bluuebunny/crossref_metadata_2025 huggingface dataset:
Foreign direct investment and the environment: disentangling the impact of greenfield investment and merger and acquisition sales
Authors: Ashraf Ayesha , Doytch Nadia , Uctum Merih
Published: July 2020

Purpose

This study aims to examine the effect of greenfield foreign direct investment (GFDI) and mergers and acquisitions (M&A) on the environment and more specifically, on the sectoral emissions of CO2. The authors identify significant differential and income effects with various data classifications of foreign direct investment (FDI) mode of entry.

Design/methodology/approach

The authors use system generalized method of moments with instruments for income and GFDI and M&A, which allows us to control for present reverse causality and endogeneity of income and the two modes of FDI.

Findings

Evidence from the full sample reveals that GFDI increases pollution, supporting the pollution haven hypothesis, while M&As decrease pollution in line with the halo effect hypothesis. GFDI flowing into poorer countries worsens the environment, while M&As flowing to industrialized economies reduce pollution. Entry-mode effects are also present at the level of industry emissions. GFDI in developed economies decreases pollution in transport industry but increases it in poorer countries.

Practical implications

The authors demonstrate: first, a recipient country level-of-development effect: GFDI investment flowing into poorer countries has harmful effects on environment, but no significant effect in rich economies, while M&As flowing to industrialized economies have a beneficial effect to the environment, supporting the halo hypothesis. Second, the authors demonstrate a differential entry-mode effect at the industry level: GFDI in developed economies decreases pollution from transport industry, while both modes of entry in developing economies increase it.

Social implications

M&As emerge as a type of FDI that is less harmful to the environment. This is especially true in the case of developed economies. However, policymakers should oversee strictly the inbound GFDI flows and determine whether they carry “dirty” or “clean” production processes. This is the type of FDI to be regulated and scrutinized to ensure that economic development is fostered alongside environmental conservation.

Originality/value

In existing theoretical and empirical literature, little guidance is available on which mode of entry would have greater effect on the environment of the host country. This paper answers this issue by disaggregating FDI flows into GFDI and M&As and examining how each mode of entry impacts pollution in host countries. To the best of the knowledge, this is the first study that analyzes the environmental impact of the two modes of entry of FDI while disentangling the environmental Kuznets curve effect from the halo effect.
Love, money and ethnicity: money’s role in polygamous marriages among the Hui in Northwest China
Authors: NIU Xuan
Published: July 2020

Purpose

This paper aims to understand the role that money plays in polygamous marriages among the Hui ethnic group in Northwest China.

Design/methodology/approach

This study conducted in-depth interviews, focus group discussions and observations based on snowball sampling of individuals who voluntarily agreed to participate from June to December 2010, and during the summer of 2011, in Qinghai in Northwest China. Follow-up interviews and observations were conducted in 2015.

Findings

This study examines how love and money intersect and work together to sustain the participants’ polygamous marriages. The study concludes that material desires unite love with money to make love consumable. With the help of money, love between the sexes is transformed into desirable consumption through economic activities associated with leisure, gift giving and religious beliefs to articulate individualism

Originality/value

This study is the first to explore money’s role in the experience of polygamy among the Hui ethnic group in China.
Voting is a right: a decade of societal, technological and experiential progress towards the goal of remote-access voting
Authors: Rosacker Kirsten M. , Rosacker Robert E.
Published: July 2020

Purpose

This study aims to revisit and extends the work of Rosacker and Rosacker (2012) that called for increased interdisciplinary efforts to address and solve the critical issues (critical success factors) facing technologically-enabled remote-access voting platforms. It builds upon the background platform presented there, which included an historical timeline of information and communication technologies and an e-voting literature review, and extends that work by providing a state-of-the-art update and review of the rapidly changing voter environment from societal, technological and experiential studies over the past decade. Specific focus is directed at technology-enabled, remote-access voting, while also considering the important role technological advances can play in improving voter registration/confirmation procedures.

Design/methodology/approach

First, a brief review of significant societal and technological changes, including the rapid evolution of the internet of things, is undertaken to frame the discussion. Second, a sample of several technology-enabled, remote-access voting experiments are reviewed and critiqued. Third, currently available technical solutions targeting technology-enabled voter registration and vote casting are offered as the next step in the process that will ultimately lead to remote-access voting becoming widely deployed across smart devices. Finally, some contemporaneous conclusions are tendered.

Findings

Society and technology-enabled devices have each witnessed myriad changes and advancements in the second decade of the 21st century. These have led to numerous remote-access voting experiments across the globe that have overwhelmingly proven the concept of technology-enabled, remote-access voting to be viable while also identifying/reasserting issues (critical success factors) that continue to restrain its full implementation. Importantly, none of the problems identified is fatal to the concept.

