bluuebunny/crossref_metadata_2025 huggingface dataset:
The relational side of intellectual capital: an empirical study on brand value evaluation and financial performance
Authors: Laghi Enrico , Di Marcantonio Michele , Cillo Valentina , Paoloni Niccolo
Published: November 2020

Purpose

This study aims to validate a direct method to measure relational capital through the estimation of corporate brands. Considering the influence of relational capital management in leading performance and brand development, we consider brand value as a proxy for relational capital. The main research goal is to extend the previous literature on intellectual capital, financial performance and brand management by elaborating and testing an original approach for valuating corporate brands using regression analysis on multiples based on firm-specific accounting data and market information.

Design/methodology/approach

The authors propose two econometric models, for both listed and non-listed companies, which consider brand valuations made by primary consulting entities (Interbrand, Brand Finance, BrandZ, European Brand Institute) and multiples derived from accounting and market data of firms. Models were tested on a sample of nonfinancial firms for the period from 2006 to 2019, distinguishing between IAS/IFRS-based and US GAAP-based reporting standards.

Findings

The empirical results show that the identified set of market and accounting multiples proved to be significant information for estimating the value of brands within the IAS/IFRS framework, while a lower explanatory power was assessed for US GAAP firms. Furthermore, the empirical evidence confirm that the direct, relative approach based on multiples is more accurate for valuating listed firms than non-listed firms. Robustness analysis demonstrates that findings do not change significantly when the reference datasets and the main assumptions of the models are altered.

Research limitations/implications

The statistical significance of the analysis is limited by the non-objective nature of brand value estimates. The use of additional sources for brand valuations might allow for the further assessment of the robustness of the relationships identified.

Practical implications

Due to their efficacy and ease of use, the proposed models represent valid practical tools for managers, investors, analysts and professional evaluators.

Originality/value

This work contributes to the existing literature through the identification of significant, stable relationships between brand values and the main economic, financial and asset characteristics of firms; the identification of those relationships would allow for the extension of the multiples approach also to the evaluation of brands.
Beyond the barriers: South Asian women’s experience of accessing and receiving psychological therapy in primary care
Authors: Yasmin-Qureshi Saimah , Ledwith Susan
Published: November 2020

Purpose

A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women’s experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context.

Design/methodology/approach

A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis.

Findings

Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and “sticking with it”. Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context.

Practical implications

Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed.

Originality/value

While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy.
Developing a conceptual model to implement green lean practices in Indian manufacturing industries using ISM-MICMAC approach
Authors: Singh Charanjit , Singh Davinder , Khamba Jaimal Singh
Published: November 2020

Purpose

Lean and green strategies are good options to increase the environmental and operational performance of manufacturing industries. The purpose of this paper is to identify the critical success factors (CSFs) to implement green lean practices (GLPs) in manufacturing industries through the review of the literature and to develop a conceptual model after analysing the fundamental facilitating factors by using ISM-MICMAC approach.

Design/methodology/approach

The methodology consists of identifying 12 critical success factors (CSFs) for the green lean implementation by reviewing the relevant available literature. The views of eight experts are valued for inter-relationships of these factors. ISM-MICMAC approach is used for analysing the relations between factors and to develop a conceptual model for green lean implementation.

Findings

Twelve CSFs are identified through a review of the literature to adopt GLPs in manufacturing industries. This paper has established the relationships among 12 identified CSFs using the ISM methodology. This paper analyses the dependence power and the driving power of identified CSFs with the help of MICMAC analysis. “Top management commitment” and “Government support” are the most significant CSFs implement GLPs successfully.

Research limitations/implications

The ISM model presented in this study is based on expert opinions. But expert opinions may be biased as these are based on their own judgements. However, the proposed ISM based model needs statistically validations. The ISM model in the present study may be tested in real-world situations of manufacturing industries where results obtained may be different.

Practical implications

This study may provide a useful input for academicians and managers of industries to differentiate between independent and dependent CSFs and their mutual relationships which would help them to focus on those key CSFs that are most significant to implement GLPs.

Originality/value

A conceptual ISM model of identified CSFs shows the different levels of these CSFs. This model may help the manufacturer to implement the green-lean strategies. It may also support policymakers towards adopting GLPs. Arranging CSFs in a hierarchy and to categorise the CSFs into different levels with the help of ISM-MICMAC is an exclusive effort in the area of green lean engagement.
The threshold of salt taste recognition among a sample of Moroccan population
Authors: Guennoun Yasmine , Benajiba Nada , Bajit Habiba , Bouziani Amina , Elammari Laila , Al-Jawaldeh Ayoub , Elhaloui Noureddine , Barkat Amina , Benkirane Hasnae , Aguenaou Hassan
Published: November 2020

Purpose

This study aims to determine the threshold of salt taste recognition and to evaluate differences by sex, age and body mass index (BMI) among a sample of Moroccan population.

