bluuebunny/crossref_metadata_2025 huggingface dataset:
Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based cohort study
Authors: Kabootari Maryam , Asgari Samaneh , Ghavam Seyedeh Maryam , Abdi Hengameh , Azizi Fereidoun , Hadaegh Farzad
Published: June 2021

Background

Fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2 h-PCPG), whether as continuous or categorical variables, are associated with incident cardiovascular disease (CVD) and diabetes; however, their role among patients with existing CVD is a matter of debate. We aimed to evaluate associations of different glucose intolerance states with recurrent CVD and incident diabetes among subjects with previous CVD.

Methods

From a prospective population-based cohort, 408 Iranians aged  ≥  30 years, with history of CVD and without known diabetes were included. Associations of impaired fasting glucose (IFG) according to the American Diabetes Association (ADA) and World Health Organization (WHO) criteria, impaired glucose tolerance (IGT), newly diagnosed diabetes (NDM) with outcomes of interest were determined by multivariable Cox proportional hazard models after adjustment for traditional risk factors. Furthermore, FPG and 2 h-PCPG were entered as continuous variables.

Results

Over a decade of follow-up, 220 CVD events including 89 hard events (death, myocardial infarction and stroke) occurred. Regarding prediabetes, only IFG-ADA was associated with increased risk of hard CVD [hazard ratio(HR), 95%CI: 1.62,1.03–2.57] in the age-sex adjusted model. In patients with NDM, those with FPG ≥ 7 mmol/L were at higher risk of incident CVD/coronary heart disease(CHD) and their related hard outcomes (HR ranged from 1.89 to 2.84, all P < 0.05). Moreover, those with 2 h-PCPG ≥ 11.1 mmol/L had significant higher risk of CVD (1.46,1.02–2.11), CHD (1.46,1.00–2.15) and hard CHD (1.95:0.99–3.85, P = 0.05). In the fully adjusted model, each 1 SD increase in FPG was associated with 20, 27, 15 and 25% higher risk of CVD, hard CVD, CHD and hard CHD, respectively; moreover each 1 SD higher 2 h-PCPG was associated with 21% and 16% higher risk of CVD, and CHD, respectively. Among individuals free of diabetes at baseline (n = 361), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes (all P < 0.05); significant associations were also found for FPG and 2 h-PCPG as continuous variables (all HRs for 1-SD increase > 2, P < 0.05).

Conclusions

Among subjects with stable CVD, NDM whether as high FPG or 2 h-PCPG, but not pre-diabetes status was significantly associated with CVD/CHD and related hard outcomes.
Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 3rd–5th, 2020, Italy)
Authors: Ascierto Paolo A. , Blank Christian , Dummer Reinhard , Ernstoff Marc S. , Ferrone Soldano , Fox Bernard A. , Gajewski Thomas F. , Garbe Claus , Hwu Patrick , Kalinski Pawel , Krogsgaard Michelle , Lo Roger S. , Luke Jason J. , Neyns Bart , Postow Michael A. , Quezada Sergio A. , Teng Michele W. L. , Trinchieri Giorgio , Testori Alessandro , Caracò Corrado , Osman Iman , Puzanov Igor , Thurin Magdalena
Published: June 2021

Advances in immune checkpoint therapy and targeted therapy have led to improvement in overall survival for patients with advanced melanoma. Single agent checkpoint PD-1 blockade and combination with BRAF/MEK targeted therapy demonstrated benefit in overall survival (OS). Superior response rates have been demonstrated with combined PD-1/CTLA-4 blockade, with a significant OS benefit compared with single-agent PD-1 blockade. Despite the progress in diagnosis of melanocytic lesions, correct classification of patients, selection of appropriate adjuvant and systemic therapies, and prediction of response to therapy remain real challenges in melanoma. Improved understanding of the tumor microenvironment, tumor immunity and response to therapy has prompted extensive translational and clinical research in melanoma. Development of novel biomarker platforms may help to improve diagnostics and predictive accuracy for selection of patients for specific treatment. There is a growing evidence that genomic and immune features of pre-treatment tumor biopsies may correlate with response in patients with melanoma and other cancers but they have yet to be fully characterized and implemented clinically. Overall, the progress in melanoma therapeutics and translational research will help to optimize treatment regimens to overcome resistance and develop robust biomarkers to guide clinical decision-making. During the Melanoma Bridge meeting (December 3rd–5th, 2020, Italy) we reviewed the currently approved systemic and local therapies for advanced melanoma and discussed novel biomarker strategies and advances in precision medicine.
Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic stroke: a pilot randomized controlled trial
Authors: Chen Shih-Ching , Yang Ling-Yu , Adeel Muhammad , Lai Chien-Hung , Peng Chih-Wei
Published: June 2021

Background

Transcranial direct current stimulation (tDCS) and intermittent theta burst stimulation (iTBS) were both demonstrated to have therapeutic potentials to rapidly induce neuroplastic effects in various rehabilitation training regimens. Recently, we developed a novel transcranial electrostimulation device that can flexibly output an electrical current with combined tDCS and iTBS waveforms. However, limited studies have determined the therapeutic effects of this special waveform combination on clinical rehabilitation. Herein, we investigated brain stimulation effects of tDCS-iTBS on upper-limb motor function in chronic stroke patients.

