bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the market discipline banks? Evidence from Balkan states
Authors: Afzal Ayesha , Firdousi Saba Fazal
Published: June 2022

Purpose

This research is designed to investigate the presence of market discipline in the banking sector, across Balkan states in Europe. Specifically, the effects of CAMEL variables on the cost of funds and deposit-switching have been assessed.

Design/methodology/approach

The CAMEL method of bank evaluation has been applied as well as two measures for market discipline (costs of funds and deposit-switching behaviour). Data have been obtained for 10 Balkan states for the 2006–2019 period. For data analysis, ordinary least squares (OLS) and fixed effects models have been utilized. The generalized method of moments (GMM) method has been deployed as well as a dynamic panel model.

Findings

Evidence of market discipline has been found, in the form of a higher cost of funds in the context of capital adequacy (but not for other CAMEL variables). Evidence of market discipline in the form of deposit-switching, however, has not been found. In addition, it has been discovered that bank size and gross domestic product (GDP) growth lower the costs of funds for banks.

Originality/value

In the wake of the pandemic, banks need to prepare themselves for very difficult situations and relevant studies can provide help. Therefore, this research has contributed to the developing literature on this topic. In addition, the findings have important practical implications. Results show that banks should maintain adequate levels of capital if they want to control their costs of funds. Results also show that market discipline, in the form of higher costs of funds, can be imposed on banks to discourage excessive risk-taking. Findings highlight the value of appropriate policies and strong supervision of the financial industry. Findings also underline the importance of offering financial incentives to banks. For example, if banks know they will be able to avoid higher costs of funds by controlling their risk levels, they will avoid unrestrained risk-taking.
Validating multi-dimensional model of financial literacy using confirmatory factor analysis
Authors: Bajaj Isha , Kaur Mandeep
Published: June 2022

Purpose

The purpose of this paper is to validate the measurement model of financial literacy in which financial literacy is a second-order construct with financial knowledge, financial attitude and financial behavior as lower-order constructs.

Design/methodology/approach

The study is based on the primary data collected from 536 adult respondents of Punjab, India. Confirmatory factor analysis (CFA) has been used in the study.

Findings

Financial knowledge, financial attitude and financial behavior have significant correlation with each other and they converge to form a second-order construct–Financial Literacy. The model of financial literacy as a second-order construct (using CFA) is the perfect fit. The study also highlights that the financial literacy level of people differ significantly depending upon the age, gender, marital status, area of residence, qualification, monthly family income, employment status.

Practical implications

The study has major implications for policymakers. It confirms the claim that financial literacy is a combination of three components–financial knowledge, financial attitude and financial behavior. The national as well as international regulatory agencies working to promote financial literacy should realize that the overall financial literacy of people can be improved by imparting financial knowledge along with inculcating positive financial attitude and financial behavior among the masses.

Originality/value

The present study is the first study to validate financial literacy as a multidimensional model in the context of India to the best of our knowledge. The study contributes to the extant literature in the field of financial literacy by providing a strong framework for future research.
Shift work, sleep, and burnout: the impact of Mediterranean dietary pattern and nutritional status on emergency healthcare workers
Authors: BAKIRHAN Hande , BAKIRHAN Yunus Emre , Yaşar Gamze
Published: June 2022

Purpose

This study aims to evaluate the relationship between dietary patterns and shift work, sleep quality and burnout among emergency health-care workers.

Design/methodology/approach

The nutritional status, sleep quality and burnout status of health-care workers (n = 91) in Turkey were investigated.

Findings

Among the burnout subgroups, only emotional exhaustion was associated with high adherence to the Meditarrenean diet. (r = 0.37, p < 0.01). Carbohydrates consumed during the shift day were associated with lower sleep quality (r = 0.24, p = 0.02). The intake of protein (r = −0.29, p < 0.01), fat (r = −0.27, p < 0.00), cholesterol (r = −0.31, p < 0.01), phosphorus (r = −0.22, p = 0.03) and iron (r = −0.21, p = 0.04) in shift day was negatively associated with Pittsburgh Sleep Quality Index (PSQI) scores (lower PSQI scores indicates good sleep quality). Consumption of vitamin C and potassium on the rest day was significantly associated with better sleep quality (respectively, r = −0.21, p = 0.04 and r=−0.23, p = 0.03). Personal accomplishment was positively correlated with carbohydrate consumption during the shift day and negatively correlated with protein, cholesterol and vitamin B6 intake (respectively, r = 0.22, p = 0.03; r = −0.21, p = 0.03; r=−0.28, p < 0.00, r = −0.28, p < 0.00). Emotional exhaustion was negatively correlated with protein consumption on the shift day (r = −0.21, p = 0.04) and positively correlated with fat consumption on the rest day (r = 0.22, p = 0.02).

Originality/value

The findings confirm the possible role of dietary patterns in health-care workers against burnout and sleep quality attributable to a possible association with nutrients intake on shift or rest day.
Stock market reactions of Malaysian firms and industries towards events surrounding COVID-19 announcements and number of confirmed cases
Authors: Aldhamari Redhwan , Ku Ismail Ku Nor Izah , Al-Sabri Haithm Mohammed Hamood , Saleh Mousa Sharaf Adin Hezam
Published: June 2022

Purpose

This paper aims to examine the stock market reactions of firms and industries in Malaysia to the government’s COVID-19 movement control order (MCO) announcement. As China is Malaysia’s leading trading partner, the authors also observe if the Chinese Government’s confirmation of human-to-human coronavirus transmission affects firms’ stock market reactions. In addition, this study examines whether the Malaysian Government’s ease of restrictions on economic activities affects firms’ stock market reactions. Finally, this study analyses the effect of COVID-19 number of confirmed cases on firms’ abnormal returns.

