bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the effects of dexmedetomidine and remifentanil on perioperative hemodynamics and recovery profile of patients undergoing laryngeal microsurgery
Authors: Kim Young Sung , Chang Hae Wone , Kim Heezoo , Park Jong Sun , Won Young Ju
Published: August 2021

Background:

Laryngeal microsurgery (LMS) causes hemodynamic instability and postoperative agitation, cough, pain, nausea, and vomiting. Moreover, because of a short operation time, it is associated with challenging anesthetic management. The aim of this study was to compare the usefulness of continuous administration of dexmedetomidine and remifentanil in inducing general anesthesia in patients undergoing LMS.

Methods:

This is a prospective randomized control design. Continuous intravenous infusion of dexmedetomidine (group D) or remifentanil (group R) was administered from 10 minutes before the induction of anesthesia to the end of surgery. In both groups, 1.5 mg/kg propofol and 0.5 mg/kg rocuronium were administered for the induction of anesthesia, and desflurane were titrated during the measurement of the bispectral index. We recorded hemodynamic data, recovery time, grade of cough, pain score, and analgesic requirements during the perioperative period.

Results:

61 patients were finally analyzed (30 for group D, 31 for group R). The incidence of moderate to severe postoperative sore throat was higher in group R than in group D (42% vs 10%, P = .008), and the quantity of rescue fentanyl used in post-anesthesia care unit was significantly higher in group R than in group D (23.2 ± 24.7 mg vs 3.3 ± 8.6 mg; P < .001); however, the time required for eye opening was significantly longer in group D than in group R (599.4 ± 177.9 seconds vs 493.5 ± 103.6 seconds; P = .006). The proportion of patients with no cough or single cough during extubation was comparable between the 2 groups (group D vs group R: 73% vs 70%) as was the incidence of hemodynamic instability.

Conclusion:

Although there was a transient delay in emergence time, dexmedetomidine reduced postoperative opioid use and the incidence of sore throat. Dexmedetomidine may be used as an alternative agent to opioids in patients undergoing LMS.
Impact of switching to tenofovir alafenamide on weight gain as compared to maintaining a non-tenofovir alafenamide containing regimen
Authors: Darnell Julia , Jain Sonia , Sun Xiaoying , Qin Huifang , Reynolds Timothy , Karris Maile Young , Hill Lucas A.
Published: August 2021

Evaluate the impact of switching to an anti-retroviral regimen containing tenofovir alafenamide (TAF) on weight and the development of metabolic complications compared to remaining on a non-TAF containing regimen.

Single-center retrospective case-control study.

We evaluated people living with human immunodeficiency virus (PLWH) who were on an anti-retroviral regimen not containing TAF and were switched to a regimen containing TAF between January 1, 2016 and September 30, 2018. The control group included PLWH on a TAF free regimen throughout the study period. The primary outcome was change in weight from baseline to 12 months postswitch. Secondary outcomes included percent change in weight, change in body mass index (BMI), change in BMI class, and new diagnoses of diabetes, hypertension, and hyperlipidemia (HLD) during the study period.

PLWH switched to TAF (n = 446) demonstrated significantly greater mean increase in weight compared to the control group (n = 162) (1.97 vs 0.88 kg, P = .01), however the effect was only seen in those switched from tenofovir disoproxil fumarate. Those that switched to TAF also had a significantly higher percent increase in weight, increase in BMI, and BMI class. We observed a higher rate of new diagnosis of HLD in the control group compared to the TAF switch group during the study period.

PLWH switched to TAF had greater increases in weight after 1 year as compared to those continuing on a TAF free regimen. However, this did not translate to higher rates of obesity related illnesses such as diabetes, hypertension, and HLD during the follow up period.
Effect of maternal age on maternal and perinatal outcomes including cesarean delivery following induction of labor in uncomplicated elderly primigravidae
Authors: Jeong Yeonseong , Choo Sung Pil , Yun Jisun , Kim Eui Hyeok
Published: August 2021

Age above 35 years at the time of birth is generally referred to as advanced maternal age (AMA), and it could be a risk factor for various complications besides genetic changes in the fetus. The primary outcome of this study was to determine if AMA is associated with emergent cesarean delivery (CD) following induction of labor (IOL). The secondary outcomes were a composite of adverse maternal and perinatal outcomes following IOL.

This retrospective observational study included women with singleton, live-born, cephalic, non-anomalous pregnancies undergoing IOL from 38 0/7 to 41 6/7 weeks of gestation. Mode of delivery and other maternal and neonatal outcomes were compared between women aged ≥35 (AMA) and <35 years. Multivariate logistic regression analyses were performed.

