bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the trade-off between liquidity, risk and return under sectoral diversification across distinct economic settings
Authors: Henriques Carla , Neves Elisabete
Published: May 2021

Purpose

This paper aims to explore the trade-off between liquidity, risk and return under sectoral diversification across distinct economic settings and investment strategies.

Design/methodology/approach

A novel multi-objective portfolio model is proposed to assess investment decisions under sectoral diversification, where the objective functions and constraints are interval-valued. The objective functions used are risk minimization (through the semi-absolute deviation measure of risk), maximization of liquidity (using turnover as a proxy) and the maximization of logarithmic return. Besides coherence constraints (imposing that the sum of the percentages of investment assigned to each stock should be equal to 100%), constraints regarding the maximum proportion of capital that can be invested (ensuring a minimum level of diversification) and cardinality constraints (to account for transaction costs) are also imposed.

Findings

Besides the trade-off between return and risk, the study findings highlight a trade-off between liquidity and return and a positive relationship between risk and liquidity. Under an economic crisis scenario, the trade-off between return and liquidity is reduced. With the economic recovery, the levels of risk increase when contrasted with the setting of the economic crisis. The highest liquidity levels are reached with the economic boom, whereas the highest returns are obtained with the economic recession.

Originality/value

This paper suggests a new modeling approach for assessing the trade-offs between liquidity, risk and return under different scenarios and investment strategies. A new interactive procedure inspired on the reference point approach is also proposed to obtain possibly efficient portfolios according to the investor's preferences. Regarding previous approaches suggested in the literature, this new procedure allows obtaining both supported and unsupported efficient solutions when cardinality constraints are included.
Optimization of delay time and environmental pollution in scheduling of production and transportation system: a novel multi-society genetic algorithm approach
Authors: Moghimi Mostafa , Beheshtinia Mohammad Ali
Published: May 2021

Purpose

The purpose of this study is to investigate the optimization of the scheduling of production and transportation systems while considering delay time (DT) and environmental pollution (EP) concurrently. To this, an integrated multi-site manufacturing process using a cumulative transportation system is investigated. Additionally, a novel multi-society genetic algorithm is developed to reach the best answers.

Design/methodology/approach

A bi-objective model is proposed to optimize the production and transportation process with the objectives of minimizing DT and EP. This is solved by a social dynamic genetic algorithm (SDGA), which is a novel multi-society genetic algorithm, in scenarios of equal and unequal impacts of each objective. The impacts of each objective are calculated by the analytical hierarchical process (AHP) using experts’ opinions. Results are compared by dynamic genetic algorithm and optimum solution results.

Findings

Results clearly depict the efficiency of the proposed algorithm and model in the scheduling of production and transportation systems with the objectives of minimizing DT and EP concurrently. Although SDGA’s performance is acceptable in all cases, in comparison to other genetic algorithms, it needs more process time which is the cost of reaching better answers. Additionally, SDGA had better performance in variable weights of objectives in comparison to itself and other genetic algorithms.

Research limitations/implications

This research is an improvement which allows both society and industry to elevate the levels of their satisfaction while their social responsibilities have been glorified through assuaging the concerns of customers on distribution networks’ emission, competing more efficient and effective in the global market and having the ability to make deliberate decisions far from bias. Additionally, implications of the developed genetic algorithm help directly to the organizations engaged with intelligent production and/or transportation planning which society will be merited indirectly from their outcomes. It also could be utilitarian for organizations that are engaged with small, medium and big data analysis in their processes and want to use more effective and more efficient tools.

Originality/value

Optimization of EP and DT are considered simultaneously in both model and algorithm in this study. Besides, a novel genetic algorithm, SDGA, is proposed. In this multi-society algorithm, each society is focused on a particular objective; however, in one society all the feasible answers will have been integrated and optimization will have been continued.
Managing bullying in the workplace: a model of servant leadership, employee resilience and proactive personality
Authors: Ahmad Saima , Islam Talat , Sohal Amrik Singh , Wolfram Cox Julie , Kaleem Ahmad
Published: May 2021

Purpose

This paper develops and tests a model for managing workplace bullying by integrating employee perceived servant leadership, resilience and proactive personality. Specifically, this paper explores servant leadership as an inhibitive factor for workplace bullying, both directly and indirectly in the presence of employee resilience as a mediator. It further explores whether proactive personality moderates the indirect relationship.

Design/methodology/approach

This is an empirical study based on analysis of survey data collected from 408 employees working in services and manufacturing sector organisations in Pakistan. Structural equation modelling was used to test the research model.

Findings

Structural equation modelling results support the proposition that servant leadership helps in discouraging workplace bullying, both directly and indirectly, in the presence of employee resilience as a mediator. However, employee proactive personality moderates this process, such that the association between resilience and workplace bullying is stronger for individuals with high proactive personality.

Research limitations/implications

This study's findings illuminate the strong potential of servant leadership for managing workplace bullying. This potential is attributed to positive role modelling in the workplace, which may assist in building followers' resilience. This study provides evidence to support the importance of leadership in the process by which employees develop better psychological resources to combat bullying at work.

