bluuebunny/crossref_metadata_2025 huggingface dataset:
The curvilinear relationship between team informational faultlines and creativity: moderating role of team humble leadership
Authors: Yao Jin , Liu Xinmei , He Wenxin
Published: February 2021

Purpose

The purpose of this paper is to examine the curvilinear relationship between team informational faultlines and team creativity and the moderating effects of team humble leadership on the relationship.

Design/methodology/approach

The multisource and longitudinal survey data were collected from 85 teams. The authors conducted linear regression analyses to analyze the data.

Findings

The results indicate that the relationship between team informational faultlines and team creativity is invertedU-shaped and such relationship is stronger in teams with low levels of humble leadership.

Research limitations/implications

The research reconciles the mixed findings in prior research and enhances our understanding of the functionality of informational faultlines.

Practical implications

Team managers should seek optimal levels of informational faultlines and make diversity coexist with similarity when assembling a new working group so as to utilize the benefits of team composition diversity and fuel collective creativity. Team leaders should learn humble leadership skills to encourage open communication.

Originality/value

The research is the first to adopt and build on the social information processing (SIP) perspective to explain the curvilinear relationship between team informational faultlines and team creativity.
COVID-19 and digitizing accounting education: empirical evidence from GCC
Authors: Sarea Adel , Alhadrami Abdulla , Taufiq-Hail Ghilan Al-Madhagy
Published: February 2021

Purpose

The main objective of the study is to investigate the effect of COVID-19 on accounting education in the higher education (public and private universities) in the Gulf Cooperation Council (GCC).

Design/methodology/approach

The study is explorative in nature conducted with quantitative survey approach and using purposive techniques in collecting data. The sample focuses on the teaching staff at public and private universities in (GCC), Kingdom of Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Oman and Qatar during the COVID-19.

Findings

This study presumed to highlight some of the emergent issues faced during the pandemic pertaining the aspects of the COVID-19 and digitizing accounting education and its effect on future direction of digital education.

Originality/value

To the best of the authors’ knowledge, this study is the first academic paper to study the effect of COVID-19 on accounting education in the higher education in the GCC.
An overview of fused deposition modelling (FDM): research, development and process optimisation
Authors: Lalegani Dezaki Mohammadreza , Mohd Ariffin Mohd Khairol Anuar , Hatami Saghi
Published: February 2021

Purpose

The purpose of this paper is to review research studies on process optimisation and machine development that lead to the enhancement of final products in various aspects of the fused deposition modelling (FDM) process.

Design/methodology/approach

An overview of the literature, focussing on process parameters, machine developments and material characterisations. This study investigates recent research studies that studied FDM capabilities in printing a vast range of materials from thermoplastics to metal alloys.

Findings

FDM is one of the most common techniques in additive manufacturing (AM) processes. Many parameters in this technology have effects on three-dimensional printed products. Therefore, it is necessary to obtain the optimum elements, for example, build orientation, layer thickness, nozzle diameter, infill pattern and bed temperature. By selecting a proper variable range of parameters, the layers adhere strongly and building end-use products of high quality are achievable. A vast range of materials and their properties from polymers to composite-based polymers are presented. Novel techniques to print metal alloys and composites are examined to increase the productivity of the FDM process. Additionally, defects such as shrinkage and warpage are discussed to eliminate the system’s limitations and improve the quality of final products. Multi-axis and mobile machines brought enhancements throughout the process to eliminate obstacles such as staircase defects in the conventional FDM process. In brief, recent developments were identified and a summary of major improvements was discussed in this study for future research.

Originality/value

This paper is an overview that provides information about research and developments in FDM. This review focusses on process optimisation and obstacles in printing polymers, composites, geopolymers and novel materials. Therefore, machine characteristics were examined to find out the accessibility of printing novel materials for different applications.
Personal connections: one library’s history of personal librarian
Authors: Ferer Elise
Published: February 2021

Purpose

To describe how a personal librarian program at a large university developed, has evolved, and continues to function. This paper aims to assist other librarians in developing their own personal librarian programs. It will also assist librarians who are working to connect to students.

Design/methodology/approach

To produce this paper, internal documents were reviewed, existing data were investigated, those who assisted in the development of the program were consulted and literature on personal librarian programs was reviewed.

Findings

Personal librarian programs can be an efficient way to connect to students and can create awareness about library services, especially without a formal orientation for new students. The personal librarian program discussed here connects the library to a large number of students with little time and effort. Planning is important in developing a working program.

Practical implications

Librarians can use this article to understand how a personal librarians program functions and how it can benefit their libraries. The paper emphasizes revising an existing program to work more effectively and using planning documents and assessment to help an outreach program run smoothly.

Originality/value

This paper details how a personal librarian program was developed and has evolved as well as how the program functions. The value is in the ways in which the program has been revised and has evolved and in the role that planning has taken in creating an effective program.
Keystone species affect the relationship between soil microbial diversity and ecosystem function under land use change in subtropical China
Authors: Yang Fan , Chen Qiong , Zhang Qian , Long Chunyan , Jia Wei , Cheng Xiaoli
Published: February 2021

Soil microbial diversity affects soil chemical cycling and ecosystem function. However, how highly connected keystone species regulate associated microbial structure and function (of the whole community and of specialized species), irrespective of their abundance under land use change, remains unresolved.