Design/methodology/approach

A simple-blind experimental study was conducted among 201 healthy subjects to determine the threshold of salt taste recognition and to evaluate differences by sex, age and BMI among a sample of Moroccan population. The threshold of salt taste recognition was determined based on the validated the three alternatives forced choice method. A total of 11 prepared solutions of sodium chloride at different concentrations ranging from 0–500 mmol/L were used.

Findings

The average of the total population was 14.6 ± 10.9 mmol/L. And, 84% of the total population recognized the salt taste at the concentration of 15 mmol/L. Women participants detected the salt taste at a lower rate (53% versus 38% at 8 mmol/L, p = 0.02, in women and men, respectively). The mean values of the threshold among women was significantly lower (12.6 ± 8.1 mmol/L) compared to men (16.7 ± 12.8 mmol/L), p < 0.001. No statistical difference was obtained among either age groups or BMI categories.

Originality/value

The present study showed that the average threshold of salt taste recognition is high, and that it is even higher in men compared to women. At a community level, a progressive reduction of salt in food items is recommended.
Prioritizing infill structure indicators in a historical context: in terms of economic sustainability- the vicinity zone of Tabriz historic bazaar
Authors: Seyyedpour Esmaeilzadeh Mitra , Nejad Ebrahimi Ahad , Vaziri Vahid
Published: November 2020

Purpose

Sustainability is one of the major factors in the way of creating new structures in historical contexts. The economic principle plays a very significant role in sustainability besides the environmental and social components. Tabriz Historic Bazaar that has been inscribed on the World Heritage list has witnessed various developments in its surrounding area over recent years. The purpose of this study is to analyze the infill structure indicators in this region in terms of economic sustainability.

Design/methodology/approach

First, based on related literature reviews and approaches, the indicators that should be considered in the creation of infill structures in historical contexts were collected. Later, by considering the vicinity zone of Tabriz Historic Bazaar, the effect of each indicator on the economic sustainability of the building was gathered by means of AHP questionnaires and in-person interviews with experts and analyzed by the Expert Choice software.

Findings

The findings present a guideline which indicates that the type of materials being used is the most important factor in order to create an economically sustainable infill structure in this setting. Accordance with the Climate of the region ranks second place and the Cultural land-use as the Suitable land use for this site goes for the third. The mentioned guideline includes 25 indicators and can help designers with a clear path.

Originality/value

This paper clarifies the order of indicators' importance for enhancing the design and consequently function of infill structures, being built in this historic context, with the aim of economic sustainability. The prioritization of indicators in this research depends mainly on their relevance to the conditions of the study area, but the methodology can be used helpfully in similar cases.
Energetic scaling across different host densities and its consequences for pathogen proliferation
Authors: Nørgaard Louise Solveig , Ghedini Giulia , Phillips Ben L. , Hall Matthew D.
Published: November 2020

The spread of infectious disease is determined by the ability of a pathogen to proliferate within and spread between susceptible hosts. Processes that limit the performance of a pathogen thus occur at two scales: varying with both the availability of energy within a host, and the number of susceptible hosts in a patch. When the rate at which a host intakes and expends energy is density‐dependent, these two processes are intimately linked.

By modifying how hosts compete for and expend resources, a shift in population density may contribute to differences in the flow of energy in a host–pathogen system, both in terms of the energy available for a host to grow, reproduce and fight infection, as well as the energy available for a pathogen to exploit. Energy flux, therefore, connects the two contrasting scales of within‐ and between‐host dynamics by directly linking the proliferation of a pathogen to the number of hosts circulating within a patch.

We use the host Daphnia magna to explore the relationship between energy intake and expenditure at various population densities, as estimated by feeding and metabolic rates respectively. By infecting hosts with the bacterial pathogen Pasteuria ramosa, we then explore how infection changes the relative balance of energy intake and expenditure, and how this energy scope translates into production of transmission spores.

Our work demonstrates that energy intake declines at a faster rate with density than does metabolic rate, leaving more excess energy (i.e. discretionary energy) available for both hosts and their dependent pathogens at low population densities. This energetic advantage translates positively into host and pathogen growth, with the production of mature transmission spores benefiting most from correlated changes in host body size, as well as a direct connection between energy scope and spore loads.

Our findings reinforce how patch quality for a pathogen operates at two contrasting scales, with the within‐host proliferation of a pathogen being optimised in energy rich, low density host populations and opportunities for between‐host transmission likely maximised in dense populations.