Originality/value

This is the first study that examines the direct relationship between servant leadership and bullying at work. In addition, this study introduced the mediating effect of resilience and the moderating effect of proactive personality on this relationship.
Developing twin‐specific 75‐g oral glucose tolerance test diagnostic thresholds for gestational diabetes based on the risk of future maternal diabetes: a population‐based cohort study
Authors: Hiersch L , Shah BR , Berger H , Geary M , McDonald SD , Murray‐Davis B , Guan J , Halperin I , Retnakaran R , Barrett J , Melamed N ,   for DOH‐NET (Diabetes, Obesity, Hypertension in Pregnancy Research Network), SOON (Southern Ontario Obstetrical Network) Investigators™
Published: May 2021

Objective

To develop twin‐specific outcome‐based oral glucose tolerance test (OGTT) diagnostic thresholds for GDM based on the risk of future maternal type‐2 diabetes.

Design

A population‐based retrospective cohort study (2007–2017).

Setting

Ontario, Canada.

Methods

Nulliparous women with a live singleton (n = 55 361) or twin (n = 1308) birth who underwent testing for gestational diabetes mellitus (GDM) using a 75‐g OGTT in Ontario, Canada (2007–2017). We identified the 75‐g OGTT thresholds in twin pregnancies that were associated with similar incidence rates of future type‐2 diabetes to those associated with the standard OGTT thresholds in singleton pregnancies.

Results

For any given 75‐g OGTT value, the incidence rate of future maternal type‐2 diabetes was lower for women with a twin than women with a singleton pregnancy. Using women with a negative OGTT as reference, the risk of future maternal type‐2 diabetes in twin pregnancies with a positive OGTT based on the standard OGTT thresholds (9.86 per 1000 person years, adjusted hazard ratio (aHR) 4.79, 95% CI 2.69–8.51) was lower than for singleton pregnancies with a positive OGTT (18.74 per 1000 person years, aHR 8.22, 95% CI 7.38–9.16). The twin‐specific OGTT fasting, 1‐hour and 2‐hour thresholds identified in the current study based on correlation with future maternal type‐2 diabetes were 5.8 mmol/l (104 mg/dl), 11.8 mmol/l (213 mg/dl) and 10.4 mmol/l (187 mg/dl), respectively.

Conclusions

We identified potential twin‐specific OGTT thresholds for GDM that are associated with a similar risk of future type‐2 diabetes to that observed in women diagnosed with GDM in singleton pregnancies based on standard OGTT thresholds.

Tweetable abstract

Potential twin‐specific OGTT thresholds for GDM were identified.
Suspected fibrin glue‐induced acute eosinophilic pneumonia after pulmonary resection: A case report
Authors: Kawamoto Nobutaka , Okita Riki , Hayashi Masataro , Okada Masanori , Ito Kosuke , Ikeda Eiji , Inokawa Hidetoshi
Published: May 2021

Air leakage is a common complication after pulmonary resection, and fibrin glue is used as a sealant to reduce postoperative air leakage. It is generally recognized that fibrin glue‐induced adverse events are rare. Herein, we report a rare case of suspected fibrin glue‐induced acute eosinophilic pneumonia (AEP). A 72‐year‐old man underwent right lower lobectomy and mediastinal lymph node dissection for right lower lung cancer. Fibrin glue was sprayed to cover the interlobar surface of the right upper and middle lobes. On postoperative day 10, computed tomography (CT) revealed ground‐glass shadows around the interlobar surface of the remaining lobes of the right lung. Although antibacterial drugs were administered for suspected bacterial pneumonia, fever spike, shortness of breath, and exacerbation of ground‐glass shadows were observed. Peripheral blood and bronchoalveolar lavage fluid showed increased eosinophil count, supporting the diagnosis of AEP. Pneumonia resolved after prednisolone administration. At one‐year follow‐up, CT showed no AEP recurrence. Drug‐induced pneumonia usually develops in the bilateral lung and rarely in the hemilateral lung. In this case, pneumonia was localized around the site covered with fibrin glue, suggesting fibrin glue‐induced AEP. Thus, the use of fibrin glue should be carefully considered during pulmonary resection.
Assaying lepidopteran flight directionality with non‐invasive methods that permit repeated use and release after testing
Authors: Parlin Adam F. , Stratton Samuel M. , Guerra Patrick A.
Published: May 2021

Research into lepidopteran flight behaviour using techniques such as disappearance bearing (DB) observations and flight simulator (FS) trials provide important information on how organisms orient using environmental cues. These techniques possess limitations, however, which preclude their use for rare or threatened species. DB observations limit the amount and diversity of data that can be collected from individuals. FS trials can be high risk, involving invasive, terminal procedures.

We develop a new non‐invasive tethering technique for lepidopterans, demonstrate this method using eight different species and include a video tutorial. We describe the means necessary to conduct FS trials (open‐loop assay) and test the tethered butterflies from different species in outdoor FS tests. We describe the use of DB observations for assaying the directionality of free‐flying individuals (closed‐loop assay). We test our methods using fall migratory monarch butterflies, Danaus plexippus, and examine the flight orientation of the same individuals using both assay methods.

Flight simulator and DB techniques each yield useful and complementary results when both are applied to the same individuals. Using both assays on the same individual, as part of our new ‘catch–test–release’ (CTR) method, permits the integrated acquisition of different types of behavioural information, in a manner not done previously.