Here, we identified the relationship between microbial diversity [soil phospholipid fatty acid (PLFA) richness and composition, and ammonia‐oxidizing archaea and bacteria (AOA and AOB) communities] with both a broad (i.e. microbial respiration) and specialized function (i.e. nitrification rate) in a woodland, shrubland and adjacent cropland in subtropical China.

Microbial respiration was significantly positively related to the microbial richness, but negatively correlated with the keystone species richness across different land use types. The relationships between biodiversity and the broad ecosystem function varied with land use, with a stronger relationship in the afforested land compared with in the cropland. In contrast to the broad function, land use did not significantly affect the specialized function, but the specialized function was positively related to AOA richness in the cropland. Additionally, the specialized function was predominately driven by the keystone species composition in AOA and AOB communities and indirectly regulated by soil environmental factors (particularly soil temperature) across land uses.

Overall, our results provide direct experimental insight into the mechanisms underlying the role of the keystone species in regulating below‐ground ecosystem functions under land use change. In particular, our findings reveal that the broad function is maintained by the niche compensation effect, while the specialized function is maintained by the identity effect.

A freePlain Language Summarycan be found within the Supporting Information of this article.
Waterfowl use of wetland habitats informs wetland restoration designs for multi‐species benefits
Authors: Casazza Michael L. , McDuie Fiona , Jones Scott , Lorenz Austen A. , Overton Cory T. , Yee Julie , Feldheim Cliff L. , Ackerman Joshua T. , Thorne Karen M.
Published: February 2021

Extensive global estuarine wetland losses have prompted intensive focus on restoration of these habitats. In California, substantial tracts of freshwater, brackish and tidal wetlands have been lost. Given the anthropogenic footprint of development and urbanization in this region, wetland restoration must rely on conversion of existing habitat types rather than adding new wetlands. These restorations can cause conflicts among stakeholders and species that win or lose depending on identified restoration priorities.

Suisun Marsh on the San Francisco Bay Estuary is the largest brackish marsh on the US Pacific coast. To understand how conversion of brackish managed wetlands to tidal marsh would impact waterfowl populations and whether future tidal marsh restorations could provide suitable habitat for dabbling ducks, we examined waterfowl wetland use with a robust GPS‐GSM tracking dataset (442,017 locations) from six dabbling duck species (N = 315).

Managed wetlands, which comprise 47% of Suisun Marsh, were consistently and strongly selected by waterfowl over tidal marshes, with use ~98% across seasons and species.

However, while use of tidal marsh (only 14% of Suisun Marsh) was generally <2%, almost half our ducks (~44%) spent some time in this habitat and exhibited strong utilization of pond‐like features. Ponds only comprise ~10% of this habitat but attracted 44% use (~4.5 times greater than availability).

Synthesis and applications. Managed wetlands were vital to dabbling ducks, but losses from conversion of these habitats may be partially mitigated by incorporating pond features that are more attractive to waterfowl, and likely to offer multi‐species benefits, into tidal marsh restoration designs. While waterfowl are presently a common taxon, previously seen calamitous population declines can be avoided through informed ecosystem‐based management that promotes species richness, biodiversity and helps ‘keep common species common’.
The Communication Infrastructure as a Social Determinant of Health: Implications for Health Policymaking and Practice
Authors: GOULBOURNE TAYLOR , YANOVITZKY ITZHAK
Published: February 2021

Policy Points

Persistent communication inequalities limit racial/ethnic minority access to life‐saving health information and make them more vulnerable to the effects of misinformation.

 Establishing data collection systems that detect and track acute gaps in the supply and/or access of racial/ethnic minority groups to credible health information is long overdue.

Public investments and support for minority‐serving media and community outlets are needed to close persistent gaps in access to credible health information.
Microstructures of encapsulates and their relations with encapsulation efficiency and controlled release of bioactive constituents: A review
Authors: Yun Pheakdey , Devahastin Sakamon , Chiewchan Naphaporn
Published: February 2021

Vitamins, peptides, essential oils, and probiotics are examples of health beneficial constituents, which are nevertheless heat‐sensitive and possess poor chemical stability. Various encapsulation methods have been applied to protect these constituents against thermal and chemical degradations. Encapsulates prepared by different methods and/or at different conditions exhibit different microstructures, which in turn differently influence the encapsulation efficiency as well as retention of encapsulated core materials. This review provides a summary of various microstructures resulted from the use of selected encapsulation methods or systems, namely, spray coating; co‐extrusion; emulsion‐, micelle‐, and liposome‐based; coacervation; and ionic gelation encapsulation, at different conditions. Subsequent effects of the different microstructures on encapsulation efficiency and retention of encapsulated core materials are mentioned and discussed. Encapsulates having compact microstructures resulted from the use of low‐surface tension and low‐viscosity encapsulants, high‐stability encapsulation systems, lower loads of core materials to total solids of encapsulants and appropriate solidification conditions have proved to exhibit higher encapsulation efficiencies and better retention of encapsulated core materials. Encapsulates with hollow, dent, shrunken microstructures or thinner walls resulted from inappropriate solidification conditions and higher loads of core materials, on the other hand, possess lower encapsulation efficiencies and protection capabilities. Encapsulates having crack, blow‐hole or porous microstructures resulted from the use of high‐viscosity encapsulants and inappropriate solidification conditions exhibit the lowest encapsulation efficiencies and poorest protection capabilities. Compact microstructures and structures formed between ionic biopolymers could be used to regulate the release of encapsulated cores.
Excess Mortality Reveals Covid's True Toll in Russia
Authors: Kobak Dmitry
Published: February 2021