A total of 307 nulliparous women underwent IOL (≥35 years n = 73, 23.8%; <35 years n = 234, 76.2%) and among them, 252 (82.1%) delivered vaginally. The rate of CD was significantly higher in women of AMA (31.5% vs 13.7%, P = .001). Multivariable analysis showed that AMA was independently associated with CD (odds ratio 3.04, 95% confidence interval 1.55–5.96, P = .001). The rate of instrumental deliveries was higher in the AMA group (19.6% vs 8.2%, P = .043) and hemoglobin decrease during delivery was similar between the 2 groups (1.90 ± 1.25 vs 2.02 ± 1.27 mg/dL, all P > .05). Regarding neonatal outcomes, there was no difference between the 2 groups in the neonatal intensive care unit admission rate and Apgar score <7 at 5 minutes (30.3% vs 30.1% and 6.0% vs 8.2%, respectively, all P > .05). Neonatal intubation rate and severe respiratory problems were non-significantly higher in AMA (3.8% vs 2.7% and 3.4% vs 1.4%, respectively, all P > .05).

AMA was associated with an approximately three-fold increased likelihood of birth by CD and operative vaginal delivery in uncomplicated nulliparous women following IOL. However, we found no evidence that IOL in primigravid women of AMA increases adverse maternal and perinatal outcomes as compared with women aged <35 years except the high prevalence of CD and operative vaginal delivery.
Comparison of results of transcatheter femoral aortic valve replacement under local and general anesthesia
Authors: Han Xiangxiang , Liu Shidong , Wang Jialu , Chen Hao , Chen Yang , Song Bing
Published: August 2021

Background:

Traditionally, TAVR (Transcatheter Aortic Valve Replacement) has been performed under general anesthesia (GA). Thus GA facilitates the use of TEE (Transesophageal echocardiography), and the use of TEE is an important means to improve the quality of cardiac surgery and reduce postoperative complications. However, GA was also associated with prolonged mechanical ventilation, longer hospitalization and intensive care unit hours, and the need for positive inotropic agents. With increasing clinical experience and advances in transcatheter techniques, transfemoral TAVR may also be feasible under local anesthesia (LA). Studies have shown that LA can avoid hemodynamic fluctuations caused by general anesthesia and lung damage caused by positive pressure ventilation, and can also reduce medical costs.

Methods:

Two researchers independently read the titles and abstracts of the literature obtained. After excluding the studies that did not meet the inclusion criteria, they read through the full text of the remaining literatures to determine whether they truly met the inclusion criteria. When two researchers disagree on the included literature, the third researcher decides whether to include it or not. For literature with incomplete data, contact the author via email for unpublished data. The included studies were assessed by two researchers for the risk of bias, and cross-checked. Stata16.0 was used for meta-analysis. Heterogeneity was assessed by χ2 test and I2 quantification. Pooled analysis was performed by random effects model. Sensitivity analysis was performed by excluding references one by one. We will perform subgroup analysis based on data conditions.

Results:

In this study, high quality evidence was provided by selecting local anesthesia and general anesthesia during transfemoral transcatheter aortic valve replacement for patients with primary arterial stenosis.

Conclusion:

Local anesthesia provides anaesthetic-guided sedation that does not require intubation and is safe and effective. Local anesthesia may be a better alternative to TAVR under general anesthesia.

Ethics and dissemination:

The study does not require ethical approval.

INPLASY registration number:

INPLASY202170078
Reflux esophagitis in patients with chronic obstructive pulmonary disease
Authors: Kang Hyeon Hui , Seo Minji , Lee Jongmin , Ha So Young , Oh Jung Hwan , Lee Sang Haak
Published: August 2021

The relationship between chronic obstructive pulmonary disease (COPD) and reflux esophagitis (RE) was controversial. We investigated the factors influencing RE development in patients with COPD and evaluated the association between RE and AECOPD.

Patients with COPD who underwent esophagogastroduodenoscopy from January 2003 to December 2013 in St. Paul's Hospital, the Catholic University of Korea (Seoul, Korea) were enrolled retrospectively. The grade of RE was based on the Los Angeles classification and minimal change esophagitis. Body mass index, smoking history, medical history, AECOPD, pulmonary function test data, endoscopic findings, and comorbidities were reviewed.

Of a total of 218 patients with COPD, 111 (50.9%) were diagnosed with RE. None of age, sex, smoking history, or the severity of airflow limitation was associated with RE. AECOPD was not related to either the presence or severity of RE. There was no significant correlation between RE grade by Los Angeles classification and severity of airflow limitation (P = .625). Those who had RE used theophylline (P = .003) and long-acting muscarinic antagonists (P = .026) significantly more often than did controls. The use of theophylline (OR 2.05; 95% CI, 1.16–3.65, P = .014) was associated with an increased incidence of RE.

The use of theophylline might increase the risk of RE in COPD patients. RE may not be associated with airflow limitation or AECOPD.
Novel Surgical Technique for Correction of Incomplete Median Cleft Lip Deformity in Oral-Facial-Digital Syndrome Type II
Authors: Osawa Masayuki , Yamamoto Yuhei , Fujita Munezumi , Maeda Taku , Funayama Emi
Published: August 2021