A free Plain Language Summary can be found within the Supporting Information of this article.
Climate change will render size‐selective harvest of cold‐water fish species unsustainable in Mediterranean freshwaters
Authors: Ayllón Daniel , Nicola Graciela G. , Elvira Benigno , Almodóvar Ana
Published: November 2020

Climate change is impacting the composition and functioning of virtually every ecosystem on Earth, and disrupting the productivity of exploited ones. Species are rapidly adjusting to their changing environments through evolutionary and/or plastic phenotypic changes in behavioural, physiological, phenological and life‐history traits. Size‐selective harvest produces severe demographic impacts on exploited populations and induces individual phenotypic changes in many of the same fitness‐related traits as climate change and thus can impair local adaptation and acclimation. We addressed in the context of inland recreational fisheries two interrelated questions: (1) Will fisheries‐induced phenotypic changes operate at different rates and direction than those induced by climate change, and thus hinder local adaptation and acclimation, threatening population persistence?; (2) which harvest regulations most likely lead to overexploitation of populations under the new environmental conditions?

We used an eco‐genetic individual‐based model to simulate the consequences of size‐selective fishing for a cold‐water fish species brown trout Salmo trutta across a range of regulatory (defined by exploitation rate and size‐based limits) and environmental scenarios (warming vs. concurrent warming and streamflow reduction) in a Mediterranean system. We ran 1,620 combinations of fishing and environmental scenarios and analysed results using artificial neural networks.

In our simulations, (a) climate change and size‐selective fishing both led to a reduced, truncated population, with increased juvenile but decreased adult growth and earlier maturation at smaller size, but fisheries‐induced changes were stronger than those produced by climate change; (b) their effects were additive or dampened but rarely synergistic and (c) phenotypic changes in fitness‐related traits resulted from both evolutionary and plastic processes.

Synthesis and applications. Our model‐based analyses highlight that any size‐selective fishing regime would lead to the overexploitation of cold‐water freshwater fish populations if climate warming is accompanied by streamflow reduction—as projected in Mediterranean fisheries. Even if we assumed no future streamflow regime changes, only a limited range of size‐based harvest regulations may provide an acceptable balance between conservation and fishery objectives. Thus, recreational fisheries of cold‐water fish in Mediterranean climates might be more sustainably managed under climate change if conservation‐oriented strategies based on harvest bans (e.g. catch‐and‐release fishing) were implemented.
Picturing Confessional Politics at the Stuart Court: Henrietta Maria and Catherine of Braganza†
Authors: Griffey Erin
Published: November 2020

The deep confessional tensions in Stuart Britain were embodied in its Catholic queens. Queens, in their portraits and in the artworks in their palaces and chapels, were positioned within this dialectic, with the competing expectations of their husbands, their families, their religious retinues, the papacy, their own personal devotions, and the public against a changing political situation. This article examines how the visual arts provided a powerful tool for Henrietta Maria and Catherine of Braganza in this dynamic, both in claiming and facilitating piety and in advancing the Catholic cause. The themes of Catholic devotion and saintly embodiment are discussed through two important aspects of their engagement with the visual arts: palace display in which devotional works were hung prominently and portraits in which the queens embody saintly guises. Artworks from their chapels, too, will be considered; these spaces were dominated by Marian imagery, which suited both theological and dynastic interests. Although operating within different political contexts and personal agendas, they marshalled such imagery to promote the Catholic cause and perform their piety.
Red imported fire ants (Hymenoptera: Formicidae) cover inaccessible surfaces with particles to facilitate food search and transportation
Authors: Wen Chao , Chen Jian , Qin Wen‐Quan , Chen Xuan , Cai Jia‐Cheng , Wen Jun‐Bao , Wen Xiu‐Jun , Wang Cai
Published: November 2020

Eusocial insects have evolved diverse particle‐use behaviors. A previous study reported that red imported fire ants, Solenopsis invicta Buren, deposited soil particles on substances treated with essential balm, a fire ant repellent. We hypothesized that S. invicta modifies inaccessible surfaces by covering them with soil particles to facilitate food search and transportation. Here, laboratory experiments were conducted to study the particle‐covering behavior of S. invicta in response to viscose surfaces or surfaces treated with essential balm or liquid paraffin in the presence of real food (sausage) or non‐food objects (acrylic plates). S. invicta workers deposited significantly more soil particles on these three types of treated surfaces than on untreated surfaces. In addition, significantly more particles were relocated on viscose and paraffin‐smeared surfaces in the presence of food than in the presence of non‐food objects. The particle‐covering behavior on viscose surfaces was also observed in the field. Interestingly, when no soil particles were available, ants searched and transported food on viscose surfaces only if the surfaces were artificially covered with sufficient quantities of soil particles but could not do so on viscose surfaces without soil particles or with insufficient quantities of soil particles. In addition, ants actively relocated particles to cover viscose surfaces if the transportation distance was within 200 mm, whereas significantly fewer particles were relocated at longer transportation distances (400 mm). Our study provides a novel example of particle use by fire ants during foraging.
Effects of electron‐beam irradiation on volatile flavor compounds of salmon fillets by the molecular sensory science technique
Authors: Guo Hongxia , Feng Tao , Qi Wenyuan , Kong Qiulian , Yue Ling , Wang Haihong
Published: November 2020

