bluuebunny/crossref_metadata_2025 huggingface dataset:
Postpartum Depression in American Indian/Alaska Native Women
Authors: Heck Jennifer L.
Published: October 2020

Background:

Postpartum depression (PPD) is the most common complication of childbirth and affects one in nine new mothers in the United States.

Objective:

The purpose of this review was to synthesize PPD research in American Indian/Alaska Native (AI/AN) women. Specific aims were to 1) explore the extent to which PPD literature includes AI/AN women measured by the proportion of study samples that were AI/AN women and 2) identify and analyze gaps in the PPD literature for AI/AN women.

Design:

Databases were searched using: “postpartum depression” and “American Indian,” “Native American,” “Alaska Native,” “Inuit,” and “Indigenous.” “Postpartum depressive symptoms” and “puerperal mood disorder” were each paired with race/ethnicity search terms, yielding a final sample of nine articles.

Results:

The proportion of study samples that were AI/AN women ranged from 0.8% to 100%. Compared with all women in the United States (11%), AI/AN women have higher PPD prevalence (14%-29.7%), suggesting a disparity among the different groups of women. Screening instruments were inconsistent among studies, and not all studies used a screening instrument specific to PPD. No cultural influences, risk, or protective factors were reported for AI/AN women. In the only intervention study, no significant differences in PPD symptoms between groups were found after the intervention.

Conclusions:

This review uncovered significant gaps in the literature and suggested ways to advance the PPD science for AI/AN women. Clinical implications were described.
An Adolescent With Intermittent Claudication
Authors: Camozzi Pietro , Wyttenbach Marina , De Rosa Vincenzo , Renzi Samuele , Bianchetti Mario G.
Published: October 2020

Intermittent claudication is very uncommon in children and adolescents. We describe the case of a 14-year-old adolescent girl experiencing left calf pain for a year that occurs during running and becomes unbearable after around 2 km. She was ultimately diagnosed with extrinsic compression of the popliteal artery caused by an osteocartilaginous exostosis (osteochondroma) originating from the fibula.
Appropriate antibiotics in dog bite injuries: an audit study
Authors: Al Omran Yasser , Evans Ellie , Jordan Chloe , Yang Ding , Huq Shahidal
Published: October 2020

Background:

Dog bite injuries are a common presentation to Accident and Emergency. In the United Kingdom ~250,000 people attend emergency units each year as a result of dog wounds. Currently, there is a lack of consistency in the approach and management of such wounds across plastic surgery units in the United Kingdom.

Method:

A retrospective review of medical record of patients who were admitted under the care of the Plastic Surgery Department at University Hospital North Midlands NHS Foundation Trust with dog-bite wounds between January and December 2018.

Results:

Of the 69 patients that were included in the study, 14 (20%) of them had been prescribed antibiotics that were ineffective and against antimicrobial guidelines. Following liaison with the antimicrobial governance team and input from NICE guidelines, the trust’s MicroGuide Antibiotic Prescribing Guidelines App was updated. A reaudit from November 2019 to February 2020 showed that there was 100% compliance with guidance.

Conclusion:

Updating the University Hospital of North Midlands NHS Trust’s MicroGuide antibiotic prescribing guidelines for the treatment of dog-bite injuries resulted in 100% of patients being treated with the correct antibiotic. Given the polymicrobial nature of animal-bite wounds, and the high levels of resistance demonstrated by organisms commonly found in such injuries, this increased compliance with guidelines helps minimize patient suffering, morbidity, length of stay, and disability, while reducing costs incurred. The intervention should be implemented within other units within the United Kingdom who similarly lack clear, detailed guidelines, in order to maximize treatment continuity and patient outcomes nationwide.
Timing of thromboprophylaxis in patients with blunt abdominal solid organ injuries undergoing nonoperative management
Authors: Gaitanidis Apostolos , Breen Kerry Ann , Nederpelt Charlie , Parks Jonathan , Saillant Noelle , Kaafarani Haytham M.A. , Velmahos George C. , Mendoza April E.
Published: October 2020

BACKGROUND

Decision making regarding the optimal timing for initiating thromboprophylaxis in patients with blunt abdominal solid organ injuries (BSOIs) remains ill-defined, with no guidelines defining optimal timing. In this study, we aimed to evaluate the relationship of the timing of thromboprophylaxis with thromboembolic and bleeding complications in the setting of BSOIs.

METHODS

A retrospective analysis of the Trauma Quality Improvement Program database was performed between 2013 and 2016. All patients with isolated BSOIs (liver, spleen, pancreas, or kidney, Abbreviated Injury Scale score, <3 in other regions) who underwent initial nonoperative management (NOM) were included. Patients were divided into three groups (early, <48 hours; intermediate, 48–72 hours; and late, >72 hours) based on timing of thromboprophylaxis initiation. Primary outcomes were rates of thromboembolism and bleeding after thromboprophylaxis initiation.