Oral-facial-digital syndromes (OFDSs) represent a heterogenous group of embryonic development disorders characterized by malformations of the face, oral cavity, and extremities. Oral-facial-digital syndrome type II is an autosomal recessive disease characterized by median cleft lip, gingival frenula, cleft lobulated tongue, and polydactyly. There are few reports on surgical techniques for correction of incomplete median cleft lip. Here we describe a novel surgical method that we used to correct an incomplete median cleft lip in a 5-year-old girl with oral-facial-digital syndrome type II. She had previously undergone surgery for congenital heart disease, oral anomalies, and polydactyly. Cheiloplasty was performed at 5 years and 8 months using a surgical approach that focused on repair of the median tubercle using lateral labial elements. A reasonably good Cupid's bow and median tubercle were achieved. Our technique for surgical correction of moderate incomplete median cleft lip provides adequate philtral height, vermillion fullness, and a good-shaped Cupid's bow.
Pan-drug resistant Providencia rettgeri contributing to a fatal case of COVID-19
Authors: Mc Gann Patrick , Geringer Matthew R. , Hall Lindsey R. , Lebreton Francois , Markelz Elizabeth , Kwak Yoon I. , Johnson Sheila , Ong Ana C. , Powell Aubrey , Tekle Tsigereda , Bergman Yehudit , Simner Patricia J. , Bennett Jason W. , Cybulski Robert J. , White Brian K.
Published: August 2021

Following prolonged hospitalization that included broad-spectrum antibiotic exposure, a strain of

Providencia rettgeri

was cultured from the blood of a patient undergoing extracorporeal membrane oxygenation treatment for hypoxic respiratory failure due to COVID-19. The strain was resistant to all antimicrobials tested including the novel siderophore cephalosporin, cefiderocol. Whole genome sequencing detected ten antimicrobial resistance genes, including the metallo-β-lactamase bla
NDM-1, the extended-spectrum β-lactamase bla
PER-1, and the rare 16S methyltransferase rmtB2.
Altered cerebellar oscillations in Parkinson’s disease patients during cognitive and motor tasks
Authors: Bosch Taylor J. , Groth Christopher , Eldridge Tiffany A. , Gnimpieba Etienne Z. , Baugh Lee A. , Singh Arun
Published: August 2021

Structural and functional abnormalities in the cerebellar region have been shown in patients with Parkinson’s disease (PD). Since the cerebellar region has been associated with cognitive and lower-limb motor functions, it is imperative to study cerebellar oscillations in PD. Here, we evaluated cerebellar electroencephalography (EEG) during cognitive processing and lower-limb motor performances in PD. Cortical and cerebellar EEG were collected from 74 PD patients and 37 healthy control subjects during a 7-second interval timing task, 26 PD patients and 13 controls during a lower-limb pedaling task, and 23 PD patients during eyes-open/closed resting conditions. Analyses were focused on the mid-cerebellar Cbz electrode and further compared to the mid-occipital Oz and mid-frontal Cz electrodes. Increased alpha-band power was observed during the eyes-closed resting-state condition over Oz, but no change in alpha power was observed over Cbz. PD patients showed higher dispersion when performing the 7-second interval timing cognitive task and executed the pedaling motor task with reduced speed compared to controls. PD patients exhibited attenuated cue-triggered theta-band power over Cbz during both the interval timing and pedaling motor tasks. Connectivity measures between Cbz and Cz showed theta-band differences, but only during the pedaling motor task. Cbz oscillatory activity also differed from Oz across multiple frequency bands in both groups during both tasks. Our cerebellar EEG data along with previous magnetoencephalography and animal model studies clearly show the alteration in the cerebellar oscillations during cognitive and motor processing in PD.
White matter disruption as a cause or consequence of schizophrenia: A Mendelian randomization study
Authors: Jefsen Oskar Hougaard , Speed Maria , Friston Karl John , Østergaard Søren Dinesen , Speed Doug
Published: August 2021

Brief abstract

Schizophrenia is hypothesized to be caused by impaired functional integration in the brain, and this could hypothetically be caused by white matter disruptions, synaptic dysfunction, or both. Neuroimaging studies consistently show reduced fractional anisotropy, a measure of white matter integrity, in patients with schizophrenia. Using Mendelian randomization, we show that these white matter changes are likely to be the consequence of a primary synaptopathy in schizophrenia.
Sensitivity of wastewater-based epidemiology for detection of SARS-CoV-2 RNA in a low prevalence setting
Authors: Hewitt Joanne , Trowsdale Sam , Armstrong Bridget , Chapman Joanne R. , Carter Kirsten , Croucher Dawn , Billiau Cassandra , Sim Rosemary , Gilpin Brent J.
Published: August 2021