Design/methodology/approach

This study uses an event study methodology to determine the abnormal returns between day −30 to day 30 of the announcements. In addition, this study uses the regression estimation to determine whether the COVID-19 number of confirmed cases explain the abnormal returns.

Findings

This study finds that investors react negatively to the announcement of the MCO and confirmation of the human-to-human transmission of coronavirus over the event windows. However, the cumulative average abnormal returns (CAARs) started to recover when stimulus packages were introduced, and the lockdown measures were eased, allowing businesses to reopen. This study also finds that only firms in the health-care sector reported significant positive CAARs. Stock returns of the utilities and telecommunication firms showed no changes, while eight other sectors fell remarkably. The results also show that the COVID-19 number of confirmed cases adversely affects firms’ abnormal returns.

Practical implications

This study suggests that stock prices incorporate bad and good news surrounding the announcements of major international and local events related to the COVID-19 pandemic. Thus, investors should consider such factors in making investment decisions.

Originality/value

To the best of the authors’ knowledge, this paper is one of the early research works investigating the stock market reactions to the COVID-19 major announcements (MCO, human-to-human transmission and ease of restrictions on economic activities) using an event study methodology in an emerging market, namely, Malaysia. This study is timely in light of the recently increasing calls for researchers to analyse the potential economic impacts of COVID-19 on global capital markets, especially in emerging markets whose evidence is scarce.
Barriers to consumer adoption of sustainable products – an empirical analysis
Authors: Nath Vishnu , Agrawal Rajat
Published: June 2022

Purpose

This paper aims to identify and study the effect of identified eight barriers to sustainable consumption on consumers’ intention to purchase sustainable products.

Design/methodology/approach

Data were collected from a self-administered field survey in India, and 315 valid responses were obtained from the survey process. Partial least square structural equation modeling analysis was carried out to establish the validity of the measures used and to examine the impact of the identified barriers on sustainable purchase intentions.

Findings

The results of this study indicate that barriers such as low willingness to pay, low functional performance, low availability of sustainable products and difficulty of integration in the normal route have a statistically significant negative impact on consumers’ sustainable purchase intentions.

Practical implications

The findings of this study are useful for marketers and policymakers who want to increase the consumer adoption of sustainable products in emerging markets.

Originality/value

This study develops measures to capture the consumers’ perception of barriers to the adoption of sustainable products.
UV radiation doubles microbial degradation of standing litter in a subtropical forest
Authors: Jiang Han , Pan Yueting , Liang Jiawen , Yang Yinghui , Chen Qi , Lv Meiqi , Pang Lu , He Weihua , Tian Xingjun
Published: June 2022

UV radiation has been recognized as a direct driver of litter decomposition by photodegrading organic matter in dryland ecosystems. However, the importance and mechanism of UV radiation on litter decomposition, especially on standing litter, in humid forest ecosystems remain unclear.

We conducted a factorial experiment in a humid subtropical forest gap, manipulating the effects of UV radiation on the decomposition of standing litter under different microbial conditions.

After 366 days of standing incubation, under normal conditions (UV pass with microorganisms), up to 40.63% of the litter mass was lost. However, under a UV pass without microorganisms, litter mass loss was only 16.30%. Under a UV block, the mass loss of litter with microorganisms was 27.68% and that of litter without microorganisms was 15.54%. Without microorganisms, UV radiation had no significant effect on the mass loss of litter carbon. However, UV radiation increased the DOC concentration of litter. And in the presence of microorganisms, UV radiation contributed to an increased mass loss of lignin by 16.72% and of cellulose by 14.75%. No negative effects of UV radiation on microorganisms were observed. These results suggest that UV radiation increased the net mass loss of litter by 106.67%, and this doubling promotion was achieved through microbial degradation.

Synthesis. The increase in microbial degradation under UV radiation may be linked to the increased degradability of lignin and cellulose caused by photodegradation. Our study indicates that direct photodegradation by UV radiation could be weak in subtropical forests, but UV photofacilitation generates rapid turnover of carbon in this system.
The carnitine degradation pathway ofAcinetobacter baumanniiand its role in virulence
Authors: Breisch Jennifer , Schumm Clemens , Poehlein Anja , Daniel Rolf , Averhoff Beate
Published: June 2022