Originality/value

This study considers the issue of technologically-enabled, remote-access voting focussing on the impacts associated with the portfolio of recent societal and technological advancements including the many vexing concerns and issues presented by the coronavirus pandemic. Social distancing is limiting access to the traditional methods of in-person voting for both election officials and voters bringing into question the November 2020 US national election. Calls for expanded mail voting options and the requisite federal funding required to support these efforts are increasing, widespread and broadly persuasive. Wholly missing in this debate is an exhaustive consideration and discussion of technologically enhanced, remote-access voting systems and their role in filling the void.
Foundation species promote local adaptation and fine‐scale distribution of herbaceous plants
Authors: O'Brien Michael J. , Carbonell Elisa P. , Losapio Gianalberto , Schlüter Philipp M. , Schöb Christian
Published: July 2020

Interactions among neighbours can alter demography and traits of commingled species via adaptation or plasticity in phenotypic expression, and understanding these two mechanisms in diverse communities is important for determining the ecological and evolutionary consequences of plant–plant interactions.

We reciprocally transplanted perennial species (Arenaria armerina and Festuca indigesta) among patches of two foundation shrub species and open ground to assess whether origin microsite (defined as the spatially distinct abiotic and biotic conditions associated with the two shrubs and open ground) determines germination, recruitment and growth that, in turn, promotes fine‐scale distribution of species among microsites. In addition, we tested the effect of origin microsite on traits, competitive ability, drought tolerance and outlier loci to assess whether origin microsite conditions drove differences in traits, strategies and adaptive loci.

Germination was consistently greater for seeds planted back into their origin microsite relative to seeds sourced from foreign microsites, although this effect was weakened for recruitment. Plant growth was best in open sites regardless of origin microsite. In the greenhouse, A. armerina had conserved traits within origin microsite but distinct trait values among origins, specifically plants from the most productive microsite (e.g. sufficient light, high nutrients and improved water availability) had distinct trait values. Festuca indigesta had conserved trait responses among microsites while within microsite, individuals had significant trait plasticity to different environmental conditions. The combined field and greenhouse results suggest that fine‐scale distributions are supported by local adaptation among microsites of A. armerina and phenotypic plasticity of F. indigesta.

Synthesis. Adaptation or plasticity in phenotypic expression has different implications for demographic rate and persistence of species in changing environments. Local adaptation to neighbours suggests that reductions in foundation species diversity could concomitantly lead to reduced genetic diversity of commingled species while a plastic response indicates a more robust and broad response to changing climatic and biotic conditions.
Passing the test: Lessons from a school district’s discourse of renewal before, during and after Hurricane Harvey
Authors: Lambiase Jacqueline , English Ashley E.
Published: July 2020

This case study tests the frameworks of the discourse of renewal theory and social legitimacy theory through an examination of the Fort Bend Independent School District's (Texas) communication strategies and tactics before, during and after Hurricane Harvey struck the Houston area in 2017. A focus of this case study is one characteristic of the discourse of renewal theory: the showcasing of leaders as “instrumental forces for renewal and overcoming crises” (Ulmer, Seeger & Sellnow, 2007, pp. 131–132), especially related to messages by the district's superintendent. Both the superintendent's and Fort Bend ISD’s communication efforts aligned with the tenets of renewal discourse and social legitimacy theory, with empathy an ingredient in many messages. Another important finding of this study is that the district used a discourse of renewal before, during, and after the storm, and not simply as a post‐crisis strategy. Overall, this strategy may have played a role in the district's organizational resilience—as shown through its sustained enrolment and continuing leadership team—after the second‐costliest hurricane in U.S. history.
cxr: A toolbox for modelling species coexistence in R
Authors: García‐Callejas David , Godoy Oscar , Bartomeus Ignasi
Published: July 2020

Recent developments in modern coexistence theory (MCT) have advanced our understanding of how species interactions among themselves and with the environment influence community dynamics.

Although the formulation of MCT is mathematically clear, its application to empirical cases is still challenging, which precludes its adoption by a large range of ecologists and evolutionary biologists interested in broad questions related to community assembly and the maintenance of species diversity.

We developed cxr, an r package that provides a complete toolbox for calculating species vital rates and interaction parameters, from which the user can obtain estimates of coexistence outcomes based on stabilizing niche differences and average fitness differences.

Our aim is to offer a highly versatile package to accommodate different research needs. This means that the user can define population models, use different optimization algorithms and include the effect of external covariates on species interactions, which may include environmental variables (e.g. temperature, precipitation, salinity) and biotic controls (e.g. predation, pollination, mycorrhizae).

To illustrate the functionality and versatility of cxr, we provide a complete set of population dynamic models and a dataset from a highly diverse grassland community.

