bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Periodontitis on Inflammatory Bowel Disease Activity
Authors: Madsen Gorm Roager , Bertl Kristina , Pandis Nikolaos , Stavropoulos Andreas , Burisch Johan
Published: May 2022

Background

Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarly complex pathogeneses that involve an interplay between dysbiotic microbiota and dysregulated immune-inflammatory responses. However, whether the presence of periodontitis is associated with IBD activity and/or its severity remains unknown.

Methods

An online, questionnaire-based study was answered by 1093 patients with IBD, comprising 527 patients with Crohn’s disease and 566 patients with ulcerative colitis. The survey included questions on social demographics; oral health, including the Periodontal Screening Score (PESS); and IBD-related characteristics, including validated disease indices.

Results

Irrespective of disease subtype, patients with a reduced number of teeth and those with self-reported severe periodontitis scored significantly higher on the IBD disability index (number of teeth: coefficient, 4.93 [95% confidence interval {CI}, 1.21–8.66; P = .010]; periodontitis: coefficient, 3.54 [95% CI, 0.27–6.80; P = .034]) and reported increased disease activity in the preceding 12 months (number of teeth: odds ratio [OR], 1.91 [95% CI, 1.36–2.69; P < .001]; periodontitis: OR, 1.71 [95% CI, 1.27–2.31; P < .001]). There was also evidence of a weak association between self-reported severe periodontitis and current disease activity (OR, 1.33; 95% CI, 0.95–1.86; P = .099). However, IBD severity, as a composite parameter of a history of surgery due to IBD and/or treatment with biological therapy, was not associated with possessing a reduced number of teeth (OR, 1.18; 95% CI, 0.77–1.80; P = .451), nor with self-reported severe periodontitis (OR, 1.15; 95% CI, 0.79–1.66; P = .467).

Conclusions

Periodontitis and tooth loss were significantly associated with increased IBD-related disability and more disease activity in the preceding 12 months. Our results suggest that greater attention should be paid to IBD patients’ oral health.
An analysis of complaints about hospital care in the Republic of Ireland
Authors: O’dowd Emily , Lydon SinÉad , Lambe Kathryn , Vellinga Akke , Rudland Chris , Ahern Elaine , Hilton Aoife , Ward Marie E , Kane Maria , Reader Tom , Gillespie Alex , Vaughan David , Slattery Dubhfeasa , O’connor Paul
Published: May 2022

Background

Patients and family members make complaints about their hospital care in order to express their dissatisfaction with the care received and prompt quality improvement. Increasingly, it is being understood that these complaints could serve as important data on how to improve care if analysed using a standardized tool. The use of the Healthcare Complaints Analysis Tool (HCAT) for this purpose has emerged internationally for quality and safety improvement. Previous work has identified hot spots (areas in care where harm occurs frequently) and blind spots (areas in care that are difficult for staff members to observe) from complaints analysis. This study aimed to (i) apply the HCAT to a sample of complaints about hospital care in the Republic of Ireland (RoI) to identify hot spots and blind spots in care and (ii) compare the findings of this analysis to a previously published study on hospital complaints in the UK.

Methods

A sample of complaints was taken from 16 hospitals in the RoI in Quarter 4 of 2019 (n = 641). These complaints were coded using the HCAT to classify complaints by domain, category, severity, stage of care and harm. Chi-squared tests were used to identify hot spots, and logistic regression was used to identify blind spots. The findings of this study were compared to a previously published UK study that used HCAT to identify hot spots and blind spots.

Results

Hot spots were identified in Irish hospital complaints while patients were receiving care on the ward, during initial examination and diagnosis, and while they were undergoing operations or procedures. This aligned with hot spots identified in the UK study. Blind spots were found for systemic problems, where patients experience multiple issues across their care.

Conclusions

Hot spots and blind spots for patient harm can be identified in hospital care using the HCAT analysis. These in turn could be used to inform improvement interventions, and direct stakeholders to areas that require urgent attention. This study also highlights the promise of the HCAT for use across different healthcare systems, with similar results emerging from the RoI and the UK.
RNA-seq reveals insights into molecular mechanisms of metabolic restoration via tryptophan supplementation in low birth weight piglet model
Authors: Xiao Ping , Goodarzi Parniyan , Pezeshki Adel , Hagen Darren E
Published: May 2022