Vacuum‐packed salmon was treated by electron beam irradiation preservation technology, to study the effects of electron‐beam irradiation on odor active compounds of salmon by two types of methods for extraction: headspace‐solid phase micro extraction (HS‐SPME) and solvent assisted flavor evaporation (SAFE). Volatile flavor compounds examined by gas chromatography‐mass spectrometry (GC‐MS) and gas chromatography‐olfactometry (GC‐O), combined with aroma extract dilution method (AEDA) and odor activity value (OAV) for identification of important odorants. In addition, the correlation between sensory attributes and volatile compounds of salmon irradiated at different doses was analyzed by partial least squares regression (PLSR). The results showed that after SPME and SAFE extraction, a total of 49 and 70 volatile flavor compounds were detected in salmon before and after electron beam irradiation. AEDA and OAV were further identified, among which 10 odorants were considered as important volatile flavor compounds and played an important role in the formation of aroma contours such as meaty, fatty, and grassy in salmon. In addition, methanethiol, 3‐methyl butyraldehyde, 3‐methyl propyl aldehyde, dimethyl disulfide, dimethyl trisulfide, and 2‐pentyl furan were identified as the important volatile flavor compounds in salmon irradiated with 4 kGy, and were also the unique compounds that constituted irradiation off‐odor. In general, salmon irradiated with 1 kGy showed the best aroma profile.

Practical Application

SPME and SAFE were used as two types of extraction methods for volatile compounds of salmon, which complemented each other. Additionally, combined with AEDA and OAV, characteristic flavor compounds were identified. Furthermore, the odor fingerprint of salmon with E‐beam irradiation was established for the first time.
The broad‐spectrum antibiofilm activity of amyloid‐forming hexapeptides
Authors: Chen Dongru , Li Jing , Pan Ting , Wu Ruixue , Tao Ye , Lin Huancai
Published: November 2020

Evidence suggests that short amyloid‐forming peptides derived from bacterial proteomes have functional roles; however, the reported activities are diverse and the underlying mechanisms remain unclear. In this study, we simulated short amyloid‐forming peptides from the amyloid‐forming truncated protein C123 of Streptococcus mutans (S. mutans), studied their biological functions in microbial proliferation and biofilm formation, and further investigated the underlying mechanism. Fourteen hexapeptides were simulated, 13 of which were successfully synthesized. We found that the amyloid‐forming hexapeptides (AFhPs) displayed efficient broad‐spectrum antibiofilm activity against the Gram‐positive bacteria S. mutans, Streptococcus sanguis and Staphylococcus aureus, Gram‐negative bacteria Escherichia coli and fungus Candida albicans, by aggregating into rigid amyloid fibres agglutinating microbes, whereas the non‐amyloid‐forming hexapeptides (non‐AFhPs) did not. The AFhPs did not kill microbes and showed little or no cytotoxicity. Furthermore, a set of AFhPs displayed broad‐spectrum antibiofilm activity, regardless of its source. The microbial cell wall carbohydrates, peptidoglycan (PGN), lipoteichoic acid (LTA), glucan and zymosan A, mediated AFhP binding and triggered significant AFhP fibrillation. Although amyloid fibres agglutinated lipid membrane model – large unilamellar vesicles (LUVs) – and LUVs facilitated AFhP fibrillation, the roles of lipid membranes in AFhP antibiofilm activities remain to be elucidated. We highlight the potential use of AFhPs as novel antibiofilm agents.
Incretins in fibrocalculous pancreatic diabetes: A unique subtype of pancreatogenic diabetes
Authors: Ghosh Ipsita , Mukhopadhyay Pradip , Das Kshaunish , Anne M Beatrice , Ali Mondal Samim , Basu Madhurima , Nargis Titli , Pandit Kaushik , Chakrabarti Partha , Ghosh Sujoy
Published: November 2020

Background

Studies evaluating endocrine and exocrine functions in fibrocalculous pancreatic diabetes (FCPD) are scarce.

Methods

Insulin, C‐peptide, glucagon, incretin hormones (glucagon‐like peptide 1 [GLP‐1] and gastric inhibitory peptide [GIP]), and dipeptidyl peptidase IV (DPP‐IV) were estimated in patients with FCPD (n = 20), type 2 diabetes mellitus (T2DM) (n = 20), and controls (n = 20) in fasting and 60 minutes after 75 g glucose.

Results

Fasting and post‐glucose C‐peptide and insulin in FCPD were lower than that of T2DM and controls. Plasma glucagon decreased after glucose load in controls (3.72, 2.29), but increased in T2DM (4.01, 5.73), and remained unchanged in FCPD (3.44, 3.44). Active GLP‐1 (pmol/L) after glucose load increased in FCPD (6.14 to 9.72, P = <.001), in T2DM (2.87 to 4.62, P < .001), and in controls (3.91 to 6.13, P < .001). Median active GLP‐1 in FCPD, both in fasting and post‐glucose state (6.14, 9.72), was twice that of T2DM (2.87, 4.62) and 1.5 times that of controls (3.91, 6.13) (P < .001 for all). Post‐glucose GIP (pmol/L) increased in all: FCPD (15.83 to 94.14), T2DM (21.85 to 88.29), and control (13.00 to 74.65) (P < .001 for all). GIP was not different between groups. DPP‐IV concentration (ng/mL) increased in controls (1578.54, 3012.00) and FCPD (1609.95, 1995.42), but not in T2DM (1204.50, 1939.50) (P = .131). DPP‐IV between the three groups was not different. Fecal elastase was low in FCPD compared with T2DM controls.