By building bridges between MCT formulation and its implementation, we provide tools to obtain a deeper mechanistic understanding of how species interactions determine basic patterns such as species abundances and dominance, which are core information for many applied fields, such as conservation, restoration and invasion biology.

Finally, the package is not limited taxonomically to any particular group. The application of tools derived from MCT to a wide range of different systems can create feedbacks between empirical and theoretical studies in a way that stimulates a better understanding of the processes maintaining biodiversity.
Meritocracy in Autocracies: Origins and Consequences
Authors: Li Weijia
Published: July 2020

Prize winner of the 2020 Asia‐Pacific Prize in Economic History, awarded by the Economic History Society of Australia and New Zealand for the best dissertation in Asia‐Pacific Economic History.
The restricted reimaging of a contemporary suburb at the turn of the 21st century
Authors: Marvell Alan
Published: July 2020

The purpose of this paper is to investigate the representation of suburbia in promotional material published by housing developers at the turn of the 21st century using a case study in the UK. The millennium offered an opportunity for housing developers to construct a narrative of 21st‐century suburban living by creating new developments and a new vision of suburbia. The research reviews a series of articles identifying several key changes taking place within culture and society, in particular with reference to gender and ethnicity. Using semiotic analysis, the research identifies what was presented within the developers' promotional material does not necessarily represent wider changes occurring in society. This paper reveals that housing developers are practising a restricted reimaging of the suburb often maintaining a nostalgic view of a suburban aesthetic.
Risk to North American birds from climate change‐related threats
Authors: Bateman Brooke L. , Taylor Lotem , Wilsey Chad , Wu Joanna , LeBaron Geoffrey S. , Langham Gary
Published: July 2020

Climate change is a significant threat to biodiversity globally. Here, we assessed the risk to 544 birds in the United States from future climate change‐related threats under a mitigation‐dependent global warming scenario of 1.5°C and an unmitigated scenario of 3.0°C. Threats considered included sea level rise, human land cover conversion, and extreme weather events. We identified potential impacts to individual species by overlaying future bird ranges with threats to calculate the proportion of species' ranges affected, and mapped a place‐based index of risk based on hazard (coincident threats), exposure (potential species richness), and vulnerability (potential richness of vulnerable species). Extreme weather events had the most extensive spatial coverage and contribution to risk, but urbanization and sea level rise also had disproportionate impacts on species relative to their coverage. With unmitigated climate change, multiple coincident threats affected over 88% of the area of the conterminous United States, and 97% of species could be affected by two or more climate‐related threats. Some habitat groups will see up to 96% of species facing three or more threats. Species of conservation concern also faced more threats regardless of climate change scenario. However, climate change mitigation would reduce risk to birds from climate change‐related threats across over 90% of the US.
Improving understanding of type 2 diabetes remission: research recommendations from Diabetes UK’s 2019 remission workshop
Authors: Hopkins M. , Andrews R. , Salem V. , Taylor R. , le Roux C. W. , Robertson E. , Burns E.
Published: July 2020

Aim

To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of remission of type 2 diabetes, and provide recommendations to researchers and research funders on how best to address them. With the ultimate aim of enabling the remission of type 2 diabetes to become a possibility for more people.

Methods

A 1‐day research workshop was conducted, bringing together 31 researchers, people living with diabetes, healthcare professionals and members of staff from Diabetes UK to identify and prioritize recommendations for future research into remission of type 2 diabetes.

Results

Workshop attendees identified 10 key themes for further research. Four of these themes were prioritized for further focus: (i) understanding how to personalize lifestyle approaches based on biology, patient choice and subtypes; (ii) understanding the biology of remission; (iii) understanding the most effective approaches to implementation of lifestyle interventions; and (iv) understanding the best approaches to combining therapies (gut hormones, other drugs, lifestyle approaches and bariatric surgery).

Conclusions

This paper outlines recommendations to address the current gaps in knowledge related to remission of type 2 diabetes.
Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: A randomized clinical trial
Authors: Montero Eduardo , López Mercedes , Vidal Honorato , Martínez María , Virto Leire , Marrero Jorge , Herrera David , Zapatero Antonio , Sanz Mariano
Published: July 2020

Aim

To determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis.

Materials and Methods

In this parallel‐arm, double‐blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive either intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg every day for 3 days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on high‐sensitivity C‐reactive protein (hs‐CRP) serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipid metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy.

Results

The intention‐to‐treat population consisted of 63 subjects randomly assigned to either the MPT (n = 31) or the IPT (n = 32) group. At baseline, mean hs‐CRP was 3.9 mg/L (standard deviation [SD] = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in cardiometabolic risk profiles were detected between the groups. Adjusting for baseline hs‐CRP, sex, age, smoking status and body mass index, hs‐CRP at 6 months was 1.2 mg/L (95% CI 0.4; 2.0; P = .004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL‐1β, TNF‐α, HbA1c and blood pressure were observed in the IPT group at 3 months compared with the MPT group.

