bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of low cadmium and mercury exposure with chronic kidney disease among Chinese adults aged ≥80 years: A cross-sectional study
Authors: Wei Yuan , Lyu Yuebin , Cao Zhaojin , Zhao Feng , Liu Yingchun , Chen Chen , Li Chengcheng , Gu Heng , Lu Feng , Zhou Jinhui , Wu Bing , Liu Yang , Li Juan , Shi Xiaoming
Published: December 2022

Background:

The heavy metals cadmium (Cd) and mercury (Hg) are known to be widespread environmental contaminants and high occupational exposure adversely affects the risk of chronic kidney disease (CKD). However, evidence from epidemiological studies linking low Cd and Hg exposure (or non-industrial) to the risk of progression to CKD are conflicting. This study aimed to explore the association of low Cd and Hg exposure with the risk of CKD in Chinese adults aged ≥80 years.

Methods:

The participants were recruited for the Healthy Aging and Biomarkers Cohort Study in 2017, an ongoing perspective survey conducted in longevity areas in China initially involving 3016 older adults. We used logistic regression models to estimate odds ratios (ORs) with 95% confidence intervals of CKD setting Cd and Hg as categorical variables. Logistic regression with restricted cubic spline was used to characterize a dose-response relationships between Cd or Hg concentrations and the risk of CKD in the study population.

Results:

The ORs for the risk of CKD comparing the fourth to the first quartile of blood Cd, blood Hg, urine Cd, and urine Hg were 1.77, 1.57, 2.03, and 1.50, respectively. Restricted cubic spline models showed that blood Cd and urine Hg were significantly linearly correlated with the risk of CKD, while blood Hg and urine Cd were non-linearly correlated with the risk of CKD with a steeper slope at concentrations <2.30 μg/L and 3.30 μg/g creatinine.

Conclusions:

Our findings suggest that even low Cd and Hg exposure (or non-industrial) were associated with increased risk of CKD in Chinese oldest old, although we did not find a significant multiplicative and additive interaction between Cd and Hg levels in relation to the risk of CKD.
Cutaneous Infection Caused by Mycobacterium smegmatis
Authors: Lago María Rosa , de Madrid Sara Pérez , Tena Daniel , Rodríguez Judith , Chacón Paula
Published: December 2022

Mycobacterium smegmatis is an environmental microorganism that has been rarely implicated in skin and soft tissue infections (SSTIs). In the present report, we present a cutaneous abscess associated with cellulitis that occurred after an infiltration with corticosteroids for a trochanteric bursitis. Clinical outcome was good after treatment with oral doxycycline for 6 months. The review of the literature showed that M. smegmatis has been implicated in SSTIs after trauma or surgery. The treatment was carried out with a wide variety of therapeutic regimens associated with surgery in many of them. In conclusion, M. smegmatis should be considered as a cause of SSTI, especially after trauma or surgery. M. smegmatis infections can be underdiagnosed if microbiological cultures are not incubated for a long time. The optimal therapeutic regimen for treating SSTIs remains unclear, but prolonged treatment with doxycycline can be a good option.
Delay in Time to Antibiotics for De Novo Inpatient Neutropenic Fever May Not Impact Overall Survival for Patients With a Cancer Diagnosis
Authors: Villars Jordan , Gardner Christopher A. , Zhan Tingting , Binder Adam F.
Published: December 2022

Neutropenic fever (NF) is an oncologic emergency for which expert consensus recommends that anti-pseudomonas antibiotics be administered within 60 minutes of detection. This study investigated whether delays in time to antibiotics (TTA) impacted overall survival (OS) for patients with hematological malignancies who developed inpatient NF via a retrospective cohort study of 187 de novo NF cases categorized by TTA (<1, 1–2, 2–3, 3–4 and >4 hours). OS at 180 days post-NF episode was compared using Kaplan-Meier estimates and multivariable Cox proportional hazards model. TTA did not significantly affect OS (P = 0.420). Patients with Charleston Comorbidity Indexes ≥3, a measure of overall health, had higher hazard (hazard ratio [HR] = 2.728, 95% confidence interval, 1.265-5.882, P = 0.010). TTA delays in the hospital may not be long enough to cause significant patient harm. Larger studies may be needed to detect small, but significant mortality differences.
Impact of a Clinician Incentive Program on Quality Measures Performance in a Medicare Shared Savings Accountable Care Organization
Authors: Han Jessica , Jathavedam Anita , Perepelyuk Mike , Casale Paul N.
Published: December 2022