RESULTS

Of the 25,118 patients with isolated BSOIs, 3,223 met the inclusion criteria (age, 38.7 ± 17.3 years; males, 2.082 [64.6%]), among which 1,832 (56.8%) received early thromboprophylaxis, 703 (21.8%) received intermediate thromboprophylaxis, and 688 (21.4%) received late thromboprophylaxis. Late thromboprophylaxis initiation was independently associated with a higher likelihood of both deep vein thrombosis (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.68–5.91, p < 0.001) and pulmonary embolism (OR, 4.29; 95% CI, 1.95–9.42; p < 0.001). Intermediate thromboprophylaxis initiation was independently associated with a higher likelihood of deep venous thrombosis (OR, 2.38; 95% CI, 1.20–4.74; p = 0.013), but not pulmonary embolism (p = 0.960) compared with early initiation. Early (but not intermediate) thromboprophylaxis initiation was independently associated with a higher likelihood of bleeding (OR, 2.05; 95% CI, 1.11–2.18; p = 0.023), along with a history of diabetes mellitus, splenic, and high-grade liver injuries.

CONCLUSION

Early thromboprophylaxis should be considered in patients with BSOIs undergoing nonoperative management who are at low likelihood of bleeding. An intermediate delay (48–72 hours) of thromboprophylaxis should be considered for patients with diabetes mellitus, splenic injuries, and Grades 3 to 5 liver injuries.

LEVEL OF EVIDENCE

Therapeutic, Level IV.
Evaluation of saliva sampling procedures for SARS-CoV-2 diagnostics reveals differential sensitivity and association with viral load
Authors: Mestdagh Pieter , Gillard Michel , Arbyn Marc , Pirnay Jean-Paul , Poels Jeroen , Hellemans Jan , Peeters Eliana , Hutse Veronik , Vermeiren Celine , Boutier Maxime , De Wever Veerle , Soentjens Patrick , Djebara Sarah , Malonne Hugues , André Emmanuel , Smeraglia John , Vandesompele Jo
Published: October 2020

Nasopharyngeal sampling has been the preferential collection method for SARS-CoV-2 diagnostics. Alternative sampling procedures that are less invasive and do not require a healthcare professional would be more preferable for patients and health professionals. Saliva collection has been proposed as such a possible alternative sampling procedure. We evaluated the sensitivity of SARS-CoV-2 testing on two different saliva collection devices (spitting versus swabbing) compared to nasopharyngeal swabs in over 2500 individuals that were either symptomatic or had high-risk contacts with infected individuals. We observed an overall poor sensitivity in saliva for SARS-CoV-2 detection (30.8% and 22.4% for spitting and swabbing, respectively). However, when focusing on individuals with medium to high viral load, sensitivity increased substantially (97.0% and 76.7% for spitting and swabbing, respectively), irrespective of symptomatic status. Our results suggest that saliva cannot readily replace nasopharyngeal sampling for SARS-CoV-2 diagnostics but may enable identification of cases with medium to high viral loads.
An immunologically active, adipose-derived extracellular matrix biomaterial for soft tissue reconstruction: concept to clinical trial
Authors: Anderson Amy E. , Wu Iwen , Parrillo Alexis J. , Maestas David R. , Graham Ian , Tam Ada J. , Payne Rachael M. , Aston Jeffrey , Cooney Carisa M. , Byrne Patrick , Cooney Damon S. , Elisseeff Jennifer H.
Published: October 2020

Soft tissue reconstruction remains an intractable clinical challenge as current surgical options and synthetic implants may produce inadequate outcomes. Soft tissue deficits may be surgically reconstructed using autologous adipose tissue, but these procedures can lead to donor site morbidity, require multiple trips to the operating room, and have highly variable outcomes. To address the clinical need for soft tissue reconstruction, we developed an “off-the-shelf” adipose matrix from allograft human adipose tissue (acellular adipose tissue, AAT). We applied physical and chemical processing methods to remove lipids and create an injectable matrix that mimicked the properties of fat grafting materials. Biological activity was assessed using cell migration and stem cell adipogenesis assays. Characterization of the regenerative immunology properties in a murine muscle injury model revealed allograft and xenograft AAT induced pro-regenerative CD4+ T cells and macrophages with xenograft AAT attracting additional eosinophils secreting interleukin 4 (Il4). In immunocompromised mice, AAT injections retained similar tissue volumes as human fat grafts but did not have the cysts and calcifications that formed in the human fat graft implants. Combination of AAT with human adipose-derived stem cells (ASCs) resulted in lower implant volumes. However, tissue remodeling and new adipose development increased significantly with the addition of cells. Larger injected volumes of porcine-derived AAT demonstrated biocompatibility and greater volume retention when applied allogeneicly in Yorkshire cross pigs. Under a biologic IND application, AAT was implanted in healthy volunteers in abdominal tissue that was later removed (panniculectomy or abdominoplasty). The AAT implants were well tolerated and biocompatible in all eight human subjects. Analysis of implants removed between 1 and 18 weeks demonstrated increasing cellular infiltration and immune populations, suggesting continued tissue remodeling and the potential for long term tissue replacement.