To assist public health responses to COVID-19, wastewater-based epidemiology (WBE) is being utilised internationally to monitor SARS-CoV-2 infections at the community level. However, questions remain regarding the sensitivity of WBE and its use in low prevalence settings. In this study, we estimated the total number of COVID-19 cases required for detection of SARS-CoV-2 RNA in wastewater. To do this, we leveraged a unique situation where, over a 4-month period, all symptomatic and asymptomatic cases, in a population of approximately 120,000, were precisely known and mainly located in a single managed isolation and quarantine facility (MIQF) building. From 9 July to 6 November 2020, 24-hr composite wastewater samples (n = 113) were collected daily from the sewer outside the MIQF, and from the municipal wastewater treatment plant (WWTP) located 5 km downstream. New daily COVID-19 cases at the MIQF ranged from 0 to 17, and for most of the study period there were no cases outside the MIQF identified. SARS-CoV-2 RNA was detected in 54.0% (61/113) at the WWTP, compared to 95.6% (108/113) at the MIQF. We used logistic regression to estimate the shedding of SARS-CoV-2 RNA into wastewater based on four infectious shedding models. With a total of 5 and 10 COVID-19 infectious cases per 100,000 population (0.005 % and 0.01% prevalence) the predicated probability of SARS-CoV-2 RNA detection at the WWTP was estimated to be 28 and 41%, respectively. When a more realistic proportional shedding model was used, this increased to 58% and 87% for 5 and 10 cases, respectively. In other words, when 10 individuals were actively shedding SARS-CoV-2 RNA in a catchment of 100,000 individuals, there was a high likelihood of detecting viral RNA in wastewater. SARS-CoV-2 RNA detections at the WWTP were associated with increasing COVID-19 cases. Our results show that WBE provides a reliable and sensitive platform for detecting infections at the community scale, even when case prevalence is low, and can be of use as an early warning system for community outbreaks.

Highlights

Over 4 months, all 0-17 new daily cases in one quarantine building, catchment 120,000 population

Wastewater tested daily at quarantine building and downstream wastewater treatment plant, WWTP

SARS-CoV-2 RNA detected in 95.6% (108/113) at the MIQF and 54.0% (61/113) at the WWTP

SARS-CoV-2 RNA detections at the WWTP associated with increasing COVID-19 cases

Probability of SARS-CoV-2 RNA detection of 87% with 0.01% total case prevalence

Graphical Abstract
Depression Remission and Response Rates and Anxiety Response as a Predictor of Depression Response in a Community ECT Clinic
Authors: VanBronkhorst Sara B. , Edwards Evonne M. , Saleem Ali A. , Evans Darci L. , Achtyes Eric D. , Nykamp Louis , Sanders William J.
Published: August 2021

Objective

To assess depression response and remission rates with electroconvulsive therapy (ECT) in a community clinic and to identify factors predicting success in treatment.

Methods

We identified 35 patients by a retrospective chart review with a diagnosis of major depressive disorder or depressive disorder not otherwise specified (according to the Diagnostic and Statistical Manual of Mental Disorders IV-TR) who were treated with an acute series of ECT at the Pine Rest ECT Clinic from March, 2014 to March, 2015. Clinical variables, demographics, depression response rates (based on Patient Health Questionnaire-9; PHQ-9), and anxiety response rates (based on Generalized Anxiety Disorder 7-item) were analyzed.

Results

Depression response (defined as ≥ 50% reduction in PHQ-9 score) and remission rates (defined as final PHQ-9 score < 5) were 54.3% and 31.4%, respectively. This was a highly treatment resistant sample, with an average of 5.3 antidepressant failures prior to initiating ECT. Logistic regression analysis found that depression response rates were predicted by an improvement in anxiety symptoms (odds ratio 1.41; 95% confidence interval, 1.11, 1.78). Additionally, patients with initial severe anxiety scores were less likely than other patients to exhibit a response in depression (p= .027).

Conclusion

Almost half of this sample of patients with treatment resistant depression did not respond to ECT in this community-based clinic. Patients who experienced a response in anxiety symptoms were more likely to experience a depression response while those with severe anxiety were less likely to respond.
Population-level survey of loss-of-function mutations revealed that background dependent fitness genes are rare and functionally related in yeast
Authors: Caudal Elodie , Friedrich Anne , Jallet Arthur , Garin Marion , Hou Jing , Schacherer Joseph
Published: August 2021

In natural populations, the same mutation can lead to different phenotypic outcomes due to the genetic variation that exists among individuals. Such genetic background effects are commonly observed, including in the context of many human diseases. However, systematic characterization of these effects at the species level is still lacking to date. Here, we sought to comprehensively survey background-dependent traits associated with gene loss-of-function (LoF) mutations in 39 natural isolates of Saccharomyces cerevisiae using a transposon saturation strategy. By analyzing the modeled fitness variability of a total of 4,469 genes, we found that 15% of them, when impacted by a LoF mutation, exhibited a significant gain- or loss-of-fitness phenotype in certain natural isolates compared to the reference strain S288C. Out of these 632 genetic background-dependent fitness genes identified, a total of 2/3 show a continuous variation across the population while 1/3 are specific to a single genetic background. Genes related to mitochondrial function are significantly overrepresented in the set of genes showing a continuous variation and display a potential functional rewiring with other genes involved in transcription and chromatin remodeling as well as in nuclear-cytoplasmic transport. Such rewiring effects are likely modulated by both the genetic background and the environment. While background-specific cases are rare and span diverse cellular processes, they can be functionally related at the individual level. All background-dependent fitness genes tend to have an intermediate connectivity in the global genetic interaction network and have shown relaxed selection pressure at the population level, highlighting their potential evolutionary characteristics.
Performance evaluation of forecasting models based on time series and machine learning techniques: an application to light fuel consumption in Brazil
Authors: Rodrigues Lucas , Rodrigues Luciano , Bacchi Mirian Rumenos Piedade
Published: August 2021

Purpose

Fuel demand forecast is a fundamental tool to guide private planning actions and public policies aim to guarantee energy supply. This paper aims to evaluate different forecasting methods to project the consumption of light fuels in Brazil (fuel used by vehicles with internal combustion engine).