Low birth weight (LBW) is associated with metabolic disorders in early life. While dietary l-tryptophan (Trp) can ameliorate postprandial plasma triglycerides (TG) disposal in LBW piglets, the genetic and biological basis underlying Trp-caused alterations in lipid metabolism is poorly understood. In this study, we collected 24 liver samples from 1-mo-old LBW and normal birth weight (NBW) piglets supplemented with different concentrations of dietary Trp (NBW with 0% Trp, N0; LBW with 0% Trp, L0; LBW with 0.4% Trp, L4; LBW with 0.8% Trp, L8; N = 6 in each group.) and conducted systematic, transcriptome-wide analysis using RNA sequencing (RNA-seq). We identified 39 differentially expressed genes (DEG) between N0 and L0, and genes within “increased dose effect” clusters based on dose-series expression profile analysis, enriched in fatty acid response of gene ontology (GO) biological process (BP). We then identified RNA-binding proteins including SRSF1, DAZAP1, PUM2, PCBP3, IGF2BP2, and IGF2BP3 significantly (P < 0.05) enriched in alternative splicing events (ASE) in comparison with L0 as control. There were significant positive and negative relationships between candidate genes from co-expression networks (including PID1, ANKRD44, RUSC1, and CYP2J34) and postprandial plasma TG concentration. Further, we determined whether these candidate hub genes were also significantly associated with metabolic and cardiovascular traits in humans via human phenome-wide association study (Phe-WAS), and analysis of mammalian orthologs suggests a functional conservation between human and pig. Our work demonstrates that transcriptomic changes during dietary Trp supplementation in LBW piglets. We detected candidate genes and related BP that may play roles on lipid metabolism restoration. These findings will help to better understand the amino acid support in LBW metabolic complications.
Hyaluronic Acid and Chondroitin Sulphate Treatment for Recurrent Severe Urinary Tract Infections due to Multidrug-Resistant Gram-Negative Bacilli in a Patient With Multiple Sclerosis: Case Report and Literature Review
Authors: Dinh Aurélien , Duran Clara , Hamami Kamel , Afif Muriel , Bonnet Francine , Donay Jean-Luc , Lafaurie Matthieu , Chartier-Kastler Emmanuel
Published: May 2022

Urinary tract infections (UTIs) are the most common bacterial infections in patients with neurogenic lower urinary tract dysfunction. Antibiotic options for prophylaxis or curative treatment in case of recurrent UTIs, especially due to multidrug-resistant organisms (MDRO), are scarce. We present the case of a 72-year-old man with neurogenic lower urinary tract dysfunction and history of frequent recurrent UTIs due to multiple MDROs who was successfully treated with hyaluronic acid (HA) and chondroitin sulfate (CS) bladder instillations. We also provide a literature review on the efficacy of HA-CS intravesical instillations for prevention of UTI among this population.
Comparison of Hyphal Fragments and Spores to Evaluate the Pathogenicity of theEucalyptusLeaf and Shoot PathogenCalonectria pseudoreteaudii
Authors: Wang Quanchao , Liu Feifei , Liu Qianli , Wu Wenxia , Wingfield Michael J. , Chen Shuaifei
Published: May 2022

The genus Calonectria includes many aggressive plant-pathogenic species with a worldwide distribution. Calonectria leaf blight is one of the most prominent diseases of Eucalyptus trees in Southeast Asian and South American plantations. Inoculation trials to evaluate pathogenicity of Calonectria spp. typically use conidial suspensions but this is not possible for species that do not sporulate sufficiently in culture. Calonectria pseudoreteaudii is one of the species that is most aggressive to Eucalyptus in China but most isolates fail to produce conidia in culture, requiring an alternative procedure for artificial inoculation. This study compared inoculations utilizing conidial and hyphal fragment suspensions. Two Eucalyptus genotypes were used, and these were inoculated with different concentrations of hyphal fragments or conidia of three C. pseudoreteaudii isolates. Three days after inoculation, the treated Eucalyptus plants displayed similar disease symptoms, regardless of whether they had been inoculated with conidia or hyphal fragments. This was consistent for all C. pseudoreteaudii isolates and also the different Eucalyptus genotypes. The results demonstrate that hyphal fragment suspensions can be used to provide a reliable indication of C. pseudoreteaudii isolate pathogenicity when conidia are not available for inoculation studies.
Biocontrol of Plant Diseases Using Glycyrrhiza glabra Leaf Extract
Authors: Hermann Sophie , Orlik Marc , Boevink Petra , Stein Elke , Scherf Andrea , Kleeberg Ina , Schmitt Annegret , Schikora Adam
Published: May 2022

The growing concern regarding the potential risks of pesticides and their impact on nontarget organisms stimulates the development and application of alternative, environmentally friendly products. It seems necessary to develop alternatives for conventional products and for those already widely used in organic agriculture, e.g., copper. Very importantly, such alternative products should not limit the productivity and profitability of agriculture. In this study, we examined the efficacy of licorice (Glycyrrhiza glabra) leaf extract as such an alternative. We tested its impact on the virulence of Pseudomonas syringae toward the model plant Arabidopsis thaliana and the crop plant tomato (Solanum lycopersicum) as well as of Clavibacter michiganensis, Xanthomonas campestris, and Phytophthora infestans toward tomato, at multiple levels. We demonstrate that licorice leaf extract acts as a direct fungicide and bactericide. Moreover, it acts against a metalaxyl-resistant P. infestans strain. In addition, the extract from licorice leaves influences the plant immune system, modulating the plant responses to the challenge with pathogen(s); this involves both salicylic acid and ethylene-based responses. Our results show that in addition to the well-known use of licorice root extract in medicine, the leaf extract can be an effective alternative in organic and integrated farming, contributing to copper reduction and resistance management.