Data on excess deaths in Russia in 2020 paint a much bleaker picture of the Covid-19 death toll than the official daily updated number, argues Dmitry Kobak
Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children
Authors: Babl Franz E , Tavender Emma , Ballard Dustin W , Borland Meredith L , Oakley Ed , Cotterell Elizabeth , Halkidis Lambros , Goergen Stacy , Davis Gavin A , Perry David , Anderson Vicki , Barlow Karen M , Barnett Peter , Bennetts Scott , Bhamjee Roisin , Cole Joanne , Craven John , Haskell Libby , Lawton Ben , Lithgow Anna , Mullen Glenda , O'Brien Sharon , Paproth Michelle , Wilson Catherine L , Ring Jenny , Wilson Agnes , Leo Grace SY , Dalziel Stuart R ,   Paediatric Research in Emergency Departments International Collaborative (PREDICT)
Published: February 2021

Objective

Children frequently present with head injuries to acute care settings. Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow‐up of mild to moderate head injuries relevant to the Australian and New Zealand context. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) set out to develop an evidence‐based, locally applicable, practical clinical guideline for the care of children with mild to moderate head injuries presenting to acute care settings.

Methods

A multidisciplinary Guideline Working Group (GWG) developed 33 questions in three key areas – triage, imaging and discharge of children with mild to moderate head injuries presenting to acute care settings. We identified existing high‐quality guidelines and from these guidelines recommendations were mapped to clinical questions. Updated literature searches were undertaken, and key new evidence identified. Recommendations were created through either adoption, adaptation or development of de novo recommendations. The guideline was revised after a period of public consultation.

Results

The GWG developed 71 recommendations (evidence‐informed = 35, consensus‐based = 17, practice points = 19), relevant to the Australian and New Zealand setting. The guideline is presented as three documents: (i) a detailed Full Guideline summarising the evidence underlying each recommendation; (ii) a Guideline Summary; and (iii) a clinical Algorithm: Imaging and Observation Decision‐making for Children with Head Injuries.

Conclusions

The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children provides high‐level evidence and practical guidance for front line clinicians.
Water loss and status in sponge cake: Impact of Eucheuma as a flour replacement
Authors: Huang Min , Zhao Lin , Yang Hongshun
Published: February 2021

The impact of Eucheuma on water loss and status in sponge cakes was measured and analyzed in this study. Eucheuma was used to replace 0%, 10%, and 20% of wheat flour to make sponge cakes, coded as the control, EP10, and EP20, respectively. The initial water content of batters showed no significant differences (around 57.0%, dry basis), whereas the final EP10 and EP20 products had higher water content. Three stages were found during baking in control sample and these three stages were fitted by linear, linear, and exponential models with root mean squared error (RMSE) of 0.016, 0.018, and 0.133, respectively. Eucheuma addition decreased the water loss rate and changed the water loss stages, which were fitted by linear, linear, and linear models in EP20 sample (RMSE = 0.027, 0.047, and 0.108, respectively). The crust formation and crumb structure analysis showed that the formation of cracks and the disappearance of pore structures hindered the water evaporation. The low‐field proton nuclear magnetic resonance and magnetic resonance imaging results showed that the water status in the final EP20 products was not as tightly as that in the control samples. A proposed schematic diagram was developed based on the qualitative analysis of the transfer mechanisms to explain the total effect of Eucheuma on the water loss rate and status. These results aid our understanding of the water loss process of sponge cakes and promote the potential application of Eucheuma in bakery products.

Practical Application

Eucheuma as a flour replacement can improve the contents of dietary fiber and minerals like potassium of sponge cake. The impact of Eucheuma on water loss and status in sponge cake was measured and analyzed in this study. The results can promote the potential application of Eucheuma in bakery products and predict the quality attributes of baking products.
Additional moisture during koji preparation contributes to the pigment production of red koji (Monascus‐fermented rice) by influencing gene expression
Authors: Zeng Chuantao , Yoshizaki Yumiko , Yin Xuan , Wang Zitai , Okutsu Kayu , Futagami Taiki , Tamaki Hisanori , Takamine Kazunori
Published: February 2021