Design/methodology/approach

Eight different methods were implemented, besides of ensemble learning technics that combine the different models. The evaluation was carried out based on the forecast error for a forecast horizon of 3, 6 and 12 months.

Findings

The statistical tests performed indicated the superiority of the evaluated models compared to a naive forecasting method. As the forecast horizon increase, the heterogeneity between the accuracy of the models becomes evident and the classification by performance becomes easier. Furthermore, for 12 months forecast, it was found methods that outperform, with statistical significance, the SARIMA method, that is widely used. Even with an unprecedented event, such as the COVID-19 crisis, the results proved to be robust.

Practical implications

Some regulation instruments in Brazilian fuel market requires the forecast of light fuel consumption to better deal with supply and environment issues. In that context, the level of accuracy reached allows the use of these models as tools to assist public and private agents that operate in this market.

Originality/value

The study seeks to fill a gap in the literature on the Brazilian light fuel market. In addition, the methodological strategy adopted assesses projection models from different areas of knowledge using a robust evaluation procedure.
A history of content marketing
Authors: Beard Fred , Petrotta Brian , Dischner Ludwig
Published: August 2021

Purpose

Contemporary practitioners of content marketing (CM) often suggest their discipline is an ancient one, yet mainly limit its origins to the custom-published magazines of the late 1800s. The purpose of this paper is to synthesize some of the many definitions of CM and to report the first scholarly history of its development and practice.

Design/methodology/approach

This study’s purposes led to the following research questions: To what extent were CM strategies and tactics used before the 20th century? How have the uses and characteristics of CM changed or remained the same over time? Sources included general histories focusing on the earliest uses of advertising and promotions and edited book chapters and journal articles on the histories of branding and early print advertising, marketing and advertising practices in ancient and medieval periods and the development of consumer cultures around the world.

Findings

Research findings support three conclusions: CM existed much earlier than often acknowledged; has emerged as a unique marketing discipline, strategically and tactically distinguishable from the others (e.g. advertising and sales promotion); and possesses objectives, strategies and tactics that have remained remarkably consistent in practice across the millennia.

Originality/value

The research supports several insights to the history of marketing and the practice of CM. Some of the CM strategies and tactics identified in this paper, for instance, have previously been concluded to be part of advertising’s history. Findings also reveal that many of advertising’s American pioneers actually used CM to persuade 19th-century businessmen to adopt widespread advertising. In addition, the emphasis on interactive, digital media in CM definitions offers a likely explanation for the recent enthusiasm behind CM as a response to global trends in consumer preferences and global competition, as well as why contemporary CM practitioners have often failed to recognize they are practicing a “new” discipline that has actually been in use for thousands of years.
Interpreting community enterprises’ ability to survive in depleted contexts through the Humane Entrepreneurship lens: evidence from Italian rural areas
Authors: Buratti Nicoletta , Albanese Massimo , Sillig Cécile
Published: August 2021

Purpose

Doing business in depleted contexts requires the adoption of an unconventional strategic orientation based on the involvement of the local community and driven by the attainment of economic, environmental and social goals. Previous studies have explored the specific nature of community enterprises (CEs); notwithstanding, little attention has been paid to the understanding of the strategic posture adopted by community entrepreneurs to overcome difficulties and make the business up. In this vein, the study aims to investigate how CEs operating in depleted contexts manage to survive, by successfully achieving multiple – conflicting – goals.

Design/methodology/approach

The authors adopted the Humane Entrepreneurship (HumEnt) framework as a form of institutional entrepreneurship where resources are leveraged to evolve the institutional context. This research adopts the case study strategy, focusing on Italian rural CEs.

Findings

The HumEnt approach, which takes into account both economic and non-economic and altruistic values of entrepreneurs, turned as better suited – compared to other approaches – to explain why people try to make business in such high-risk contexts. Second, the holistic approach of the HumEnt framework allowed catching up the particular mechanism that has enabled the CEs to obtain positive achievement.

Originality/value

The adoption of the HumEnt perspective enabled us to understand better the way CEs may survive and even grow where other initiatives have failed.
The effect of engagement partner workload on audit quality
Authors: Cheng Yun , Haynes Christine M. , Yu Michael D.
Published: August 2021

Purpose

Auditing studies have shifted the research focus from the audit firm level to the individual audit partner level in recent years. Motivated by the call from Lennox and Wu (2018) to explore the effect of audit partners’ characteristics on audit quality in the US, this study aims to develop a new measure of engagement partner workload (EPW), which includes both the size and number of clients audited to test the effect of EPW on audit quality. This study also examines the moderating effect of the partner firm size on audit quality.

Design/methodology/approach

To test the effect of the EPW on audit quality, this study runs multivariate regressions of EPW on each specific client’s discretionary accruals and audit report delays. This study also runs a logistic regression of EPW on clients’ probability of having small profit increases to meet performance benchmarks.