[Formula: see text] Copyright © 2022 The Author(s). This is an open-access article distributed under the CC BY 4.0 International license .
The Effectiveness of a Novel Skin Barrier Protectant in the Management of Acute Radiation Dermatitis: A Case Series
Authors: Robijns Jolien , Van Bever Leen , Claes Stefan , Censabella Sandrine , Pannekoeke Luc , Maes Annelies , Van de Werf Evelyn , Bulens Paul
Published: May 2022

Objective

Acute radiation dermatitis (ARD) is a frequent adverse effect in patients with cancer undergoing radiotherapy (RT). The aim of this case series is to evaluate the effect of a novel skin barrier protectant in patients with ARD.

Methods

The skin barrier protectant was used in four patients with different cancer types undergoing RT at two clinical sites. All patients received the standard institutional skincare alongside the novel skin barrier protectant. The skin reactions were evaluated by an RT nurse using the modified version of the Radiation Therapy Oncology Group criteria.

Results

At the final RT session, three of four patients developed erythema with or without dry desquamation. One patient presented only a minor patchy moist wound. Overall, the pain and pruritus due to ARD was low or nonexistent. No adverse events related to the skin barrier protectant were reported.

Conclusions

This case series demonstrates the beneficial effects and safety of the novel skin barrier protectant in the management of ARD in patients with cancer of different etiologies. These results lay the foundation for future studies with larger, more homogeneous patient populations; a well-defined application scheme; and a stricter study design.
Etiologies and Outcomes of Spinal Epidural Lipomatosis
Authors: Alomari Safwan , Lubelski Daniel , Khalifeh Jawad M. , Sacino Amanda N. , Theodore Nicholas , Witham Timothy , Bydon Ali
Published: May 2022

Study Design:

This was a systematic review of the literature.

Objective:

The aim was to examine the contemporary demographics, etiological factors, treatment options and outcomes of spinal epidural lipomatosis (SEL) in adults.

Summary of Background Data:

SEL is primarily seen in obese patients as well as those on steroid therapy. Much regarding the etiology and treatment outcomes of SEL is unknown.

Methods:

We reviewed Ovid MEDLINE, PubMed, SCOPUS, and Google Scholars databases from 1990 through August 2020 to identify cases of SEL. Data collected included patient characteristics, disease associations, level of pathology, treatment, and clinical outcomes.

Results:

Ninety articles (145 individual cases) were included in the analysis. The median age was 54 years and 79% were males. Obesity-associated SEL constituted the largest proportion (52%) of our cohort. 22% of SEL cases were related to steroid use, while 26% cases were considered to be idiopathic. Lumbosacral SEL was the most frequently reported level of disease (68.9%), followed by the thoracic level (26.2%). The mean age of cases who underwent surgical intervention was 55 years, as compared with 48 years in those who received conservative management (P=0.03). 95% of patients reported some degree of symptomatic improvement regardless of the treatment modality. Logistic regression suggested a possible superior outcome associated with those undergoing surgical treatment.

Conclusion:

In contrast to historical comparisons, contemporary articles support that obesity has become the major contributing factor for SEL. Logistic regression of the existing cases suggests that there may be a role for surgical intervention in select patients.
Statistical Deconvolution for Inference of Infection Time Series
Authors: Miller Andrew C. , Hannah Lauren A. , Futoma Joseph , Foti Nicholas J. , Fox Emily B. , D’Amour Alexander , Sandler Mark , Saurous Rif A. , Lewnard Joseph A.
Published: May 2022

Accurate measurement of daily infection incidence is crucial to epidemic response. However, delays in symptom onset, testing, and reporting obscure the dynamics of transmission, necessitating methods to remove the effects of stochastic delays from observed data. Existing estimators can be sensitive to model misspecification and censored observations; many analysts have instead used methods that exhibit strong bias. We develop an estimator with a regularization scheme to cope with stochastic delays, which we term the robust incidence deconvolution estimator. We compare the method to existing estimators in a simulation study, measuring accuracy in a variety of experimental conditions. We then use the method to study COVID-19 records in the United States, highlighting its stability in the face of misspecification and right censoring. To implement the robust incidence deconvolution estimator, we release incidental, a ready-to-use R implementation of our estimator that can aid ongoing efforts to monitor the COVID-19 pandemic.
External Radiation Dose to Owners of Canines Treated with (117mSn) Radiosynoviorthesis for Osteoarthritis
Authors: Smith Chad A. , Krimins Rebecca A.
Published: May 2022