Additional moisture in preparing red koji, Monascus‐fermented rice, is a characteristic production process. To determine how additional moisture affects red koji preparation as per quality, we compared the growth of Monascus purpureus, enzyme and pigment production, and related gene expressions using our findings. We considered two kinds of red koji: one prepared with additional moisture at the middle part of the preparation and the other prepared without additional moisture. Our results showed that additional moisture did not promote the growth of M. purpureus, but it was significantly increased the pigment (red and yellow) and tended to increase the α‐amylase level and saccharification power. Although adding a high amount of moisture (approximately 60% moisture content) promoted pigment production, it slightly repressed enzyme production. In contrast, adding approximately 50% moisture content promoted enzyme production. These findings showed that the additional moisture can affect the quality of red koji on the purpose. The expression of 10 pigment biosynthetic gene clusters and two glycohydrolase genes in red koji after adding moisture was analyzed through real‐time qPCR. Eight genes were upregulated within 1 hr after adding water, with mppR2 being the first upregulated gene within 30 min. The expression of genes as per pigment production quickly responded to additional moisture during solid‐state fermentation. Moreover, acetyl‐CoA, which is a starting substrate for pigment content in red koji was increased within 3 hr after adding water. This study first described the relationship between additional moisture and expression of pigment biosynthetic genes by Monascus spp. during red koji preparation.
Use of the volatile trichodiene to reduce Fusarium head blight and trichothecene contamination in wheat
Authors: Taylor Laurie , Gutierrez Santiago , McCormick Susan P. , Bakker Matthew G. , Proctor Robert H. , Teresi Jennifer , Kurtzman Ben , Hao Guixia , Vaughan Martha M.
Published: February 2021

Fusarium graminearum is the primary cause of Fusarium head blight (FHB), one of the most economically important diseases of wheat worldwide. FHB reduces yield and contaminates grain with the trichothecene mycotoxin deoxynivalenol (DON), which poses a risk to plant, human and animal health. The first committed step in trichothecene biosynthesis is formation of trichodiene (TD). The volatile nature of TD suggests that it could be a useful intra or interspecies signalling molecule, but little is known about the potential signalling role of TD during F. graminearum‐wheat interactions. Previous work using a transgenic Trichoderma harzianum strain engineered to emit TD (Th + TRI5) indicated that TD can function as a signal that can modulate pathogen virulence and host plant resistance. Herein, we demonstrate that Th + TRI5 has enhanced biocontrol activity against F. graminearum and reduced DON contamination by 66% and 70% in a moderately resistant and a susceptible cultivar, respectively. While Th + TRI5 volatiles significantly influenced the expression of the pathogenesis‐related 1 (PR1) gene, the effect was dependent on cultivar. Th + TRI5 volatiles strongly reduced DON production in F. graminearum plate cultures and downregulated the expression of TRI genes. Finally, we confirm that TD fumigation reduced DON accumulation in a detached wheat head assay.
Elucidating shark diets with DNA metabarcoding from cloacal swabs
Authors: van Zinnicq Bergmann Maurits P. M. , Postaire Bautisse D. , Gastrich Kirk , Heithaus Michael R. , Hoopes Lisa A. , Lyons Kady , Papastamatiou Yannis P. , Schneider Eric V. C. , Strickland Bradley A. , Talwar Brendan S. , Chapman Demian D. , Bakker Judith
Published: February 2021

Animal dietary information provides the foundation for understanding trophic relationships, which is essential for ecosystem management. Yet, in marine systems, high‐resolution diet reconstruction tools are currently under‐developed. This is particularly pertinent for large marine vertebrates, for which direct foraging behaviour is difficult or impossible to observe and, due to their conservation status, the collection of stomach contents at adequate sample sizes is frequently impossible. Consequently, the diets of many groups, such as sharks, have largely remained unresolved. To address this knowledge gap, we applied metabarcoding to prey DNA in faecal residues (fDNA) collected on cotton swabs from the inside of a shark's cloaca. We used a previously published primer set targeting a small section of the 12S rRNA mitochondrial gene to amplify teleost prey species DNA. We tested the utility of this method in a controlled feeding experiment with captive juvenile lemon sharks (Negaprion brevirostris) and on free‐ranging juvenile bull sharks (Carcharhinus leucas). In the captive trial, we successfully isolated and correctly identified teleost prey DNA without incurring environmental DNA contamination from the surrounding seawater. In the field, we were able to reconstruct high‐resolution teleost dietary information from juvenile C. leucas fDNA that was generally consistent with expectations based on published diet studies of this species. While further investigation is needed to validate the method for larger sharks and other species, it is expected to be broadly applicable to aquatic vertebrates and provides an opportunity to advance our understanding of trophic interactions in marine and freshwater systems.
Variation of bacterial communities along the vertical gradient in Lake Issyk Kul, Kyrgyzstan
Authors: Rojas‐Jimenez Keilor , Araya‐Lobo Alex , Quesada‐Perez Fabio , Akerman‐Sanchez Johana , Delgado‐Duran Brayan , Ganzert Lars , Zavialov Peter O. , Alymkulov Salmor , Kirillin Georgiy , Grossart Hans‐Peter
Published: February 2021