Financial incentives are often used to encourage and reward clinicians for achieving specific outcomes; however, there is limited data on their effectiveness. This study evaluates the impact of NewYork Quality Care’s Clinician Incentive Program on improving quality measure performance over 4 years. Clinicians including primary care physicians and specialists actively opted-in to an incentive program where their quality performance was evaluated and rewarded biannually. Using Medicare Shared Savings Program data extracted for quality measures (2016–2019), this study analyzes quality measure performance between clinicians who opted-in to the program compared to those who did not. Additional analysis was performed comparing primary care clinician and specialist performance. The analysis revealed that clinicians in the incentive program significantly outperform (P < 0.05) clinicians who chose not to join the program in 6 of the 7 quality measures. In addition, the program helped facilitate discussions with clinicians more broadly in population health efforts.
Integrating biology into clinical trial design
Authors: van Amstel Rombout B.E. , van Vught Lonneke A. , Bos Lieuwe D.J.
Published: December 2022

Purpose of review

Critical care medicine revolves around syndromes, such as acute respiratory distress syndrome (ARDS), sepsis and acute kidney injury. Few interventions have shown to be effective in large clinical trials, likely because of between-patient heterogeneity. Translational evidence suggests that more homogeneous biological subgroups can be identified and that differential treatment effects exist. Integrating biological considerations into clinical trial design is therefore an important frontier of critical care research.

Recent findings

The pathophysiology of critical care syndromes involves a multiplicity of processes, which emphasizes the difficulty of integrating biology into clinical trial design. Biological assessment can be integrated into clinical trials using predictive enrichment at trial inclusion, time-dependent variation to better understand treatment effects and biological markers as surrogate outcomes.

Integrating our knowledge on biological heterogeneity into clinical trial design, which has revolutionized other medical fields, could serve as a solution to implement personalized treatment in critical care syndromes. Changing the trial design by using predictive enrichment, incorporation of the evaluation of time-dependent changes and biological markers as surrogate outcomes may improve the likelihood of detecting a beneficial effect from targeted therapeutic interventions and the opportunity to test multiple lines of treatment per patient.
Prone positioning of nonintubated patients with acute hypoxemic respiratory failure
Authors: Li Jie , Roca Oriol , Ehrmann Stephan
Published: December 2022

Purpose of review

Since the early pandemic, prone positioning has been broadly utilized for nonintubated patients (so-called ‘awake prone positioning, APP’) with coronavirus disease 2019 (COVID-19) induced acute hypoxemic respiratory failure (AHRF).

Recent findings

Numerous clinical studies have been conducted to investigate the effects of APP on oxygenation, intubation, and mortality. However, several questions remain unclear, such as the patient populations who benefit most from APP, the best length of daily duration on APP, how to improve adherence to APP, and the mechanisms of APP efficacy.

APP has been shown to improve oxygenation for patients with COVID-19 induced AHRF and is a safe treatment. However, the benefits of reducing intubation rates are only seen in moderate-to-severe patients who are undergoing HFNC treatment. In these patients, APP should be initiated early and with a target of at least 8 h/day of APP. Pillows under the body and patients-healthcare team collaboration to find the optimal position is essential to enhance patients’ adherence. Oxygenation improvement and changes in the lung ultrasound findings may help to identify those patients who are more likely to avoid the need for intubation.
The impact of the coronavirus pandemic on sedation in critical care: volatile anesthetics in the ICU
Authors: Jerath Angela , Slessarev Marat
Published: December 2022

Purpose of review

To reflect on the impact of the coronavirus pandemic on sedation for mechanically ventilated patients.

Recent findings

Shortages of intravenous sedatives during coronavirus pandemic renewed interest in using widely available inhaled anaesthetics for sedation of critically ill patients. Universally used for surgical anaesthesia, inhaled anaesthetics may offer therapeutic advantages in patients with acute lung injury with good sedation profiles, rapid clearance and lower lung inflammation in pilot trials. However, enabling ICU sedation with inhaled anaesthetics required technological and human resource innovation during the chaos of the global pandemic. The disruption of standard sedation practices is challenging during normal operations, yet pandemic facilitated innovation in this field by fostering cross-discipline collaboration supported by healthcare professionals, hospitals, research institutes and regulators.

Although further research is needed to establish the role of inhaled anaesthetics in critical care sedation toolkit, maintaining the spirit of innovation ignited during the recent coronavirus pandemic would require ongoing collaboration and streamlining of processes among healthcare, research and regulatory institutions.
Delayed graft function: current status and future directions
Authors: Swanson Kurtis J. , Bhattarai Manoj , Parajuli Sandesh
Published: December 2022

Purpose of review

Delayed graft function is a common early posttransplant event predictive of adverse outcomes including hospital readmission, impaired long-term graft function, and decreased graft and patient survival. The purpose of this review is to summarize recent literature describing delayed graft function in hopes of better understanding and managing this condition.

Recent findings

Recent research efforts have been garnered towards risk factor modification, prevention, and earlier detection of delayed graft function. In this review, we aim to summarize current innovative approaches and future directions.