An adipose-derived injectable biomaterial provides volume correction for soft tissue defects while promoting pro-healing immune responses.
Effectiveness of Influenza Vaccine for Preventing Laboratory-Confirmed Influenza Hospitalizations in Immunocompromised Adults
Authors: Hughes Kailey , Middleton Donald B , Nowalk Mary Patricia , Balasubramani Goundappa K , Martin Emily T , Gaglani Manjusha , Talbot H Keipp , Patel Manish M , Ferdinands Jill M , Zimmerman Richard K , Silveira Fernanda P ,   for the HAIVEN Study Investigators
Published: October 2020

Background

Yearly influenza immunization is recommended for immunocompromised (IC) individuals, although immune responses are lower than that for the non-immunocompromised and the data on vaccine effectiveness (VE) in the IC is scarce. We evaluated VE against influenza-associated hospitalization among IC adults.

Methods

We analyzed data from adults ≥ 18 years hospitalized with acute respiratory illness (ARI) during the 2017-2018 influenza season at 10 hospitals in the United States. IC adults were identified using pre-specified case-definitions, utilizing electronic medical record data. VE was evaluated with a test-negative case-control design using multivariate logistic regression with PCR-confirmed influenza as the outcome and vaccination status as the exposure, adjusting for age, enrolling site, illness onset date, race, days from onset to specimen collection, self-reported health, and self-reported hospitalizations.

Results

Of 3,524 adults hospitalized with ARI, 1,210 (34.3%) had an immunocompromising condition. IC adults were more likely to be vaccinated than non-IC (69.5% vs 65.2%), and less likely to have influenza (22% vs 27.8%). The mean age did not differ among IC and non-IC (61.4 vs 60.8 years old). The overall VE against influenza hospitalization, including immunocompetent adults, was 33% (95% CI, 21% to 44%). VE among IC vs non-IC adults was lower at 5% (−29% to 31%) vs. 41% (27% to 52%) (p<0.05 for interaction term).

Conclusions

VE in one influenza season was very low among IC individuals. Future efforts should include evaluation of VE among the different immunocompromising conditions and whether enhanced vaccines improve the suboptimal effectiveness among the immunocompromised.
Group Testing with Homophily to Curb Epidemics with Asymptomatic Carriers
Authors: de Belleville Louis-Marie Harpedanne
Published: October 2020

Contagion happens through heterogeneous interpersonal relations (homophily) which induce contamination clusters. Group testing is increasingly recognized as necessary to fight the asymptomatic transmission of the COVID-19. Still, it is plagued by false negatives. Homophily can be taken into account to design test pools that encompass potential contamination clusters. I show that this makes it possible to overcome the usual information-theoretic limits of group testing, which are based on an implicit homogeneity assumption. Even more interestingly, a multiple-step testing strategy combining this approach with advanced complementary exams for all individuals in pools identified as positive identifies asymptomatic carriers who would be missed even by costly exhaustive individual tests. Recent advances in group testing have brought large gains in efficiency, but within the bounds of the above cited information-theoretic limits, and without tackling the false negatives issue which is crucial for COVID-19. Homophily has been considered in the contagion literature already, but not in order to improve group testing.
Temperature and species-dependent regulation of browning in retrobulbar fat
Authors: Rajaii Fatemeh , Kim Dong Won , Pan Jianbo , Mahoney Nicholas R. , Eberhart Charles G. , Qian Jiang , Blackshaw Seth
Published: October 2020

Retrobulbar fat deposits surround the posterior retina and optic nerve head, but their function and origin are obscure. We report that mouse retrobulbar fat is a neural crest-derived tissue histologically and transcriptionally resembles interscapular brown fat. In contrast, human retrobulbar fat closely resembles white adipose tissue. Retrobulbar fat is also brown in other rodents, which are typically housed at temperatures below thermoneutrality, but is white in larger animals. We show that retrobulbar fat in mice housed at thermoneutral temperature show reduced expression of the brown fat marker Ucp1, and histological properties intermediate between white and brown fat. We conclude that retrobulbar fat can potentially serve as a site of active thermogenesis, that this capability is both temperature and species-dependent, and that this may facilitate regulation of intraocular temperature.
Vital organisational capabilities for strategic agility: an empirical study
Authors: Chan Josephine Ie Lyn , Muthuveloo Rajendran
Published: October 2020

Purpose

The purpose of this study is to examine the organisational capabilities needed for strategic agility among private higher education institutions (HEIs) in Malaysia that are operating in a turbulent business environment. In addition, the study also intends to determine the area of prioritisation for these institutions.

Design/methodology/approach

A two-month data collection was carried out on 375 private HEIs via a Web-based survey, which garnered a response rate of 41.33%. The data were subsequently analysed with the partial least squares structural equation modelling to establish the validity and reliability of the research model and to test the postulated hypotheses. The assessment of importance and performance matrix analysis (IPMA) was also carried out to highlight the areas of significance for improvement.

Findings

The study discovered that all three constructs of organisational capabilities, i.e. environmental scanning, marketing and organisational learning, attributed significantly to strategic agility. This in turn enabled strategic agility to significantly influence the organisational performance of private HEIs in Malaysia. Finally, IPMA revealed that private HEIs need to prioritise organisational learning to strengthen their strategic agility, thus optimise organisational performance.