We explored the diversity and community composition of bacteria along a vertical gradient in Lake Issyk Kul, Kyrgyzstan, one of the world's largest and deepest brackish lakes. We identified 4904 bacterial amplicon sequence variants based on the 16S rRNA gene analysis and determined significant changes in the composition, responding mainly to depth and salinity. A higher abundance of Proteobacteria and Bacteroidetes was observed in the surface waters and lake tributaries. Cyanobacteria were more abundant in the deep chlorophyll maximum from 28.5 to 128 m, while Planctomycetes and Chloroflexi were dominant in the deepest layers, from 128 to 600 m. According to our machine learning analyses, depth and temperature were the most critical environmental factors, with strong effects on Proteobacteria, Planctomycetes and Chloroflexi, while oxygen was associated with the variations in Cyanobacteria. We also observed that with increasing depth, the alpha diversity values increased. The dominance of Planctomycetes and Chloroflexi in the deepest layers can only be seen in a few lakes of the world. However, the lake is facing increasing anthropogenic and climatic pressure. There is an urgent need to understand better the ecological role and function of these unique deep‐water microbial communities.
Authority, Monitoring, and Incentives in Hierarchies*†
Authors: Hofmann Christian , Indjejikian Raffi J.
Published: February 2021

We study three elements of management control: incentive compensation, performance monitoring, and delegation of authority to managers to contract with lower‐level employees. Using a principal‐agent model, we highlight important direct and indirect interactions between and among these endogenous control elements, themes often emphasized in the economics and accounting literatures using the analogy of a three‐legged stool. We identify circumstances in which control elements are complements or substitutes and exhibit a coherent pattern of practices observed together. For instance, contrary to typical predictions that quality monitoring complements steep effort incentives, we find that when contracting authority adjusts easily to changes in firm circumstances, then both incentive pay and contracting authority substitute for monitoring quality, while incentive pay complements contracting authority. Overall, our findings suggest a number of empirical implications and generally inform a growing literature that documents the presence or absence of complementarities among management control elements.
Evaluation of bedside sonography performed by emergency physicians to detect intussusception in children in the emergency department
Authors: Tonson la Tour Aude , Desjardins Marie Pier , Gravel Jocelyn
Published: February 2021

Objective

The aim of our study was to evaluate the test characteristics of point‐of‐care ultrasound (POCUS) performed by emergency physicians with varying levels of experience among children having undergone diagnostic radiology ultrasound for intussusception in a pediatric emergency department (PED).

Methods

This was a subanalysis of a prospective cohort study conducted at a tertiary care PED. The study population was a sample of children younger than 5 years old who required an abdominal ultrasound for suspected intussusception. Participating physicians had varying levels of POCUS experience. They received a 1‐hour didactic and practical training session on intussusception ultrasound. All POCUS was performed following the initial physical examination and prior to further radiologic evaluation. The final outcome was determined by radiologic evaluation performed by a pediatric radiologist. Test characteristics were calculated for POCUS compared with the criterion standard of ultrasound read by a pediatric radiologist. A secondary analysis compared test characteristics of POCUS performed by physicians with different level of POCUS training.

Results

A total of 131 children were evaluated by POCUS, of whom 45 (34%) had an intussusception. Twenty‐four physicians performed between one and 25 POCUS procedures. POCUS identified 39 of 45 intussusception cases, with a sensitivity of 0.87 (95% confidence interval [CI] = 0.74 to 0.94). A normal or inconclusive POCUS was reported for 83 of the 86 negative studies, with a specificity of 0.97 (95% CI = 0.90 to 0.99). When excluding the 28 patients for whom the physician reported an inconclusive examination, the sensitivity improved to 0.98 (95% CI = 0.97 to 1.00) and the specificity to 0.94 (95% CI = 0.85 to 0.99). The accuracy of diagnosis using POCUS was 42 of 43 (98%) for experienced sonographers in comparison to 81 of 88 (92%) for novices.

Conclusion

This study demonstrated a very good sensitivity and specificity of POCUS for intussusception in children when performed by multiple emergency physicians with varying POCUS experience.
Outcomes of surgical site infections following spinal column trauma
Authors: Baroun‐Agob Louay , Liew Susan , Gabbe Belinda
Published: February 2021

Background

Surgical site infections (SSI) are an undesirable outcome of spinal surgery for both the patient and healthcare system. To date, few studies have investigated the impact of SSI on patient‐reported and clinical outcomes. Sepsis and readmission are potential sequelae of SSI, with sepsis potentially being life threatening. This study aimed to assess the association between SSI and patient outcomes in a spinal trauma cohort.

Methods

Adult (16+ years) patients who underwent emergency spinal surgery due to trauma between January 2010 and December 2016 at a major trauma centre in Melbourne, Australia, were identified through the Victorian Orthopaedic Trauma Outcomes Registry. The presence of an SSI was abstracted from the electronic medical record and outcomes were compared between patients with and without an SSI. Clinical outcomes were obtained from the medical record, and patient‐reported outcomes at 6 and 12 months were obtained from the Victorian Orthopaedic Trauma Outcomes Registry. Chi‐squared tests were used to compare patient outcomes between groups.

Results

Of the 458 included patients, 26 (5.7%) developed an SSI. Patient‐reported outcomes at 6 and 12 months were not different between the groups. An SSI was associated with sepsis (χ21 = 24.20, P < 0.01), readmission (χ21 = 215.34, P < 0.01), revision surgery (χ21 = 171.21, P < 0.01) and removal of implants (χ21 = 4.31, P = 0.04) within 12 months of discharge.