Delayed graft function portends worse graft and patient outcomes. Continued research to prevent, and detect early perturbations in allograft function, and more optimally manage this disease will hopefully improve graft function, along with graft/patient survival.
Immune checkpoint inhibitors in kidney transplantation
Authors: Alzahrani Nora , Al Jurdi Ayman , Riella Leonardo V.
Published: December 2022

Purpose of review

The development of immune checkpoint inhibitor (ICI) immunotherapy has revolutionized the treatment of several cancers. Malignancies are one of the leading causes of death in solid organ transplant recipients (SOTRs). Although ICI treatment may be an effective option in treating malignancies in SOTRs, concerns about triggering allograft rejection have been raised in this population. Herein, we will review currently available data regarding patients, allograft and malignancy outcomes in SOTRs who received ICI therapy.

Recent findings

Cancer incidence is three to five-fold higher among SOTRs, compared with the general population. Skin cancer is the most prevalent cancer after transplant, followed by kidney cancer, lymphoma and Kaposi sarcoma. There are no large prospective studies evaluating ICI therapy's use for treating cancers in SOTRs. However, retrospective studies have shown that ICI treatment may be associated with improved malignancy outcomes and overall survival (OS). However, the risk of allograft rejection is high (around 40%) of whom about half lose their allograft. Maintaining higher levels of immunosuppression may be associated with a lower risk of allograft rejection, but potentially worse malignancy outcomes.

Although ICI treatment may be associated with improved patient and malignancy outcomes, the risk of allograft rejection and loss are high. Prospective studies are needed to confirm the benefits of ICI therapy in SOTRs and to evaluate the optimal immunosuppression regimen modifications, if any, to improve patient, malignancy and allograft outcomes in transplant recipients.
The ethics of donation after circulatory death organ recovery: an overview of new considerations arising from procurement practice and policy changes
Authors: Thiessen Carrie , Gordon Elisa J. , Kelly Beau , Wall Anji
Published: December 2022

Purpose of review

The aim of this study is to examine ethical issues raised by organ recovery from donors after circulatory death (DCD).

Recent findings

Recent technological developments and policy modifications have implications for evolving ethical issues related to DCD organ procurement and donation. We identify four such changes and discuss the most significant ethical issues raised by each: the use of cardiac perfusion machines and the need to develop criteria to allow prioritization for organ preservation in joint thoracic-abdominal procurements, normothermic regional perfusion and the irreversibility criterion in the definition of death, practice variability in DCD withdrawal of care and death declarations, and equitable access to donation, and changes in organ procurement organization evaluation metrics and transplant system resource utilization.

The evolution of DCD donation raises new ethical concerns that require further analysis to ensure that deceased donors, donor families and transplant recipients are treated respectfully and equitably.
The PEAK Aesthetic Consultation
Authors: Black Jenna
Published: December 2022

Aesthetic practitioners work diligently to perfect the depth of the needle injection, find the right products regimen, and create a perfect before and after visual. However, the true work of an aesthetic nurse lies in the conversations we have with our patients. Consultation may be overlooked by practitioners who are starting out and consultation is almost always the first item to be put aside by patients seeking aesthetic treatments. It is imperative for aestheticians to incorporate an effective consultation into the patient experience. The longevity of your career lives in the effectiveness of your patient consultation. This article explores the aesthetic consultation process and evaluates the importance of providing meaningful conversation that includes the patient while also managing patient expectations and creating a long-term care plan. Here, I share my own concept regarding aesthetic consultation. This concept allows me to consistently create a plan of care for my patients, while building trust and longevity in my practice. The PEAK Aesthetic Consultation process incorporates four elements: Prioritize the patient story; Education and expectations; Aesthetic treatment; and Kinetic plan.
Effects of Implementing a Self-Care Program for Adults With Lower Limb Prostheses
Authors: Agamy Heba S. , Soliman Nawal M. , Esmat Omima M. , Ibrahim Wafaa K.
Published: December 2022

An artificial replacement for a lost limb or portion of a limb, known as a prosthesis, is a tool that can assist a person to regain their independence. The aim of this project was to evaluate the effect of a self-care program for adults with lower limb prostheses. We used a quasi-experimental research design. We conducted our study at the Physical Medicine and Rehabilitation and Rheumatology Center affiliated with the Armed Forces, located in the Al-Geza Governorate of Egypt using a purposeful sample of 81 adults with lower limb prostheses. We used two tools for data collection: a structured interviewing questionnaire and the Trinity Amputation and Prosthesis Experience Scales (TAPES). The mean age of adults with lower limb prosthesis in our study was 38.91 years (10.53). A total of 64.2% of the study participants (n = 51) were men. We found that before the self-care program, 22.2% of the participants (n = 18) had a satisfactory level of knowledge about self-care, which increased to 88.9% (n = 72) after the program. Before the self-care program, the number of participants with adequate practice levels was 13.6% (n = 11), which increased to 100.0% (n = 81) after the program. We concluded that implementing the self-care program provided a significant improvement in the attendee's total satisfactory knowledge (χ2[79,81] = 72.90, p < .000) and adequate practice levels (p < .001).
Preoperative Value of Contrast-Enhanced Ultrasound in Totally Laparoscopic Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy for Liver Tumors: A Preliminary Study
Authors: Xu Li-Long , Zhou Ling , Liang Xiao , Zheng Lin-Lin , Xu Hai-Shan , Chen Chao , Hu Peng , Li Shi-Yan
Published: December 2022