The opportunistic human pathogenAcinetobacter baumanniican grow with carnitine but its metabolism, regulation and role in virulence remained elusive. Recently, we identified a carnitine transporter encoded by a gene closely associated with potential carnitine degradation genes. Among those is a gene coding for a putatived‐malate dehydrogenase (Mdh). Deletion of themdhgene led to a loss of growth with carnitine but notl‐malate; growth withd‐malate was strongly reduced. Therefore, it is hypothesized thatd‐malate is formed during carnitine oxidation and further oxidized to CO2and pyruvate and, that not, as previously suggested,l‐malate is the product and funnelled directly into the TCA cycle. Mutant analyses revealed that the hydrolase in this cluster funnels acetylcarnitine into the degradation pathway by deacetylation. A transcriptional regulator CarR bound in a concentration‐dependent manner to the intergenic region between themdhgene, the first gene of the carnitine catabolic operon and thecarRgene in the presence and absence of carnitine. Both carnitine andd‐malate induced CarR‐dependent expression of the carnitine operon. Infection studies withGalleria mellonellalarvae demonstrated a strong increase in virulence by addition of carnitine indicating that carnitine degradation plays a pivotal role in virulence ofA.baumannii.
Antifungal properties of whey fermented by lactic acid bacteria in films for the preservation of cheese slices
Authors: Dopazo Victor , Luz Carlos , Calpe Jorge , Vila‐Donat Pilar , Rodríguez Lorena , Meca Giuseppe
Published: June 2022

Fungal deterioration by Penicillium species in refrigerated storage conditions is one of the main risk factors for health issues and food waste in the dairy industry. The purpose of this study was to evaluate the antifungal properties of a plastic film carrying whey fermented by lactic acid bacteria (LAB). The results evidenced that a film containing whey fermented using lactic acid bacteria inhibited the growth of Penicillium commune, Penicillium verrucosum and Penicillium solitum for 23, 20 and 17 days, respectively.
Rocuronium ≤1.5 mg/kg versus >1.5 mg/kg and inadequate paralysis in prehospital and retrieval intubation: A retrospective study
Authors: Hayes‐Bradley Clare , Tarrant Madelaine
Published: June 2022

Objective

Greater Sydney Area Helicopter Emergency Medical Service encouraged an increased dose of rocuronium for rapid sequence intubations (RSIs) from 1.5 mg/kg to 2.0 mg/kg from the end of 2017 in response to a number of inadequately paralysed patients identified by our airway audit processes. Subsequent protocol change incorporated 2.0 mg/kg rocuronium. This retrospective observational study was undertaken to see if doses over 1.5 mg/kg rocuronium were associated with a reduction in the number of inadequately paralysed patients.

Methods

Retrospective review of patient prehospital notes and airway database records from 2017 to 2018 for all cases using rocuronium for RSI. Primary outcome of interest was physician notes describing skeletal muscle activity at laryngoscopy. Patients with tissued vascular access were excluded. Dose of rocuronium, estimated patient actual weight and grade of laryngoscopy were recorded. Comparisons were made between rocuronium doses ≤1.5 mg/kg and >1.5 mg/kg by estimated weight.

Results

From 211 patients receiving rocuronium ≤1.5 mg/kg, five cases were inadequately paralysed, compared with two cases from 384 patients receiving >1.5 mg/kg rocuronium.

Conclusions

Although there were fewer inadequately paralysed patients with rocuronium doses >1.5 mg/kg, this did not reach statistical significance, presumably because of the low event rate. Further investigation into rocuronium dose for RSI is warranted.
Why eDNA fractions need consideration in biomonitoring
Authors: Nagler Magdalena , Podmirseg Sabine Marie , Ascher‐Jenull Judith , Sint Daniela , Traugott Michael
Published: June 2022

The analysis of environmental DNA (eDNA) is revolutionizing the monitoring of biodiversity as it allows to assess organismic diversity at large scale and unprecedented taxonomic detail. However, eDNA consists of an extracellular and intracellular fraction, each characterized by particular properties that determine the retrievable information on when and where organisms live or have been living. Here, we review the fractions of eDNA, describe how to obtain them from environmental samples and present a four‐scenario concept that aims at enhancing spatial and temporal resolution of eDNA‐based monitoring. Importantly, we highlight how the appropriate choice of eDNA fractions precludes misinterpretation of eDNA‐based biodiversity data. Finally, future avenues of research towards eDNA fraction‐specific analyses are outlined to unravel the full potential of eDNA‐based studies targeting micro‐ and macro‐organisms.
Providing octane degradation capability to Pseudomonas putidaKT2440 through the horizontal acquisition of oct genes located on an integrative and conjugative element
Authors: Duque Estrella , Udaondo Zulema , Molina Lázaro , de la Torre Jesús , Godoy Patricia , Ramos Juan L.
Published: June 2022

The extensive use of petrochemicals has produced serious environmental pollution problems; fortunately, bioremediation is considered an efficient way to fight against pollution. In line with Synthetic Biology is that robust microbial chassis with an expanded ability to remove environmental pollutants are desirable. Pseudomonas putida KT2440 is a robust lab microbe that has preserved the ability to survive in the environment and is the natural host for the self‐transmissible TOL plasmid, which allows metabolism of toluene and xylenes to central metabolism. We show that the P. putida KT2440 (pWW0) acquired the ability to use octane as the sole C‐source after acquisition of an almost 62‐kb ICE from a microbial community that harbours an incomplete set of octane metabolism genes. The ICE bears genes for an alkane monooxygenase, a PQQ‐dependent alcohol dehydrogenase and aldehyde dehydrogenase but lacks the electron donor enzymes required for the monooxygenase to operate. Host rubredoxin and rubredoxin reductase allow metabolism of octane to octanol. Proteomic assays and mutants unable to grow on octane or octanoic acid revealed that metabolism of octane is mediated by redundant host and ICE enzymes. Octane is oxidized to octanol, octanal and octanoic acid, the latter is subsequently acylated and oxidized to yield acetyl‐CoA that is assimilated via the glyoxylate shunt; in fact, a knockout mutant in the aceA gene, encoding isocitrate lyase was unable to grow on octane or octanoic acid.
Microphysiological system for studying contractile differences in young, active, and old, sedentary adult derived skeletal muscle cells
Authors: Giza Shelby , Mojica‐Santiago Jorge A. , Parafati Maddalena , Malany Legrand K. , Platt Don , Schmidt Christine E. , Coen Paul M. , Malany Siobhan
Published: June 2022