The non‐invasive CTR technique has significant implications for movement research with lepidopteran species of variable conservation status or that are considered pests. Our CTR technique aids conservation science by expanding the scope of species and the questions that can be tested, as individuals are re‐released into nature unharmed after experimentation.
Guidelines improve patient outcomes in specialised mental health care: A systematic review and meta‐analysis
Authors: Setkowski Kim , Boogert Kelly , Hoogendoorn Adriaan W. , Gilissen Renske , van Balkom Anton J. L. M.
Published: May 2021

Objective

The uptake of evidence‐based guideline recommendations appears to be challenging. In the midst of the discussion on how to overcome these barriers, the question of whether the use of guidelines leads to improved patient outcomes threatens to be overlooked. This study examined the effectiveness of evidence‐based guidelines for all psychiatric disorders on patient health outcomes in specialist mental health care. All types of evidence‐based guidelines, such as psychological and medication‐focused guidelines, were eligible for inclusion. Provider performance was measured as a secondary outcome. Time to remission when treated with the guidelines was also examined.

Method

Six databases were searched until 10 August 2020. Studies were selected, and data were extracted independently according to the PRISMA guidelines. Random effects meta‐analyses were used to pool estimates across studies. Risk of bias was assessed according to the Cochrane Effective Practice and Organization of Care Review Group criteria. PROSPERO:CRD42020171311.

Results

The meta‐analysis included 18 studies (N = 5380). Guidelines showed a positive significant effect size on the severity of psychopathological symptoms at the patient level when compared to treatment‐as‐usual (TAU) (d = 0.29, 95%‐CI = (0.19, 0.40),p < 0.001). Removal of a potential outlier gave globally the same results with Cohen'sd = 0.26. Time to remission was shorter in the guideline treatment compared with TAU (HR = 1.54, 95%‐CI = (1.29, 1.84),p = 0.001, n = 3).

Conclusions

Patients cared for with guideline‐adherent treatments improve to a greater degree and more quickly than patients treated with TAU. Knowledge on the mechanisms of change during guideline‐adherent treatment needs to be developed further such that we can provide the best possible treatment to patients in routine care.
Moderators and mediators of outcomes of parents with substance use problems: further evaluation of the Parents under Pressure programme
Authors: Dawe Sharon , Harnett Paul , Gullo Matthew J. , Eggins Elizabeth , Barlow Jane
Published: May 2021

Background and aims

Family‐focused interventions can improve family functioning when parents have substance use problems. However, there has been little focus upon potential predictors of change and analysis of mechanisms of change. This study aims to identify mediators and moderators of change in a pragmatic, multi‐site, randomized controlled trial of the Parents under Pressure (PuP) programme, a family‐focused intervention for parents with substance use and other problems, and treatment‐as‐usual (TAU).

Design

Secondary analysis of data: multi‐level modelling was used to investigate moderators of treatment outcome; mediation was tested with cross‐lagged models.

Setting

Community‐based family support services in the United Kingdom.

Participants

Parents (n = 100) attending community‐based addiction services with children aged 2.5 years or younger.

Measurements

Predictors of the primary outcome, child abuse potential, were: baseline child age and gender, composite family risk score, parental substance use and parental emotional dysregulation. Mediation was tested across three time‐points with the observed variables parental emotion dysregulation and child abuse potential.

Findings

Increased child age [Z = 2.14, 95% confidence interval (CI) = 0.01, 0.33] at baseline was associated with greater reductions in child abuse potential for PuP programme participants compared with TAU. Poorer parental emotional regulation (Z = 2.48, 95% CI = –2.76, −0.32) was associated with greater reductions in child abuse potential for all participants. Parental substance use (either recent use or primary substance of concern) did not alter any treatment effects on child abuse potential. The mediation analysis showed that PuP produced greater improvements in emotional regulation at post‐treatment (P < 0.001) compared with TAU, which predicted lower child abuse potential at 6‐month follow up (P < 0.05).

Conclusions

For UK parents enrolled in a family‐focused intervention, baseline measurements of higher child age appear to be associated with greater reductions in child abuse potential at 6‐month follow‐up in PuP participants compared with treatment as usual (TAU). Poorer parental emotional regulation and, potentially, higher family risk, appears to be associated with greater reductions in child abuse potential at 6‐month follow‐up in PuP and TAU. Emotional regulation appeared to act as a mediator as improvements in parental emotional regulation post‐treatment appeared to be associated with greater reductions in child abuse potential at 6‐month follow up. Notably, participation in the PuP programme led to better parental emotional regulation compared with TAU.
Outcomes associated with the use of medications for opioid use disorder during pregnancy
Authors: Krans Elizabeth E. , Kim Joo Yeon , Chen Qingwen , Rothenberger Scott D. , James Alton Everette , Kelley David , Jarlenski Marian P.
Published: May 2021

Aim

To test the effect of the duration of medication for opioid use disorder (MOUD) use during pregnancy on maternal, perinatal and neonatal outcomes.

Design

Retrospective cohort analysis of claims, encounter and pharmacy data.

Setting

Pennsylvania, USA.