Methods

Twenty-four subjects with a chronic stroke were randomly assigned to a real non-invasive brain stimulation (NIBS; who received the real tDCS + iTBS output) group or a sham NIBS (who received sham tDCS + iTBS output) group. All subjects underwent 18 treatment sessions of 1 h of a conventional rehabilitation program (3 days a week for 6 weeks), where a 20-min NIBS intervention was simultaneously applied during conventional rehabilitation. Outcome measures were assessed before and immediately after the intervention period: Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Jebsen-Taylor Hand Function Test (JTT), and Finger-to-Nose Test (FNT).

Results

Both groups showed improvements in FMA-UE, JTT, and FNT scores after the 6-week rehabilitation program. Notably, the real NIBS group had greater improvements in the JTT (p = 0. 016) and FNT (p = 0. 037) scores than the sham NIBS group, as determined by the Mann–Whitney rank-sum test.

Conclusions

Patients who underwent the combined ipsilesional tDCS-iTBS stimulation with conventional rehabilitation exhibited greater impacts than did patients who underwent sham stimulation-conventional rehabilitation in statistically significant clinical responses of the total JTT time and FNT after the stroke. Preliminary results of upper-limb functional recovery suggest that tDCS-iTBS combined with a conventional rehabilitation intervention may be a promising strategy to enhance therapeutic benefits in future clinical settings.

Trial registration:ClinicalTrials.gov Identifier: NCT04369235. Registered on 30 April 2020.
Ability of dietary factors to affect homocysteine levels in mice: a review
Authors: Brütting Christine , Hildebrand Pia , Brandsch Corinna , Stangl Gabriele I.
Published: June 2021

Homocysteine is associated with several diseases, and a series of dietary factors are known to modulate homocysteine levels. As mice are often used as model organisms to study the effects of dietary hyperhomocysteinemia, we collected data about concentrations of vitamin B12, vitamin B6, folate, methionine, cystine, and choline in mouse diets and the associated plasma/serum homocysteine levels. In addition, we more closely examined the composition of the control diet, the impact of the mouse strain, sex and age, and the duration of the dietary intervention on homocysteine levels. In total, 113 out of 1103 reviewed articles met the inclusion criteria. In the experimental and control diets, homocysteine levels varied from 0.1 to 280 µmol/l. We found negative correlations between dietary vitamin B12 (rho = − 0.125; p < 0.05), vitamin B6 (rho = − 0.191; p < 0.01) and folate (rho = − 0.395; p < 0.001) and circulating levels of homocysteine. In contrast, a positive correlation was observed between dietary methionine and homocysteine (methionine: rho = 0.146; p < 0.05). No significant correlations were found for cystine or choline and homocysteine levels. In addition, there was no correlation between the duration of the experimental diets and homocysteine levels. More importantly, the data showed that homocysteine levels varied widely in mice fed control diets as well. When comparing control diets with similar nutrient concentrations (AIN-based), there were significant differences in homocysteine levels caused by the strain (ANOVA, p < 0.05) and age of the mice at baseline (r = 0.47; p < 0.05). When comparing homocysteine levels and sex, female mice tended to have higher homocysteine levels than male mice (9.3 ± 5.9 µmol/l vs. 5.8 ± 4.5 µmol/l; p = 0.069). To conclude, diets low in vitamin B12, vitamin B6, or folate and rich in methionine are similarly effective in increasing homocysteine levels. AIN recommendations for control diets are adequate with respect to the amounts of homocysteine-modulating dietary parameters. In addition, the mouse strain and the age of mice can affect the homocysteine level.
Impact of mining projects on water and sanitation infrastructures and associated child health outcomes: a multi-country analysis of Demographic and Health Surveys (DHS) in sub-Saharan Africa
Authors: Dietler Dominik , Farnham Andrea , Loss Georg , Fink Günther , Winkler Mirko S.
Published: June 2021

Background

Access to improved water and sanitation infrastructures are key determinants of health. The sub-Saharan African region in particular is lagging behind the ambitious goal of the 2030 Agenda for Sustainable Development to ensure universal access to improved and reliable water and sanitation for all (Sustainable Development Goal (SDG) 6). Large mining projects can promote economic growth and hence investments in water and sanitation infrastructures, but at the same time lead to rapid population growth and environmental degradation. In turn, these changes can pose risks and opportunities for child health (SDG 3). In this study we aim to quantify the impacts of mining projects on access to water and sanitation infrastructure as well as diarrhea and malnutrition among children using data from 131 Demographic and Health Surveys from sub-Saharan Africa.

Results

From a sample of around 1.2 million households, data within the proximity of 52 mine-panels were selected for longitudinal analyses, resulting in 41,896 households and 32,112 children. Improvements in access to modern water and sanitation infrastructures after mine opening were much larger in households near mining sites than in comparison areas located further away (adjusted relative risk ratio (aRRR) water: 18.60, 95 % confidence interval (CI): 13.08–26.46 and aRRR sanitation: 2.56, 95 % CI: 1.32–4.99). However, these associations were weaker among poorer households. In areas close to the mining sites, stunting and underweight prevalence decreased more strongly upon mine opening (adjusted odds ratio (aOR) stunting: 0.62, 95 % CI: 0.43–0.90; aOR underweight: 0.55, 95 % CI: 0.36–0.84). No differential changes were seen for wasting and diarrhea. Large impact heterogeneity was observed both within and across countries.