Conclusions

In FCPD, basal C‐peptide and glucagon are low, and glucagon does not increase after glucose load. GLP‐1, but not GIP, in FCPD increases 1.5 to 2 times as compared with T2DM and controls (fasting and post glucose) without differences in DPP‐IV.
How to choose a cost‐effective indicator to trigger conservation decisions?
Authors: Bal Payal , Rhodes Jonathan R. , Carwardine Josie , Legge Sarah , Tulloch Ayesha , Game Edward , Martin Tara G. , Possingham Hugh P. , McDonald‐Madden Eve
Published: November 2020

Effective biodiversity conservation requires responding to threats in a timely fashion. This requires understanding the impacts of threats on biodiversity and when management needs to be implemented. However, most ecological systems face multiple threats, so monitoring to assess their impacts on biodiversity is a complex task. Indicators help simplify the challenge of monitoring but choosing the best indicator(s) to inform management is not straightforward.

We provide a decision framework that can help identify optimal indicators to trigger management in a system faced with multiple threats. The approach evaluates indicators based on criteria spanning monitoring efficiency, management outcomes and the economic constraints for decision‐making. Critical decision factors (or parameters) are identified and detailed in a six‐step process to estimate the cost‐effectiveness of alternate indicators, including threat impacts, sensitivity of indicators to detect change, and the benefits, costs and feasibility of alternative indicators and management actions.

Using the Kimberley as a case study, we evaluate 18 indicators for informing management of three key threats in the region: fire and grazing, feral cat predation, and weeds. We show that indicator selection based on our approach can help improve the expected outcome of management decisions under limited resources. By accounting for multiple factors in estimating benefit and costs of monitoring, our approach improves on common approaches that select indicators based only on whether they are sensitive to change and/or cheap to monitor. We also identify how uncertainty in decision factors influences indicator selection.

Although cost‐effectiveness analyses are gaining popularity, ours is the first study to integrate multiple selection criteria using a return on investment framework to compare indicators for monitoring multiple threats and triggering management.
Outpatient Management of Patients Following Diagnosis of Acute Pulmonary Embolism
Authors: Westafer Lauren M. , Shieh Meng‐Shiou , Pekow Penelope S. , Stefan Mihaela S. , Lindenauer Peter K.
Published: November 2020

Objective

While guidelines recommend outpatient management of patients with low‐risk pulmonary embolism (PE), little is known about the disposition of patients with PE diagnosed in United States emergency departments (EDs). We sought to determine disposition practices and subsequent health care utilization in patients with acute PE in U.S. EDs.

Methods

This was a retrospective cohort study of adult ED patients with a new diagnosis of acute PE treated at 740 U.S. acute care hospitals from July 1, 2016, through June 30, 2018. The primary outcome was the initial disposition following an ED visit for acute PE. Additional measures included hospital cost and 30‐day revisit rate to the ED.

Results

A total of 61,070 cases were included in the overall cohort, of which 4.1% of new cases of PE were discharged from the ED. The median hospital‐specific proportion of patients discharged was 3.1% (interquartile range = 0.8%–6.8%). The median odds ratio, representing the importance of the hospital in initial disposition decisions, was 2.21 (95% confidence interval = 2.05 to 2.37), which was greater than any patient‐level factor with the exception of concurrent ED diagnosis of hypoxemia/respiratory failure, shock, or hypotension. Within 30 days of discharge, 17.9% of discharged cases had an ED return visit to the ED only and 10.3% of patients were hospitalized. Of the 30‐day ED return visits in patients initially managed as outpatients, 1.3% had a bleeding‐associated diagnosis.

Conclusion

Despite guidelines promoting outpatient management, few patients are currently discharged home in the United States; however, practice varies widely across hospitals. Return visit rates were high but most did not result in hospitalization.
Effect of errorless learning on the acquisition of fine motor skills in pre‐clinical endodontics
Authors: El‐Kishawi Mohamed , Khalaf Khaled , Masters Rich , Winning Tracey
Published: November 2020