A novel device in the veterinary market uses a colloid containing radioactive 117mSn to treat osteoarthritis in the synovial joints of canines. The technique of injecting a radioisotope to restore synovia is referred to as radiosynoviorthesis. The outpatient canine procedure uses a maximum administration of 222 MBq of 117mSn injected into one or more joints. Due to the 13.91 d half-life and 158.6 keV gamma output of 117mSn, abiding by the annual public dose limit of 1 mSv is of primary regulatory concern. The therapy protocol starts with a pre-screening questionnaire to establish owner and animal behavior patterns. The questionnaire is used to determine the duration of written time and distance limitations post therapy. In this study, external radiation doses to owners were measured by providing optically stimulated luminescent dosimeters (OSLD) for up to 30 d post-treatment of the pet. Twelve owners were measured over various time frames at two licensed locations independent of each other. In one location, the average (OSLD) measured 0.029 mSv over a 14-d wear period. In the second location, the average (OSLD) measured 0.057 mSv over a 30-d wear period; both values were well below the recommended annual public dose. The overall average extrapolated external radiation dose was estimated at 0.092 mSv, while the maximum dose estimate was 0.25 mSv. The (OSLD) results and extrapolated owner doses provide reasonable assurance that the public dose limits will be met.
Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens
Authors: Dick H. Burkhard , Ang Robert E. , Corbett Dean , Hoffmann Peter , Tetz Manfred , Villarrubia Alberto , Palomino Carlos , Castillo-Gomez Alfredo , Tsai Linda , Thomas Eugenia K. , Janakiraman Priya
Published: May 2022

Purpose:

To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery.

Setting:

Multicenter clinical setting.

Design:

Prospective randomized comparative study.

Methods:

Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety.

Results:

Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs.

Conclusions:

The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.
Alternatives to whole gland treatment for localized prostate cancer: a review of novel focal therapies
Authors: Benjamin Tavya G.R. , Williams Thomas R. , Zhang Bertie , Schwartz Michael J. , Rastinehad Ardeshir R.
Published: May 2022

Purpose of review

The mainstays of the management of clinically localized prostate cancer have historically rested upon active surveillance, radiation therapy, or radical prostatectomy. Although both radiation and surgical treatment of localized prostate cancer can achieve excellent oncologic outcomes, the subsequent potential adverse effects of urinary stress incontinence and erectile dysfunction are unappealing to patients. This has led to investigational studies centered upon focal treatment of the cancerous lesion, with the aim to improve quality-of-life outcomes. In this review, we describe numerous novel modalities, including nanoparticle ablation and irreversible electroporation, which are being utilized for the focal treatment of clinically localized prostate cancer.

Recent findings

Although many of these novel therapies are in their investigational infancy, several have revealed very promising results both in their post-treatment pathologic outcomes as well as objective quality-of-life measures.

Initial data regarding novel focal therapy for prostate cancer treatment show promising short-term outcomes in regards to oncologic and quality-of-life assessments. Further investigational studies are needed to determine inclusion criteria for the selection of optimal candidates.
Patient-Reported Outcomes for Function and Pain in Total Knee Arthroplasty Patients
Authors: Buus Amanda A. Ø. , Udsen Flemming W. , Laugesen Britt , El-Galaly Anders , Laursen Mogens , Hejlesen Ole K.
Published: May 2022

Background

Some patients undergoing total knee arthroplasty successfully manage their condition postoperatively, whereas others encounter challenges in regaining function and controlling pain during recovery at home.

Objective

The aim of this study was to use traditional statistics and machine learning to develop prediction models that identify patients likely to have increased care needs related to managing function and pain following total knee arthroplasty.

Methods

This study included 201 patients. Outcomes were changes between baseline and follow-up in the functional and pain subcomponents of the Oxford Knee Score. Both classification and regression modeling were applied. Twenty-one predictors were included. Tenfold cross-validation was used, and the regression models were evaluated based on root-mean-square error, mean absolute error, and coefficient of determination. Classification models were evaluated based on the area under the receiver operating curve, sensitivity, and specificity.

Results

In classification modeling, random forest and stochastic gradient boosting provided the best overall metrics for model performance. A support vector machine and a stochastic gradient boosting machine in regression modeling provided the best predictive performance. The models performed better in predicting challenges related to function compared to challenges related to pain.

Discussion

There is valuable predictive information in the data routinely collected for patients undergoing total knee arthroplasty. The developed models may predict patients who are likely to have enhanced care needs regarding function and pain management. Improvements are needed before the models can be implemented in routine clinical practice.
A Case of COL1A1-PDGFB Fusion Uterine Sarcoma
Authors: Hogeboom Adriana , Bárcena Carmen , Parrilla-Rubio Lucía , Revilla Enrique , Ruano Yolanda , Gallego-Gutiérrez Irene , Martínez-López Mario
Published: May 2022

COL1A1-PDGFB gene fusion uterine sarcoma is a recently described entity which shows some overlapping features with dermatofibrosarcoma protuberans. To date, only 4 cases have been reported in the literature. Due to its rarity, succinct clinicopathologic characteristics are yet to be established. We report a fifth case initially mistaken as a uterine fibroid which histologically proved to be a CD34+ high-grade spindle cell proliferation which on fluorescence in situ hybridization analysis displayed COL1A1-PDGFB gene rearrangement. With this case description we hope to raise awareness and aid in the characterization of this emerging entity.
Detection of Incidental Nonosseous Thoracic Pathology on State-of-the-Art Ultralow-Dose Protocol Computed Tomography in Pediatric Patients With Pectus Excavatum
Authors: Gallo-Bernal Sebastian , Kim Jesi , Savage Cristy , Nimkin Katherine , Gee Michael S.
Published: May 2022

Objective

The aim of the study was to compare a pediatric ultralow-dose pectus excavatum computed tomography (CT) protocol versus standard-dose pediatric thoracic CT in terms of radiation dose, subjective and objective image quality, and its ability to detect incidental nonosseous thoracic pathology compared with imaging and clinical reference.