Conclusions

Our results suggest that the opening of mines is associated with improvements in access to modern water and sanitation infrastructures (SDG 6) as well as in some health outcomes (SDG 3). However, the large impact heterogeneity suggests that the assessment and management of mining-related impacts on communities should have an increased equity-focus, in order to “leave no one behind” in the work towards the 2030 Agenda for Sustainable Development. Overall, the findings of this study underscore that the resource extraction sector has the potential to make positive and substantial contributions towards achieving the SDGs.
A systematic review of moral reasons on orphan drug reimbursement
Authors: Zimmermann Bettina M. , Eichinger Johanna , Baumgartner Matthias R.
Published: June 2021

Background

The number of market approvals of orphan medicinal products (OMPs) has been increasing steadily in the last 3 decades. While OMPs can offer a unique chance for patients suffering from rare diseases, they are usually very expensive. The growing number of approved OMPs increases their budget impact despite their low prevalence, making it pressing to find solutions to ethical challenges on how to fairly allocate scarce healthcare resources under this context. One potential solution could be to grant OMPs special status when considering them for reimbursement, meaning that they are subject to different, and less stringent criteria than other drugs. This study aims to provide a systematic analysis of moral reasons for and against such a special status for the reimbursement of OMPs in publicly funded healthcare systems from a multidisciplinary perspective.

Results

With a systematic review of reasons, we identified 39 reasons represented in 243 articles (scientific and grey literature) for and against special status for the reimbursement of OMPs, then categorized them into nine topics. Taking a multidisciplinary perspective, we found that most articles came from health policy (n = 103) and health economics (n = 49). More articles took the position for a special status of OMPs (n = 97) than those against it (n = 31) and there was a larger number of reasons identified in favour (29 reasons) than against (10 reasons) this special status.

Conclusion

Results suggest that OMP reimbursement issues should be assessed and analysed from a multidisciplinary perspective. Despite the higher occurrence of reasons and articles in favour of a special status, there is no clear-cut solution for this ethical challenge. The binary perspective of whether or not OMPs should be granted special status oversimplifies the issue: both OMPs and rare diseases are too heterogeneous in their characteristics for such a binary perspective. Thus, the scientific debate should focus less on the question of disease prevalence but rather on how the important variability of different OMPs concerning e.g. target population, cost-effectiveness, level of evidence or mechanism of action could be meaningfully addressed and implemented in Health Technology Assessments.
Oral ulcers in children- a clinical narrative overview
Authors: Légeret Corinne , Furlano Raoul
Published: June 2021

The prevalence of oral ulcers in children is reported to be 9%, however diagnosis of oral lesions can be challenging, being an unspecific symptom of several diseases. Differential diagnosis can range from classic infectious disease of childhood (e.g. herpangina, hand-foot-and-mouth-disease) over nutritional deficiencies, gastrointestinal disorders, inflammations (e.g. pemphigus vulgaris, lichen planus, mucous membrane pemphigoid) to side effects of medications (Stevens-Johnson Syndrome) or chronic dieseases (e.g. sarcoidosis, systemic Lupus erythematodes, familial Mediterrenean fever). Therefore, children with oral ulcers are treated by many different specialists such as dentists, family doctors, paediatricians, rheumatologists, haematologists, gastroenterologists and otorhinolaryngologists.

A systematic literature search and a narrative literature review about the potential 48 diseases connected to oral ulcers were performed. According to the duration of symptoms and size of the lesions, a tabular overview was created to support the clinician in making a correct diagnosis, additionally different treatment options are presented.
Monocyte distribution width (MDW) performance as an early sepsis indicator in the emergency department: comparison with CRP and procalcitonin in a multicenter international European prospective study
Authors: Hausfater Pierre , Robert Boter Neus , Morales Indiano Cristian , Cancella de Abreu Marta , Marin Adria Mendoza , Pernet Julie , Quesada Dolores , Castro Iris , Careaga Diana , Arock Michel , Tejidor Liliana , Velly Laetitia
Published: June 2021

Background

Early sepsis diagnosis has emerged as one of the main challenges in the emergency room. Measurement of sepsis biomarkers is largely used in current practice to improve the diagnosis accuracy. Monocyte distribution width (MDW) is a recent new sepsis biomarker, available as part of the complete blood count with differential. The objective was to evaluate the performance of MDW for the detection of sepsis in the emergency department (ED) and to compare to procalcitonin (PCT) and C-reactive protein (CRP).

Methods

Subjects whose initial evaluation included a complete blood count were enrolled consecutively in 2 EDs in France and Spain and categorized per Sepsis-2 and Sepsis-3 criteria. The performance of MDW for sepsis detection was compared to that of procalcitonin (PCT) and C-reactive protein (CRP).

Results

A total of 1,517 patients were analyzed: 837 men and 680 women, mean age 61 ± 19 years, 260 (17.1%) categorized as Sepsis-2 and 144 patients (9.5%) as Sepsis-3. The AUCs [95% confidence interval] for the diagnosis of Sepsis-2 were 0.81 [0.78–0.84] and 0.86 [0.84–0.88] for MDW and MDW combined with WBC, respectively. For Sepsis-3, MDW performance was 0.82 [0.79–0.85]. The performance of MDW combined with WBC for Sepsis-2 in a subgroup of patients with low sepsis pretest probability was 0.90 [0.84–0.95]. The AUC for sepsis detection using MDW combined with WBC was similar to CRP alone (0.85 [0.83–0.87]) and exceeded that of PCT. Combining the biomarkers did not improve the AUC. Compared to normal MDW, abnormal MDW increased the odds of Sepsis-2 by factor of 5.5 [4.2–7.1, 95% CI] and Sepsis-3 by 7.6 [5.1–11.3, 95% CI].

