
Published: December 2020

The ongoing climate change may strongly impact soil biodiversity with cascading effects on the processes they drive. Thus, it is of prime interest to improve our knowledge about responses by soil organisms such as collembolans to expected shifts in environmental conditions by considering communities comprising both detritivores and predators.

The aim of the present study was to evaluate how simulated climate change and predation under laboratory conditions alter a collembolan community.

To infer the impact of climate change, we applied a decreased level of soil moisture (60% vs. 30% soil water holding capacity) and an increasing air temperature (15°C vs. 25°C) to a collembolan community constituted by four species (Folsomia candida,Protaphorura fimata,Proisotoma minutaandMesaphorura macrochaeta) exhibiting distinct functional traits, for example, body size and furca presence, in the presence or absence of a predatory gamasid AcariStratiolaelaps scimitusduring 2 months in a microcosm experiment.

We observed that decreasing soil moisture altered the collembolan community with species‐specific responses. Interaction between soil moisture, temperature and predation indicates that low soil moisture reduced total collembolan abundance especially (a) by suppressing the positive effect of increasing temperature and (b) by increasing the predatory control on collembolan abundance.

These results highlight that soil moisture is the major driver of Collembola community and by consequence, a shift in climatic parameters with the ongoing climate change should strongly modify the Collembola community structure and the predator–prey interaction. Our findings are highly important since a strengthening of predation impact on Collembola prey could have major consequences on the whole soil food web being able to lead to a slowdown of key ecosystem processes they drive (e.g. litter decomposition and nutrient recycling). Finally, our study promotes the need to study more complex systems considering distinct soil‐dwelling species, their functional traits and their trophic interactions to better predict the ecosystem responses to the ongoing climate change.

A freePlain Language Summarycan be found within the Supporting Information of this article.
Short‐term apparent mutualism drives responses of aquatic prey to increasing productivity
Authors: Chaguaceda Fernando , Scharnweber Kristin , Dalman Erik , Tranvik Lars J. , Eklöv Peter
Published: December 2020

According to apparent competition theory, sharing a predator should cause indirect interactions among prey that can affect the structure and the dynamics of natural communities.

Though shifts in prey dominance and predator resource use along environmental gradients are rather common, empirical evidence on the role of indirect prey–prey interactions through shared predation particularly with increasing productivity, is still scarce.

In an 8‐week lake mesocosm experiment, we manipulated both the addition of inorganic nutrients and the presence of generalist fish predators (crucian carp, Carassius carassius L.), to test for the effects of indirect interactions through shared predation along a productivity gradient.

We found that apparent mutualism (indirect positive interaction) between benthic and pelagic prey strongly affected short‐term responses of aquatic food webs to increasing productivity in the presence of a generalist fish. Increasing productivity favoured the relative abundance of benthic prey, following trends in natural productive lake systems. This led to a shift in fish selectivity from pelagic to benthic prey driven by changes in fish behaviour, which resulted in apparent mutualism due to the lower and delayed top‐down control of pelagic prey at increasing productivity.

Our results show empirical evidence that the coupling of multiple production pathways can lead to strong indirect interactions through shared predation, whereby prey dynamics on short time‐scales are highly dependent on the foraging behaviour of generalist predators. This mechanism may play an important role in short‐term responses of food webs across environmental gradients.
A decision support tool to prioritize ballast water compliance monitoring by ranking risk of non‐indigenous species establishment
Authors: Bradie Johanna N. , Bailey Sarah A.
Published: December 2020

Despite the availability of research which has direct applications to environmental management, there is often a disconnect between scientific research and applied management that presents challenges for using academic knowledge in day‐to‐day operations by non‐scientists.

A science‐based decision support tool was developed in partnership with Canada's marine authority, Transport Canada, for use by ballast water inspectors in their daily operations to inform prioritization of ships for regulatory compliance inspections.

This science‐based tool combines information on the two primary pathway‐level predictors of species establishment success: environmental matching between source and recipient locations and propagule pressure (introduction effort), to generate risk estimates and relative rankings using data taken directly from ballast water reporting forms submitted by arriving ships.

This tool thus packages the best available scientific knowledge in such a way as to be readily accessible for day‐to‐day decision‐making. While this tool was developed for Canada, it could be applied in any country with very little, if any, modification. This tool can also be updated in the future to incorporate advances in scientific understanding of ballast‐mediated introductions of non‐indigenous species.

Synthesis and applications. Partnerships between scientists and managers are essential for ensuring that best‐available science translates into effective adaptive management. Recognizing a need to inform ballast water management compliance inspections, a tool was created that automatically estimates relative risk of establishment of non‐indigenous species for arriving ships. This information can be used by ballast water inspectors developing priorities for resource‐limited regulatory compliance inspections.
Spatial heterogeneity in soil pyrogenic carbon mediates tree growth and physiology following wildfire
Authors: Gale Nigel V. , Thomas Sean C.
Published: December 2020

Pyrogenic carbon (PyC) is a ubiquitous legacy of wildfire in terrestrial soils, yet how it affects the growth and function of regenerating plants has received little research attention.