Methods

A single institution radiology database identified a total of 104 ultralow-dose pediatric thoracic CT cases with an equal number of age-matched standard-dose chest CT cases also selected for retrospective analysis. Objective image quality (contrast-to-noise and signal-to-noise ratios) and radiation dose were assessed. Qualitative Likert scorings of the bone, lung, and soft tissues were performed by 2 expert radiologists. Electronic health records of the ultralow-dose cohort were reviewed for at least 1 year to evaluate for potentially missed thoracic pathology and symptoms. Variables were compared using parametric and nonparametric tests in R software 4.0.5.

Results

The ultralow-dose protocol group had statistically significant reductions (P < 0.001) in the volume CT dose index (0.31 ± 0.19 vs 2.20 ± 1.64 mGy), effective radiation dose (0.14 ± 0.08 vs 1.07 ± 0.86 mSv), and size-specific dose estimates (0.50 ± 0.30 vs 3.43 ± 2.56 mGy) compared with the standard protocol, yielding an 86.51% and 85.32% reduction, respectively. The signal-to-noise ratio (20.49 ± 6.19 vs 36.48 ± 10.20), contrast-to-noise (21.65 ± 6.57 vs 38.47 ± 10.59), and subjective measures of image quality (lung parenchyma [3.07 ± 0.92 vs 4.42 ± 0.47], bony structures [3.30 ± 0.86 vs 4.52 ± 0.51], and surrounding soft tissues [2.57 ± 0.63 vs 3.89 ± 0.65]) were also significantly lower in the ultralow-dose protocol (P < 0.001). No differences were seen in the number and size of pulmonary nodules between groups. Clinical and imaging follow of all 104 patients undergoing ultralow-dose CT demonstrated no evidence of missed thoracic pathology causing symptoms.

Conclusions

Ultralow-dose thoracic CT is an acceptable modality for imaging pediatric patients with pectus excavatum and other conditions primarily causing osseous pathology, with effective radiation dose comparable to plain radiographs and a moderate increase in image noise that did not significantly reduce its ability to detect incidental nonosseous thoracic pathology.
Beyond pain and disability: The lasting effects of trauma on life after injury
Authors: Hatchimonji Justin S. , Kaufman Elinore J. , Babalola Deborah , Candido Katelyn , Chreiman Kristen , Jackson Sunny , Reilly Patrick M. , Seamon Mark J.
Published: May 2022

BACKGROUND

The impact of traumatic injury likely extends beyond direct physical consequences and lasts well beyond the acute injury phase. Data collection is sparse after hospital discharge, however. In this observational study, we hypothesized that sequelae of injury would last at least 6 months and sought to prospectively determine patient-reported physical, emotional, and social outcomes during this postinjury period.

METHODS

We surveyed patients admitted to our Level I trauma center (July 2019 to October 2020) regarding baseline functioning and quality of life after injury, using the Patient-Reported Outcomes Measurement Information System (PROMIS-29) instrument, a primary care posttraumatic stress disorder screen, and questions on substance use, employment, and living situation. Patients were re-surveyed at 6 months. PROMIS-29 scores are reported as t scores compared with the US population. Differences between groups were analyzed using χ2, signed-rank, and t tests, with paired tests used for changes over time.

RESULTS

Three hundred sixty-two patients completed the baseline, 130 of whom completed 6-month follow-up. Those completing the 6-month survey were similar ages (43.3 ± 17.8 vs. 44.4 ± 19.0, p = 0.57), mechanism (24.7% vs. 28.0% shot or stabbed, p = 0.61), and severities (median Injury Severity Score, 9 vs. 9; p = 0.15) as those who only completed the baseline. There were 55.0% reported being hospitalized for an injury previously. Patients reported decreases in ability to participate in social roles and activities (mean t score 51.4 vs. 55.3; p = 0.011) and increases in anxiety (53.8 vs. 50.5, p = 0.011) and depression (51.0 vs. 48.7, p = 0.025). There were 26.2% that screened positive for posttraumatic stress disorder at 6 months. Employment decreased at 6 months, with 63.9% reporting being “occasionally” employed or unemployed at 6 months versus 44.6% preinjury (p < 0.001).

CONCLUSION

The effects of injury extend beyond pain and disability, impacting several realms of life for at least 6 months following trauma. These data support the development of screening and intervention protocols for postinjury patients.