Conclusions

MDW in combination with WBC has the diagnostic accuracy to detect sepsis, particularly when assessed in patients with lower pretest sepsis probability. We suggest the use of MDW as a systematic screening test, used together with qSOFA score to improve the accuracy of sepsis diagnosis in the emergency department.

Trial Registration ClinicalTrials.gov (NCT03588325).
Evaluation of thiamine as adjunctive therapy in COVID-19 critically ill patients: a two-center propensity score matched study
Authors: Al Sulaiman Khalid , Aljuhani Ohoud , Al Dossari Maram , Alshahrani Asma , Alharbi Aisha , Algarni Rahmah , Al Jeraisy Majed , Al Harbi Shmeylan , Al Katheri Abdulmalik , Al Eidan Fahad , Al Bekairy Abdulkareem M. , Al Qahtani Nouf , Al Muqrin Mashael , Vishwakarma Ramesh , Al Ghamdi Ghassan
Published: June 2021

Background

Thiamine is a precursor of the essential coenzyme thiamine pyrophosphate required for glucose metabolism; it improves the immune system function and has shown to reduce the risk of several diseases. The role of thiamine in critically ill septic patient has been addressed in multiple studies; however, it’s role in COVID-19 patients is still unclear. The aim of this study was to evaluate the use of thiamine as an adjunctive therapy on mortality in COVID-19 critically ill patients.

Methods

This is a two-center, non-interventional, retrospective cohort study for critically ill patients admitted to intensive care units (ICUs) with a confirmed diagnosis of COVID19. All patients aged 18 years or older admitted to ICUs between March 1, 2020, and December 31, 2020, with positive PCR COVID-19 were eligible for inclusion. We investigated thiamine use as an adjunctive therapy on the clinical outcomes in critically ill COVID-19 patients after propensity score matching.

Results

A total of 738 critically ill patients with COVID-19 who had been admitted to ICUs were included in the study. Among 166 patients matched using the propensity score method, 83 had received thiamine as adjunctive therapy. There was significant association between thiamine use with in-hospital mortality (OR = 0.39; 95% CI 0.19–0.78; P value = 0.008) as well as the 30-day mortality (OR = 0.37; 95% CI 0.18–0.78; P value = 0.009). Moreover, patients who received thiamine as an adjunctive therapy were less likely to have thrombosis during ICU stay [OR (95% CI) 0.19 (0.04–0.88), P value = 0.03].

Conclusion

Thiamine use as adjunctive therapy may have potential survival benefits in critically ill patients with COVID-19. Additionally, it was associated with a lower incidence of thrombosis. Further interventional studies are required to confirm these findings.
Increased time from physiological derangement to critical care admission associates with mortality
Authors: Whebell Stephen F. , Prower Emma J. , Zhang Joe , Pontin Megan , Grant David , Jones Andrew T. , Glover Guy W.
Published: June 2021

Background

Rapid response systems aim to achieve a timely response to the deteriorating patient; however, the existing literature varies on whether timing of escalation directly affects patient outcomes. Prior studies have been limited to using ‘decision to admit’ to critical care, or arrival in the emergency department as ‘time zero’, rather than the onset of physiological deterioration. The aim of this study is to establish if duration of abnormal physiology prior to critical care admission [‘Score to Door’ (STD) time] impacts on patient outcomes.

Methods

A retrospective cross-sectional analysis of data from pooled electronic medical records from a multi-site academic hospital was performed. All unplanned adult admissions to critical care from the ward with persistent physiological derangement [defined as sustained high National Early Warning Score (NEWS) > / = 7 that did not decrease below 5] were eligible for inclusion. The primary outcome was critical care mortality. Secondary outcomes were length of critical care admission and hospital mortality. The impact of STD time was adjusted for patient factors (demographics, sickness severity, frailty, and co-morbidity) and logistic factors (timing of high NEWS, and out of hours status) utilising logistic and linear regression models.

Results

Six hundred and thirty-two patients were included over the 4-year study period, 16.3% died in critical care. STD time demonstrated a small but significant association with critical care mortality [adjusted odds ratio of 1.02 (95% CI 1.0–1.04, p = 0.01)]. It was also associated with hospital mortality (adjusted OR 1.02, 95% CI 1.0–1.04, p = 0.026), and critical care length of stay. Each hour from onset of physiological derangement increased critical care length of stay by 1.2%. STD time was influenced by the initial NEWS, but not by logistic factors such as out-of-hours status, or pre-existing patient factors such as co-morbidity or frailty.