Findings

Results of the hypotheses show that partner workload is positively related to audit quality. The results indicate that partners with larger, but fewer, clients conduct higher quality audits. Further analysis indicates that the relationship between partner workload and audit quality only holds for partners from the non-Big 4 firms.

Originality/value

This study contributes to the literatures of both audit quality and audit partner characteristics, and the results complement initial research aimed at identifying US partner-related characteristics that influence audit quality.
Airline effective operations strategy during COVID-19 pandemic: across regional worldwide survey
Authors: Migdadi Yazan Khalid Abed-Allah
Published: August 2021

Purpose

This study aims to identify the effective operational strategies for airlines in a pandemic that allow them to recover and bounce back smoothly.

Design/methodology/approach

This study adopted quantitative methodology based on secondary data published by the airlines related to operational and performance indicators. The total number of airlines surveyed was 145. The sample of study covers all the following regions: Africa, Asia, Europe, the Middle East, North America and South America. The data analysis of this research passed through several phases to compare the situation before and during pandemic period.

Findings

The effective operational strategy patterns during the outbreak of the COVID-19 pandemic comprise three hybrid strategies and one scheduling strategy. It appears from these strategy models that four strategic alternatives are available for international airlines to adopt, while two strategic alternatives are available for regional airlines. The strategy alternatives for regional and international airlines are all effective, but those of the international airlines are the more effective ones.

Originality/value

Previous studies rarely adopted the theory of operations strategy configuration (emphasizing taxonomies-based perspective) and the organizational resilience theory (emphasizing capability-based perspective) to identify the effective airlines operations strategy patterns in a pandemic, that allow airlines to recover and bounce back smoothly by analyzing the practices of airlines from different geographic regions worldwide.
Visual and olfactory sensory responses of the butterfly Papilio maackii during foraging and courtship
Authors: Chen Shunan , Li Mingtao , Liu Ji , Feng Ying , Yao Jun , Shi Lei , Chen Xiaoming
Published: August 2021

Colors and chemicals are the most important cues for butterflies to localize mating partners and food. In this study, we used artificial flowers with different colors and plastic butterfly wing mimics to separate the impact of colors from other cues on foraging and courtship of the butterfly Papilio maackii. We found that males relied more on visual cues during foraging and courtship, but females responded more to olfactory signals. Males visited artificial flowers more frequently than females. However, when honey was applied on artificial flowers, the frequency of female's flower visits increased and was much higher than that of male's, suggesting that females may have stronger olfactory than visual senses. During courtship, females were passive, whereas males were very active in chasing females and driving away other males. Similar to courtship among butterflies in a natural population, males showed recognition ability to butterfly wing mimics, indicating that males could accurately identify mates using colors only without any chemical cues. We also analyzed volatiles and identified five types of male‐specific chemicals while no female‐specific chemicals were identified, suggesting that females might have used these male‐specific volatiles to recognize and accepted males during courtship. Pollination of the plant Primula sieboldii mainly depends on P. maackii, and the plant has flowers with purple and mauve colors. Coincidently, P. maackii showed color preference to blue and purple, suggesting that the butterfly and plants might have coevolved during the long course of interactions.
Trends in the surgical management of rectal prolapse: An Asian experience
Authors: Ng Yvonne Ying‐Ru , Tan Emile John Kwong Wei , Fu Cherylin Wan Pei
Published: August 2021

Background

Posterior compartment pelvic floor prolapse (PCPFP) leads to anatomical distortion and functional impairment. Definitive management involves surgery. Ventral mesh rectopexy (VMR) has gained increasing popularity in the West as it emerges as a durable approach. Existing literature and evidence on safety and efficacy of PCPFP surgery in the Asian population remains sparse. Our study aims to review our institution's experience in surgery for PCPFP.

Methods

All cases of PCPFP surgery in Singapore General Hospital between 2014 to 2019 were studied.

Results

Eighty‐three patients had surgery performed for PCPFP, with the majority (83%) in the last 3 years. Median age was 63 years and 92% were female. Most patients (64%) had obstructive defecation symptoms, while the remaining had fecal incontinence, rectal bleeding, or anal discomfort. Main anatomical indication for surgery was external rectal prolapse (48%). Other indications were rectocele and/or rectal intussusception. The majority (66%) had abdominal rectopexy, while 28 underwent Delorme's procedure. Forty‐five of the 50 VMRs were minimally invasive. Patients undergoing rectopexy were observed to be younger. Median length of stay was 3 days. Nine patients had early operative complications of which ileus was most common. Median length of follow‐up was 12 months. The majority (93%) had initial symptom satisfaction. Eleven patients had anatomical recurrence with a median length of 9 months to development. There was no significant difference in outcomes between abdominal vs perineal approach, or laparoscopic vs robotic VMR.