Microphysiological systems (MPS), also referred to as tissue chips, incorporating 3D skeletal myobundles are a novel approach for physiological and pharmacological studies to uncover new medical treatments for sarcopenia. We characterize a MPS in which engineered skeletal muscle myobundles derived from donor‐specific satellite cells that model aged phenotypes are encapsulated in a perfused tissue chip platform containing platinum electrodes. Our myobundles were derived from CD56+ myogenic cells obtained via percutaneous biopsy of the vastus lateralis from adults phenotyped by age and physical activity. Following 17 days differentiation including 5 days of a 3 V, 2 Hz electrical stimulation regime, the myobundles exhibited fused myotube alignment and upregulation of myogenic, myofiber assembly, signaling and contractile genes as demonstrated by gene array profiling and localization of key components of the sarcomere. Our results demonstrate that myobundles derived from the young, active (YA) group showed high intensity immunofluorescent staining of α‐actinin proteins and responded to electrical stimuli with a ~1 μm displacement magnitude compared with non‐stimulated myobundles. Myobundles derived from older sedentary group (OS) did not display a synchronous contraction response. Hypertrophic potential is increased in YA‐derived myobundles in response to stimulation as shown by upregulation of insulin growth factor (IGF‐1), α‐actinin (ACTN3, ACTA1) and fast twitch troponin protein (TNNI2) compared with OS‐derived myobundles. Our MPS mimics disease states of muscle decline and thus provides an aged system and experimental platform to investigate electrical stimulation mimicking exercise regimes and may be adapted to long duration studies of compound efficacy and toxicity for therapeutic evaluation against sarcopenia.
Restrictive fluids versus standard care in adults with sepsis in the emergency department (REFACED): A multicenter, randomized feasibility trial
Authors: Jessen Marie K. , Andersen Lars W. , Thomsen Marie‐Louise H. , Kristensen Peter , Hayeri Wazhma , Hassel Ranva E. , Messerschmidt Tina G. , Sølling Christoffer G. , Perner Anders , Petersen Jens Aage K. , Kirkegaard Hans
Published: June 2022

Background

Fluid treatment in sepsis is a challenge and clinical equipoise exists regarding intravenous (IV) volumes. We aimed to determine whether a 24‐h protocol restricting IV fluid was feasible in adult patients with sepsis without shock presenting to the emergency department (ED).

Methods

The REFACED Sepsis trial is an investigator‐initiated, multicenter, randomized, open‐label, feasibility trial, assigning sepsis patients without shock to 24 h of restrictive, crystal IV fluid administration or standard care. In the IV fluid restriction group fluid boluses were only permitted if predefined criteria for hypoperfusion occurred. Standard care was at the discretion of the treating team. The primary outcome was total IV crystalloid fluid volumes at 24 h after randomization. Secondary outcomes included total fluid volumes, feasibility measures, and patient‐centered outcomes.

Results

We included 123 patients (restrictive 61 patients and standard care 62 patients) in the primary analysis. A total of 32% (95% confidence interval [CI] 28%–37%) of eligible patients meeting all inclusion criteria and no exclusion criteria were included. At 24 h, the mean (±SD) IV crystalloid fluid volumes were 562 (±1076) ml versus 1370 (±1438) ml in the restrictive versus standard care group (mean difference –801 ml, 95% CI −1257 to −345 ml, p = 0.001). Protocol violations occurred in 21 (34%) patients in the fluid‐restrictive group. There were no differences between groups in adverse events, use of mechanical ventilation or vasopressors, acute kidney failure, length of stay, or mortality.

Conclusions

A protocol restricting IV crystalloid fluids in ED patients with sepsis reduced 24‐h fluid volumes compared to standard care. A future trial powered toward patient‐centered outcomes appears feasible.
Symptomatic versus disease‐modifying effects of psychiatric drugs
Authors: Ghaemi S. Nassir
Published: June 2022

Objective

Drugs can be divided into two major categories, symptomatic and disease modifying. This review explores whether and how psychiatric drugs fall into one or the other of those categories, and the implications of those results for clinical practice and research in psychopharmacology.

Method

Narrative review.

Results

Most psychiatric drugs have only short‐term effects of improving active symptoms. They do not show long‐term benefits for the underlying disease, such as improving the course of illness and improving mortality. Evidence is provided for this claim in the treatment literature of antidepressants for depressive illness and antipsychotics for schizophrenia. Developing truly beneficial drugs for disease modification also is limited by the poor clinical and biological validity of Diagnostic and Statistical Manual diagnoses as well as the use of invalid falsely positive maintenance efficacy randomized discontinuation trial designs.