The clinical data of 15 cases that planned to receive totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy were retrospectively collected. Before the stage 1 operation, the size and number of the tumors in future liver remnant (FLR) and the presence of cancer embolus in the portal vein were assessed using contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT). Before the stage 2 operation, CEUS was performed to assess the presence of traffic blood flow between the diseased liver and FLR after round-the-liver ligation. Before the stage 1 operation, 5 cases with tumors in FLR were found by CEUS and 6 cases were found by CECT (P > 0.05). Similarly, CEUS found 5 cases with cancer thrombus in portal vein, and CECT found 7 cases (P = 0.500). The consistency between the 2 modalities was good (κ = 0.857, P < 0.05, κ = 0.727, P < 0.05, respectively). Before the stage 2 operation, CEUS confirmed that there were 7 cases without traffic blood flow between the diseased liver and FLR, and 3 cases with residual traffic blood flow. The daily growth rate of FLR in the group without traffic blood flow (mean rank = 7.00) was higher than that in the group with traffic blood flow (2.00) significantly (P < 0.05). Contrast-enhanced ultrasound is a promising application in the preoperative evaluation of totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy.
Understanding Donor-derived Cell-free DNA in Kidney Transplantation: An Overview and Case-based Guide for Clinicians
Authors: Graver Alison S. , Lee Darren , Power David A. , Whitlam John B.
Published: December 2022

Kidney transplant recipients undergo lifelong monitoring of allograft function and evaluation for transplant complications. The current monitoring paradigm utilizes blood, urine, and tissue markers that are insensitive, nonspecific, or invasive to obtain. As a result, problems are detected late, after significant damage has accrued, and often beyond the time at which complete resolution is possible. Indeed, most kidney transplants eventually fail, usually because of chronic rejection and other undetected injury. There is a clear need for a transplant-specific biomarker that enables a proactive approach to monitoring via early detection of reversible pathology. A biomarker that supports timely and personalized treatment would assist in achieving the ultimate goal of improving allograft survival and limiting therapeutic toxicity to the recipient. Donor-derived cell-free DNA (ddcfDNA) has been proposed as one such transplant biomarker. Although the test is presently utilized most in the United States, it is conceivable that its use will become more widespread. This review covers aspects of ddcfDNA that support informed use of the test by general nephrologists, including the basic biology of ddcfDNA, methodological nuances of testing, and general recommendations for use in the kidney transplant population. Clinical contexts are used to illustrate evidence-supported interpretation of ddcfDNA results and subsequent management. Finally, knowledge gaps and areas for further study are discussed.
Evidence of kinesin motors involved in stable kinetochore assembly during early meiosis
Authors: Shah Seema , Mittal Priyanka , Kumar Deepanshu , Mittal Anjani , Ghosh Santanu K
Published: December 2022

The characteristic ‘bi-lobed’ organization of the kinetochores observed during mitotic metaphase is a result of separation of the sister kinetochores into two clusters upon their stable end-on attachment to the microtubules emanating from opposite spindle poles. In contrast, during metaphase I of meiosis despite bi-orientation of the homologs, we observe that the kinetochores are linearly dispersed between the two spindle poles indicating that pole-distal and pole-proximal kinetochores are attached laterally and end-on, respectively to the microtubules. Colocalization studies of kinetochores and kinesin motors suggest that budding yeast kinesin 5, Cin8 and Kip1 perhaps localize to the end-on attached kinetochores while kinesin 8, Kip3 resides at all the kinetochores. Unlike mitosis in budding yeast, in meiosis, the outer kinetochores assemble much later after prophase I. From the findings including co-appearance of kinesin 5 and the outer kinetochore protein Ndc80 at the centromeres after prophase I and a reduction in Ndc80 level in Cin8 null mutant, we propose that kinesin motors are required for reassembly and stability of the kinetochores during early meiosis. Thus, this work reports yet another meiosis specific function of kinesin motor.
Stakeholder perceptions of sustainability reporting on the websites of technical universities in Ghana
Authors: Amoako Kwame Oduro , Marfo Emmanuel Opoku , Akwaa-Sekyi Ellis Kofi , Amaning Newman , Yankey Nicholas
Published: December 2022

Purpose

This paper explores stakeholder perceptions on the nature and extent of sustainability reporting on the websites of technical universities (TUs) in Ghana.

Design/methodology/approach

The authors collected data from the websites of the 10 TUs in Ghana and interviewed the stakeholders of the TUs. In analyzing the data, the authors used thematic analysis for the interview responses. The authors also adopted the global reporting initiative (GRI) guidelines and campus sustainability assessment tools for the presentation and analysis of the sustainability disclosures on the websites of the TUs.