Participants

We analyzed 13 320 pregnancies among 10 741 women with opioid use disorder aged 15–44 years enrolled in Pennsylvania Medicaid between 2009 and 2017.

Measurements

We examined five outcomes during pregnancy and for 12 weeks postpartum: (1) overdose, (2) postpartum MOUD continuation, (3) preterm birth (< 37 weeks gestation), (4) term low birth weight (< 2500 g at ≥ 37 weeks) and (5) neonatal abstinence syndrome (NAS). Our primary exposure was the duration (count of weeks) of any MOUD use, including methadone or buprenorphine, during pregnancy.

Findings

Among 13 320 pregnancies, 306 (2.3%) were complicated by an overdose, 1753 (13.2%) resulted in a preterm birth and 6787 (50.9%) continued MOUD postpartum. Among infants, 874 (7.6%) were low birth weight at term and 7706 (57.9%) were diagnosed with NAS. As the duration of MOUD use increased, we found a statistically significant decrease in the rate of overdose and preterm birth, a statistically significant increase in the rate of postpartum MOUD continuation and NAS and a decline in term low birth weight. Specifically, for each additional week of MOUD, the adjusted odds of overdose decreased by 2% [adjusted odds ratio (aOR) = 0.98; 95% confidence interval (CI) = 0.97, 0.99], preterm birth decreased by 1% (aOR = 0.99; 95% CI = 0.99, 1.00), postpartum MOUD continuation increased by 95% (aOR = 1.95; 95% CI = 1.87, 2.04) and NAS increased by 41% (aOR = 1.41; 95% CI = 1.35, 1.47). The odds of term low birth weight did not change (aOR = 1.00; 95% CI = 0.99, 1.00), although the rate declined with a longer duration of MOUD use during pregnancy.

Conclusions

Longer duration of medication for opioid use disorder use during pregnancy appears to be associated with improved maternal and perinatal outcomes.
Interprofessional education between dentistry and pharmacy students: delivery, barriers and facilitating implementation
Authors: Carlisle C , Taing M‐W
Published: May 2021

Interprofessional education (IPE) between dentistry and pharmacy students is an approach to teach effective collaborative practice between a team of future health care providers. It relies on the support and motivation of students, staff and professionals to implement a variety of educational strategies and might involve evaluating student progression before and after delivery. Many barriers exist towards the implementation of IPE between dentistry and pharmacy health disciplines and outlining experiences across educational/clinical practice settings and possible solutions would assist in reducing those walls to realization. Implementation of IPE between pharmacy and dentistry undergraduate programs might lead to improved workplace collaborations and reduce medication errors, adverse events and increase in cross‐referrals. Interprofessional education within undergraduate training forms the first steps towards reducing the burden on health care systems by enabling effective collaboration to improve patient outcomes. This narrative review describes IPE strategies used between pharmacy and dentistry undergraduate disciplines to enable collaboration, discusses the barriers and facilitators towards implementing IPE, and future directions for IPE education between these two disciplines.
Opening up on airways: the purported effect of nasorespiratory obstruction on dentofacial growth
Authors: Cheung J‐LS , Dreyer C , Ranjitkar S
Published: May 2021

Nasorespiratory obstruction has been purported to influence dentofacial growth adversely. This has sparked considerable debate for decades with a resurgence in interest in ‘airway friendly orthodontics’ among both general and specialist dental practitioners. This critical review aims to evaluate the current literature relating to two questions: does nasorespiratory obstruction alter dentofacial growth, and does early intervention targeted at alleviating nasorespiratory obstruction improve dentofacial growth? The strength of association between nasorespiratory obstruction, mouth breathing and a long face is weak. The common methodological flaws in research include unblinded and cross‐sectional study designs, a lack of adequate controls, inadequate follow‐up, subjective assessments and inadequate statistical power. Vertical dentofacial growth has a strong genetic influence, which implies a relatively minor contribution of environmental factors including airway obstruction. The current evidence does not support recommending procedures, such as adenotonsillectomy and maxillary expansion, with the singular aim of negating a hyperdivergent (vertical) dentofacial growth pattern. In light of low‐quality evidence, both the World Health Organization guidelines and ethical principles dictate that greater emphasis is placed on avoiding harm and wastage of resources over alternative options. These findings call for quality improvement in undergraduate and postgraduate curricula and continuing professional development for health professionals.
A dynamic stochastic frontier approach with persistent and transient inefficiency and unobserved heterogeneity
Authors: Minviel Jean Joseph , Sipiläinen Timo
Published: May 2021

This article introduces a dynamic stochastic frontier analysis (SFA) framework with unobserved heterogeneity, persistent and transient inefficiency effects, based on recent advances in the SFA literature. The newly developed dynamic frontier model is applied on a sample of French crop‐livestock farms. The estimates provide useful insights for the estimation of the technical efficiency scores as well as for the analysis of the associations of contextual drivers, such as public subsidies and indebtedness, with technical efficiency.
Leading the way – foreign direct investment and dairy value chain upgrading in Uganda
Authors: Van Campenhout Bjorn , Minten Bart , Swinnen Johan F. M.
Published: May 2021