Conclusion

Effective periodontal treatment significantly reduced hs‐CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients.
Thrombocytopenia in pediatric patients on concurrent cannabidiol and valproic acid
Authors: McNamara Nancy A. , Dang Louis T. , Sturza Julie , Ziobro Julie M. , Fedak Romanowski Erin M. , Smith Garnett C. , Joshi Sucheta M. , Leber Steven M. , Carlson Martha , Robertson Patricia , Shellhaas Renée A.
Published: July 2020

In January 2019, a new plant‐derived purified cannabidiol preparation, approved by the US Food and Drug Administration, became commercially available for patients ≥2 years old with Lennox‐Gastaut syndrome or Dravet syndrome. Among our patients who were prescribed the new cannabidiol formulation, we observed several cases of thrombocytopenia and therefore embarked on this study. We conducted a single‐center systematic chart review of all pediatric patients (<21 years old) who were prescribed cannabidiol from January to August 2019. We evaluated salient features of the patients’ epilepsy syndrome, age, concurrent medications, and surveillance laboratory results before and after cannabidiol initiation. Among 87 patients, nine (10%) developed thrombocytopenia (platelet nadir range = 17 000‐108 000) following initiation of cannabidiol. Each of these nine children was on combination therapy of cannabidiol with valproic acid. Whereas no children on cannabidiol without valproic acid (0/57) developed thrombocytopenia, nine of 23 treated with combination valproic acid and cannabidiol developed platelets < 110 000/µL (P < .0001). We report a novel and clinically important side effect of thrombocytopenia in one‐third of patients treated concurrently with cannabidiol and valproic acid. If this finding is confirmed, clinicians should perform close monitoring for thrombocytopenia when adding cannabidiol to a regimen that includes valproic acid.
Elevated temperature shifts soil N cycling from microbial immobilization to enhanced mineralization, nitrification and denitrification across global terrestrial ecosystems
Authors: Dai Zhongmin , Yu Mengjie , Chen Huaihai , Zhao Haochun , Huang Yanlan , Su Weiqin , Xia Fang , Chang Scott X. , Brookes Philip C. , Dahlgren Randy A. , Xu Jianming
Published: July 2020

We assessed the response of soil microbial nitrogen (N) cycling and associated functional genes to elevated temperature at the global scale. A meta‐analysis of 1,270 observations from 134 publications indicated that elevated temperature decreased soil microbial biomass N and increased N mineralization rates, both in the presence and absence of plants. These findings infer that elevated temperature drives microbially mediated N cycling processes from dominance by anabolic to catabolic reaction processes. Elevated temperature increased soil nitrification and denitrification rates, leading to an increase in N2O emissions of up to 227%, whether plants were present or not. Rates of N mineralization, denitrification and N2O emission demonstrated significant positive relationships with rates of CO2 emissions under elevated temperatures, suggesting that microbial N cycling processes were associated with enhanced microbial carbon (C) metabolism due to soil warming. The response in the abundance of relevant genes to elevated temperature was not always consistent with changes in N cycling processes. While elevated temperature increased the abundances of the nirS gene with plants and nosZ genes without plants, there was no effect on the abundances of the ammonia‐oxidizing archaea amoA gene, ammonia‐oxidizing bacteria amoA and nirK genes. This study provides the first global‐scale assessment demonstrating that elevated temperature shifts N cycling from microbial immobilization to enhanced mineralization, nitrification and denitrification in terrestrial ecosystems. These findings infer that elevated temperatures have a profound impact on global N cycling processes with implications of a positive feedback to global climate and emphasize the close linkage between soil microbial C and N cycling.
Modeling the circular economy in environmentally extended input–output: A web application
Authors: Donati Franco , Niccolson Sidney , de Koning Arjan , Daniels Bart , Christis Maarten , Boonen Katrien , Geerken Theo , Rodrigues João F. D. , Tukker Arnold
Published: July 2020

Global environmental and resource problems ask for new ways of managing the production and consumption of resources. The implementation of new paradigms, such as the circular economy, requires decision‐makers at multiple levels to make complex decisions. For this, clear analyses and modeling of scenarios are of utmost importance. Meanwhile, as the sophistication of databases and models increases so does the need for user‐friendly tools to use them. The RaMa‐Scene web platform reduces these barriers by allowing users to visualize easily diverse impacts of implementing circular‐economy interventions. This online web platform makes use of the multi‐regional environmentally extended input–output database EXIOBASE version 3 in monetary units, which has been modified to show explicit transactions of raw materials from recycling activities.
Health specialists’ views on the needs for developing a digital gaming solution for paediatric day surgery: A qualitative study
Authors: Rantala Arja , Pikkarainen Minna , Pölkki Tarja
Published: July 2020

Aims and objectives

To describe the views on the needs of health specialists to consider when developing a digital gaming solution for children and families in a paediatric day surgery.