Findings

The authors found that due to weak institutional coercions, there were limited disclosures on the websites of the TUs, which aimed at gaining stakeholders' legitimacy; the disclosures were more focused on organizational profile, governance and educational aspects of sustainability. To a large extent, while some external stakeholders such as parents, regulators and alumni appear to be less interested in the disclosures on the TU's websites, internal stakeholders such as employees (teaching and non-teaching staff) and students who frequently visited the TU's websites perceived limited reporting and were not impressed with the extent of sustainability disclosures on these websites.

Practical implications

The findings of this study are intended to assist policy-makers in the educational sector to appreciate the importance of sustainability reporting on their websites. The results of this study will assist higher educational institutions (HEIs) in increasing the success rate of sustainability implementation by overcoming the lack of sustainability disclosures on their websites. Thus, the results of this study have implications for sustainability implementations, particularly those in emerging economies and policy-makers of universities worldwide.

Originality/value

This study could provide two significant values. First, to the best of the authors’ knowledge, no other study has explored stakeholder perceptions of sustainability reporting in implementing sustainability within the education sector. Second, the results were arrived at by combining stakeholder consultations with content analyses, which could be a good guideline for sustainability implementation in the educational sector of developing countries.
Auditor industry specialization and cost of equity on earnings management: the moderating role of institutional ownership
Authors: Arianpoor Arash , Farzaneh Najmeh
Published: December 2022

Purpose

This study aims to explore the moderating role of institutional ownership in the impact of auditor industry specialization and the cost of equity on earnings management in Tehran Stock Exchange.

Design/methodology/approach

A total number of 198 firms were assessed in this study from 2014 to 2021. In this study, both accrual earning management (AEM) and real earnings management (REM) have been included. The industry-adjusted earnings price ratio and Gordon Growth Model were used for the cost of equity capital. In addition, auditor’s within-industry market share was used as a proxy for auditor industry specialization.

Findings

The results showed that institutional ownership positively moderates the impact of auditor industry specialization on AEM/REM. Furthermore, institutional ownership positively moderates the impact of cost of equity on AEM/REM. Hypothesis testing based on a robust regression and t + 1 test were also used for the results.

Originality/value

Previous studies have reported mixed results of this empirical question whether institutional ownership actually monitors managers and control earning management, considering the auditor industry specialization and the cost of equity. To the best of authors’ knowledge, this is a pioneering study to fill the existing gap. This study would not only benefit companies to manage financial and strategic decisions more efficiently but also help national and international society apply effective mechanisms to assist companies in decreasing earning management and increasing the firm performance, and try to push the market into a favorable direction.
Combating deceptive counterfeiting in digital supply chain
Authors: Dash Aishwarya , Sarmah Sarada Prasad , Tiwari M.K. , Jena Sarat Kumar
Published: December 2022

Purpose

Product counterfeiting has been ubiquitously observed in various segments of the supply chain. The intrinsic values of brands create more opportunities for counterfeiting. The damaging reputation of such brands leaves them to deal with the fallouts of counterfeits. Hence, such companies address them mainly through legal action, price and quality strategy. However, consumer characteristics and the random distribution of counterfeit products to the consumer types affect the effectiveness of a counter strategy. This paper aims to generate insights on how to leverage digital technology to curb counterfeit entities with consideration of consumer characteristics and the random distribution of counterfeits to them.

Design/methodology/approach

The authors used game theory and vertical differentiation model to understand and encounter deceptive counterfeiting of brand products. The study understands the economic relationship between a brand product manufacturer and consumer types based on their awareness. Further, the authors have considered different cases in the model to gain useful insights.

Findings

The results reveal that when the consumers are proactive, informed and value-conscious brand product manufacturers take digital technology counterstrategy to earn the maximum revenue. Hence, this analysis highlights that the effectiveness of a counterstrategy critically depends on the consumer characteristics, whether they are proactive, informed or unaware.

Practical implications

The study outlines that brand product manufacturers must emphasize on the digital supply chain, product redesign and product tracking facility to empower informed and value-conscious and proactive consumers. Moreover, the government should take steps to create awareness among uninformed consumers via information campaigns.

Originality/value

This paper incorporates the role of consumers and brand product manufacturers to understand and address the deceptive counterfeiting issue.
Impact of the divestment of Spanish FDI on economic growth of Morocco: an econometric analysis of 13 country-of-origin
Authors: Ait Soussane Jihad , Mansouri Dalal , Mansouri Zahra
Published: December 2022

Purpose

This study aims to identify the impact of foreign direct investment (FDI) on economic growth in Morocco depending on each origin country, including Spain. This study uses a linear model to measure the marginal impact of FDI on the growth of Morocco. This marginal effect allows to compare the different effects of FDI among countries of origin. Also, the marginal effect helps to measure the rate of substitution between FDI in an easier way than the other specifications of the model. The second step determines the substitute for Spain in case he decides to divest its FDI from Morocco to maintain the economic growth.