Conclusions

Current psychopharmacology is limited mostly to symptomatic effects, not transformative treatments for the diseases underlying those symptoms. A change in approach is needed in psychopharmacology practice and research, focusing on long‐term disease modification rather than short‐term symptom improvement.
Duration of medication treatment for opioid‐use disorder and risk of overdose among Medicaid enrollees in 11 states: a retrospective cohort study
Authors: Burns Marguerite , Tang Lu , Chang Chung‐Chou H. , Kim Joo Yeon , Ahrens Katherine , Allen Lindsay , Cunningham Peter , Gordon Adam J. , Jarlenski Marian P. , Lanier Paul , Mauk Rachel , McDuffie Mary Joan , Mohamoud Shamis , Talbert Jeffery , Zivin Kara , Donohue Julie
Published: June 2022

Background and aims

Medication for opioid use disorder (MOUD) reduces harms associated with opioid use disorder (OUD), including risk of overdose. Understanding how variation in MOUD duration influences overdose risk is important as health‐care payers increasingly remove barriers to treatment continuation (e.g. prior authorization). This study measured the association between MOUD continuation, relative to discontinuation, and opioid‐related overdose among Medicaid beneficiaries.

Design

Retrospective cohort study using landmark survival analysis. We estimated the association between treatment continuation and overdose risk at 5 points after the index, or first, MOUD claim. Censoring events included death and disenrollment.

Setting and participants

Medicaid programs in 11 US states: Delaware, Kentucky, Maryland, Maine, Michigan, North Carolina, Ohio, Pennsylvania, Virginia, West Virginia and Wisconsin. A total of 293 180 Medicaid beneficiaries aged 18–64 years with a diagnosis of OUD and had a first MOUD claim between 2016 and 2017.

Measurements

MOUD formulations included methadone, buprenorphine and naltrexone. We measured medically treated opioid‐related overdose within claims within 12 months of the index MOUD claim.

Findings

Results were consistent across states. In pooled results, 5.1% of beneficiaries had an overdose, and 67% discontinued MOUD before an overdose or censoring event within 12 months. Beneficiaries who continued MOUD beyond 60 days had a lower relative overdose hazard ratio (HR) compared with those who discontinued by day 60 [HR = 0.39; 95% confidence interval (CI) = 0.36–0.42; P < 0.0001]. MOUD continuation was associated with lower overdose risk at 120 days (HR = 0.34; 95% CI = 0.31–0.37; P < 0.0001), 180 days (HR = 0.31; 95% CI = 0.29–0.34; P < 0.0001), 240 days (HR = 0.29; 95% CI = 0.26–0.31; P < 0.0001) and 300 days (HR = 0.28; 95% CI = 0.24–0.32; P < 0.0001). The hazard of overdose was 10% lower with each additional 60 days of MOUD (95% CI = 0.88–0.92; P < 0.0001).

Conclusions

Continuation of medication for opioid use disorder (MOUD) in US Medicaid beneficiaries was associated with a substantial reduction in overdose risk up to 12 months after the first claim for MOUD.
Influence of respiratory movement during post mastectomy radiotherapy on targets and heart for breast cancer
Authors: Jeon Hosang , Ki Yongkan , Kim Dong Woon , Kim Wontaek , Nam Jiho , Kim Donghyun , Park Dahl , Park Jongmoo , Joo Ji Hyeon
Published: June 2022

Background/aim

This study aimed to compare the dosimetric consequences of respiratory movement in volumetric‐modulated arc therapy (VMAT) and three‐dimensional conformal radiation therapy (3D‐CRT) during postmastectomy radiation therapy, including internal mammary nodes (IMNs).

Materials and methods

Respiratory motion was implemented to a phantom using a dynamic device. The plans were delivered during cranial‐caudal and ventral‐dorsal movement in 5‐mm (R05) and 10‐mm (R10) amplitudes.

Results

At the IMN, the dose errors were –2.8% (R05) and –6.2% (R10) for 3D‐CRT and –4.9% (R05) and –8.5% (R10) for VMAT. The dose errors in chest wall were –.5% (R05) and –6.0% (R10) for 3D‐CRT and –1.9% (R05) and –5.3% (R10) for VMAT. The left anterior descending doses showed significantly small absolute values. The gamma pass rates of VMAT were higher than those of 3D‐CRT.

Conclusions

The benefit of VMAT technique in dose distribution was maintained, except in occasional instances of large breathing motion.
Cow's milk and egg protein threshold dose distributions in children tolerant to beef, baked milk, and baked egg
Authors: Valluzzi Rocco Luigi , Riccardi Carla , Arasi Stefania , Piscitelli Anna Lucia , Calandrelli Veronica , Dahdah Lamia , Fierro Vincenzo , Mennini Maurizio , Fiocchi Alessandro
Published: June 2022

Background

The use of eliciting doses (EDs) for food allergens is necessary to inform individual dietary advice and food allergen risk‐management. The Eliciting Dose 01 (ED01) for milk and egg, calculated from populations of allergic subjects undergoing oral food challenges (OFCs), are 0.2 mg total protein. The respective Eliciting Dose 05 (ED05) is 2.4 mg for milk and 2.3 mg for egg. As about 70% children allergic to such foods may tolerate them when baked, we sought to verify the EDs of that subpopulation of milk and egg‐allergic children.

Methods

We retrospectively assessed consecutive OFC for fresh milk and egg between January 2018 and December 2020 in a population of baked food‐tolerant children.