Background

Children's day surgery treatment is often cancelled at the last minute for various reasons, for example due to the lack of information. Digital gaming solutions could help families to be better oriented to the coming treatment. Despite the increasing demands for mHealth systems, there is not enough evidence‐based information from the health specialist perspective for developing a digital gaming solution.

Design

A qualitative descriptive study was conducted.

Methods

Health specialists (N = 15) including 11 nurses, one physiotherapist and four doctors from different areas from one university hospital in Finland were recruited using a snowball sampling method. Semi‐structured, face‐to‐face interviews were conducted in March and April 2019. The data were analysed using inductive conduct analyses. The COREQ checklist was used to report the data collection, analysis and the results.

Results

The data yielded 469 open codes, 21 sub‐categories, three upper categories and one main category. The main category the digital gaming solution to support knowledge, care and guidance in children’s day surgery included three upper categories: (a) support for preoperative information and guidance, (b) support for intra‐operative information and care, and (c) support for postoperative information, care and guidance.

Conclusion

Digital gaming solutions could be used to help children and families to be better prepared for upcoming treatments, to support communication in different languages and to improve children’s pain management after operations.

Relevance to clinical practice

Evidence‐based information is important to ensure that future digital solutions answer the real needs of the staff and patients. There is a need for families and children’s views to be taken into consideration when developing digital gaming solutions in the hospital context.
Perspective: Vitamin D deficiency and COVID‐19 severity – plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis
Authors: Rhodes J. M. , Subramanian S. , Laird E. , Griffin G. , Kenny R. A.
Published: July 2020

Background

SARS‐CoV‐2 coronavirus infection ranges from asymptomatic through to fatal COVID‐19 characterized by a ‘cytokine storm’ and lung failure. Vitamin D deficiency has been postulated as a determinant of severity.

Objectives

To review the evidence relevant to vitamin D and COVID‐19.

Methods

Narrative review.

Results

Regression modelling shows that more northerly countries in the Northern Hemisphere are currently (May 2020) showing relatively high COVID‐19 mortality, with an estimated 4.4% increase in mortality for each 1 degree latitude north of 28 degrees North (P = 0.031) after adjustment for age of population. This supports a role for ultraviolet B acting via vitamin D synthesis. Factors associated with worse COVID‐19 prognosis include old age, ethnicity, male sex, obesity, diabetes and hypertension and these also associate with deficiency of vitamin D or its response. Vitamin D deficiency is also linked to severity of childhood respiratory illness. Experimentally, vitamin D increases the ratio of angiotensin‐converting enzyme 2 (ACE2) to ACE, thus increasing angiotensin II hydrolysis and reducing subsequent inflammatory cytokine response to pathogens and lung injury.

Conclusions

Substantial evidence supports a link between vitamin D deficiency and COVID‐19 severity but it is all indirect. Community‐based placebo‐controlled trials of vitamin D supplementation may be difficult. Further evidence could come from study of COVID‐19 outcomes in large cohorts with information on prescribing data for vitamin D supplementation or assay of serum unbound 25(OH) vitamin D levels. Meanwhile, vitamin D supplementation should be strongly advised for people likely to be deficient.
Voting over selfishly optimal tax schedules: Can Pigouvian tax redistribute income?
Authors: Dai Darong
Published: July 2020

This paper studies pairwise majority voting over selfishly optimal nonlinear income tax schedules proposed by a continuum of individuals who differ in privately observable skills and make consumption comparisons, which creates a negative positional externality. It shows that the tax schedule preferred by the median skill type will win the voting contest. Given a reference consumption defined as the average consumption in the population, all skills face the same Pigouvian tax rate in the utilitarian optimum, whereas in selfish optima high skills face a Pigouvian tax rate larger than that facing low skills, generating a novel income redistributive effect. Under a constant elasticity of labor supply, two more results are obtained. First, for Pareto, Champernowne, Weibull, and lognormal skill distributions, the selfishly optimal tax schedule facing high (low) skills tends to be more progressive when the bottom‐skill's (top‐skill's) status concern intensifies. Second, it identifies the conditions under which, in the voting equilibrium, high skills face higher marginal tax rates while low skills face lower ones than what they face in the utilitarian optimum.
Health literacy and related health behaviour: a community-based cross-sectional study from a developing country
Authors: Karasneh Reema A , Al-Azzam Sayer I , Alzoubi Karem H , Rababah Lana K , Muflih Suhaib M
Published: July 2020

Objectives

The concept of health literacy (HL) is globally evolving, and understanding its nature and impact is essential for disease prevention and treatment. Therefore, we aimed in this study to assess level of HL and predictors of inadequate HL in Jordanian population as an example case of a developing country.