Design/methodology/approach

Using data of FDI from 13 countries of origin from 1995 to 2020 and two estimation methods (Dynamic Ordinary Least Squares and Autoregressive model), this study aims to measure the marginal impact of the divestment of FDI from Spain on growth. Then this study estimates how much Morocco should attract FDI from other countries when Spain divests. This study uses the differential calculus, assuming a perfect substitution between FDI from different countries. This calculus implies an indifference curve between FDI from Spain and FDI from another country where we deduct the substitution rates between FDI.

Findings

The results indicate that the FDI from Spain and France are the only ones to impact positively Moroccan economic growth. The FDI coming from Germany, Holland, China and Turkey have a negative impact, whereas those from the USA, Italy, UK, Switzerland and Gulf countries: Saudi Arabia, Kuwait and UAE have an insignificant effect. Second, using the differential calculus, the result indicates that when Spain divests 1m dirhams of its investments from Morocco, France would have to increase its own by 0.1509m dirhams so that Morocco could maintain its economic growth.

Research limitations/implications

The research focuses only on economic growth, neglecting the impact on other aggregates, such as total factor productivity, technology transfer and employment. Also, this research marginalized the sectorial analysis of FDI by the source to better understand the divergent effects.

Originality/value

This paper fills a research gap when analyzing the effect of FDI on the host economy depending on country-of-origin. In addition, it contributes to the body of literature by constructing the rate of substitution between the different sources of FDI to adapt to divestment policy.
Delphi study for evaluating critical success factors (CSFs) for PPP power projects in Ghana
Authors: Kukah Augustine Senanu Komla , Owusu-Manu De-Graft , Badu Edward , Edwards David John
Published: December 2022

Purpose

This study aims to identify the critical success factors of public private partnership (PPP) power projects in Ghana and further evaluates the most significant critical success factors (CSFs) influencing both the public and private sector participation in PPP power projects.

Design/methodology/approach

Ranking-type Delphi survey in two rounds was conducted to establish a comprehensive list of critical success factors of PPP power projects. Using purposive and snowball sampling techniques, experts were targeted for the Delphi survey. Mean score ranking, Cronbach’s alpha coefficient and Kendall’s concordance were used for analysis.

Findings

From the list of 37 critical success factors, 9 CSFs were deemed to be extremely significant. The five topmost CSFs were as follows: shared authority, trust and communication between public and private sectors; necessity of power project; debt guarantee to enable private partner to raise funds from the local or international financial markets; appropriate risk allocation and risk sharing; and thorough and realistic assessment of cost, projections and benefits.

Originality/value

The CSFs identified and prioritized in this study have the propensity to trigger policy development towards the PPP power sector in Ghana and developing countries that shares similar context. This is because the study has wide implications for financing, politics, procurement, regulations, legal and capacity building.
Do environmental, social and governance practices affect portfolio returns? Evidence from the US stock market from 2002 to 2020
Authors: Kabderian Dreyer Johannes , Moreira Mateus , Smith William T. , Sharma Vivek
Published: December 2022

Purpose

This paper aims to investigate whether environmental, social and governance (ESG) practices influence stock returns in the US stock market, looking at the period from 2002 to 2020.

Design/methodology/approach

The authors quasi-replicate two reference articles that found that socially responsible funds used to underperform, but that this underperformance tendency has disappeared in more recent periods.

Findings

Using US data, the authors show that independent of the ESG database used, portfolios of neutral stocks present consistently higher systematic risk (beta) than ESG portfolios, although this difference decreases over time. This may be due to the significant increase in demand for ESG portfolios in the past decade, and their consequent price inflation and increase in volatility. However, concerning risk-adjusted returns and contrary to the authors’ reference literature, the results are highly dependent on the rating provider used, and neither support underperformance nor indicate a tendency over time. These inconsistent results suggest that the “ESG label” is not a determinant of portfolio performance.

Research limitations/implications

If ESG ratings are a legitim benchmark for sustainability, then the costs of going sustainable in stock portfolios might be marginal for fund managers.

Originality/value

Two different ESG-rating agencies, Morgan Stanley Capital International (MSCI) and Thomson Reuters, are used to identify sustainable stocks. Different from the literature, the authors selected stocks for their portfolios stochastically following a uniform probability distribution, thus avoiding fund manager bias.
Significance of anti‐desmocollin autoantibodies in pemphigus
Authors: Ishii Norito
Published: December 2022