LEVEL OF EVIDENCE

Prognostic and Epidemiologic; Level IV.
Integrating traffic safety data with area deprivation index: A method to better understand the causes of pediatric pedestrian versus automobile collisions
Authors: de Cos Víctor , Rooney Alexandra S. , Sykes Alicia G. , Ghetti Claudio B. , Henry Owen S. , Krzyzaniak Andrea , Thangarajah Hari , Bickler Stephen W. , Bansal Vishal , Martin Matthew , Lazar David , Ignacio Romeo C.
Published: May 2022

BACKGROUND

The purpose of this study was to identify clinical and traffic factors that influence pediatric pedestrian versus automobile collisions (P-ACs) with an emphasis on health care disparities.

METHODS

A retrospective review was performed of pediatric (18 years or younger) P-ACs treated at a Level I pediatric trauma center from 2008 to 2018. Demographic, clinical, and traffic scene data were analyzed. Area deprivation index (ADI) was used to measure neighborhood socioeconomic disadvantage (NSD) based on home addresses. Traffic scene data from the California Statewide Integrated Traffic Records System were matched to clinical records. Traffic safety was assessed by the streetlight coverage, the proximity of the collision to home addresses, and sidewalk coverage. Descriptive statistics and univariate analysis for key variables and outcomes were calculated using Kruskal-Wallis, Wilcoxon, χ2, or Fisher's exact tests. Statistical significance was attributed to p values of <0.05.

RESULTS

Among 770 patients, the majority were male (65%) and Hispanic (54%), with a median age of 8 years (interquartile range, 4–12 years). Hispanic patients were more likely to live in more disadvantaged neighborhoods than non-Hispanic patients (67% vs. 45%, p < 0.01). There were no differences in clinical characteristics or outcomes across ADI quintiles. Using the Statewide Integrated Traffic Records System (n = 272), patients with more NSD were more likely injured during dark streetlight conditions (15% vs. 4% least disadvantaged; p = 0.04) and within 0.5 miles from home (p < 0.01). Pedestrian violations were common (65%). During after-school hours, 25% were pedestrian violations, compared with 12% driver violations (p = 0.02).

CONCLUSION

A larger proportion of Hispanic children injured in P-ACs lived in neighborhoods with more socioeconomic disadvantage. Hispanic ethnicity and NSD are each independently associated with P-ACs. Poor streetlight conditions and close proximity to home were associated with the most socioeconomically disadvantaged neighborhoods. This research may support targeted prevention programs to improve pedestrian safety in children.

LEVEL OF EVIDENCE

Prognostic/Epidemiological; Level IV.
Relationships Between Socioeconomic Deprivation and Pediatric Firearm-Related Injury at the Neighborhood Level
Authors: Trinidad Stephen , Vancil Andrew , Brokamp Cole , Moody Suzanne , Gardner Dawne , Parsons Allison A. , Riley Carley , Sahay Rashmi , Sofer Nicole , Beck Andrew F. , Falcone Richard A. , Kotagal Meera
Published: May 2022

Background

Disparities in pediatric injury are widely documented and partly driven by differential exposures to social determinants of health (SDH). Here, we examine associations between neighborhood-level SDH and pediatric firearm-related injury admissions as a step to defining specific targets for interventions to prevent injury.

Methods

We conducted a retrospective review of patients ≤16 years old admitted to our level 1 pediatric trauma center (2010-2019) after a firearm-related injury. We extracted patients’ demographic characteristics and intent of injury. We geocoded home addresses to enable quantification of injury-related admissions at the neighborhood (census tract) level. Our population-level exposure variable was a socioeconomic deprivation index for each census tract.

Results

Out of 15,686 injury-related admissions, 140 were for firearm-related injuries (median age 14 years [IQR 11,15]). Patients with firearm-related injuries were 75% male and 64% Black; 66% had public insurance. Nearly half (47%) of firearm-related injuries were a result of assault, 32% were unintentional, and 6% were self-inflicted; 9% died. At the neighborhood level, the distribution of firearm-related injuries significantly differed by deprivation quintile (p < .05). Children from the highest deprivation quintile experienced 25% of injuries of all types, 57% of firearm-related injuries, and 70% of all firearm-related injuries from assault. They had an overall risk of firearm-related injury 30-times that of children from the lowest deprivation quintile.

Conclusions

Increased neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization, at rates far higher than injury-related admissions overall. Addressing neighborhood-level social determinants of health may help prevent pediatric firearm-related injury.

Level of Evidence

Prognostic and Epidemiological – Level III
Disaster Response—A Global Concern
Authors: Hallman Melanie Gibbons , McCullough M. Allen
Published: May 2022

The threat of bioterrorism is increasing in lethality and numbers of events globally. Weapons of mass destruction include devices of chemical, biological, radiological, and nuclear origin and are often selected by terrorists because they are capable of causing widespread destruction, harm, and panic. Emergency personnel are often first to recognize and report potential terrorist activities. It is essential that emergency personnel maintain a high index of suspicion for symptom patterns that correspond with effects of bioterrorism agents. Health care providers must have a solid understanding of personal protective equipment for specific categories of bioterrorism agents to protect themselves and others while providing care to victims in the emergency department. A clear understanding of disaster protocols, established communication systems, reporting requirements, and available resources to aid in patient management following a bioterrorism event is crucial for optimal, safe, quality care to be administered.
International expansion or stagnation: market development for mature products
Authors: Rundh Bo
Published: May 2022

Purpose

The purpose of this paper is to explore international market development for mature products and practices used in a novel business context.