Originality/value

Aside from business and management research of strategic agility in other industries, the current study manages to establish that strategic agility also plays an important role in the private higher education sector. Furthermore, the use of IPMA provides fresh insight into the importance and performance of the organisational capabilities examined against strategic agility.
The impact of economic blockade on the performance of Qatari Islamic and conventional banks: a period-and-group-wise comparison
Authors: Ali Abdilatif Mao
Published: October 2020

Purpose

This paper aims to empirically assess the performance of Islamic banks (IBs) and conventional banks (CBs) in Qatar before and after the imposition of the economic blockade on Qatar and the significance of the blockade’s subsequent impact.

Design/methodology/approach

This study focuses only on the domestic commercial banks comprising four IBs and five CBs operating in Qatar. The banks’ financial reports are used as a secondary source to generate data. A study period from 2015 to 2019, separated into pre-blockade and post-blockade periods and comprising data on a semi-annual basis, was examined. Financial ratios and t-tests are used to compare bank performance and test the significance level of the blockade, respectively.

Findings

Generally, the findings show that IBs slightly outperformed CBs. Solvency ratios show strong capitalization (measured by capital adequacy ratio, CAR) and external fund (measured by equity multiplier ratio, EMR) reliance of the banks, despite minor fluctuations. Yet, only the CAR of CBs has been significantly affected by the blockade. Profitability (measured by return on assets, ROA and return on equity, ROE) of both bank groups grew unsteadily over the period, but IBs remained more efficient (measured by operating efficiency, OEOI) than CBs. Liquidity ratios indicate almost similar depositor fund utilization (measured by loans to deposit ratio, LDR) and credit offering (measured by loans to assets ratio, LAR) by the banks. All three metrics were weakly impacted. In terms of asset quality, bad loans (measured by non-performing loans ratio, NPL) and provisions (measured by loan loss provisions, LLP) surged moderately post-blockade. The blockade affected both groups’ asset quality.

Originality/value

To the author’s knowledge, this is the first study to comparatively examine the performance of Qatari IBs and CBs during the latest economic embargo and their exposure to the crisis.
Characterization of solid wastes as a tool to implement waste management strategies in a university campus
Authors: Nolasco Elaine , Vieira Duraes Pedro Henrique , Pereira Gonçalves Júlia , Oliveira Maria Cristina de , Monteiro de Abreu Lucijane , Nascimento de Almeida Alexandre
Published: October 2020

Purpose

Universities are an example of institutions that aggregate people around work/study who consume water, energy and produce waste daily in their activities, generating an impact on the environment. The purpose of this study is to determine the quantity, composition and recycling potential of waste generated at the Faculdade UnB Planaltina (FUP) campus, of the University of Brasilia in the Federal District, Brazil, to develop a waste management strategy compatible with national legislation and sustainable global practices.

Design/methodology/approach

This study was based on conducting on-site visits to identify the sources of generation, hazardousness, management and gravimetric characteristics of residual waste from 2015 to 2016. In 2016, a selective collection was implemented on the FUP campus, and since then, actions to raise awareness for the selective disposal and monitoring of waste were conducted with the academic community.

Findings

The results showed that the campus generates 148 kg of waste/day, whereas the per capita generation is 92 g/day. The production of hazardous waste is related to campus laboratories which manage it under a specific program. The campus restaurant is the place that generates the most waste, of which organic waste is the most representative. When categorizing the waste generated on campus, the authors found that the majority are recyclables at 67% of the total. This category includes material composed of cardboard, paper and plastic, all able to be recycled in the Federal District.

Practical implications

The recyclable waste generated at the FUP campus is being diverted from the city’s landfill because they are donated to a recycling cooperative. These actions promote income generation, social inclusion of waste pickers and a circular economy, all in compliance with the National Solid Waste Policy. As a result, the FUP campus is more in line with Brazilian legislation and the global context of adopting sustainable waste management amongst higher education institutions.

Originality/value

This paper contributes to the literature on sustainability in higher education by reporting the process of implementation of a waste management strategy in a university campus. Further, it presents tools and methods that can be used to achieve sustainability in waste management. The study also identifies that the crucial factor for the success of such actions is the mobilization and participation of the academic community in the process. It does so by presenting findings demonstrating how the University of Brasilia has been concerned with adopting pro-environmental measures for sustainable development.
The behaviour of US investors during presidential elections
Authors: Colón De Armas Carlos , Rodriguez Javier , Romero Herminio
Published: October 2020

Purpose

This study examines the influence of the presidential elections on the behaviour of US investors according to the trading activity of two of the most popular investment vehicles: exchange-traded funds and close-ended funds.

Design/methodology/approach

Based on the fact that investors in these two investment vehicles differ by, at least, two demographic factors that influence investment decisions, age and labour status, inferences are made about the degree of interest and the amount of trading activity that presidential elections provoke.

Findings

The evidence demonstrates that, during the last four US presidential elections, exchange-traded funds' investors trade significantly more than close-ended funds' investors during several event windows centred on the day of an election in which a republican candidate is elected. Close-ended funds' investors are more active during the election of a democratic candidate, although the statistical evidence in that regard is weak. Thus, it appears reasonable to conclude that younger investors who are gainfully employed are induced to trade by a presidential election in which a republican candidate prevails. Apparently, a democratic victory does not provoke the same behaviour.