Conclusion

These findings indicate that spine trauma SSIs are not associated with patient‐reported outcomes and may not have lasting effects on patients. Larger studies are required to assess further follow‐up and support our findings and possibly distinguish outcomes between superficial and deep SSI.
Remediation for surgical trainees: recommendations from a narrative review
Authors: To Henry , Cargill Ashleigh , Tobin Stephen , Nestel Debra
Published: February 2021

Remediation involves formalized support for surgical trainees with significant underperformance to return to expected standards. We have reviewed current published literature to understand the evidence for remediation of surgical trainees to inform practice and justify investment of resources. If performed in a programmatic framework, it is a complex but often successful approach to return surgical trainees to their expected standard using system and process level changes.
A bi‐centric experience of extracorporeal carbon dioxide removal (ECCO2R) for acute hypercapnic respiratory failure following allogeneic hematopoietic stem cell transplantation
Authors: Wohlfarth Philipp , Schellongowski Peter , Staudinger Thomas , Rabitsch Werner , Hermann Alexander , Buchtele Nina , Turki Amin T. , Tzalavras Asterios , Liebregts Tobias
Published: February 2021

Acute respiratory failure (ARF) is the main reason for ICU admission following allogeneic hematopoietic stem cell transplantation (HSCT). Extracorporeal CO2 removal (ECCO2R) can be used as an adjunct to mechanical ventilation in patients with severe hypercapnia but has not been assessed in HSCT recipients. Retrospective analysis of all allogeneic HSCT recipients ≥18 years treated with ECCO2R at two HSCT centers. 11 patients (m:f = 4:7, median age: 45 [IQR: 32‐58] years) were analyzed. Acute leukemia was the underlying hematologic malignancy in all patients. The time from HSCT to ICU admission was 37 [8‐79] months, and 9/11 (82%) suffered from chronic graft‐versus‐host disease (GVHD) with lung involvement. Pneumonia was the most frequent reason for ventilatory decompensation (n = 9). ECCO2R was initiated for severe hypercapnia (PaCO2: 96 [84‐115] mm Hg; pH: 7.13 [7.09‐7.27]) despite aggressive mechanical ventilation (invasive, n = 9; non‐invasive, n = 2). ECCO2R effectively resolved blood gas disturbances in all patients, but only 2/11 (18%) could be weaned off ventilatory support, and one (9%) patient survived hospital discharge. Progressive respiratory and multiorgan dysfunction were the main reasons for treatment failure. ECCO2R was technically feasible but resulted in a low survival rate in our cohort. A better understanding of the prognosis of ARF in patients with chronic GVHD and lung involvement is necessary before its use can be reconsidered in this setting.
Effect of age on reoperation rate in children undergoing exotropia surgery
Authors: Heo Hwan , Lambert Scott R.
Published: February 2021

Purpose

To determine the effect of age on the reoperation rate in children undergoing exotropia surgery.

Methods

This was a population‐based retrospective cohort study using claims data that included children ≤ 12 years who had undergone exotropia surgery as the first strabismus operation and had ≥ 3 years of continuous enrolment were selected from the Optum de‐identified Clinformatics Data Mart Database (2003–2019). Patient age at the first exotropia surgery was grouped into three categories; 0–3, 4–6, and 7–12 years. We assessed the sex, race, age, surgical methods, continuous enrolment period after the first surgery, and the time between the first surgery and reoperation. Cox regression analysis was used to estimate the risk of reoperation at different ages. The hazard ratio of reoperation in children undergoing exotropia surgery according to the age at the first exotropia surgery.

Results

Among 2015 children, 312 (15.5%) underwent one or more reoperations. A reoperation was more often performed for recurrent exotropia (n = 231) than for consecutive esotropia (n = 81). The time between the first surgery and reoperation was shorter for reoperation for consecutive esotropia (376 days) than for recurrent exotropia (672 days) (p < 0.001). Younger children showed a higher reoperation hazard ratio than older children (p < 0.001). In reoperation for consecutive esotropia, the patients aged 0–3 years showed a high hazard ratio (2.82; 95% CI, 1.59–5.01).

Conclusion

Children undergoing exotropia surgery at a younger age have a higher reoperation rate than those undergoing surgery at an older age.
Impact of anticoagulant exposure misclassification on the bleeding risk of direct oral anticoagulants
Authors: Hempenius Mirjam , Groenwold Rolf H. H. , Souverein Patrick C. , de Boer Anthonius , Klungel Olaf H. , Gardarsdottir Helga
Published: February 2021

Aims

Drug exposure status based on routinely collected data might be misclassified when the database contains only prescriptions from 1 type of prescriber (e.g. general practitioner and not specialist). This study aims to quantify the impact of such exposure misclassification on the risk of major bleeding and stroke/transient ischaemic attack (TIA)associated with direct oral anticoagulants (DOACs) vs. vitamin K antagonists (VKAs).