Driven by increased demand from both local and export markets and facilitated by far‐reaching liberalization and privatization policies, the dairy sub‐sector in Uganda has undergone significant changes in the last decade. With a comparative advantage in milk production, the southwest of Uganda has started to attract considerable Foreign Direct Investment (FDI) in processing capacity, mainly targeting the export market. As a result, processing capacity increased five‐fold and dairy became Uganda's third most important export product, coming from negligible amounts a decade earlier. In this study, we use data collected at different nodes within the value chain to identify some of the key innovations in these value chains. This is done by comparing the area that received the bulk of FDI to a similar area that did not. Furthermore, we also provide an econometric analysis that focuses on the integration of value chain actors into modern value chains more broadly defined. We find that dairy value chains are transforming rapidly, but innovations are more pronounced in areas that received the bulk of FDI. Our analysis further underscores the importance of milk collection centers, which often take the form of farmer cooperatives, in providing many of the support services that enable other actors in the value chain to produce sufficient milk, and maintain milk sanitation levels necessary for a modern export sector to emerge.
Imaging in gynecomastia
Authors: Billa Evangelia , Kanakis George A. , Goulis Dimitrios G.
Published: May 2021

Background

Gynecomastia (GM) is the benign proliferation of glandular tissue in the male breast. It is a common condition, which may occur physiologically and shows three age peaks during a male's lifespan: infancy, puberty, and senescence. An underlying pathology may be revealed in 45%–50% of adult men with GM, such as aggravating medications, systemic diseases, obesity, endocrinopathies, or malignancy.

Objective

To discuss the role of imaging in the evaluation of GM and its contribution to therapeutic decision‐making.

Materials/methods

The current literature was reviewed through PubMed, Scopus, and CENTRAL electronic databases to identify the best available evidence concerning imaging modalities in patients with GM.

Results

Most male breast lesions can be diagnosed on clinical grounds; however, in certain cases, when physical examination is inconclusive, imaging may be helpful.

Discussion

The main purpose of evaluating a patient with GM is to establish the diagnosis and differentiate true GM from pseudogynecomastia, exclude breast cancer, and detect the possible cause. GM is seen in mammography as a subareolar opacity and three mammographic patterns of GM are described: nodular, dendritic, and diffuse, corresponding to florid GM of early onset, fibrous persistent GM, and GM due to exogenous estrogen administration, respectively. In ultrasound (US), florid GM is depicted as a disk‐shaped, hypoechoic area underlying the areola, whereas echogenicity of the lesions increases as fibrosis develops. Data on the use of MRI in the evaluation of the male breast and GM are still limited. Imaging findings can be classified according to the BIRADS (breast imaging reporting and data system) based on their malignant potential.

Conclusion

Both mammography and US are sensitive and specific to diagnose GM and distinguish it from breast cancer. When clinical findings are suggestive of malignancy or imaging findings are inconclusive, a histological confirmation should be sought.
Comparison between wide‐field digital imaging system and the red reflex test for universal newborn eye screening in Brazil
Authors: da Cunha Laura Pires , Cavalcante Costa Marcelo Alexandre Agra , de Miranda Homero Augusto , Reis Guimarães Juliana , Aihara Teruo , Ludwig Cassie A. , Rosenblatt Tatiana , Callaway Natalia F. , Pasricha Malini , Al‐Moujahed Ahmad , Vail Daniel , Ji Marco H. , Kumm Jochen , Moshfeghi Darius M.
Published: May 2021

Purpose

To compare neonatal eye screening using the red reflex test (RRT) versus the wide‐field digital imaging (WFDI) system.

Methods

Prospective cohort study. Newborns (n = 380, 760 eyes) in the Maternity Ward of Irmandade Santa Casa de Misericórdia de São Paulo hospital from May to July 2014 underwent RRT by a paediatrician and WFDI performed by the authors. Wide‐field digital imaging (WFDI) images were analysed by the authors. Validity of the paediatrician’s RRT was assessed by unweighted kappa [κ] statistic, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results

While WFDI showed abnormalities in 130 eyes (17.1%), RRT was only abnormal in 13 eyes (1.7%). Wide‐field digital imaging (WFDI) detected treatable retina pathology that RRT missed including hyphema, CMV retinitis, FEVR and a vitreous haemorrhage. The sensitivity of the paediatrician’s RRT to detect abnormalities was poor at 0.77% (95% confidence interval, CI, 0.02%–4.21%) with a PPV of only 7.69% (95% CI, 1.08%–38.85%). Overall, there was no agreement between screening modalities (κ = −0.02, 95% CI, −0.05 to 0.01). The number needed to screen to detect ocular abnormalities using WFDI was 5.9 newborns and to detect treatable abnormalities was 76 newborns.