Results

Among 288 children (median age 56 ‐ IQR 36–92.5 months, 67.1% male) included, 87 (30.2%) returned positive OFC results, 38 with milk and 49 with egg. The most conservative ED01 was 0.3 mg total protein (IQR 0.03–2.9) for milk and 14.4 mg total protein (IQR 3.6–56.9) for egg. The respective ED05 was 4.2 (IQR 0.9–19.6) mg for milk and 87.7 (IQR 43–179) mg for egg. Such thresholds are, respectively, 1.5 (milk ED01), 1.75 (milk ED05), 72 (egg ED01), and 38.35 (egg ED05) times higher than the currently used thresholds.

Conclusions

The subpopulation of children allergic to milk and egg, but tolerant to baked proteins, displays higher reactivity thresholds than the general population of children allergic to milk and egg. Their risk stratification, in both individual and population terms, should consider this difference. In baked milk‐tolerant children, milk causes reactions at lower doses than egg in our group of egg‐tolerant children. This could be associated with the relative harmlessness of egg compared with milk in the determinism of fatal anaphylactic reactions in children.
Dialysate sodium management in hemodialysis and online hemodiafiltration: The single‐pool kinetic model revisited
Authors: Petitclerc Thierry
Published: June 2022

Background

Determining the optimal dialysate sodium remains one of the challenges of hemodialysis prescription. Several arguments suggest that the dialysate sodium should be individually adjusted according to the patient's natremia. This strategy is greatly facilitated by using an algorithm. Only three such algorithms have been embedded in hemodialysis machines for the widespread generalization of this strategy in clinical routine: the Diacontrol (Hospal‐Baxter Healthcare Corp., Deerfield, IL, USA), the HFR‐Aequilibrium (Bellco‐Medtronic, Dublin, Ireland), and the Na‐control (Fresenius Medical Care, Bad‐Homburg, Germany).

Methods

Model the solute mass‐transfer across the dialyzer membrane in online hemodiafiltration and adapt the Diacontrol algorithm based on a single‐pool kinetic model of sodium balance for quantifying ionic balance and managing tonicity.

Results

(1) Substituting sodium measurements with conductivity measurements allows the control of tonicity which is a more physiological parameter than natremia. (2) Consideration of all ion exchanges as a whole and not just sodium exchange avoids some of the assumptions required by kinetic modeling of sodium balance. (3) Equations provided by the model are applicable to both hemodialysis and online hemodiafiltration. (4) The differences between this model used by Diacontrol and the models on which the other two software's (HFR‐Aequilibrium and Na‐control) are based are highlighted.

Conclusions

The single‐pool kinetic model developed for the management of natremia in hemodialysis is also valid for the management of tonicity for both conventional hemodialysis and all online hemodiafiltration procedures.
Replication of the abnormal niacin response in first episode psychosis measured using laser Doppler flowmeter
Authors: Gan RanPiao , Zhao YuanQiao , Wu GuiSen , Zeng JiaHui , Hu YeGang , Xu LiHua , Wei YanYan , Tang XiaoChen , Liu XiaoHua , Liu HaiChun , Chen Tao , Wang JiJun , Zhang TianHong
Published: June 2022

Introduction

Impaired sensitivity of the skin flush response to niacin is found in approximately 30% of patients with schizophrenia. Although the niacin response abnormality (NRA) may serve as a useful endophenotype for schizophrenia, few studies have directly replicated NRA in patients with first‐episode psychosis (FEP).

Methods

In total, 204 patients with FEP, 16 with psychotic mood disorder (PMD), and 68 healthy controls (HC) were included. The log10(EC50) values represent the concentration of methyl nicotinate required to elicit a half‐maximal blood flow (MBF) response, and the MBF value was calculated. The NRA was defined as having log10(EC50) molar value above the 90% and an MBF value below the 60% of those in the HC group.

Results

In total, 13.7% of the FEP, 12.5% of the PMD, and 7.4% of the HC group met the definition of NRA. Significant differences were found in the log10(EC50) values between the FEP and HC groups (p = .014) and in the MBF between the FEP and PMD groups (p = .011). Patients with FEP and NRA had more severe negative symptoms than those with a normal niacin response.

Discussion

These data represent the NRA in patients with FEP, defining a small subgroup of patients with early‐phase psychosis possessing a clinically significant phospholipid‐signaling defect.
How would final‐year medical students perform if their skill‐based prescription assessment was real life?
Authors: Kalfsvel Laura , Hoek Kirsten , Bethlehem Corine , van der Kuy Hugo , van den Broek Walter W. , Versmissen Jorie , van Rosse Floor
Published: June 2022

Aims

Prescribing errors occur frequently, especially among junior doctors. Our aim was to investigate prescribing errors made by final‐year medical students. Information on these errors can help to improve education on and assessment of clinical pharmacotherapy (CPT).

Methods

This was a retrospective cohort study amongst final‐year medical students at Erasmus Medical Centre, The Netherlands. Errors made in the final prescribing assessment were analysed. Errors were categorized by type, possible consequence and possibility of reaching the patient in real life.