Conclusion

In a strictly defined population of high NEWS patients, the time from onset of sustained physiological derangement to critical care admission was associated with increased critical care and hospital mortality. If corroborated in further studies, this cohort definition could be utilised alongside the ‘Score to Door’ concept as a clinical indicator within rapid response systems.
Altered hypothalamic DNA methylation and stress-induced hyperactivity following early life stress
Authors: Fitzgerald Eamon , Sinton Matthew C. , Wernig-Zorc Sara , Morton Nicholas M. , Holmes Megan C. , Boardman James P. , Drake Amanda J.
Published: June 2021

Exposure to early life stress (ELS) during childhood or prenatally increases the risk of future psychiatric disorders. The effect of stress exposure during the neonatal period is less well understood. In preterm infants, exposure to invasive procedures is associated with altered brain development and future stress responses suggesting that the neonatal period could be a key time for the programming of mental health. Previous studies suggest that ELS affects the hypothalamic epigenome, making it a good candidate to mediate these effects. In this study, we used a mouse model of early life stress (modified maternal separation; MMS). We hypothesised MMS would affect the hypothalamic transcriptome and DNA methylome, and impact on adult behaviour. MMS involved repeated stimulation of pups for 1.5 h/day, whilst separated from their mother, from postnatal day (P) 4–6. 3’mRNA sequencing and DNA methylation immunoprecipitation (meDIP) sequencing were performed on hypothalamic tissue at P6. Behaviour was assessed with the elevated plus, open field mazes and in-cage monitoring at 3–4 months of age. MMS was only associated with subtle changes in gene expression, but there were widespread alterations in DNA methylation. Notably, differentially methylated regions were enriched for synapse-associated loci. MMS resulted in hyperactivity in the elevated plus and open field mazes, but in-cage monitoring revealed that this was not representative of habitual hyperactivity. ELS has marked effects on DNA methylation in the hypothalamus in early life and results in stress-specific hyperactivity in young adulthood. These results have implications for the understanding of ELS-mediated effects on brain development.
Healthcare workers’ behaviors on infection prevention and control and their determinants during the COVID-19 pandemic: a cross-sectional study based on the theoretical domains framework in Wuhan, China
Authors: Yang Qiuxia , Wang Xuemei , Zhou Qian , Tan Li , Zhang Xinping , Lai Xiaoquan
Published: June 2021

Background

Infection prevention and control (IPC) measures are crucial to combat the COVID-19 pandemic. This study aimed to explore the levels and determinants of HCWs’ IPC behaviors based on the theoretical domains framework (TDF), which has been shown to be effective in guiding behavior change.

Methods

A cross-sectional survey was conducted in Wuhan, China in January 2020. Self-reported hand hygiene and droplet isolation behaviors (including the use of masks, gloves, goggles and gowns) were set as dependent variables. TDF domains and HCWs’ characteristics were independent variables. Negative binomial regression analyses were performed to explore their relationships.

Results

HCWs reported good IPC behaviors, while the compliance with goggle and gown use was relatively low (below 85%). Environmental context and resources domain was significantly related to hand hygiene (β = 0.018, p = 0.026), overall droplet isolation behaviors (β = 0.056, p = 0.001), goggle (β = 0.098, p = 0.001) and gown use (β = 0.101. p < 0.001). Knowledge domain was significantly related to goggle (β = 0.081, p = 0.005) and gown use (β = 0.053, p = 0.013). Emotion domain was a predictor of overall droplet isolation behaviors (β = 0.043, p = 0.016), goggle (β = 0.074, p = 0.026) and gown use (β = 0.106, p < 0.001). Social influences domain was a predictor of overall droplet isolation behaviors (β = 0.031, p = 0.029) and gown use (β = 0.039, p = 0.035). HCWs in high-risk departments had better behaviors of gown use (β = 0.158, p = 0.032). HCWs who had encountered confirmed or suspected patients reported worse behaviors of goggle (β = − 0.127, p = 0.050) and gown use (β = − 0.153, p = 0.003).

Conclusions

Adequate personal protective materials and human resources, education and training, as well as supervision and role model setting are necessary to improve IPC behaviors regarding the COVID-19 pandemic.
Assessing the impact of corporate entrepreneurship in the financial performance of subsidiaries of Colombian business groups: under environmental dynamism moderation
Authors: Rodríguez-Peña Antonio
Published: June 2021

Corporate entrepreneurship creates opportunities in employment, technological advances, value creation, and cultural transformation for entrepreneurial ecosystems, entrepreneurs, governments, economies, and society around the globe. The purpose of this study is to assess the impact of corporate entrepreneurship on the financial performance of subsidiaries in Colombian business groups under the moderating effect of the environmental dynamism, because the relationship between corporate entrepreneurship and financial performance in emerging economies must differ from developed economies. Using a cross-sectional structural equation modeling analysis, this study assessed the impact of entrepreneurial orientation and corporate venturing on the firm financial performance of 87 subsidiaries of Colombian business groups at different levels of environmental dynamism. This study also confirms that the relationship between corporate entrepreneurship and performance is context-dependent and that entrepreneurial orientation has a strong and positive causal relationship with corporate venturing. Additionally, subsidiaries of Colombian business groups increase their financial performance when also does the entrepreneurial orientation, and decrease financial performance when so does corporate venturing. Furthermore, the results show that environmental dynamism does not have a moderating effect on the relationship between corporate entrepreneurship of subsidiaries in Colombian business groups and their performance. This paper would contribute to important areas in Latin America business, where such studies are scarce.
Crime and COVID-19: effect of changes in routine activities in Mexico City
Authors: Estévez-Soto Patricio R.
Published: June 2021

Background

This study aimed to determine whether crime patterns in Mexico City changed due to the COVID-19 pandemic, and to test whether any changes observed were associated with the disruption of routine activities, as measured by changes in public transport passenger numbers.