The major autoantigens for pemphigus are desmogleins (Dsgs), cell–cell adhesive structure proteins, one of the desmosomal cadherins. Recent progress in molecular biology has revealed that IgG autoantibodies of classical pemphigus react with Dsg1 or Dsg3. Desmocollins (Dscs) also belong to the cadherin supergene family that provides structure to the desmosomes and play an important role in cell‐to‐cell adhesion. In addition to the presence of four desmosomal Dsg isoforms, i.e. Dsg1‐4, Dsc1, 2 and 3, all of which are derived from different genes, Dsc1 has been previously identified as the target antigen of IgA autoantibodies in the subcorneal pustular dermatosis (SPD)‐type of intercellular IgA dermatosis. In addition to the IgA anti‐Dsc1 autoantiboides, the presence of IgG anti‐Dsc autoantibodies is described in patients of some autoimmune bullous diseases. In particular, the current pemphigus detecting autoantibodies to Dscs has shown a tendency in atypical variants of pemphigus. Therefore, autoantibodies against Dscs alone may cause detachment of cell–cell adhesion in the epidermis in some pemphigus. However, except for the findings of a few in vitro and in vivo studies, there is currently no clear evidence for the pathogenicity of anti‐Dsc autoantibodies in pemphigus, whereas significance of anti‐Dsg autoantibodies is well established. This article describes the structure and function of the Dscs, and explores the evidence regarding the pathogenic role of anti‐Dsc autoantibodies in pemphigus.
Unique protein signatures evolve during the course of a delayed‐type hypersensitivity reaction in human skin
Authors: Han Joseph , Stratman Scott , Young Jade N. , Poplausky Dina , Owji Shayan , Luu Yen , Estrada Yeriel , Correa da Rosa Joel , Krueger James G. , Gulati Nicholas
Published: December 2022

Diphencyprone (DPCP) is a hapten that causes a delayed‐type hypersensitivity reaction when applied topically. It has clinical uses in the treatment of various conditions such as melanoma metastases, warts, and alopecia areata, but the mechanisms are currently not well understood in humans. To further characterize the immunologic effects of DPCP, the authors performed a proteomic analysis of normal skin of eight healthy volunteers following a single application of DPCP and compared them with placebo‐treated skin from the same volunteers. A total of 96 proteins were examined using the Olink immuno‐oncology panel at 3 days (peak response), 14 days (partially resolved response), and 120 days (completely resolved response). Our analysis revealed significant upregulation of markers of immune cell activation (interleukin [IL] 8), vascular and tissue remodeling (matrix metallopeptidase 12 [MMP12], nitric oxide synthase 3 [NOS3]), antineoplastic markers (granzyme B [GZMB]), and the Th1 axis (interferon gamma [IFNG], chemokine (C‐X‐C motif) ligand [CXCL] 9, CXCL10, CXCL11) at days 3 and 14 compared with placebo (p < 0.05). In addition, several negative regulators of immune function such as programmed cell death 1 (PD1), programmed cell death ligand 1 (PDL1) (p < 0.001), and lymphocyte activation gene 3 (LAG3) (p < 0.05) were significantly upregulated at days 3 and 14. This induction of negative regulators may explain the seemingly paradoxical therapeutic benefits of DPCP in autoimmune conditions such as alopecia areata. The current analysis also indicated IL‐4 upregulation only at day 3, followed by IL‐12 upregulation only at day 14, suggesting a transient Th2 response followed by Th1 polarization. Overall, these data suggest a complex and evolving immunological delayed‐type hypersensitivity response to a single application of DPCP over time. Future proteomic studies of samples from patients with melanoma metastases, warts, and alopecia areata treated long term with DPCP are needed to further evaluate its pharmacologic mechanisms.
KaiC‐like proteins contribute to stress resistance and biofilm formation in environmental Pseudomonas species
Authors: Terrettaz Céline , Cabete Bruno , Geiser Johan , Valentini Martina , Gonzalez Diego
Published: December 2022

KaiC is the central cog of the circadian clock in Cyanobacteria. Close homologues of this protein are widespread among nonphotosynthetic bacteria, but the function, interaction network, and mechanism of action of these proteins are still largely unknown. Here, we focus on KaiC homologues found in environmental Pseudomonas species. Using bioinformatics, we describe the distribution of this protein family in the genus and reveal a conserved interaction network comprising a histidine kinase and response regulator. We characterize experimentally the only KaiC homologue present in Pseudomonas putida KT2440 and Pseudomonas protegens CHA0. Through phenotypic assays and transcriptomics, we show that KaiC is involved in osmotic and oxidative stress resistance in P. putida and in biofilm production in both species. KaiC homologues are found in different phosphorylation states and physically interact with a cognate histidine kinase and response regulator. In contrast with cyanobacterial counterparts, the expression and phosphorylation of KaiC homologues do not correlate with light variations under 12:12 light: dark cycles in either Pseudomonas species, and KaiC itself is not required to support a light‐driven behaviour in P. putida. Overall, this suggests that KaiC homologues in Pseudomonas species are involved in environmental stress resistance but not in responses to diurnal rhythms.
Income‐related disparities in Medicare advantage behavioral health care quality
Authors: Breslau Joshua , Haviland Amelia M. , Klein David J. , Martino Steven , Adams John , Dembosky Jacob W. , Tamayo Loida , Gaillot Sarah , Overton Yvette , Elliott Marc N.
Published: December 2022

Objective

To inform efforts to improve equity in the quality of behavioral health care by examining income‐related differences in performance on HEDIS behavioral health measures in Medicare Advantage (MA) plans.