This study aimed to evaluate the impact of errorless and errorful learning, on acquisition of root canal hand‐instrumentation skills. Dental students prepared standardised canals of different diameters and curvatures. Learning involved minimising (errorless: n = 21) or maximising errors (errorful: n = 21). Students who had completed accredited pre‐clinical activities provided comparative data (n = 17). During testing, the distal canal of a plastic mandibular molar was prepared, first as a single task and then under multi‐tasking conditions. Performance was assessed by preparation accuracy and time. Differences were assessed using anova (P < 0.05). Performance in the experimental groups was similar during learning. When multi‐tasking, errorful learners showed a deterioration in preparation accuracy (P < 0.05). In contrast, preparation accuracy and completion times for the errorless and comparative groups remained stable when multi‐tasking. Errorless learning resulted in stable performance under multi‐tasking conditions. Investigation of alternative approaches to learning motor skills in dentistry is warranted as such approaches may provide better outcomes, especially under demanding conditions.
Coronaviruses in children: A review of potential mechanisms of childhood protection
Authors: Rabi Firas A. , Al Zoubi Mazhar S. , Al‐Iede Montaha Mohammed , Kasasbeh Ghena , Badran Eman Farouk
Published: November 2020

Aim

The 2019 coronavirus disease (COVID‐19) has spread worldwide and the number of cases continues to rise exponentially. Epidemiologic reports indicate that severity of illness increases with age. However, the reasons behind the relative protection of children and infants are unclear. Whether the rationale is host‐related or virus dependent is important to determine since the latter could change with viral mutations. We review factors that could affect the susceptibility of children to the novel coronavirus.

Methods

We search publications indexed on PUBMED.

Results

Descriptions of the pathophysiology of current and previous coronavirus infections suggest several viral targets and immunomodulatory pathways affecting the severity of illness. There is limited evidence to suggest age‐variability of viral cell receptors and transmembrane co‐factors required for coronavirus entry and replication. However, the ensuing cytokine storm and the effect of higher melatonin in children are age‐dependent and could explain decreased disease variability in children.

Conclusion

We believe that current evidence suggests host factors can play a role in disease severity in children and thus may remain protective despite potential virus mutation in the future. However, we recognise and discuss avenues of future research that can further illuminate the reasons children are protected from severe COVID‐19 illness.
Native plant turnover and limited exotic spread explain swamp biotic differentiation with urbanization
Authors: Paquin Léo Janne , Bourgeois Bérenger , Pellerin Stéphanie , Alard Didier , Poulin Monique
Published: November 2020

Questions

Does urbanization promote biotic differentiation or homogenization of swamp plant communities? What is the contribution of natives and exotics to swamp response to urbanization?

Location

Quebec City, Canada.

Methods

Plant communities of 34 swamps located in low, moderately or highly urbanized landscapes were sampled, and species classified into three exclusive groups: native wetland, native upland and exotic plants. Urbanization’s influence on the richness of each plant group was assessed using mixed models. Between‐site compositional similarities were calculated to identify variations in beta diversity with urbanization level using tests for homogeneity in multivariate dispersion. Beta diversity was further partitioned into species replacement and richness difference for each plant group. Finally, the relationships of ten environmental variables representing soil water saturation and microtopography with plant assemblages were determined by redundancy analysis.

Results

Although the richness of exotics increased with urbanization intensity, revealing increasing propagule pressure, it remained six to 27 times lower compared to the richness of natives, which remained stable with urbanization. On the other hand, beta diversity increased with urbanization, with higher dissimilarities in species composition between highly urbanized swamps than between low‐urbanized ones. This pattern resulted from high species replacement among natives, while richness difference mainly contributed to exotic beta diversity. Changes in plant assemblages were mostly associated with bryophyte cover and soil drainage and red mottle size, suggesting that hydrological conditions likely acted as a strong driver of swamp plant community response to urbanization.

Conclusions

Swamp plant communities experienced biotic differentiation with increasing urbanization. This differentiation pattern likely was linked to the unpredictable effect of urbanization on hydrological regimes, which promoted high native turnover while limiting exotic spread. Long‐term monitoring is recommended to ensure that exotics do not outcompete natives through time. Designing sustainable cities requires a greater understanding of the multifaceted effect of urbanization on biodiversity.
Model‐based meta‐analysis of the time to first acute urinary retention or benign prostatic hyperplasia‐related surgery in patients with moderate or severe symptoms
Authors: D'Agate Salvatore , Chavan Chandrashekhar , Manyak Michael , Palacios‐Moreno Juan Manuel , Oelke Matthias , Michel Martin C. , Roehrborn Claus G. , Della Pasqua Oscar
Published: November 2020

Aims

Combination therapy of 5α‐reductase inhibitor and α‐blocker is a guideline‐endorsed therapeutic approach for patients with moderate‐to‐severe lower urinary tract symptoms or benign prostatic hyperplasia (LUTS/BPH) who are at risk of disease progression. We aimed to disentangle the contribution of clinical and demographic baseline characteristics affecting the risk of acute urinary retention or BPH‐related surgery (AUR/S) from the effect of treatment with drugs showing symptomatic and disease‐modifying properties.