Conclusion

Surgery for PCPFP has gained acceptance in our Asian institution with good symptom improvement, alongside low morbidity and recurrence.
Molecular profiling and identification of prognostic factors in Chinese patients with small bowel adenocarcinoma
Authors: Pan Hongming , Cheng Huanqing , Wang Huina , Ge Weiting , Yuan Meiqin , Jiang Sujing , Wan Xiangbo , Dong Ying , Liu Zhen , Zhao Rongjie , Fang Yong , Lou Feng , Cao Shanbo , Han Weidong
Published: August 2021

Small bowel adenocarcinoma (SBA) is a rare malignancy with a poor prognosis and limited treatment options. Despite prior studies, molecular characterization of this disease is not well defined, and little is known regarding Chinese SBA patients. In this study, we conducted multigene next‐generation sequencing and 16S ribosomal RNA gene sequencing on samples from 76 Chinese patients with surgically resected primary SBA. Compared with colorectal cancer and Western SBA cohorts, a distinctive genomic profile was revealed in Chinese SBA cohorts. According to the levels of clinical actionability to targetable alterations stratified by OncoKB system, 75% of patients harbored targetable alterations, of which ERBB2, BRCA1/2, and C‐KIT mutations were the most common targets of highest‐level actionable alterations. In DNA mismatch repair–proficient (pMMR) patients, significant associations between high tumor mutational burden and specific genetic alterations were identified. Moreover, KRAS mutations/TP53 wild‐type/nondisruptive mutations (KRASmut/TP53wt/non‐dis) were independently associated with an inferior recurrence‐free survival (hazard ratio [HR] = 4.21, 95% confidence interval [CI] = 1.94‐9.14, P < .001). The bacterial profile revealed Proteobacteia, Actinobacteria, Firmicutes, Bacteroidetes, Fusobacteria, and Cyanobacteria were the most common phyla in SBA. Furthermore, patients were clustered into three subgroups based on the relative abundance of bacterial phyla, and the distributions of the subgroups were significantly associated with the risk of recurrence stratified by TP53 and KRAS mutations. In conclusion, these findings provided a comprehensive molecular basis for understanding SBA, which will be of great significance in improving the treatment strategies and clinical management of this population.
Effects of canagliflozin on major adverse cardiovascular events by baseline estimated glomerular filtration rate: Pooled Hispanic subgroup analyses from the CANVAS Program and CREDENCE trial
Authors: Weir Matthew R. , Gogate Jagadish , Damaraju C.V. , Correa‐Rotter Ricardo , Mahaffey Kenneth W.
Published: August 2021

Aim

To assess the risk of major adverse cardiovascular events (MACE) of canagliflozin in Hispanic patients with type 2 diabetes (T2D) and high cardiovascular risk or nephropathy with varying levels of kidney function.

Materials and Methods

This post hoc analysis included integrated, pooled data from the CANVAS Program and CREDENCE trial. The effects of canagliflozin versus placebo on major adverse cardiovascular events (MACE; i.e. cardiovascular death, non‐fatal myocardial infarction, and non‐fatal stroke) were assessed in subgroups by baseline estimated glomerular filtration rate (eGFR; <45, 45‐60, and >60 mL/min/1.73 m2) overall and in the Hispanic cohort. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models, with subgroup by treatment interaction terms added to test for heterogeneity.

Results

A total of 14 543 participants were included; 3029 (20.8%) self‐identified as Hispanic. In the overall population, canagliflozin reduced the risk of MACE compared with placebo (HR, 0.83; 95% CI, 0.75, 0.92), with no heterogeneity observed across eGFR subgroups (interaction P = .22). In the Hispanic cohort, canagliflozin also reduced the risk of MACE (HR, 0.71; 95% CI, 0.55, 0.92), with no heterogeneity by baseline eGFR (interaction P = .25), including among the Hispanic participants at highest risk with a baseline eGFR of less than 45 mL/min/1.73 m2.

Conclusion

Canagliflozin reduced the risk of MACE overall, and among Hispanic participants with T2D and high cardiovascular risk or nephropathy in the CANVAS Program and CREDENCE trial, without heterogeneity by baseline eGFR.
Fiber orientation dependence of tribological behavior of short carbon fiber reinforced ceramic matrix composites
Authors: Zhou Wei , Meiser Matthias , Wich Felix , Liensdorf Tom , Freudenberg Wolfgang , Li Yang , Langhof Nico , Krenkel Walter
Published: August 2021

Carbon fibers as key component in short carbon fiber reinforced ceramic matrix composites (CMCs) have obvious influence on their tribological behavior. In this work, we creatively design CMCs with five different fiber orientations, namely, randomly oriented fibers, fibers oriented parallel to the friction surface and angled at 0°, 45°, and 90° toward the sliding direction, and standing fibers that are vertical to the friction surface, to investigate fiber orientation dependence of tribological behavior of short carbon fiber reinforced ceramic matrix composites. Tribological tests of CMC brake pads mated with steel disk on a laboratory‐scale dynamometer indicate that short carbon fiber reinforced carbon−silicon carbide (C/C‐SiC) brake pads with fibers orientated at 45° show the best tribological performance among the pads with fibers unidirectionally aligned. C/C‐SiC composites with short carbon fibers randomly distributed, exhibiting excellent tribological properties, are still ideal candidates for manufacturing high performance friction materials.
Bipolar fractionated radiofrequency midface lift: A retrospective review
Authors: Martin Jennifer C. , Dokic Yelena , Munavalli Gilly , Malone Cedar Helen
Published: August 2021

Introduction

Midface rejuvenation is an important component of overall facial rejuvenation. Traditionally, midfacial skin laxity and volume loss have been addressed with surgical midfacial lifting and soft tissue augmentation with dermal fillers. We present a novel noninvasive approach to midface rejuvenation with a bipolar fractionated radiofrequency (FRF) device that addresses both volume loss and improves skin laxity.