Data Sources and Study Setting

Reporting Year 2019 MA HEDIS data were obtained and analyzed.

Study Design

Logistic regression models were used to estimate differences in performance related to enrollee income, adjusting for sex, age, and race‐and‐ethnicity. Low‐income enrollees were identified by Dual Eligibility for Medicare and Medicaid or receipt of the Low‐Income Subsidy (DE/LIS). Models without and with random effects for plans were used to estimate overall and within‐plan differences in measure performance. Heterogeneity by race‐and‐ethnicity in the associations of low‐income with behavioral health quality were examined using models with interaction terms.

Data Collection/Extraction Methods

Data were included for all MA contracts in the 50 states and the District of Columbia that collect HEDIS data.

Principal Findings

For six of the eight measures, enrollees with DE/LIS coverage were more likely to have behavioral health conditions that qualify for HEDIS measures than higher income enrollees. In mixed‐effects logistic regression models, DE/LIS coverage was associated with statistically significantly worse overall performance on five measures, with four large (>5 percentage point) differences (−7.5 to −11.1 percentage points) related to follow‐up after hospitalization and avoidance of drug‐disease interactions. Where the differences were large, they were primarily within‐plan rather than between‐plan. Interactions between DE/LIS and race‐and‐ethnicity were statistically significant (p < 0.05) for all measures; income‐based quality gaps were larger for White enrollees than for Black or Hispanic enrollees.

Conclusions

Low income is associated with lower performance on behavioral health HEDIS measures in MA, but these associations differ across racial‐and‐ethnic groups. Improving care integration and addressing barriers to care for low‐income enrollees may improve equity across income levels in behavioral health care.
Peripheral blood subpopulations of Bregs producing IL‐35 in women with endometriosis
Authors: Slawek Anna , Lorek Daria , Kedzierska Anna Ewa , Kubik Paulina , Pajak Jaroslaw , Chrobak Agnieszka , Chelmonska‐Soyta Anna
Published: December 2022

Problem

Interleukin 35 (IL‐35) is involved in the pathogenesis of endometriosis by suppressing immunoreaction and promoting endometrial cell proliferation. It may also be an essential cytokine in forming the immunosuppressive functions of regulatory B lymphocytes (Bregs). The involvement of Bregs in the pathogenesis of endometriosis has not been previously investigated. In this study, we determined the frequencies of different Breg subpopulations, namely, B10, immature B‐cells, and plasmablasts, and their abilities to produce IL‐35 in women with endometriosis compared to healthy women.

Methods

The frequencies of different subpopulations of Bregs producing IL‐35 were measured in the peripheral blood of women with endometriosis (total pool), women with deep infiltration endometriosis (DIE), women with ovarian endometriosis, and healthy women as a control by flow cytometry.

Results

We observed a decrease in the percentage of B10 cells and plasmablasts in women with endometriosis and an increase in the percentage of these Breg populations producing IL‐35 in the same experimental group. Interestingly, we also revealed that women with DIE had increased percentages of B10 cells and plasmablasts producing IL‐35.

Conclusion

Taken together, our findings are the first to reveal the frequencies of different subpopulations of Bregs producing IL‐35 in women with endometriosis. The results suggest that IL‐35 expression in B lymphocytes could be used as a peripheral marker of endometriosis; however, further studies are needed.
Metabolic assessment in children with neuromuscular disorders shows risk of liver enlargement, steatosis and fibrosis
Authors: Naume Marie Mostue , Jørgensen Marianne Hørby , Høi‐Hansen Christina Engel , Born Alfred Peter , Vissing John , Borgwardt Lise , Stærk Dorte Marianne Rohde , Ørngreen Mette Cathrine
Published: December 2022

Aim

The aim of this study was to conduct a metabolic and nutritional assessment of children with neuromuscular disorders, including the investigation of the liver and bone mineral density.

Methods

In this observational study, we included 44 children with neuromuscular disorders. The nutritional status, bone health and liver were assessed by ultrasound, transient elastography, dual X‐ray absorptiometry scan, blood samples, anthropometric measurements and 3‐day diet registration.

Results

Liver involvement was found in 31.0%: liver enlargement in 7.1%, steatosis in 4.8%, fibrosis in 14.3% and liver enlargement together with steatosis or fibrosis was found in 4.8%. These changes were found in 9/23 patients with Duchenne muscular dystrophy, 4/9 patients with spinal muscular atrophy type II and 0/12 patients with other neuromuscular diagnoses. Low bone mineral density was found in 44.0% of the patients, though the majority used daily vitamin D and calcium supplements. Vitamin D insufficiency or deficiency was found in 22.6%.

Conclusion

The metabolic assessment in children with neuromuscular disorders shows an increased risk of liver enlargement, steatosis and fibrosis. Possible causes are obesity, decreased mobility, low skeletal muscle mass and for a subgroup the use of glucocorticoids. The findings suggest that monitoring liver function should be part of the nutritional assessment in patients with neuromuscular disorders.