Originality/value

Although the relation between politics and economics is not an unexplored topic, it is not clear whether the presidential elections themselves constitute an event that triggers the trading behaviour of investors.
Implementing lean-led hospital design; lessons gained at a pioneer
Authors: Schouten Hannelore , Heusinkveld Stefan , van der Kam Wouter , Benders Jos
Published: October 2020

Purpose

The aim of this study is to document and analyze experiences with building a new hospital guided by lean-led hospital design (LLHD) (Grunden and Hagood, 2012) and to investigate key mechanisms enhancing healthcare professionals' participation and collaboration in implementing this innovative approach.

Design/methodology/approach

An in-depth case study of the implementation of LLHD in a Dutch hospital was performed based on multiple data sources. The case hospital presented a unique opportunity since there was embedded access to the data by the first author.

Findings

Three mechanisms supporting participation and collaboration of staff for implementing LLHD were identified. (1) Freedom in translating a concept enables managers to balance it with variations in practice at the organizational level. (2) A set of key principles governing the design process appeared an important anchor on a managerial level in a changing environment. (3) Creation of a supportive attitude toward lean and lean facility design, with co-creation as a key element of LLHD.

Practical implications

By using the emerging mechanisms, managers/change agents can enlarge collaboration and participation of hospital staff when implementing organization-wide innovations.

Originality/value

This case study delivers a unique inside view on the dynamics evolving in the complex change processes at organizational, managerial and personal levels involved in implementing LLHD.
Internal auditing in the public sector: a systematic literature review and future research agenda
Authors: Nerantzidis Michail , Pazarskis Michail , Drogalas George , Galanis Stergios
Published: October 2020

Purpose

This study reviews post-2009 literature on public sector internal auditing (IA) and addresses three interrelated research questions (RQ): How is research on the public sector IA being developed? What are the focus and criticisms of the literature on public sector IA? What is the future of public sector IA research?

Design/methodology/approach

We adopt a systematic literature review approach and analyze 78 peer-reviewed journal articles published between 2010 and 2019. We evaluate five criteria to identify the development of public sector IA research (RQ1), namely level of government, academic discipline, number of countries, geographic areas and MSCI country classification. Similarly, we use four criteria to present the focus and criticisms of the literature (RQ2), namely, type of organizational respondent, research instrument, theories and research theme examined. Finally, we use two criteria to propose new directions for future research (RQ3), namely, the directions resulted from RQ1 and RQ2 and the directions highlighted by the 10 most cited studies in the IA literature (i.e. out of the 78 papers identified).

Findings

We find an increase of publications up to 2017, most of which are single country–focused, particularly on emerging markets. Moreover, we note that IA has been studied at all government levels, most often at the local government level. Although we identify multiple research themes examined in the literature, most studies emphasize “governance” and “operational effectiveness” using quantitative analysis, without reference to any theory. By analyzing these key features, we critically interpret the challenges as well as the skepticism that may surface by researchers. Finally, considering implications from this stream of research and analyzing the most influential studies, we recommend new avenues for investigation such as comparative studies among countries and different markets that provide further evidence on the international and regional levels and studies on the effect of cultural, institutional and demographical characteristics in IA.

Practical implications

Our results will help researchers, practitioners and consultants to identify the key issues related with IA.

Originality/value

This study is the first to provide a systematic literature review on public sector IA. Furthermore, it develops insights, critical reflections and avenues for future research in this field.
Can the market divide and multiply? A case of 807 percent mispricing
Authors: van den Assem Martijn J. , van Dolder Dennie , Zwinkels Remco C.J. , Schauten Marc B.J.
Published: October 2020

Purpose

This paper documents a strong violation of the law of one price surrounding a large rights issue.

Design/methodology/approach

If prices are right, the relation between the prices of shares and rights follows the outcome of a simple calculation.

Findings

In the case of Royal Imtech N.V. in 2014, prices deviated sharply and persistently from the theoretical prediction. Throughout the term of the rights, investors were buying shares at prices that were many times what they should have been given the price of the rights. Short-selling constraints in the form of high recall risk and lacking stock lending supply are the most likely explanation for the failure of arbitrage as a safeguard of market efficiency. Still, it remains remarkable that investors were buying large volumes of shares at highly inflated prices in the presence of a cheap, perfect substitute.

Originality/value

The mispricing was special not just because of its severity but also because unlike previously documented cases there was no fundamental risk and no material noise trader risk.
Class and status in interwar England: Current issues in the light of a historical case
Authors: Goldthorpe John H.
Published: October 2020

There has been much recent discussion concerning the conceptual and empirical viability and value of the distinction between social class and social status, and in particular as implemented in the work of Chan and Goldthorpe. The present paper addresses certain of the issues that arise on the basis of a historical case, that of class and status in interwar England, with reference to housing, sports club membership, and dress. It seeks to show that, contrary to what has been claimed by various authors, the distinction can be effectively made and is indeed necessary to an understanding of these features of the social history of the period; that it is differential association that has to be seen as constitutive of status stratification, rather than differences in lifestyle; and that increased status striving, anxieties, and segregation, with adverse psychological consequences, can result from a narrowing as well as from a widening of class inequalities.
Sociodemographic and clinical factors associated with breakfast skipping among high school students
Authors: Lee Ju‐Yeon , Ban Dahye , Kim Honey , Kim Seon‐Young , Kim Jae‐Min , Shin Il‐Seon , Kim Sung‐Wan
Published: October 2020

Aim

Breakfast plays an important role in the academic performance and mental health of adolescents. This study explored factors associated with breakfast skipping in high school students in South Korea.