Methods

An institutional review board‐approved retrospective review was performed and included subjects who received midfacial treatment with a bipolar FRF device. Follow‐up photographs were objectively assessed by a blinded evaluator using a validated scale, the Facial Laxity Rating Scale. Paired t tests were used to evaluate the results for statistical significance.

Results

A total of 15 subjects were included in the study. The average age was 64 and ranged from 48 to 73. The average midface laxity score prior to treatment was 5.6 and post‐treatment was 6.3 (p < 0.01).

Conclusion

Bipolar FRF is a promising noninvasive intervention for midface rejuvenation.
Metabolic changes in the cingulate gyrus, precuneus, and white matter in anorexia nervosa using multivoxel MR spectroscopy
Authors: Regnaud Alice , Boto José , Klauser Antoine , Lövblad Karl‐Olof , Vargas Maria Isabel , Lazeyras François
Published: August 2021

Background and Purpose

This study aimed to highlight anorexia nervosa‐related metabolic changes in different brain regions with different gray and white matter contents.

Methods

In a prospective study, 25 anorexic patients with mean body mass index (BMI) of 14.79 kg/m2(range 10.04–20.58) were compared with 15 healthy controls with mean BMI of 21.08 kg/m2(range 18.36–27.34). Two‐dimensional magnetic resonance spectroscopic imaging was acquired in the axial plane above the corpus callosum, including frontal, precentral, postcentral, cingular, and parietal regions, as well as the precuneus, each voxel containing gray and white matter.

Results

In the anorexic group, a significant increase of choline/creatine was observed in all brain regions except the precuneus: frontal (p= 0.009), cingulate (p= 0.001), precentral (p= 0.001), postcentral (p= 0.001), and parietal (p= 0.002); and in white and gray matter (p< 0.001). Macromolecules09/creatine was decreased in the following regions: frontal (p= 0.003), cingulate (p< 0.001), precentral (p= 0.004), and precuneus (p= 0.007), and in white and gray matter (p< 0.05). We observed significantly lower values of N‐acetyl aspartate/creatine in the frontal (p< 0.001) and precentral (p< 0.001) regions and in voxels containing more than 50% white matter (p= 0.001); and significantly lower values of myo‐inositol/creatine in the precentral (p= 0.006), postcentral (p< 0.001), and precuneus (p= 0.006) regions.

Conclusions

We observed an increase in choline/creatine in anorexics, possibly reflecting increased cell turnover; a decrease in macromolecules, which was particularly low in the cingulate and precuneus the former being known to be altered in eating disorders; and a decrease in N‐acetyl aspartate/creatine considered as a marker of neuronal density and function.
Risk and Protective Factors for Changes in Adolescent Psychosocial Adjustment During COVID‐19
Authors: Romm Katelyn F. , Park Yea Won , Hughes Jeffrey L. , Gentzler Amy L.
Published: August 2021

The current study examined (1) changes in psychosocial adjustment among adolescents completing two surveys before COVID‐19 and those completing the final survey during COVID‐19 and (2) related risk/protective factors. Participants were 208 US adolescents (Mage = 15.09, SD = 0.50, 48.8% female, 86.1% White; 40.9% COVID group) who completed longitudinal surveys assessing psychosocial adjustment and related risk/protective factors (e.g., emotion regulation, well‐being pursuits). Only adolescents completing Wave 3 during COVID‐19 experienced increases in depressive symptoms, negative affect, and isolation and decreases in positive affect and friendship. Several variables served as risk (i.e., dampening) and protective (i.e., eudaimonic and hedonic motives) factors of these changes. Findings highlight the range of factors that are distinctly associated with negative changes in adolescent adjustment during COVID‐19.
The perverse effect of environmental regulation on emissions: The role of product‐mix changes
Authors: St‐Pierre Marc , Elrod Aaron A.
Published: August 2021

We study the effect of environmental regulation (taxation) on emissions when the only available abatement method consists of product‐mix changes. Firms choose to produce one or both varieties of a product—a pollution‐intensive (dirty) and a non‐pollution‐intensive (green)—and compete in a differentiated Cournot duopoly. We characterize the equilibrium market structure as a function of the tax rate and show that increases in the tax can promote product‐mix changes that lead to a jump in emissions for some tax range, an effect we callthe perverse effect of taxation. Our work emphasizes the key role horizontal product differentiation in this process and shows that the perverse effect does not require the presence of vertical product differentiation. Further, the perverse effect of taxation is especially strong in the presence of incomplete regulation, that is, when only one of the markets is subject to taxation.