Design/methodology/approach

Taking a qualitative approach, the case study method was chosen to investigate how firms develop markets in relation to a new international business context. Critical international decisions are analysed using a managerial perspective.

Findings

The success of international ventures depends on managerial learning and effectiveness. In this paper, the authors argue that decisions about international market development can add significantly to the understanding of how business firms enter and develop markets in novel business contexts. Two case studies show different approaches for meeting challenges in distant markets. Four propositions are developed.

Originality/value

A theoretical contribution of this study is the importance of factors that explain international market development decisions in novel business contexts. The balance between incomplete knowledge and making resource commitments is of central concern to international managers. Some of this is tacit knowledge that a firm achieves and learns during the process of market development and other knowledge can only become available after an actual market entry. A second theoretical contribution of this study is the significance of contextual market knowledge in a novel business context.
Encouraging product reuse and upcycling via creativity priming, imagination and inspiration
Authors: Tarabashkina Liudmila , Devine Alua , Quester Pascale G.
Published: May 2022

Purpose

Consumers seldom consider end-use consumption (reuse or upcycling) when products reach the end of their lifecycle. This study shows that end-use consumption can be encouraged if individuals are primed to think creatively, engage in end-use ideation (imagine end-use) and become inspired by more original ideas.

Design/methodology/approach

Three studies were carried out. Study 1 tested if creativity priming resulted in more effective end-use ideation (greater number of ideas and more original ideas) compared to environmental appeals and no intervention. Study 2 tested the effectiveness of creativity priming in a longitudinal setting. Study 3 demonstrated how creativity priming and end-use ideation could be practically executed using product packaging.

Findings

Creativity priming represents an effective intervention to stimulate end-use consumption with particularly positive results amongst less creative consumers. However, it was not the number of generated ideas, but their originality during end-use ideation that triggered inspiration.

Research limitations/implications

This study demonstrates which interventions are more effective in changing consumer behaviour in favour of more sustainable practices.

Practical implications

Increasing environmental degradation requires consumers to change their behaviour by re-consuming products. This study shows that consumers can adopt end-use if they are primed to think creatively, imagine end-use consumption and generate more original ideas.

Originality/value

Creative thinking has been leveraged at product development stages, but not at the end of products’ lifecycle. This study integrated creativity priming, consumer imagination and inspiration theories to explain the underlying mechanism behind end-use consumption to scale up its adoption by consumers.
The effect of corruption on the level of real and accrual earnings management in cases of target firms
Authors: Christopoulos Apostolos , Dokas Ioannis , Leontidis Christos , Spyromitros Eleftherios
Published: May 2022

Purpose

This paper attempts to investigate the effect of corruption on the real and accrual earnings management of target firms in the process of mergers and acquisitions.

Design/methodology/approach

The sample includes target firms from the European area that participate in mergers or acquisitions announced during 2010–2020. The preliminary empirical part estimates the level of earnings management during the period two years before the deal's announcement to identify whether the sample follows the manipulation behavior that the literature suggests for target firms. The primary empirical analysis focuses on the impact of corruption on real and accrual-based earnings management proxies, employing regression models and two alternative proxies for corruption. The existing literature points out that the combination of low levels of corruption and an integrated legal system reduces earnings manipulation.

Findings

The findings provide strong evidence for systematic downwards accounting manipulation practices, whereas the findings for real earnings management are not significant. The findings of the main empirical part show that corruption is positively associated with accrual-based manipulation and negatively related to real earnings management. In essence, in economies with a high level of transparency, managers adopt the manipulation of operating activities as a less detectable practice of earnings management instead of engaging in accounting procedures.

Originality/value

This study contributes to the literature highlighting the diversification of these firms' manipulation strategies according to the national level's corruption status.
Preferences and insights of learning process in pandemic era: a case study of South Africa
Authors: Joaquim Isaque Manteiga , Morolong Mamoqenelo Priscilla , Tundumula Elzira Tiago , Cheng Wen
Published: May 2022

Purpose

The Covid-19 pandemic closed most educational institutions covering all world and academic calendars are threatened. In this situation keeping academic activities live, most institutions adopted learning via online platforms. However, the question about online learning effectiveness especially in developing countries like South Africa is still not clearly or evidently recognized, as in developing countries due to technical constraints of availability of bandwidth and device suitability is a serious challenge. The authors focus is to obtain the perception and insights of business and commerce students towards online learning education in order to improve an effective online learning environment.

Design/methodology/approach

The research study is based on an online survey of 415 students. The research study also explored a mixed-method and numerous explanatory attributes which helped the authors to discuss the results.

Findings

Results find out that 73 percent of students were ready to manage online learning and the majority of them prefer curriculum learning through smartphones during this pandemic. Some of the students have an attractive opinion due to the convenience and flexibility of online learning while some students in rural areas face many challenges in online learning due to the connectivity of broadband.