Method

The first objective was assessed by comparing the observed incidence of crime after the COVID-19 pandemic was detected in the country with that expected based on ARIMA forecasts based on the pre-pandemic trends. The second objective was assessed by examining the association between crime incidence and the number of passengers on public transport using regressions with ARIMA errors.

Results

Results indicated that most crime categories decreased significantly after the pandemic was detected in the country or after a national lockdown was instituted. Furthermore, the study found that some of the declines observed were associated with the reductions seen in public transport passenger numbers. However, the findings suggested that the changes in mobility explain part of the declines observed, with important variations per crime type.

Conclusion

The findings contribute to the global evaluation of the effects of COVID-19 on crime and propose a robust method to explicitly test whether the changes observed are associated with changes in routine activities.
A clinical course of a patient with anorexia nervosa receiving surgery for superior mesenteric artery syndrome
Authors: Kurisu Ken , Yamanaka Yukari , Yamazaki Tadahiro , Yoneda Ryo , Otani Makoto , Takimoto Yoshiyuki , Yoshiuchi Kazuhiro
Published: June 2021

Background

Superior mesenteric artery (SMA) syndrome is a well-known but relatively rare complication of anorexia nervosa. Although several reports have proposed surgery for SMA syndrome associated with anorexia nervosa, these have shown poor outcomes or did not reveal the long-term weight course. Thus, the long-term effectiveness of surgery for SMA syndrome in such cases remains unclear. This case report describes a patient with anorexia nervosa who underwent surgery for SMA syndrome.

Case presentation

An 18-year-old woman presented with anorexia nervosa when she was 16 years old. She also presented with SMA syndrome, which seemed to be caused by weight loss due to the eating disorder. Nutrition therapy initially improved her body weight, but she ceased treatment. She reported that symptoms related to SMA syndrome had led to her weight loss and desired to undergo surgery. Laparoscopic duodenojejunostomy was performed, but her body weight did not improve after the surgery. The patient eventually received conservative nutritional treatment along with psychological approaches, which led to an improvement in her body weight.

Conclusions

The case implies that surgery for SMA syndrome in patients with anorexia nervosa is ineffective for long-term weight recovery and that conservative treatment can sufficiently improve body weight; this is consistent with the lack of evidence on the topic and reports on potential complications of surgery. Due to difficulties in assessing psychological status, consultation with specialists on eating disorders is necessary for treating patients with severely low body weight.
Gastroenteropancreatic neuroendocrine tumor of the accessory papilla of the duodenum: a case report
Authors: Takagi Kosei , Umeda Yuzo , Yoshida Ryuichi , Yoshida Kazuhiro , Yasui Kazuya , Sato Hiroki , Yagi Takahito , Fujiwara Toshiyoshi
Published: June 2021

Background

Contrary to the increasing incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs), GEP-NETs of the accessory papilla of the duodenum are extremely rare. Furthermore, there have been no recommendations regarding the treatment strategy for GEP-NETs of the accessory papilla of the duodenum. We present a case of GEP-NET of the accessory papilla of the duodenum successfully treated with robotic pancreatoduodenectomy.

Case presentation

A case of a 70-year-old complaining of no symptoms was diagnosed with GEP-NET of the accessory papilla of the duodenum. A 8-mm tumor was located at the submucosal layer with a biopsy demonstrating a neuroendocrine tumor grade 1. The patient underwent robotic pancreatoduodenectomy as curative resection for the tumor. The total operative time was 406 min with an estimated blood loss of 150 mL. The histological examination revealed a well-differentiated neuroendocrine tumor with low Ki-67 index (< 1%). In the posterior areas of the pancreas, the lymph node metastases were detected. The patient was followed up for 6 months with no recurrence postoperatively.

Conclusions

Considering the potential risks of the lymph node metastases, the standard treatment strategy for GEP-NETs of the accessory papilla of the duodenum should be radical resection with pancreatoduodenectomy. Minimally invasive approach can be the alternative to the conventional open surgery.
Phytotoxicity, cytotoxicity and chemical composition of Spondias mombin Linn. Stem bark
Authors: Orumwensodia Kissinger Obaogie , Uadia Patrick Ojeifo , Choudhary Muhammed Iqbal
Published: June 2021

Background

Spondias mombin Linn. is a tropical climate plant with wide applications in ethnomedicinal practice. This study evaluates the phytotoxicity, cytotoxicity and chemical composition of the plant’s stem bark.

Methods

Dried stem bark sample of Spondias mombin Linn. was subjected to exhaustive extraction and partitioned into sub-fractions (hexane-ethylacetate, ethylacetate, ethylacetate-methanol and methanol) by graded polarity technique. The phytotoxicity and cytotoxicity indices of the crude hydro-ethanol extract and fractions were evaluated using Lemna minor and brine shrimp lethality assays, respectively, while chemical composition of the oily hexane:ethylacetate fraction was determined by gas chromatography-mass spectroscopy (GC-MS) technique.

Results

Phytotoxicity was dose-dependent which ranged from low (crude plant extract), moderate (hexane-ethylacetate and methanol fractions), high (ethylaacetate-methanol fraction) to significant toxicity (ethylacetate fraction) at the highest dose. However, for brine shrimp lethality assay only hexane-ethylacetate (LD50: 284.02 μg/mL) and ethylacetate (LD50: 210.24 μg/mL) fractions were cytotoxic at the highest dose. The GC-MS profile of the oily hexane:ethylacetate fraction identified sixty-eight compounds comprising hydrocarbons, fatty acids, alcohols, steroids, nitrogen and fluoride-containing compounds, terpenes and esters.