Methods

Incident anticoagulant users (>12 mo free of anticoagulation use) in the Dutch PHARMO Database Network between 2008 and 2017 were included. Drug exposure was assessed using pharmacy dispensing information. The risks of hospital admission of major bleeding for DOAC vs. VKA users was assessed with Cox regression analysis, where exposure was based on all dispensings, on general practitioner (GP)‐prescribed dispensings only or on specialist‐prescribed dispensings only. Hazard ratios (HRs) were estimated also for hospitalization for gastrointestinal bleeding, intracranial bleeding and stroke/TIA.

Results

We included 99 182 VKA‐initiators and 21 795 DOAC‐initiators. Use of DOAC was associated with a lower risk of major bleeding compared to VKA use; HR 0.79 (95% confidence interval 0.70–0.90), 0.78 (0.68–0.91) and 0.62 (0.50–0.76), for exposure based on complete dispensing information, only GP‐ and only specialist‐prescribed dispensings, respectively. Similar results were found for the other bleeding outcomes. For stroke/TIA the HRs were 0.96 (0.84–1.09), 1.00 (0.84–1.18) and 0.72 (0.58–0.90), respectively.

Conclusion

Including only GP‐prescribed anticoagulant dispensings in this case did not materially impact the effect estimates compared to including all anticoagulant dispensings. Including only specialist‐prescribed dispensings, however, strengthened the effect estimates.
Causal interaction trees: Finding subgroups with heterogeneous treatment effects in observational data
Authors: Yang Jiabei , Dahabreh Issa J. , Steingrimsson Jon A.
Published: February 2021

We introduce causal interaction tree (CIT) algorithms for finding subgroups of individuals with heterogeneous treatment effects in observational data. The CIT algorithms are extensions of the classification and regression tree algorithm that use splitting criteria based on subgroup‐specific treatment effect estimators appropriate for observational data. We describe inverse probability weighting, g‐formula, and doubly robust estimators of subgroup‐specific treatment effects, derive their asymptotic properties, and use them to construct splitting criteria for the CIT algorithms. We study the performance of the algorithms in simulations and implement them to analyze data from an observational study that evaluated the effectiveness of right heart catheterization for critically ill patients.
Bayesian dose regimen assessment in early phase oncology incorporating pharmacokinetics and pharmacodynamics
Authors: Gerard Emma , Zohar Sarah , Thai Hoai‐Thu , Lorenzato Christelle , Riviere Marie‐Karelle , Ursino Moreno
Published: February 2021

Phase I dose‐finding trials in oncology seek to find the maximum tolerated dose of a drug under a specific schedule. Evaluating drug schedules aims at improving treatment safety while maintaining efficacy. However, while we can reasonably assume that toxicity increases with the dose for cytotoxic drugs, the relationship between toxicity and multiple schedules remains elusive. We proposed a Bayesian dose regimen assessment method (DRtox) using pharmacokinetics/pharmacodynamics (PK/PD) to estimate the maximum tolerated dose regimen (MTD‐regimen) at the end of the dose‐escalation stage of a trial. We modeled the binary toxicity via a PD endpoint and estimated the dose regimen toxicity relationship through the integration of a dose regimen PD model and a PD toxicity model. For the first model, we considered nonlinear mixed‐effects models, and for the second one, we proposed the following two Bayesian approaches: a logistic model and a hierarchical model. In an extensive simulation study, the DRtox outperformed traditional designs in terms of proportion of correctly selecting the MTD‐regimen. Moreover, the inclusion of PK/PD information helped provide more precise estimates for the entire dose regimen toxicity curve; therefore the DRtox may recommend alternative untested regimens for expansion cohorts. The DRtox was developed to be applied at the end of the dose‐escalation stage of an ongoing trial for patients with relapsed or refractory acute myeloid leukemia (NCT03594955) once all toxicity and PK/PD data are collected.
Bayesian data fusion: Probabilistic sensitivity analysis for unmeasured confounding using informative priors based on secondary data
Authors: Comment Leah , Coull Brent A. , Zigler Corwin , Valeri Linda
Published: February 2021

Bayesian causal inference offers a principled approach to policy evaluation of proposed interventions on mediators or time‐varying exposures. Building on the Bayesian g‐formula method introduced by Keil et al., we outline a general approach for the estimation of population‐level causal quantities involving dynamic and stochastic treatment regimes, including regimes related to mediation estimands such as natural direct and indirect effects. We further extend this approach to propose a Bayesian data fusion (BDF), an algorithm for performing probabilistic sensitivity analysis when a confounder unmeasured in a primary data set is available in an external data source. When the relevant relationships are causally transportable between the two source populations, BDF corrects confounding bias and supports causal inference and decision‐making within the main study population without sharing of the individual‐level external data set. We present results from a simulation study comparing BDF to two common frequentist correction methods for unmeasured mediator‐outcome confounding bias in the mediation setting. We use these methods to analyze data on the role of stage at cancer diagnosis in contributing to Black–White colorectal cancer survival disparities.
Talking with parents of children with learning disabilities: Parents’ ideas about the Circle of Security parenting programme
Authors: Muddle Sarah , McElwee Jennifer , Vincent Regine , Birdsey Nicola , Best Lara
Published: February 2021

Accessible Summary

The Circle of Security Parenting (COS‐P) programme can be helpful for some parents of children with learning disabilities to think about their relationship with their child.