We examined responses to a natural gradient of PyC deposition 5 years following a severe fire in a northern boreal forest, based on measurements of growth (height, basal area increment and leader extension), physiological performance (Fv/Fm) and foliar nutrition (C, N, P, K, Mg) of Pinus banksiana Lamb. We determined the concentration of PyC, expressed as a dosage (t/ha, in mineral soils collected from the rootzones of each sapling and used it as an independent factor to model trait responses to increasing PyC levels, in conjunction with measurements of soil physio‐chemical properties (pH, EC, VOC, Ash, N, P, K, Ca and Mg).

Quantification and spatial analysis of PyC reveals heterogeneous deposition across the landscape with fine‐grained patchiness at scales <0.5 m. In response to this heterogeneity, phenotypic and nutritional adjustments followed dose‐dependent response patterns. Beneficial effects of PyC on sapling growth occurred to an optimum point of ~30–60 t/ha, while declining patterns were found for trees in dosages exceeding 100 t/ha. Some traits were positively and negatively related to soil K and N, respectively, and shared strong negative associations with soil pH and volatile matter.

Synthesis. This study supports the longstanding hypothesis that soil PyC enhances growth and physiological function of fire‐adapted plants, but indicates that responses are highly dosage‐dependent, with natural levels of PyC deposition commonly exceeding an optimum point. These results also suggest that the main mechanisms for observed responses to PyC include: (a) enhanced supply of base cations, (b) immobilization of N and (c) pronounced liming. Future changes in climate are expected to increase fire frequency, particularly in circumpolar boreal forests. We predict shifts in PyC to frequently exceed the threshold resulting in reduced plant growth and ultimately ecosystem productivity.
Taking climate change into account: Non‐stationarity in climate drivers of ecological response
Authors: Bueno de Mesquita Clifton P. , White Caitlin T. , Farrer Emily C. , Hallett Lauren M. , Suding Katharine N.
Published: December 2020

Changes in the global climate system are creating increasingly non‐analogue climate conditions with expectations of non‐stationarity among climate drivers. Decoupling among climate drivers complicates the assessment of ecological response to the changing climate as characteristics that could be once treated as a suite of conditions now need to be treated as potentially independent with possible synergistic effects.

Ecologists commonly use ordination techniques (often principal component analysis; PCA) on large climate and environmental datasets to reduce a range of variables to a few axes that are uncorrelated with each other and often explain large proportion of the variation in the original data. However, non‐stationarity, with correlations among variables changing over time, can affect this approach. Here, we use a 37‐year climate dataset from the Niwot Ridge Long Term Ecological Research site (Colorado, USA) to present the use of both moving window principal component analysis and moving window correlation analysis to determine non‐stationarity in climate data.

Relationships among climate variables and between input variables and PCA axes changed over time; this obscured interpretation of relationships between PCA axes and an ecological response (plant biomass), suggesting that one‐time PCA for environmental variables may lead to inappropriate inferences.

Synthesis. Care must be taken in analysing climate–ecological relationships when predictor variables exhibit non‐stationarity. We present a conceptual decision‐making tree to help ecologists consider when to use PCA and extract axis scores or use alternative approaches for incorporating non‐stationarity into subsequent analysis, including testing variables individually to aid in interpretation, break point analyses and averaging PC scores.
Different functional characteristics can explain different dimensions of plant invasion success
Authors: Liao Huixuan , Pal Robert W. , Niinemets Ülo , Bahn Michael , Cerabolini Bruno E. L. , Peng Shaolin
Published: December 2020

The success of invasive plant species can be evaluated using different dimensions, such as, range size, abundance and impact. These different dimensions do not always covary but are rarely separated, suggesting an urgency to disentangle the functional mechanisms behind them.

A dataset of leaf traits and four dimensions of invasion success (i.e. range size, local abundance, impact on native plant abundance and impact on native plant diversity) were compiled for 395 non‐native plant species in the US and Europe. Associations among dimensions of invasion success and between leaf traits and dimensions were analysed with general linear models (LMs) and supplemented by phylogenetic generalized least square (PGLS) models, which control for the phylogenetic relatedness across species.

The pair‐wise associations between most pairs of invasion dimensions were weak or neutral. The only exception was the association between impact on native plant abundance and impact on native plant diversity, which was strongly positive. Traits of species that have large range sizes were associated with a high metabolic rate; whereas, traits of species that were abundant or had a strong impact at the local scale were associated with low metabolic rate. In addition, traits of species with a large range size or having strong impacts on native plant abundance were associated with acquisitive strategies; whereas, traits of species with a high local abundance or strong impacts on native plant diversity were associated with conservative strategies.