Conclusion

While RRT detects gross abnormalities that preclude visualization of the retina (i.e. media opacities and very large tumours), only WFDI consistently detects subtle treatable retina and optic nerve pathology. With a higher sensitivity than the current gold standard, universal WFDI allows for early detection and management of potentially blinding ophthalmic disease missed by RRT.
Reactance revisited: Consequences of mandatory and scarce vaccination in the case of COVID‐19
Authors: Sprengholz Philipp , Betsch Cornelia , Böhm Robert
Published: May 2021

Psychological reactance theory assumes that the restriction of valued behaviors elicits anger and negative cognitions, motivating actions to regain the limited freedom. Two studies investigated the effects of two possible restrictions affecting COVID‐19 vaccination: the limitation of non‐vaccination by mandates and the limitation of vaccination by scarce vaccine supply. In the first study, we compared reactance about mandatory and scarce vaccination scenarios and the moderating effect of vaccination intentions, employing a German quota‐representative sample (N = 973). In the preregistered second study, we replicated effects with an American sample (N = 1394) and investigated the consequences of reactance on various behavioral intentions. Results revealed that reactance was stronger when a priori vaccination intentions were low and a mandate was introduced or when vaccination intentions were high and vaccines were scarce. In both cases, reactance increased intentions to take actions against the restriction. Further, reactance due to a mandate was positively associated with intentions to avoid the COVID‐19 vaccination and an unrelated chickenpox vaccination; it was negatively associated with intentions to show protective behaviors limiting the spread of the coronavirus. Opposite intentions were observed when vaccination was scarce. The findings can help policy‐makers to curb the spread of infectious diseases such as COVID‐19.
Middle Stone Age mineral pigment procurement at Pinnacle Point 5–6 North, Western Cape province, South Africa
Authors: McGrath James R. , MacDonald Brandi L. , Stalla David
Published: May 2021

We report on a multi‐method sourcing study of 35 mineral pigment artefacts from the Middle Stone Age site of Pinnacle Point 5–6 North (PP5–6 N), dating from about 90–50 ka. The artefacts were analysed and compared with geological samples from seven sources using neutron activation analysis (NAA), and supplemented by data from X‐ray diffraction (XRD) and scanning electron microscopy (SEM). Our preliminary results suggest that the occupants of PP5–6 N likely used at least two local and one currently unidentified and possibly non‐local Fe oxide mineral pigment sources. The mineral pigment artefacts derived from the latter source(s) exhibited manganese (Mn) enrichment with concentrations well above those observed in all sampled source deposits in the study area, suggesting a distinctive formation process. The proportions of the Mn‐enriched mineral pigment artefacts within the PP5–6 N assemblage vary over time, but tend to occur at higher rates in the glacial Marine Isotope Stage (MIS) 4 deposits, which holds potential implications for changes in the use of sources over time, increased mobility or increased exchange during this period.
Go beyond tokens: Number and type both matter
Authors: Wang Yu , Luo Xiaoyi , Wang Tienan , Hu Die
Published: May 2021

Drawing upon token theory and critical mass theory, this study examines whether all female directors are equally considered as tokens. We argue that inside female directors are less likely than outside female directors to be considered as tokens because they are more powerful and influential. Using a 10‐year sample of Chinese publicly listed firms on the Shanghai or Shenzhen Stock Exchanges from 2008 to 2017, we find that even one inside female director can make a significant contribution to corporate social responsibility (CSR), while outside female directors do not have a positive effect on CSR until their number reaches the critical mass (i.e., three). The results suggest that the predictions of token theory and critical mass theory vary across female director types. These findings contribute to the current literature by integrating female director typology with their numerical representation to explain their token status.
Exploring the phenomenon and ethical issues of AI paternalism in health apps
Authors: Kühler Michael
Published: May 2021

Health apps, including consumer‐oriented fitness apps, have two functions. They are supposed to monitor and promote users’ health, the latter by way of being an instance of persuasive technology. The use of artificial intelligence (AI) allows for AI health apps, i.e., health apps that act more and more autonomously when it comes to analyzing users’ health data and arriving at tailor‐made results on how to improve their health. Consequently, AI health apps seem to gain a paternalistic potential. This is a game‐changer, for corresponding issues of paternalism can then no longer be traced back to human engineers. Instead, the paternalizing party just is the AI system. Hence, AI health apps lead to the novel issue of AI paternalism in health care. In this paper, I explore this novel phenomenon and its ethical implications. Firstly, I discuss from a critical perspective whether the notion of AI paternalism makes (conceptual) sense to begin with. Unsurprisingly, I argue that it does and how so. Secondly, I briefly indicate important ethical issues that AI paternalism in health apps raise and which need to be discussed in more detail in order to judge under which conditions (certain forms of) AI paternalism might be considered acceptable, if at all.
Exploring group size for statistical analysis of real‐time signalling experiments
Authors: Yang Liang , Zhu Xiao , Finlay David B. , Glass Michelle , Duffull Stephen B.
Published: May 2021

Background and Purpose

Classical pharmacological bioassays generally use observed effects from a concentration series, at a single equilibrium time point to construct a concentration–effect curve, representing one experiment. However, if the full kinetic profile of the effect data for each concentration was evaluated simultaneously, then the analysis would be more powerful. In this work, we explore if more precise parameters can be achieved by using the full kinetic method.

Experimental Approach

We used a simulation estimation study to explore the influence of kinetic analysis on the precision of the Emax model parameter estimates (Emax and C50). We compared a full kinetic approach in which all effect versus time data from a theoretical real‐time signalling experiment were analysed simultaneously with a ‘reference’ approach. The theoretical real‐time signalling experiment was based on a previously published CB2 receptor‐binding experiment.