Methods

A time‐to‐event model was developed using pooled data from patients (n = 10 238) enrolled into six clinical studies receiving placebo, tamsulosin, dutasteride or tamsulosin‐dutasteride combination therapy. A parametric hazard function was used to describe the time to first AUR/S. Covariate model building included the assessment of relevant clinical and demographic factors on baseline hazard. Predictive performance was evaluated by graphical and statistical methods.

Results

An exponential hazard model best described the time to first AUR/S in this group of patients. Baseline International Prostate Symptom Score, prostate‐specific antigen, prostate volume and maximum urine flow were identified as covariates with hazard ratio estimates of 1.04, 1.08, 1.01 and 0.91, respectively. Dutasteride monotherapy and tamsulosin‐dutasteride combination therapy resulted in a significant reduction in the baseline hazard (56.8% and 66.4%, respectively). By contrast, the effect of tamsulosin did not differ from placebo.

Conclusions

Our analysis showed the implications of disease‐modifying properties of dutasteride and tamsulosin‐dutasteride combination therapy for the risk of AUR/S. It also elucidated the contribution of different baseline characteristics to the risk of these events. The use of tamsulosin monotherapy (symptomatic treatment) has no impact on individual long‐term risk.
Dental status of young adults born with very low birthweight: A national cohort study
Authors: McKelvey Victoria , Darlow Brian A. , Horwood L. John , Martin Julia
Published: November 2020

Objectives

Little is known about the oral health of very low birthweight (<1500 g: VLBW) young adults. This study compared the oral health and self‐reported oral health in a 1986 birth cohort of VLBW young adults with that of term‐born controls.

Methods

Oral health interviews and dental examinations were conducted. The dental examinations were carried out in a dental clinic using the standardized examination protocols from the 2009 New Zealand Oral Health Survey. Participants were interviewed to obtain data on self‐reported oral health, oral hygiene practices, use of dental health services and oral health–related quality of life using the OHIP‐14 measure.

Results

Interviews were completed by 250 VLBW participants and 226 (90.4%) of those underwent the dental examination. All 100 controls completed both the interview and dental examination.

While there were few overall differences in clinical or self‐reported oral health between the VLBW or control groups, proportionally fewer VLBW participants attended the dentist for regular check‐ups or cleaned between their teeth than controls. The VLBW and controls did not differ in the prevalence of untreated dental caries or in the number of carious tooth surfaces after adjusting for confounders. However, participants in the control group had more teeth that had been restored due to caries (4.4 teeth) than did the VLBW group (3.4 teeth, P = .045), after adjusting for confounding.

Conclusions

Very low birthweight young adults showed poorer self‐care than the control group when it came to oral health; they were less likely to regularly attend dental visits, had poorer oral hygiene and were less likely to have had their dental disease treated. VLBW young adults should be encouraged to attend regular dental check‐up appointments and to carry out effective home oral hygiene care.
The impact of the COVID‐19 pandemic on the mental health and well‐being of children and young people
Authors: Cowie Helen , Myers Carrie‐Anne
Published: November 2020

The COVID‐19 pandemic has had an enormous impact across the world. In this discussion paper, we examine the effect that lockdown has had on the mental health and well‐being of children and young people. We write from a UK perspective in the light of the international evidence. Many of the discussion points raised resonate globally. We discuss how these issues can be dealt with and set out potential solutions as we emerge from this global crisis.
Long‐term urogenital assessment after elective laparoscopic sigmoid resection for diverticulitis: a comparison between central and peripheral vascular resection
Authors: Posabella Alberto , Varathan Nadshathra , Steinemann Daniel Christian , Göksu Ayçiçek Selin , Tampakis Athanasios , von Flüe Markus , Droeser Raoul André , Füglistaler Ida , Rotigliano Niccolò
Published: November 2020

Aim

Increasing attention has been given to postoperative gastrointestinal functional outcome and quality of life after sigmoid resection for diverticulitis. Conversely, very little has been described about postoperative urogenital functional outcome and even less about its potential relationship to the type of vascular approach. The aim of this study was to evaluate whether central ligation of the inferior mesenteric artery (IMA) compared with peripheral dissection could impair urinary and sexual function in the long term.

Method

Patients undergoing elective laparoscopic sigmoid resection for diverticulitis from 2004 to 2017 were retrospectively analysed. They were asked to complete the American Urological Association Symptom Index (AUASI) questionnaire. Men received the five‐item version of the International Index of Erectile Function (IIEF‐5) questionnaire. Patients were then divided according to the type of vascular resection.

Results

A response rate of the 36.4% to the AUASI and 43.8% to the IIEF‐5 questionnaires was achieved. Three hundred and twenty four patients with a mean age of 62 ± 9.85 years were analysed for their urinary function (IMA preserved n = 217; IMA resected n = 107) in a median follow‐up of 87 months. Furthermore, 115 men with a mean age of 60 ± 8.97 years were investigated for their sexual function (IMA preserved n = 80; IMA resected n = 35) in a median follow‐up of 89 months. No difference (AUASI: 8 ± 6.32 IMA preserved vs. 7 ± 6.26 IMA resected, P = 0.204; IIEF‐5: 15 ± 7.67 IMA preserved vs. 15 ± 8.61 IMA resected, P = 0.674) was found regarding the type of vascular approach during sigmoid resection.