Parenting a child with learning disabilities is different, and COS‐P can highlight this difference.

This can feel painful for parents and may stop them engaging with the programme.

Background

Background: The promotion of secure attachment relationships in childhood leads to better outcomes in later life (British Psychological Society 2017, Incorporating Attachment Theory into Practice: Clinical Practice Guideline for Clinical Psychologists Working with People who have Intellectual Disabilities). The Circle of Security Parenting Programme (COS‐P) provides a clear framework for reflecting on attachment relationships (Cooper et al 2009, Zero to Three, 37, 27).

Methods

Methods: Semi‐structured interviews were conducted with parents of children with learning disabilities who attended a COS‐P programme to find out about their experiences of the course and how applicable it was to them. The data were analysed using thematic analysis.

Findings

Findings: Four key themes were identified: these related to (1) COS‐P concepts are relevant to all children but (2) parenting a child with a learning disability is different and (3) COS‐P can create a focus on their child as different, which can be painful, and (4) changes recommended to make COS‐P suitable for parents of children with learning disabilities.

Conclusions

Conclusions: This paper outlines the benefits and challenges of COS‐P in sharing concepts related to attachment, whilst highlighting differences for parents of children and young people with learning disabilities, which can be painful.
The functional ecology of bat pollination in the African sausage tree Kigelia africana (Bignoniaceae)
Authors: Newman Ethan , Govender Keeveshnee , van Niekerk Sandy , Johnson Steven D.
Published: February 2021

Plants often interact with a wide range of animal floral visitors that can vary in their pollination effectiveness. Flowers of the African sausage tree Kigelia africana are visited by bats and bush babies during the night and by birds during the day. We studied floral traits (phenophases, scent, color, and nectar chemistry) and the visitation frequency and pollination effectiveness of different flower visitors to determine whether K. africana is functionally specialized for bat pollination. We found that flower opening corresponds with bat activity, flowers emit scent dominated by aliphatic esters and alcohols, and that nectar is produced in copious amounts accessible to bats. Pollen deposition on stigmas was twenty‐fold greater per visit by bats than it was per visit by birds, likely a result of the close morphological fit between snouts of bats and the flowers. However, bat visits appear to be rare at some sites and the delayed senescence of flowers that are open throughout the morning provides an opportunity for additional pollination by birds. We conclude that K. africana is primarily adapted for bat pollination, but is also able to exploit other animals for pollination.
Accuracy evaluation of partially guided and fully guided templates applied to implant surgery of anterior teeth: A randomized controlled trial
Authors: Lou Fangzhi , Rao Pengcheng , Zhang Maorui , Luo Shihong , Lu Shi , Xiao Jingang
Published: February 2021

Objectives

To study the accuracy of partially guided and fully guided templates applied to implant surgery of anterior teeth.

Materials and methods

Sixty patients who were scheduled to receive dental implant treatment in the anterior region were enrolled and randomly assigned to one of the following study groups (n = 20 each): routine implant‐supported restoration treatment (control group, 30 implants), implant‐supported restoration treatment using a partially guided template (test group 1, 36 implants), and implant‐supported restoration treatment using a fully guided template (test group 2, 33 implants). The depth of implant was controlled for fully guided template. After implantation, planned implants and placed implants were superimposed using digital software, and the deviations (angular, coronal, apical, depth) were analyzed. Esthetic parameters were assessed at baseline, 6 months, and 1 year after the final restoration. Pink esthetic score (PES) and white esthetic score (WES) were respectively used to evaluate the soft tissue and restoration esthetic outcome. Each parameter of PES and WES is assessed with a 0–1‐2 score with 2 being the best and 0 being the worst score.

Results

There were significant differences in all of the deviation parameters between the control group, test group 1, and test group 2 (p < 0.001). Mean angular, coronal, apical and depth deviations were all the highest in the control group (6.61 ± 1.09°, 1.05 ± 0.17 mm, 1.36 ± 0.13 mm, and 1.02 ± 0.13 mm, respectively), and lowest in test group 2 (2.05 ± 0.45°, 0.39 ± 0.12 mm, 0.28 ± 0.09 mm, and 0.24 ± 0.06 mm, respectively). At 1 year after the final restoration, the analysis revealed mean PES values of 7.09 ± 0.56 (control group), 8.39 ± 0.54 (test group 1), and 9.04 ± 0.35 (test group 2). The WES values were 7.24 ± 0.54 (control group), 8.47 ± 0.44 (test group 1), and 8.97 ± 0.38 (test group 2). At all examinations, the mean PES and WES values were both the highest in test group 2 and lowest in the control group. The PES and WES values recorded in the control group at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test groups (p < 0.001). Moreover, the PES and WES values recorded in the test group 1 at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test group 2 (p < 0.05).

Conclusions

Digital surgical guides can improve the accuracy of the three‐dimensional position of implants in the maxillary esthetic zone, the fully guided template has higher precision than that of the partially guided template, and plays an important role in obtaining the ideal esthetic outcome for maxillary anterior teeth.