Method

This cross-sectional study was conducted in a public tertiary hospital and community pharmacies in Jordan. All respondents answered a questionnaire, which included demographic data, Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R), Short Test of Functional HL in Adults (S-TOFHLA), and All Aspects of HL Scale (AAHLS). Chi-square test and logistic regression analysis were conducted to determine the relationship and significant predictors for HL.

Key findings

Among 310 participants, REALM-R showed that around 27.1% had limited HL. Similar findings with S-TOFHLA and AAHLS were shown with a mean score 25.6 out of 35 (SD = 3.54, Range = 16–33) for AAHLS. Functional and critical HL were comparably low. Education level, age, living area and chronic conditions were significant predictors of HL (P < 0.05).

Conclusions

Health literacy was inadequate among Jordanians. Further research is required to assess the effect of inadequate HL on healthcare access and health outcomes. Health education programmes are required to improve HL particularly for patients with chronic diseases.
Decomposing Urban and Rural Disparities of Preventable ED Visits Among Patients With Alzheimer's Disease and Related Dementias: Evidence of the Availability of Health Care Resources
Authors: Wang Nianyang , Albaroudi Asmaa , Chen Jie
Published: July 2020

Purpose

The purpose of this study was to examine the urban and rural differences in the frequency of preventable Emergency Department (ED) visits among Alzheimer's Disease and Related Dementias (ADRD) patients, with a focus on the availability of health care resources in urban and rural areas.

Methods

Linked datasets of 2015 State Emergency Department Databases from the Healthcare Cost and Utilization Project and the Area Health Resource File were used. ED discharges of 7 states were included in our analysis. We performed a state fixed‐effect multivariable logistic regression to estimate the variation of preventable EDs by urban and rural areas. Individual characteristics and county‐level health care resources were included in the estimation. The Oaxaca decomposition was used to quantify the association of county‐level health care resources and urban/rural disparities.

Findings

Rural patients with ADRD had 1.23 higher adjusted odds (P < .001) of going to the ED for a preventable visit compared to urban counterparts. The decomposition results showed that the model specification explained 49.2% of the differences between urban and rural patients. Patient residence in a mental health professional shortage area is one of the driving factors (contributing to 27%‐48%) that explained the urban and rural disparities.

Conclusions

Our study demonstrates the importance of improving health care resources in rural areas to improve health care quality and outcomes among ADRD patients who reside in rural areas. Future research and data collection on unobserved factors, such as health care quality, will be helpful in explaining the geographic differences.
Causal versus Consequential Motives in Mental Models of Agent Social and Economic Action: Experiments, and the Neoclassical Diversion in Economics
Authors: Smith Vernon L.
Published: July 2020

Since the neoclassical revolution of the 1870s, reasoning and analysis in economic theory has been dominated by utility theory, in which: Action implies Outcome implies Utility. I describe three prominent and unexpected failures of this utilitarian framework to predict the replicable outcomes of experiments. First, in supply and demand experiments for non‐durables the predicted equilibrium obtains, but under conditions violating those thought necessary: complete information, large numbers and price‐taking behavior. The failure is in not accounting for the weak conditions under which equilibrium is actually attained. Second, in asset markets it is thought that price bubbles cannot rationally occur under complete common information on fundamental value. Replicable experiments consistently yield price bubbles in violation of this prediction. Third, in two‐person trust and ultimatum games, equilibrium predicted outcomes failed decisively and massively. The observed failures stem from modelling only the outcome consequences of actions, not “the impulses from which action proceeds.” Utility theory rigidly binds the origins of action to their outcome value, thereby trumping alternative mental models of the actor.
The What and When of Universal Perception: A Review of Early Speech Sound Acquisition
Authors: Chládková Kateřina , Paillereau Nikola
Published: July 2020

The young universal listener is an established concept in psycholinguistics. However, it is unclear what abilities universal perception entails and at what age it exists. This article aims to motivate rethinking about what it means to be a universal listener. Early and recent studies on infant speech acquisition are reviewed, considered in the light of cross‐language variation and adult performance, and finally linked to the current understanding of fetal hearing and learning. It turns out that language‐universal perception is best described as an auditory‐based perception rather than an ability to perceptually categorize the sounds of any possible language. Interestingly, at birth infants might no longer listen in a language‐universal mode because learning from the ambient speech signal begins at least several weeks before birth. Future studies need to answer the remaining questions concerning the point in perinatal development at which speech perception begins to take on language‐specific traits and for which sounds.
New insights into the population genetics of partially clonal organisms: When seagrass data meet theoretical expectations
Authors: Arnaud‐Haond Sophie , Stoeckel Solenn , Bailleul Diane
Published: July 2020