Methods

A cross‐sectional survey was completed by 1684 high school students. A logistic regression analysis was conducted to determine the factors associated with skipping breakfast, including sociodemographic factors, mental health problems (such as depression and anxiety), sleep and smartphone use patterns.

Results

A total of 29.2% of the adolescents reported skipping breakfast and girls were significantly more likely to skip breakfast than boys (P < .001). The breakfast skipping group spent more time using a smartphone on weekdays [mean (SD) = 186.2 (180.0) min/d] than the breakfast eating group [mean (SD) = 110.2 (111.5) min/d] (P < .001). The Korean scale for smartphone addiction (S‐scale) score was higher in the breakfast skipping group (P = .006). Multivariate logistic regression analysis showed that female gender, poor academic performance (odds ratio (OR),  1.575; 95% CI,  1.166‐2.126, P = .003), depression (OR,  1.023; 95% CI,  1.002‐1.043, P = .031), time spent using a smartphone on weekdays (OR,  1.003; 95% CI,  1.002‐1.004, P < .001), and low parental monitoring of smartphone use were significantly associated with skipping breakfast.

Conclusions

Findings indicate that unhealthy lifestyle including smartphone overuse negatively affects breakfast eating in adolescents. School‐based nutritional programs should be designed to assess and overcome various individual factors associated with breakfast skipping.
Repositioning microbial biotechnology against COVID‐19: the case of microbial production of flavonoids
Authors: Goris Tobias , Pérez‐Valero Álvaro , Martínez Igor , Yi Dong , Fernández‐Calleja Luis , San León David , Bornscheuer Uwe T. , Magadán‐Corpas Patricia , Lombó Felipe , Nogales Juan
Published: October 2020

Coronavirus‐related disease 2019 (COVID‐19) became a pandemic in February 2020, and worldwide researchers try to tackle the disease with approved drugs of all kinds, or to develop novel compounds inhibiting viral spreading. Flavonoids, already investigated as antivirals in general, also might bear activities specific for the viral agent causing COVID‐19, SARS‐CoV‐2. Microbial biotechnology and especially synthetic biology may help to produce flavonoids, which are exclusive plant secondary metabolites, at a larger scale or indeed to find novel pharmaceutically active flavonoids. Here, we review the state of the art in (i) antiviral activity of flavonoids specific for coronaviruses and (ii) results derived from computational studies, mostly docking studies mainly inhibiting specific coronaviral proteins such as the 3CL (main) protease, the spike protein or the RNA‐dependent RNA polymerase. In the end, we strive towards a synthetic biology pipeline making the fast and tailored production of valuable antiviral flavonoids possible by applying the last concepts of division of labour through co‐cultivation/microbial community approaches to the DBTL (Design, Build, Test, Learn) principle.
Do Debt Investors Adjust Financial Statement Ratios When Financial Statements Fail to Reflect Economic Substance? Evidence from Cash Flow Hedges*†
Authors: Campbell John L. , D'Adduzio Jenna , Downes Jimmy F. , Utke Steven
Published: October 2020

Cash flow hedge derivatives are an example of an economic transaction that is not fully portrayed in the financial statements in two key ways. First, while changes in the fair value of the derivative are recorded at each reporting date, changes in the value of the underlying purchase or sale commitment are not recorded or disclosed until that transaction occurs. Therefore, until the purchase or sale occurs, the financial statements only portray half of the economic transaction. Second, the gains/losses associated with these derivatives provide an inverse signal about the persistence of firm profitability. We document a method by which financial statement users can partially adjust for these distortions and find evidence that debt investors incorporate information conveyed by cash flow hedge gains/losses into their pricing of new debt issuances. We also find evidence that credit analysts incorporate these adjustments into their firm‐level credit ratings but are unable to find consistent evidence of similar adjustments to credit ratings on new debt issuances. Overall, our results suggest that a subset of sophisticated investors (i.e., those in public debt markets) appear to incorporate information from cash flow hedge accounting into their assessments of firm risk, and that users may benefit from enhanced disclosure about the amount and timing of a firm's future transactions that are exposed to foreign currency, interest rate, or commodity price risk as well as the amount and timing of derivatives that protect the firm from those risks.
Aerosolisation during tracheal intubation and extubation in an operating theatre setting
Authors: Dhillon R. S. , Rowin W. A. , Humphries R. S. , Kevin K. , Ward J. D. , Phan T. D. , Nguyen L. V. , Wynne D. D. , Scott D. A. ,   the Clinical Aerosolisation Study Group
Published: October 2020