Conclusion

This study concludes that fractions of Spondias mombin Lin. could be potentially toxic. While its phytotoxic potential can be useful in the agrochemical industry for the production of natural herbicides, its cytotoxic property can be cautiously harnessed for ethnomedicinal purposes.
Genetic diversity and plant growth-promoting activity of the dominant bacteria from canola plants in Western Iran
Authors: Jamalzadeh Azadeh , Darvishnia Mostafa , Khodakaramian Gholam , Bazgir Eydi , Zafari Doostmorad
Published: June 2021

Background

Plant growth-promoting bacteria (PGPB) can be used as a safe and sustainable agricultural measure to increase plant yield. In this study, cultivable rhizospheric, endophytic, and epiphytic bacteria associated with canola were isolated on nutrient agar medium. The SDS-PAGE method was used for grouping the bacterial strains. Bacterial strains with more than 80% similarity in their protein patterns were placed in the same species and selected as a representative for partial 16S rRNA encoding gene sequence analysis.

Results

It was found that the bacteria used in this study belonged to Pseudomonas, Frigoribacterium, Sphingomonas, Sphingobacterium, Microbacterium, Bacillus, and Rhodococcus genera. Three PGP bioactivities including siderophore production, nitrogen fixation ability, and phosphate solubilization were evaluated for 18 Pseudomonas representative strains. All tested strains were able to produce siderophore, although only 5 strains could fix nitrogen and none was able to solubilize phosphate. Greenhouse experiments showed that 4 bacterial strains (i.e., 8312, 642, 1313W, and 9421) significantly affected canola seed germination and seedling growth. Bacterial strain 8312, which was identified as Pseudomonas sp., showed the highest effect on the growth of the canola plant. These results indicated the potential of strain 8312 to be used as a biofertilizer in canola cultivation.

Conclusions

The results of this research indicated that canola-related bacteria were diverse during the flowering stage. One isolate had a significant effect on all canola plant growth factors in the greenhouse. Hence, it is recommended to investigate this strain further in field infestation experiments.
In-vivo application of low frequency alternating currents on porcine cervical vagus nerve evokes reversible nerve conduction block
Authors: Muzquiz Maria Ivette , Richardson Lindsay , Vetter Christian , Smolik Macallister , Alhawwash Awadh , Goodwill Adam , Bashirullah Rizwan , Carr Michael , Yoshida Ken
Published: June 2021

Background

This paper describes a method to reversibly block nerve conduction through direct application of a 1 Hz sinusoidal current waveform delivered through a bipolar nerve cuff electrode. This low frequency alternating current (LFAC) waveform was previously shown to reversibly block the effects of vagal pulse stimulation evoked bradycardia in-vivo in the anaesthetised rat model (Mintch et al. 2019). The present work measured the effectiveness of LFAC block on larger caliber myelinated vagal afferent fibers in human sized nerve bundles projecting to changes in breathing rate mediated by the Hering-Breuer (HB) reflex in anaesthetized domestic swine (n=5).

Methods

Two bipolar cuff electrodes were implanted unilaterally to the left cervical vagus nerve, which was crushed caudal to the electrodes to eliminate cardiac effects. A tripolar recording cuff electrode was placed rostral to the bipolar stimulating electrodes on the same nerve to measure changes in the compound nerve action potentials (CNAP) elicited by the vagal pulse stimulation and conditioned by the LFAC waveform. Standard pulse stimulation was applied at a sufficient level to induce a reduction in breathing rate through the HB reflex. If unblocked, the HB reflex would cause breathing to slow down and potentially halt completely. Block was quantified by the ability of LFAC to reduce the effect of the HB reflex by monitoring the respiration rate during LFAC alone, LFAC and vagal stimulation, and vagal stimulation alone.

Results

LFAC achieved 87.2 ±8.8% block (n=5) at current levels of 1.1 ±0.3 mAp (current to peak), which was well within the water window of the working electrode. CNAP showed changes that directly correlated to the effectiveness of LFAC block, which manifested itself as the slowing and amplitude reduction of components of the CNAP.

Conclusion

These novel findings suggest that LFAC is a potential alternative or complementary method to other electrical blocking techniques in clinical applications.
HMGB1, neuronal excitability and epilepsy
Authors: Dai Sijie , Zheng Yang , Wang Yi , Chen Zhong
Published: June 2021

Epilepsy is a common neurological disease caused by synchronous firing of hyperexcitable neurons. Currently, anti-epileptic drugs remain the main choice to control seizure, but 30% of patients are resistant to the drugs, which calls for more research on new promising targets. Neuroinflammation is closely associated with the development of epilepsy. As an important inflammatory factor, high mobility group protein B1 (HMGB1) has shown elevated expression and an increased proportion of translocation from the nucleus to the cytoplasm in patients with epilepsy and in multiple animal models of epilepsy. HMGB1 can act on downstream receptors such as Toll-like receptor 4 and receptor for advanced glycation end products, thereby activating interleukin (IL)-1β and nuclear factor kappa-B (NF-κB), which in turn act with glutamate receptors such as the N-methyl-D-aspartate (NMDA) receptors to aggravate hyperexcitability and epilepsy. The hyperexcitability can in turn stimulate the expression and translocation of HMGB1. Blocking HMGB1 and its downstream signaling pathways may be a direction for antiepileptic drug therapy. Here, we review the changes of HMGB1-related pathway in epileptic brains and its role in the modulation of neuronal excitability and epileptic seizure. Furthermore, we discuss the potentials of HMGB1 as a therapeutic target for epilepsy and provide perspective on future research on the role of HMGB1 signaling in epilepsy.
Gödel-type solutions in hybrid metric-Palatini gravity
Authors: Gonçalves J. S. , Santos A. F.
Published: June 2021