Key Results

The reference method with a group size (n) of 5 provided highly precise parameter estimates (coefficient of variation [CV] 3.4% for Emax and 0.72% for C50). A full kinetic method provided more precise estimates than the reference with equal or smaller group sizes. Note that group size ‘n’ here refers to the number of technical replicates rather than the number of biological replicates.

Conclusion and Implications

A full kinetic method can yield more precise parameter estimates than the equilibrium method. Such an approach may be more useful for researchers.
Consistent trade‐offs in ecosystem services between land covers with different production intensities
Authors: Gómez‐Creutzberg Carla , Lagisz Malgorzata , Nakagawa Shinichi , Brockerhoff Eckehard G. , Tylianakis Jason M.
Published: May 2021

Sustaining multiple ecosystem services across a landscape requires an understanding of how consistently services are shaped by different categories of land uses. Yet, this understanding is generally constrained by the availability of fine‐resolution data for multiple services across large areas and the spatial variability of land‐use effects on services. We systematically surveyed published literature for New Zealand (1970–2015) to quantify the supply of 17 non‐production services across 25 land covers (as a proxy for land use). We found a consistent trade‐off in the services supplied by anthropogenic land covers with a high production intensity (e.g. cropping)versusthose with extensive or no production. By contrast, forest cover was not associated with any distinct patterns of service supply. By drawing on existing research findings, we reveal complementarity and redundancy (potentially influencing resilience) in service supply from different land covers. This will guide practitioners in shaping land systems that sustainably support human well‐being.
Combining ECG and echocardiography to identify transthyretin cardiac amyloidosis in heart failure
Authors: Löfbacka Viktor , Suhr Ole B. , Pilebro Bjorn , Wixner Jonas , Sundström Torbjorn , Lindmark Krister , Anan Intissar , Lindqvist Per
Published: May 2021

Aims/background

Transthyretin amyloid (ATTR) amyloidosis cardiomyopathy is an underdiagnosed, causatively treatable cause of heart failure (HF). The aim of this study was to evaluate the efficacy of electrocardiogram (ECG) and echocardiography on patients with increased interventricular septum diameter (IVSd) to identify ATTR cardiac amyloidosis (ATTR‐CA) patients.

Methods

We investigated 58 patients with HF and an IVSd > 14 mm. Included were 33 ATTR‐CA patients and 25 controls that consisted of non‐amyloidosis HFpatients with negative 99mTc‐3,3‐diphosphono‐1,2‐propanodicarboxylic acid (DPD) scintigraphy. We used echocardiography including 2D speckle‐tracking strain and a 12‐lead ECG to test the accuracy to differentiate the groups.

Results

We found high diagnostic accuracy (98%) for differentiating ATTR‐CA from HF controls using a combination of R amplitude in ‐aVR from ECG and relative wall thickness acquired from echocardiography. With this combined model (RWT/R in ‐aVR), the sensitivity was 100% and specificity was 95% using a cut‐off value of 0.90. Furthermore, the area under the curve was 99% and the negative predictive value was 100%.

Conclusion

We found that a simple combination of ECG and echocardiographic parameters used in clinical settings was able to differentiate ATTR‐CA from other aetiologies of HF with increased interventricular septum thickness. The high sensitivity and negative predictive value render the algorithm useful for selection of patients for further diagnostic procedures for ATTR‐CA.
Impact of preterm birth on the cellular characteristics of neonatal buccal cells
Authors: Donmez Hanife Guler , Celik Hasan Tolga , Kayki Gozdem , Yigit Sule , Yurdakok Murat , Cakar Ayse Nur , Beksac Mehmet Sinan
Published: May 2021

Objective

To demonstrate the impact of preterm birth on the cytological, cytomorphometrical, and nuclear parameters of neonatal buccal smears.

Methods

This study consisted of Early Preterm Neonates (EPN; ≤34th gestational week [gw]; n = 36), Late Preterm Neonates (LPN; 34th to <37th gw; n = 46), and Term Neonates (control; ≥37th gw; n = 56). Cytological evaluation and buccal cytome assay were performed using Papanicolaou and Feulgen methods, respectively.

Results

Cytological evaluation demonstrated that smear background was cleaner (P < .05) and there were less macrophages in the control group (P < .001). Cyto‐morphometric analysis showed that the measurements of nuclear diameter, nuclear area, and nucleus‐to‐cytoplasm ratio were higher in the preterm (EPN and LPN) versus the control groups (P = .016, P < .001, and P < .001, respectively). We also demonstrated that staining intensity of the nucleus and cytoplasm were less intense in the EPN and LPN groups (P < .001). There was no statistically significant difference between the EPN and LPN groups for any parameters (P > .05). Buccal cytome assay showed that nuclear buds were more prevalent in term newborns compared to preterm neonates (P < .001).