Results

A total of 381 students wrote 1502 analysable prescriptions. Forty per cent of these contained at least one error, and 54% of errors were of the inadequate information type. The rating of prescriptions for children was lower than for other question categories (P = <.001). Fifty per cent of errors were classified as “would have reached the patient but would not have had the potential to cause harm”. In total, 253 (29%) errors would not have been intercepted by an electronic prescribing system or a pharmacist. Ten (4%) of these would probably have caused harm in the patient.

Conclusions

There is a high rate of errors in prescriptions written by final‐year medical students. Most errors were of the inadequate information type, indicating that students had difficulties determining the content and amount of information needed to make treatment successful. Prescriptions for children contained most errors. Curricula could be improved by offering more case‐based CPT education, focusing on the practical issues of prescribing, especially for paediatric cases, and offering more practice time for prescribing during clerkships.
The role of doulas in respectful care for communities of color and Medicaid recipients
Authors: Mallick Lindsay M. , Thoma Marie E. , Shenassa Edmond D.
Published: June 2022

Background

Despite the tenets of rights‐based, person‐centered maternity care, racialized groups, low‐income people, and people who receive Medicaid insurance in the United States experience mistreatment, discrimination, and disrespectful care more often than people with higher income or who identify as white. This study aimed to explore the relationship between the presence of a doula (a person who provides continuous support during childbirth) and respectful care during birth, especially for groups made vulnerable by systemic inequality.

Methods

We used data from 1977 women interviewed in the Listening to Mothers in California survey (2018). Respondents who reported high levels of decision making, support, and communication during childbirth were classified as having “high” respectful care. To examine associations between respectful care and self‐reported doula support, we conducted multivariable logistic regressions. Interactions by race/ethnicity and private or Medi‐Cal (Medicaid) insurance status were assessed.

Results

Overall, we found higher odds of respectful care among women supported by a doula than those without such support (odds ratios [OR]: 1.4, 95% CI: 1.0–1.8). By race/ethnicity, the association was largest for non‐Hispanic Black women (2.7 [1.1–6.7]) and Asian/Pacific Islander women (2.3 [0.9–5.6]). Doula support predicts higher odds of respectful care among women with Medi‐Cal (1.8 [1.3–2.5]), but not private insurance.

Conclusions

Doula support was associated with high respectful care, particularly for low‐income and certain racial/ethnic groups in California. Policies supporting the expansion of doulas for low‐income and marginalized groups are consistent with the right to respectful care and may address disparities in maternal experiences.
Licensing cost‐reducing innovations under supply function competition
Authors: Saglam Ismail
Published: June 2022

In this paper, we study the licensing of cost‐reducing innovations in a duopoly under supply function competition. We show that the innovator prefers fixed‐fee licensing to no licensing if its cost advantage is not extremely large. Moreover, if its cost advantage is not extremely small, the innovator prefers fixed‐fee licensing and mixed licensing to revenue‐royalty licensing. This second result arises only because of our assumption that the cost functions are quadratic. We show that if the cost functions are linear and royalty payments are per unit of output, the innovator strictly prefers royalty licensing to fixed‐fee licensing. We also show that in our model, consumer surplus is remarkably higher under any type of licensing than under no licensing. However, revenue‐royalty licensing is slightly superior for consumers to the other two types of licensing and only so if the cost advantage of the innovator is sufficiently large.
Optimal taxation in a free‐entry Cournot oligopoly: The average cost function approach
Authors: Hamada Kojun , Ohkawa Takao , Okamura Makoto
Published: June 2022

This study examines the optimal taxation in a free‐entry Cournot oligopoly using the average cost function and aggregative games approach when either a specific tax, an ad valorem tax, or both, is imposed. When either a specific or an ad valorem tax is imposed, we obtain the following results. First, the business‐stealing (business‐augmenting) effect in the free‐entry equilibrium makes the optimal tax rate positive (negative). Second, social welfare under the optimal specific tax is lower than that under the optimal ad valorem tax. Third, when both taxes are imposed, marginally increasing a positive ad valorem tax (negative specific tax) improves social welfare when the optimal specific (ad valorem) tax is initially imposed. Finally, the optimal combination of a specific subsidy and ad valorem tax depends on the shape of the average cost function.
Policy resistance to paradigm shifts: Inclusive growth and innovation in Canada
Authors: Jansen Alix J. , Robbins Mark
Published: June 2022

We assess Canada's labour market policy mix in order to determine whether the inclusive growth and innovation agenda indicates that technological change has triggered a policy paradigm shift. Our analysis of four policy areas concerning labour market access indicates no paradigm shift has occurred. Instead, the agenda is an example of policy resistance: first‐ and second‐order policy changes (changes to policy settings) maintain the status quo of labour market arrangements. The result is a revised set of supply‐side policies unlikely to reorganize the labour market. Technological disruption and the COVID‐19 pandemic offer opportunities to reorganize Canada's labour market policies' current policy mix, but, even under the banner of inclusive innovation, this shift is unlikely to happen.
Canadian graduate programs in public administration: The state of the field
Authors: Roberge Ian , Oduro Judy
Published: June 2022

Graduate public administration programs at Canadian universities have seen significant growth and change over the last fifteen years. This research note assesses current programming and considers recent developments. We argue that Canadian public administration programs exhibit diversity and that they are responsive to key trends and forces shaping society. To support these claims, we compare program curriculums and highlight distinguishing features. We suggest in closing, though, that further adjustments are required for programs to take advantage of arising opportunities and to remain resilient in the face of new challenges.
Long‐term results of mesh pelvic floor reconstruction to address the empty pelvis syndrome
Authors: Khaw Chern Wern , Ebrahimi Nargus , Lee Peter , McCarthy Alexander S. E. , Solomon Michael
Published: June 2022

Aim

As the “empty pelvis syndrome” continues to pose challenges in patients undergoing radical pelvic exenteration, there remains an ongoing need to consider solutions to mitigate or avoid its associated morbidity. As such, this study aims to review the long‐term outcomes of a proposed strategy of pelvic reconstruction with BioA mesh.