In this paper, the hybrid metric-Palatini gravity is an approach to modified gravity in which is added to the usual Einstein-Hilbert action a supplementary term containing a Palatini-type correction of the form

. Here,

is the Palatini curvature scalar, which is constructed from an independent connection and T is the trace of the energy-momentum tensor. This theory describes a non-minimal coupling between matter and geometry. The modified Einstein field equations in this hybrid metric-Palatini approach are obtained. Then, it is investigated whether this modified theory of gravity and its field equations allow Gödel-type solutions, which essentially lead to violation of causality. Considering physically well-motivated matter sources, causal and non-causal solutions are explored.
The Economic Consequences of Bankruptcy Reform
Authors: Gross Tal , Kluender Raymond , Liu Feng , Notowidigdo Matthew J. , Wang Jialan
Published: June 2021

A more generous consumer bankruptcy system provides greater insurance against financial risks but may also raise the cost of credit. We study this trade-off using the 2005 Bankruptcy Abuse Prevention and Consumer Protection Act (BAPCPA), which increased the costs of filing for bankruptcy. We identify the effects of BAPCPA on borrowing costs using variation in the effects of the reform across credit scores. We find that a one-percentage-point reduction in bankruptcy filing risk decreased credit card interest rates by 70–90 basis points. Conversely, BAPCPA reduced the insurance value of bankruptcy, with uninsured hospitalizations 70 percent less likely to obtain bankruptcy relief after the reform. (JEL D18, G15, I13, K35)
Pay Me Later: Savings Constraints and the Demand for Deferred Payments
Authors: Brune Lasse , Chyn Eric , Kerwin Jason
Published: June 2021

We study a simple savings scheme that allows workers to defer receipt of part of their wages for three months at zero interest. The scheme significantly increases savings during the deferral period, leading to higher postdisbursement spending on lumpy goods. Two years later, after two additional rounds of the savings scheme, we find that treated workers have made permanent improvements to their homes. The popularity of the scheme implies a lack of good alternative savings options. The results of a follow-up experiment suggest that demand for the scheme is partly due to its ability to address self-control issues. (JEL D91, G51, J31, O12, O13)
Recruitment, Effort, and Retention Effects of Performance Contracts for Civil Servants: Experimental Evidence from Rwandan Primary Schools
Authors: Leaver Clare , Ozier Owen , Serneels Pieter , Zeitlin Andrew
Published: June 2021

This paper reports on a two-tiered experiment designed to separately identify the selection and effort margins of pay for performance (P4P). At the recruitment stage, teacher labor markets were randomly assigned to a “pay-for-percentile” or fixed-wage contract. Once recruits were placed, an unexpected, incentive-compatible, school-level re-randomization was performed so that some teachers who applied for a fixed-wage contract ended up being paid by P4P, and vice versa. By the second year of the study, the within-year effort effect of P4P was 0.16 standard deviations of pupil learning, with the total effect rising to 0.20 standard deviations after allowing for selection. (JEL C93, I21, J23, J33, J41, J45, O15)
Security Transitions
Authors: Fetzer Thiemo , Souza Pedro C. L. , Vanden Eynde Oliver , Wright Austin L.
Published: June 2021

How do foreign powers disengage from a conflict? We study this issue by examining the recent, large-scale security transition from international troops to local forces in the ongoing civil conflict in Afghanistan. We construct a new dataset that combines information on this transition process with declassified conflict outcomes and previously unreleased quarterly survey data of residents’ perceptions of local security. Our empirical design leverages the staggered roll-out of the transition, and employs a novel instrumental variables approach to estimate the impact. We find a significant, sharp, and timely decline of insurgent violence in the initial phase: the security transfer to Afghan forces. We find that this is followed by a significant surge in violence in the second phase: the actual physical withdrawal of foreign troops. We argue that this pattern is consistent with a signaling model, in which the insurgents reduce violence strategically to facilitate the foreign military withdrawal to capitalize on the reduced foreign military presence afterward. Our findings clarify the destabilizing consequences of withdrawal in one of the costliest conflicts in modern history, and yield potentially actionable insights for designing future security transitions. (JEL D74, F51, F52, O17)
Market Fragmentation
Authors: Chen Daniel , Duffie Darrell
Published: June 2021

We model a simple market setting in which fragmentation of trade of the same asset across multiple exchanges improves allocative efficiency. Fragmentation reduces the inhibiting effect of price-impact avoidance on order submission. Although fragmentation reduces market depth on each exchange, it also isolates cross-exchange price impacts, leading to more aggressive overall order submission and better rebalancing of unwanted positions across traders. Fragmentation also has implications for the extent to which prices reveal traders’ private information. While a given exchange price is less informative in more fragmented markets, all exchange prices taken together are more informative. (JEL D47, D82, G14)