Conclusions

Morphological and cytological properties of neonatal buccal cells are influenced by preterm birth status, and buccal smears may be used as a tool to detect biological markers of neonatal health problems.
Immunocytochemistry for diagnostic cytopathology—A practical guide
Authors: Kanber Yonca , Pusztaszeri Marc , Auger Manon
Published: May 2021

Cytological specimens, which are obtained by minimally invasive methods, are an excellent source of diagnostic material. Sometimes they are the only material available for diagnosis as well as for prognostic/predictive markers. When cytomorphology is not straightforward, ancillary tests may be required for a definitive diagnosis to guide clinical management. Immunocytochemistry (ICC) is the most common and practical ancillary tool used to reach a diagnosis when cytomorphology is equivocal, to differentiate entities with overlapping morphological features, and to determine the cell lineage and the site of origin of a metastatic neoplasm. Numerous immunomarkers are available, and some are expressed in multiple neoplasms. To rule out entities within a differential diagnosis, the use of more than one marker, sometimes panels, is necessary. ICC panels for diagnostic purposes should be customised based on the clinical context and cytomorphology, and the markers should be used judiciously to preserve material for additional tests for targeted therapies in the appropriate setting. This review offers a practical guide for the use of ICC for diagnostic cytopathology, covering the most commonly encountered non‐hematolymphoid diagnostic scenarios in various body sites.
SARS‐CoV‐2 RNA may rarely be present in a uterine cervix LBC sample at the asymptomatic early stage of COVID 19 disease
Authors: Ondič Ondrej , Černá Kateřina , Kinkorová‐Luňáčková Iva , Němcová Jana , Mejchar Bořivoj , Chytra Jan , Bouda Jiří
Published: May 2021

Objective

Currently, it is thought that uterine cervix mucosal samples present a low risk of SARS‐CoV‐2 exposure. So far, there is no evidence of SARS‐CoV‐2 detection in Papanicolaou (Pap) smears. Nevertheless, clinicians could be exposed unaware to the coronavirus while performing and handling a Pap smear. We aimed to retrospectively evaluate the presence of SARS‐CoV‐2 RNA in cervical liquid‐based cytology (LBC) samples in women who tested positive for a nasopharyngeal COVID‐19 PCR test.

Methods

From our laboratory database, we identified patients with data on a cervical cancer screening LBC sample paired with a positive nasopharyngeal COVID‐19 PCR test. Relevant LBC samples taken within an incubation period of 14 days and post‐onset RNA shedding interval of 25 days were subsequently tested for SARS‐CoV‐2 RNA using RT‐PCR tests.

Results

The study group consisted of 102 women. Of those, 23 LBC samples were tested. SARS‐CoV‐2 RNA was detected in one LBC sample from a 26‐year‐old asymptomatic woman taken six days before reporting headaches and knee arthralgia with a positive nasopharyngeal SARS‐CoV‐2 RT‐PCR test.

Conclusions

It is possible to detect SARS‐CoV‐2 RNA in cervical LBC samples at an early asymptomatic stage of COVID‐19. In general, this finding is infrequent in asymptomatic women who tested SARS‐CoV‐2 positive within an incubation of 14 days and a post‐onset RNA shedding period of 25 days. We fully support the current thinking that cervical LBC samples from asymptomatic women pose a low risk of SARS‐CoV‐2 exposure and can be handled in the frame of good microbiological practice and procedures.
An inquiry‐based, partial information exercise for teaching inventory management
Authors: Drake Matthew J. , Atkins Ryan D.
Published: May 2021

We present a classroom exercise developed to teach the tools of determining order quantities and reorder points for inventory management. This exercise presents the students with an inventory management scenario but only provides a portion of the data that are required to set order quantities and reorder points. The activity is a type of inquiry‐based, partial information exercise that requires the students to identify the data they need and request it from the instructor to develop their recommendations. It has been used successfully at both the undergraduate and graduate level to teach inventory management concepts.
An improved fatigue damage model based on the virtual load spectrum of golden section method
Authors: Liu Yating , Ye Nanhai , Hu Xiulin , Zhao Gongwei
Published: May 2021

This paper presents an improved damage model based on the construction technology of nonlinear partition virtual load spectrum by golden section method which is closer to the actual condition. In contrast to the Palmgren–Miner classical model, the result of fatigue life is more accurate. The improved damage model uses reliability instead of cumulative fatigue damage as the fatigue failure criterion. The objectives in this paper include verifying the convergence of the improved model and analyzing the influence of key parameters on fatigue life. The correction coefficient of the key parameters outperforms the traditional model which ignores the effect of stress sequence on fatigue. The fatigue life of several typical models and improved model is calculated and compared with the experimental results. It is shown that the improved model has higher accuracy and safety.
Vibration fatigue analysis of circumferentially notched specimens under coupled multiaxial random vibration environments
Authors: Luo Zhengbo , Vantadori Sabrina , Ronchei Camilla , Carpinteri Andrea , Chen Huaihai
Published: May 2021

The time domain critical plane‐based Carpinteri et al. criterion and the Theory of the Critical Distance are here combined together to propose a novel procedure for vibration fatigue analysis of circumferentially notched specimens subjected to coupled multiaxial random vibration environments. A novel metallic testing equipment is specially devised for notched specimens; meanwhile, a biaxial random vibration environment fatigue test is specially implemented on notched specimens in order to investigate how both coherence and phase shift between the auto‐spectral density functions in different directions influence the specimen fatigue life. The location of the verification point where to perform the fatigue damage estimation is determined by applying both the point method and the Carpinteri et al. criterion (for damage evaluation). The obtained results prove that the proposed procedure can provide satisfactory fatigue life estimations.