Aerosol‐generating procedures such as tracheal intubation and extubation pose a potential risk to healthcare workers because of the possibility of airborne transmission of infection. Detailed characterisation of aerosol quantities, particle size and generating activities has been undertaken in a number of simulations but not in actual clinical practice. The aim of this study was to determine whether the processes of facemask ventilation, tracheal intubation and extubation generate aerosols in clinical practice, and to characterise any aerosols produced. In this observational study, patients scheduled to undergo elective endonasal pituitary surgery without symptoms of COVID‐19 were recruited. Airway management including tracheal intubation and extubation was performed in a standard positive pressure operating room with aerosols detected using laser‐based particle image velocimetry to detect larger particles, and spectrometry with continuous air sampling to detect smaller particles. A total of 482,960 data points were assessed for complete procedures in three patients. Facemask ventilation, tracheal tube insertion and cuff inflation generated small particles 30–300 times above background noise that remained suspended in airflows and spread from the patient’s facial region throughout the confines of the operating theatre. Safe clinical practice of these procedures should reflect these particle profiles. This adds to data that inform decisions regarding the appropriate precautions to take in a real‐world setting.
The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants
Authors: Akhbari Ziegler Schirin , von Rhein Michael , Meichtry André , Wirz Markus , Hielkema Tjitske , Hadders‐Algra Mijna ,   the Swiss Neonatal Network & Follow‐Up Group
Published: October 2020

Aim

We compared the impact of standard infant physiotherapy and the family‐centred programme, Coping with and Caring for Infants with Special Needs (COPCA), in infants born before 32 weeks without significant brain lesions.

Methods

This randomised controlled trial was carried out in patients' homes and outpatient settings in Switzerland between January 2016 and October 2019. We used data from the national SwissNeoNet register and an assessment battery that included infant and family outcomes and video analyses of therapy sessions. The Infant Motor Profile was the primary outcome instrument.

Results

The COPCA group comprised six boys and two girls with a median gestational age of 27 weeks (range 25‐30), and the standard care group comprised seven boys and one girl with a median gestational age of 29.5 weeks (range 26‐31). COPCA participants improved significantly more between baseline and 18 months in the IMP variation (9.0 percentage points, 95% confidence interval: 0.3‐17.5) and performance (12.0 percentage points, 95% confidence interval: 4.1‐20.6) domains than standard care participants. COPCA coaching was positively associated with IMP scores at 18 months, but some standard care actions were negatively associated.

Conclusion

COPCA was associated with better motor outcome in infants born before 32 weeks than standard infant physiotherapy.
Structure of small tropical island freshwater fish and crustacean communities: A niche‐or dispersal‐based process?
Authors: Lagarde Raphael , Teichert Nils , Valade Pierre , Ponton Dominique
Published: October 2020

Determining the relative importance of niche‐ and dispersal‐based processes in the structuring of animal communities is central in ecology. Freshwater fish and crustacean communities of small tropical islands can bring new insights for understanding these processes as all their species present a pelagic larval stage which gives them important dispersal capacities. Consequently, we hypothesized that dispersal‐based process may be preponderant for structuring these communities from the regional to the local, that is, survey site, scales. Gradient forest analyses allowed us to model the effect of 12 environmental variables on freshwater taxa abundances in two southwestern Indian Ocean islands: Mayotte (26 taxa) and Reunion (21). A total of 153 surveys in Mayotte and 266 in Reunion were used for building the models. Despite the strong heterogeneity of environmental conditions between the two islands, the main factors structuring freshwater fish and crustacean communities in both islands were the elevation and the slope of the sites. The observed structure appeared more pronounced for predatory species than for primary consumers and omnivores. As predators generally have limited locomotor capacities, it is concluded that dispersal‐based process structures these communities not only at large geographical scales but also at the intra‐watershed scale, by limiting the inland penetration (or dispersion) of species in relation to their locomotor capacities. However, more knowledge concerning ecological traits and taxonomic status of many species is needed to confirm this assumption.

Abstract in French is available with online material
Exploring genotype‐phenotype relationships in the CDKL5 deficiency disorder using an international dataset
Authors: MacKay Conor I. , Wong Kingsley , Demarest Scott T. , Benke Tim A. , Downs Jenny , Leonard Helen
Published: October 2020

Characterized by early‐onset seizures, global developmental delay and severe motor deficits, CDKL5 deficiency disorder is caused by pathogenic variants in the cyclin‐dependent kinase‐like 5 gene. Previous efforts to investigate genotype‐phenotype relationships have been limited due to small numbers of recurrent mutations and small cohort sizes. Using data from the International CDKL5 Disorder Database we examined genotype‐phenotype relationships for 13 recurrent CDKL5 variants and the previously analyzed historic variant groupings. We have applied the CDKL5 Developmental Score (CDS) and an adapted version of the CDKL5 Clinical Severity Assessment (CCSA), to grade the severity of phenotype and developmental outcomes for 285 individuals with CDKL5 variants. Comparisons of adapted CCSA and CDS between recurrent variants and variant groups were performed using multiple linear regression adjusting for age and sex. Individuals with the missense variant, p.Arg178Trp, had the highest mean adapted CCSA and lowest mean developmental scores. Other variants producing severe phenotypes included p.Arg559* and p.Arg178Gln. Variants producing milder phenotypes included p.Arg134*, p.Arg550*, and p.Glu55Argfs*20. There are observed differences in phenotype severity and developmental outcomes for individuals with different CDKL5 variants. However, the historic variant groupings did not seem to reflect differences in phenotype severity or developmental outcomes as clearly as analyzed by individual variants.
Feedback of extended panel sequencing in 1530 patients referred for suspicion of hereditary predisposition to adult cancers
Authors: Cavaillé Mathias , Uhrhammer Nancy , Privat Maud , Ponelle‐Chachuat Flora , Gay‐Bellile Mathilde , Lepage Mathis , Viala Sandrine , Bidet Yannick , Bignon Yves‐Jean
Published: October 2020