Seagrass meadows are among the most important coastal ecosystems in terms of both spatial extent and ecosystem services, but they are also declining worldwide. Understanding the drivers of seagrass meadow dynamics is essential for designing sound management, conservation and restoration strategies. However, poor knowledge of the effect of clonality on the population genetics of natural populations severely limits our understanding of the dynamics and connectivity of meadows. Recent modelling approaches have described the expected distributions of genotypic and genetic descriptors under increasing clonal rates, which may help us better understand and interpret population genetics data obtained for partial asexuals. Here, in the light of these recent theoretical developments, we revisited population genetics data for 165 meadows of four seagrass species. Contrasting shoot lifespan and rhizome turnover led to the prediction that the influence of asexual reproduction would increase along a gradient from Zostera noltii to Zostera marina, Cymodocea nodosa and Posidonia oceanica, with increasing departure from Hardy–Weinberg equilibrium (Fis), mostly towards heterozygote excess, and decreasing genotypic richness (R). This meta‐analysis provides a nested validation of this hypothesis at both the species and meadow scales through a significant relationship between Fis and R within each species. By empirically demonstrating the theoretical expectations derived from recent modelling approaches, this work calls for the use of Hardy–Weinberg equilibrium (Fis) rather than only the strongly sampling‐sensitive R to assess the importance of clonal reproduction (c), at least when the impact of selfing on Fis can be neglected. The results also emphasize the need to revise our appraisal of the extent of clonality and its influence on the dynamics, connectivity and evolutionary trajectory of partial asexuals in general, including in seagrass meadows, to develop the most accurate management strategies.
Meta‐analysis of the coral environmental stress response: Acropora corals show opposing responses depending on stress intensity
Authors: Dixon Groves , Abbott Evelyn , Matz Mikhail
Published: July 2020

As climate change progresses, reef‐building corals must contend more often with suboptimal conditions, motivating a need to understand coral stress response. Here, we test the hypothesis that there is a stereotyped transcriptional response that corals enact under all stressful conditions, functionally characterized by downregulation of growth, and activation of cell death, response to reactive oxygen species, immunity, and protein folding and degradation. We analyse RNA‐seq and Tag‐Seq data from 14 previously published studies and supplement them with four new experiments involving different stressors, totaling over 600 gene expression profiles from the genus Acropora. Contrary to expectations, we found not one, but two distinct types of response. The type A response was observed under all kinds of high‐intensity stress, was correlated between independent projects and was functionally consistent with the hypothesized stereotyped response. The consistent correlation between projects, irrespective of stress type, supports the type A response as the general coral environmental stress response (ESR), a blanket solution to severely stressful conditions. The distinct type B response was observed under lower intensity stress and was more variable among studies. Unexpectedly, at the level of individual genes and functional categories, the type B response was broadly opposite the type A response. Finally, taking advantage of the breadth of the data set, we present contextual annotations for previously unannotated genes based on consistent stress‐induced differences across independent projects.
Identification of a hormogonium polysaccharide‐specific gene set conserved in filamentous cyanobacteria
Authors: Zuniga Esthefani G. , Boateng Kelvin K. A. , Bui Nhi U. , Kurnfuli Shadi , Muthana Sawsan M. , Risser Douglas D.
Published: July 2020

Cyanobacteria comprise a phylum defined by the capacity for oxygenic photosynthesis. Members of this phylum are frequently motile as well. Strains that display gliding or twitching motility across semisolid surfaces are powered by a conserved type IV pilus system (T4P). Among the filamentous, heterocyst‐forming cyanobacteria, motility is usually confined to specialized filaments known as hormogonia, and requires the deposition of an associated hormogonium polysaccharide (HPS). The genes involved in assembly and export of HPS are largely undefined, and it has been hypothesized that HPS exits the outer membrane via an atypical T4P‐driven mechanism. Here, several novel hps loci, primarily encoding glycosyl transferases, are identified. Mutational analysis demonstrates that the majority of these genes are essential for both motility and production of HPS. Notably, most mutant strains accumulate wild‐type cellular levels of the major pilin PilA, but not extracellular PilA, indicating dysregulation of the T4P motors, and, therefore, a regulatory interaction between HPS assembly and T4P activity. A co‐occurrence analysis of Hps orthologs among cyanobacteria identified an extended set of putative Hps proteins comprising most components of a Wzx/Wzy‐type polysaccharide synthesis and export system. This implies that HPS may be secreted through a more canonical pathway, rather than a T4P‐mediated mechanism.
Improving the utility of high‐resolution manometry for the diagnosis of defecatory disorders in women with chronic constipation
Authors: Sharma Mayank , Muthyala Anjani , Feuerhak Kelly , Puthanmadhom Narayanan Susrutha , Bailey Kent R. , Bharucha Adil E.
Published: July 2020

Background

We compared the utility of existing and modified versions of high‐resolution manometry for diagnosing defecatory disorders (DD).