Method

We conducted a retrospective observational cohort study, reviewing cases of pelvic exenteration and/or pelvic bone resection involving BioA mesh pelvic reconstruction between 2017 and 2021 at our quaternary institution, identified from a prospectively collected database. The primary outcome was pelvic complications including perineal fistula, wound breakdown and pelvic collections.

Results

Over a 4‐year period, there were a total of 36 patients who had pelvic exenteration and/or pelvic bone resection with BioA mesh pelvic reconstruction. The overall pelvic complication rate was 36% (n = 13), including 11 symptomatic pelvic collections, two enteroperineal fistulas, and no cases of perineal hernia. Reoperation was required in two patients. There was no perioperative mortality.

Conclusion

Given that pelvic complications post BioA mesh reconstruction are of an acceptable rate and can be considered minor, using this technique is a safe and practical strategy in patients undergoing major pelvic surgery with or without pelvic bone resection.
Deep grace in deep space? How to become an astrotheologian
Authors: Peters Ted
Published: June 2022

If God's grace is already present to outer space, then Christian doctrines such as creation and redemption become as public as outer space is public. The public Christian theologian should engage in astrotheology as well as astroethics. This article tenders seven steps toward becoming an astrotheologian and astroethicist. (1) Become sensitive to the Beyond and the Intimate when talking about the true God. (2) Think cosmically. (3) Do not be bullied by the Cosmological Principle or the Copernican Principle. (4) Explore deep incarnation in deep space. (5) Add eschatology to deep incarnation. (6) By using a Theology of Culture, demarcate science, scientism, and pseudoscience. (7) Celebrate the 60th Anniversary of Astroethics. These steps presuppose a comprehensive hypothesis: the historical incarnation of the divine Logos in Jesus of Nazareth on Earth is constituted by the exchange of divine and creaturely attributes, the communicatio idiomatum; and, when communicatio idiomatum is combined with an eschatological vision of God's promised new creation, we can accompany the entire material history of all galaxies and all extraterrestrial creatures into the eternal perichoresis of God as Trinity.
Detecting and interpreting higher‐order interactions in ecological communities
Authors: Kleinhesselink Andrew R. , Kraft Nathan J. B. , Pacala Stephen W. , Levine Jonathan M.
Published: June 2022

When species simultaneously compete with two or more species of competitor, higher‐order interactions (HOIs) can lead to emergent properties not present when species interact in isolated pairs. To extend ecological theory to multi‐competitor communities, ecologists must confront the challenges of measuring and interpreting HOIs in models of competition fit to data from nature. Such efforts are hindered by the fact that different studies use different definitions, and these definitions have unclear relationships to one another. Here, we propose a distinction between ‘soft’ HOIs, which identify possible interaction modification by competitors, and ‘hard’ HOIs, which identify interactions uniquely emerging in systems with three or more competitors. We show how these two classes of HOI differ in their motivation and interpretation, as well as the tests one uses to identify them in models fit to data. We then show how to operationalise this structure of definitions by analysing the results of a simulated competition experiment underlain by a consumer resource model. In the course of doing so, we clarify the challenges of interpreting HOIs in nature, and suggest a more precise framing of this research endeavour to catalyse further investigations.
Prognostic value of glycemic gap in patients with spontaneous intracerebral hemorrhage
Authors: Wang Chuanying , Wang Wenjuan , Li Guangshuo , Wang Anxin , Zhang Xiaoli , Xiong Yunyun , Zhao Xingquan
Published: June 2022

Background and purpose

Glycemic gap (GG), as a novel biomarker showing the acute glycemic change after the onset of acute illness, has been found to be associated with adverse outcomes in many diseases. This study aimed to explore the prognostic value of GG on long‐term outcomes of spontaneous intracerebral hemorrhage (sICH).

Methods

The current study included 528 patients from a multicenter, prospective, consecutive, observational cohort study. Poor clinical outcome was defined as modified Rankin Scale ≥ 3. GG was calculated using admission blood glucose minus hemoglobin A1c‐derived average blood glucose. Logistic regression analyses were performed to determine the association between GG and poor clinical outcomes at 30 days, 90 days, and 1 year.

Results

Glycemic gap was significantly associated with poor clinical outcomes at 30 days, 90 days, and 1 year (p < 0.05 for all models), where patients with higher GG were more likely to have poor clinical outcome. Restricted cubic splines revealed a positive association between GG and poor clinical outcome. In addition, patients with higher GG were more likely to have a higher 1‐year mortality rate. The addition of GG to the intracerebral hemorrhage score improved the discrimination and calibration properties for the prediction of poor clinical outcome.

Conclusions

Glycemic gap was independently associated with poor outcomes and may be a valuable prognostic factor in patients with sICH.