High‐throughput sequencing analysis represented both a medical diagnosis and technological revolution. Gene panel analysis is now routinely performed in the exploration of hereditary predisposition to cancer, which is becoming increasingly heterogeneous, both clinically and molecularly. We present 1530 patients with suspicion of hereditary predisposition to cancer, for which two types of analyses were performed: a) oriented according to the clinical presentation (n = 417), or b) extended to genes involved in hereditary predisposition to adult cancer (n = 1113). Extended panel analysis had a higher detection rate compared to oriented analysis in hereditary predisposition to breast / ovarian cancer (P < .001) and in digestive cancers (P < .094) (respectively 15% vs 5% and 19.3%, vs 12.5%). This higher detection is explained by the inclusion of moderate penetrance genes, as well as the identification of incident mutations and double mutations. Our study underscores the utility of proposing extended gene panel analysis to patients with suspicion of hereditary predisposition to adult cancer.
Comparison of nonself‐tapping tapered implant and self‐tapping hybrid implant in terms of implant stability at initial and second fixation: A prospective randomized clinical trial
Authors: Moroi Akinori , Saito Yuki , Takayama Akihiro , Ueki Koichiro
Published: October 2020

Background

Various features are provided in dental implants to improve initial fixation.

Purpose

To compare the implant stability of the nonself‐tapping tapered implant and self‐tapping hybrid implant over a 3‐month healing period.

Materials and methods

A randomized controlled trial was conducted. Patients were randomly divided into tapered and self‐tapping groups. Patients in the tapered group received NobelReplace Tapered (Nobel Biocare, Sweden) implants, while those in the self‐tapping group received NobelSpeedy (Nobel Biocare, Sweden) implants. Implant stability was measured by resonance frequency analysis at surgery and 3 months following implant insertion. Data were analyzed using an independent t‐test.

Results

Forty‐three patients (tapered group: 21, self‐tapping group: 22) received a total of 88 implants. Initial stability in the tapered group was significantly higher (mean: 60.14, SD: 12.40) than that in the self‐tapping group (mean: 54.72, SD: 7.92). Implant stability significantly increased 3 months after implantation in the tapered group (mean: 66.61, SD: 9.00) and self‐tapping group (mean: 64.01, SD: 5.78). No significant intergroup difference in implant stability was noted 3 months after surgery.

Conclusions

The tapered shape affected initial fixation more than the self‐tapping function. However, during the second fixation, both implants showed good stability, and the difference disappeared.
Coproporphyrin I Can Serve as an Endogenous Biomarker for OATP1B1 Inhibition: Assessment Using a Glecaprevir/Pibrentasvir Clinical Study
Authors: Kalluri Hari V. , Kikuchi Ryota , Coppola Sheryl , Schmidt Jeffrey , Mohamed Mohamed‐Eslam F. , Bow Daniel A.J. , Salem Ahmed H.
Published: October 2020

Organic anion transporting polypeptide (OATP) 1B1 and OATP1B3 are involved in the disposition of a variety of commonly prescribed drugs. The evaluation of OATP1B1/1B3 inhibition potential by investigational drugs is of interest during clinical drug development due to various adverse events associated with increased exposures of their substrates. Regulatory guidance documents on the in vitro assessment of OATP1B1/1B3 inhibition potential are conservative with up to a third of predictions resulting in false positives. This work investigated the utility of OATP1B1/1B3 endogenous biomarkers, coproporphyrin (CP)‐I and CP‐III, to assess clinical inhibition of OATP1B1/1B3 and potentially eliminate the need for prospective clinical drug‐drug interaction (DDI) studies. Correlations between CP‐I exposures and various OATP1B1 static DDI predictions were also evaluated. Glecaprevir/pibrentasvir (GLE/PIB) 300/120 mg fixed‐dose combination is known to cause clinical inhibition of OATP1B1/1B3. In a clinical study evaluating the relative bioavailability of various formulations of GLE/PIB regimen, CP‐I peak plasma concentration (Cmax) ratio and 0–16‐hour area under the concentration‐time curve (AUC0–16) ratio relative to baseline increased with increasing GLE exposures, whereas there was a modest correlation between GLE exposure and CP‐III Cmax ratio but no correlation with CP‐III AUC0–16 ratio. This suggests that CP‐I is superior to CP‐III as an endogenous biomarker for evaluation of OATP1B1 inhibition. There was a significant correlation between CP‐I and GLE Cmax (R2 = 0.65; P < 0.001) across individual subjects. Correlation analysis between GLE OATP1B1 R values and CP‐I exposures (Cmax ratio and AUC0–16 ratio) suggests that an R value of > 3 can predict a biologically meaningful inhibition of OATP1B1 when the inhibitor clinical pharmacokinetic parameters are available.