Methods

In 64 healthy and 136 constipated women, we compared left lateral (LL) and seated manometry, and analyzed with existing (ManoView™) and new methods, for discriminating between constipated patients with normal and prolonged rectal balloon expulsion time (BET). In both positions, the rectoanal gradient (RAG) and, for the new analysis, the pressure topography pattern during evacuation were used to discriminate between constipated patients without and with DD.

Key Results

The BET was prolonged, suggestive of a DD, in 52 patients (38%). During evacuation, rectoanal pressures and the RAG were greater in the seated than the LL position (P≤.001). The new analysis identified 4 rectoanal pressure patterns. In the seated position, the BET was associated with the pattern (P=.0001), being prolonged in, respectively, 45%, 15%, 53%, and 0% of patients with minimal change, anal relaxation, paradoxical contraction, and transmission. Within each pattern, the RAG was greater (ie, less negative, P<.0001) in patients with a normal than a prolonged BET. Compared to the ManoView™ RAG in the LL position, the integrated analysis (ie, pattern and new RAG) in the LL position (P<.01) and the seated ManoView™ gradient (P=.02) were more effective for discriminating between constipated patients without and with DD.

Conclusions & Inferences

Anorectal HRM ideally should be performed in the more physiological seated position and analyzed by a two‐tier approach, which incorporates the overall pattern followed by the rectoanal gradient. These findings reinforce the utility of manometry for diagnosing DD.
A Prospective, Multi‐Center, Clinical Trial of a 10‐kHz Spinal Cord Stimulation System in the Treatment of Chronic Pelvic Pain
Authors: Tate Jordan L. , Stauss Thomas , Li Sean , Rotte Anand , Subbaroyan Jeyakumar
Published: July 2020

Background

Chronic pelvic pain (CPP) is a debilitating condition that often leads to disability and does not respond to conventional treatments. This study was conducted to evaluate the effects of paresthesia‐independent 10‐kHz spinal cord stimulation (SCS) in subjects with CPP.

Methods

This prospective, single‐arm pilot study enrolled subjects with clinical diagnoses of CPP and mean pain scores of ≥ 5.0 cm on a 10‐cm VAS. Subjects underwent trial stimulations with 10‐kHz SCS, and those who had successful trial stimulations (≥40% pain relief) received permanently implanted devices and were followed for 12 months.

Results

Of the 21 subjects who underwent the 10‐kHz SCS trial, 17 were successful and 14 subjects received permanent implants. No neurological deficits were observed in any subjects and all adverse events (AEs) were resolved without sequelae during the study period. Over 12 months, mean VAS scores decreased by 72% from baseline, and 10 of 13 subjects (77%) were responders (≥50% pain relief). Pain remission (VAS score ≤ 3.0 cm) was reported by 8 of 13 subjects (62%), and mean pain scores on the short‐form McGill Pain Questionnaire 2 decreased as well. Pain Disability Index scores declined by 29 points, and 85% of the subjects reported satisfaction.

Conclusions

Paresthesia‐independent stimulation with 10‐kHz SCS reduced pelvic pain in subjects with CPP and was not associated with any unexpected AEs. While larger, controlled studies are needed, results of this study suggest that this therapeutic modality could potentially treat patients with CPP while improving their quality of life.
Perioperative changes in platelet count in patients with atrial septal defect
Authors: Akashi Akiko , Kamada Masahiro , Nakagawa Naomi , Ishiguchi Yukiko , Moritou Yuuji , Hara Mayuko , Eguchi Yoshimi
Published: July 2020

Background

Platelet count and function change following atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO). However, the clinical significance of these changes remains unclear. We examined changes in platelet count and mean platelet volume (MPV) before and after ASO placement, and the association between platelet count, MPV and various factors. We discussed the mechanism and clinical significance of changes in platelet count and MPV.

Methods

We evaluated 109 patients with ASD who underwent ASO placement, and we performed various analyses of platelet count and MPV.

Results

Younger patients typically had higher platelet counts and lower MPV on admission. They also had large ASDs relative to their body constitution; larger devices were therefore used. Rates of change in platelet count were higher in younger patients. There were no significant associations between platelet count or MPV before placement and mean pulmonary artery pressure, and Qp/Qs, and between the number of thrombocytopenia and presence or absence of headache or residual ASD. Platelet counts decreased on average by 21.3% for the first 3 days after ASO placement. One month after placement, platelet counts were slightly improved but remained lower than before placement. Conversely, MPV increased significantly after ASO placement and remained high a month after placement. The ASO size was the most influential factor in platelet count reduction after ASD closure by ASO.

Conclusions

One month after ASO placement, platelet counts decreased and MPVs continued to increase, suggesting that platelet consumption and new production were still occurring a month after placement.