Research limitations/implications

Research has been uniquely limited to students of tertiary level and vocational training in the field of commerce across some educational institutions from South Africa. Some students were not cooperative in providing answers on time as per the questionnaire.

Practical implications

The insights of this research study will be very helpful in curriculum designing for the next academic session.

Social implications

Its findings will help to improve the online learning method so that it can be socially inclusive to all the students no matter their condition on data bundle accessibility background and location.

Originality/value

One of the few case studies done during this pandemic era and its findings will help understand how students perceive online learning in order to improve the learning environment.
Dividend policy, its asymmetric behavior and stock liquidity
Authors: Ali Taher Fatima N. , Al-Shboul Mohammad
Published: May 2022

Purpose

This paper examines the impact of dividend policy on stock market liquidity, and whether the dividend payouts has an asymmetric effect on stock liquidity.

Design/methodology/approach

A multivariate panel-data regression analysis is conducted for a sample of the largest 411 nonfinancial US firms. Three main hypothesis are tested: (1) whether dividend payouts impact affect stock liquidity, (2) whether low and high dividend payments can asymmetrically effect on stock liquidity and (3) whether the presence of the GFC has an impact the relationship between dividend payments and stock liquidity.

Findings

The study finds that dividend policy is adversely associated with stock liquidity. This supports the prediction of the liquidity-dividend hypothesis. The authors also report that stock liquidity asymmetrically responds to changes in dividend payouts, confirming the prediction of the dividend-signaling approach. More specifically, higher dividend payments decrease stock liquidity by a lower magnitude than the increase in stock liquidity resulting from lower dividend payments. Finally, the presence of the GFC weakened the relationship between dividend payments and stock liquidity.

Research limitations/implications

The paper can help in performing future research by using different dataset covering the COVID-19 crisis.

Practical implications

The paper allows market participants to better understand the impact of dividend policy and its asymmetric effects on stock liquidity. The authors’ analyses can direct investors and regulators to adopt new supervisory devices to create an appropriate level of dividend payouts that helps to effectively support the level of stock liquidity.

Social implications

The paper intends to support the business community and to make strong contributions to the economic development and the welfare of the community.

Originality/value

The originality comes from its new evidence as it can help in assessing the importance of dividend policy and its asymmetric impact on stock liquidity in the full sample and during the GFC. The paper is helpful in performing future analyses using a new sample period for another set of data as well as accounting for COVID-19 pandemic crisis.
Does being culturally intelligent make you a transformational and adaptable leader?
Authors: Al Dhaheri Ali
Published: May 2022

Purpose

The purpose of this study is to investigate the relationships between cultural intelligence (CQ) and both leadership style (MLQ) and leadership adaptability (LA), seeking to understand whether leaders with higher CQ will more frequently practise an adaptive and transformational leadership.

Design/methodology/approach

Respondents are 167 leaders of public and private schools in the UAE; they completed a questionnaire that incorporated the 20-item version of the CQ scale, the 36-item MLQ5x scale and the 13-item LA scale. Correlation and regression analyses assess the relationships between the concepts.

Findings

CQ has a significant relationship with the transformational component of MLQ; the strategy, motivation and behaviour components of CQ are significantly related to transformational leadership. CQ is not related to transactional or laissez-faire leadership style. CQ has a significant relationship with LA; the strategy, motivation and behaviour components of CQ are significant predictors of LA.

Originality/value

To the best of the author’s knowledge, this is the first study to bring together these three concepts, and to understand the relationships between them.
The future of apitourism in Iran based on critical uncertainty approach and DEMATEL/COPRAS techniques
Authors: Fathi Mohammad Reza , Torabi Mohsen , Razi Moheb Saraj Somayeh
Published: May 2022

Purpose

Apitourism is a form of tourism that deals with the culture and traditions of rural communities and can be considered one of the most sustainable methods of development and tourism. Accordingly, this study aims to identify the key factors and plausible scenarios of Iranian apitourism in the future.

Design/methodology/approach

This study is applied research. For this purpose, first, by examining the theoretical foundations and interviewing experts, the key factors affecting the future of Iranian apitourism were identified. Then, using a binomial test, these factors were screened. Both critical uncertainty and DEMATEL techniques were used to select the final drivers.

Findings

Two drivers of “apitourism information system and promotional activities” and “organizing ecological infrastructure” were selected for scenario planning using critical uncertainty and DEMATEL techniques. According to these two drivers, four golden beehive, expectancy, anonymous bee and black beehive scenarios were developed. Each scenario represents a situation for apitourism in the future. According to the criteria of trend compliance, fact-based plausibility and compliance with current data, the “Black Beehive” scenario was selected as the most likely scenario. The “Golden Beehive” scenario shows the best case in terms of apitourism information system and implementation of promotional activities and organizing and providing ecological infrastructure. The “Black Beehive” scenario, on the other hand, describes an isolated and vulnerable system.

Originality/value

Developing plausible Iranian apitourism scenarios helps key stakeholders and actors develop flexible plans for various situations.