Synthesis. Different dimensions of invasion success were associated with different functional traits. Invasion success at the regional scale was related to traits that promote rapid colonization; whereas, invasion success at the local scale was related to traits that are potentially less preferred by herbivores. Some locally successful invaders even possessed traits that facilitate a high stress tolerance and conservative strategy, which were similar to locally abundant native species. Therefore, an ambiguous definition of ‘invasion success’ in mechanism‐related studies may produce inconsistent or even controversial conclusions, highlighting the importance of separately studying different dimensions of invasion success.
A randomized control trial of duloxetine and gabapentin in painful diabetic neuropathy
Authors: Khasbage Sameer , Shukla Ravindra , Sharma Praveen , Singh Surjit
Published: December 2020

Background

To analyze the efficacy and safety of duloxetine and gabapentin in painful diabetic neuropathy (PDN).

Methods

A randomized, open‐label, active control, 12‐week trial was conducted. A total of 86 participants were randomized in 1:1 ratio into gabapentin 300 mg and duloxetine 60 mg groups. The primary efficacy objective was comparison of mean change in Visual Analogue Scale (VAS) (0‐100 points) scores between duloxetine and gabapentin. The symptom scores and adverse events were assessed as secondary outcomes.

Results: Statistically significant (P value<.001) improvement was observed in VAS scores in both duloxetine group and gabapentin group at 12 weeks as compared to baseline. However, no significant difference in VAS scores between duloxetine and gabapentin. Similar improvement in diabetic neuropathy symptoms (DNS), diabetic neuropathy examination (DNE), and neuropathic disability score (NDS) was observed in either group over 12 weeks. There were no significant differences in DNS (P = 0.578), DNE (P = 0.410), and NDS (P = 0.071) scores between the two treatment groups. The overall safety evaluation of both duloxetine and gabapentin were similar. The most common adverse events reported were gastrointestinal.

Conclusion

The results indicated that both drugs were effective for the symptomatic relief from PDN and had similar efficacy. Follow‐up of patients was only for 12 weeks and therefore the long‐term efficacy and safety of the study drugs could not be assessed.
Motivating Managers to Invest in Accounting Quality: The Role of Conservative Accounting*
Authors: Ewert Ralf , Wagenhofer Alfred
Published: December 2020

Although internal control over financial reporting has gained increasing regulatory attention, its enforcement is far from perfect; thus, firm‐specific incentives to management become important to increase the quality of financial reports. We study how owners can motivate managers to invest in accounting quality even though it is costly to the managers. Using an agency model, we establish that a sufficiently conservative accounting system (which understates performance) is necessary to induce a manager to invest in accounting quality, and more conservatism increases this investment. The reason is that higher accounting quality mitigates the expected reduction of the manager's compensation from conservatively measured performance. Higher accounting quality makes the performance measure more precise, and the owner optimally lowers incentives, even though that entails some loss of productivity. In total, more conservatism increases both firm value and accounting quality. Our findings suggest that striving for neutral accounting can counteract incentives to improve accounting quality, and they provide support to using conservatism as a metric of financial reporting quality in empirical studies.
Clinical impact of chronic substance abuse in a Norwegian ICU‐population
Authors: Tollisen K. H. , Hadley C. L. , Bjerva M. , Dahl G. T. , Högvall L. M. , Sandvik L. , Andersen G. Ø. , Heyerdahl F. , Jacobsen D.
Published: December 2020

Background

The clinical impact of chronic substance abuse of alcohol and drugs—referred to as substance use disorders (SUD)—is often overlooked in the intensive care (ICU) setting. The aims of the present study were to identify patients with SUD—regardless of cause of admission—in a mixed Norwegian ICU‐population, and to compare patients with and without SUD with regard to clinical characteristics and mortality.

Methods

Cross‐sectional prospective study of a mixed medical and surgical ICU‐population aged ≥18 years in Oslo, Norway. Data were collected consecutively, using a questionnaire including the AUDIT‐C test, medical records and toxicology results. Patients classified with SUD were divided into the subgroups alcohol use disorders (AUD) and drug use disorders (DUD).

Results

Overall, 222 (26%) of the 861 patients included were classified with SUD; 137 (16%) with AUD and 85 (10%) with DUD. 130/222 (59%) of the SUD‐patients had substance abuse‐related cause of ICU‐admission. Compared to non‐SUD patients, DUD‐patients were younger (median age 42 vs 65 years) and had lower SAPS II scores (41 vs 46), while AUD‐patients had higher SOFA scores (8.0 vs 7.3). Overall, age‐adjusted logistic regression analysis showed similar hospital mortality for SUD‐patients and non‐SUD patients, but AUD was associated with increased mortality among medical patients and in patients with sepsis (OR 1.7 (95% CI 1.0‐2.8), and OR 2.6 (95% CI 1.1‐6.2)).

Conclusion

One in four ICU‐patients had SUD regardless of cause of admission. Alcohol use disorder was associated with increased mortality in medical patients and in patients with sepsis.