Conclusions

No association was found between the type of vascular approach and the long‐term urogenital functional outcome in patients undergoing sigmoid resection for diverticulitis.
Impact and outcomes of postoperative anaemia in colorectal cancer patients: a systematic review
Authors: Moncur Aileen , Chowdhary Manish , Chu Yajing , Francis Nader K
Published: November 2020

Aim

Preoperative anaemia is common in colorectal cancer patients. Little attention has been given to the prevalence and consequences of postoperative anaemia. The aim of this study was to systematically review the published literature and determine the knowledge of the prevalence and impact of postoperative anaemia in colorectal cancer patients.

Methods

The databases Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medline, via EBSCOhost, were systematically searched to identify suitable articles published between 2004 and 2020. After an initial search, articles were screened and all eligible articles reporting on the prevalence of postoperative anaemia and clinical and long‐term outcome data in colorectal cancer patients undergoing surgery were included. The Risk of Bias 2.0 tool for the assessment of randomized controlled trials and the Risk of Bias 1.0 tool for non‐randomized studies were used for the assessment of bias in the studies selected in our review.

Results

Six studies, one randomized control trial and five cohort studies, were included with a total population size of 1714. The prevalence of anaemia at discharge of 76.6% was reported as the primary end‐point in only one study. The rate of red blood cell transfusion and length of hospital stay were found to be significantly increased in anaemic patients, while postoperative infection rate results were variable. Quality of life scores and overall survival at 5 years were significantly affected among anaemic patients as reported in two papers.

Conclusion

The available limited evidence on postoperative anaemia indicates its high prevalence with negative impact on clinical and long‐term outcomes. Further research is required to standardize the measurement and address the true impact of correcting postoperative anaemia on functional and oncological outcomes.
I want to go home: should we abandon open surgery for treatment of rectal prolapse? Consideration of discharge destination following surgery for rectal prolapse
Authors: Jochum Sarah B. , Becerra Adan Z. , Zhang Yanyu , Santos Carlos A. Q. , Hayden Dana M. , Saclarides Theodore J. , Bhama Anuradha R.
Published: November 2020

Aim

Despite the financial and value‐based implications associated with higher levels of care at discharge, few studies have evaluated modifiable treatment factors that may optimize postacute care. The aim of this work was to assess the association between operative approach and disposition to a higher level of care and other outcomes following surgery for rectal prolapse.

Method

Using a retrospective cohort study design, the database of the National Surgical Quality Improvement Program was used to identify patients with rectal prolapse who underwent perineal repair or open or laparoscopic rectopexy with or without resection between 2012 and 2017. Discharge destination and 30‐day postoperative outcomes were compared using propensity score mathcing and weighting. Nomograms generated using multivariable regression calculated the risk of requiring higher levels of care upon discharge and morbidity.

Results

Propensity‐score analysis included 3000 patients [1500 in the perineal group, 580 in the open abdominal group and 920 in the minimally invasive (MIS) group]. Patients who received open abdominal surgery were more likely to require elevation of care at destination compared with those who received perineal surgery (OR 1.65, 95% CI 1.22–1.24) and MIS abdominal surgery (OR 1.80, 95% CI 1.18–2.76). Similar effects were seen for overall morbidity. Increased age, higher American Society of Anesthesiologists class, congestive heart failure, dependent functional status and open surgery were independent predictors of discharge to higher level of care (c‐statistic = 0.79).

Conclusion

Open surgery compared with MIS and perineal surgery was associated with higher levels of discharge disposition following rectal prolapse surgery. Future research should continue to identify modifiable treatment factors that reduce poor postoperative outcomes among patients with rectal prolapse.
Role of systemic immune‐inflammation index in asthma and NSAID‐exacerbated respiratory disease
Authors: Erdogan Tuba
Published: November 2020

Objective

Asthma is a heterogeneous disease characterized by chronic progressive airway inflammation. Although the disease has numerous phenotypes, there are no practical biomarkers for distinguishing the phenotypes from one another. To address this challenge, we aimed to reveal whether the systemic immune‐inflammation index (SII), an important indicator of systemic inflammation and prognosis in various malignancies and vasculitis, can be used for distinguishing between asthma and NSAID‐exacerbated respiratory disease (NERD).

Methods

The study enrolled 105 patients (asthma: n = 69; NERD: n = 36). SII was calculated using the formula of neutrophil X platelet/lymphocyte number. Major risk factors, namely ACT score, eosinophil level, total IgE level, N‐L ratio (NLR), P‐L ratio (PLR), and SII, were evaluated by logistic regression analysis.

Results

No significant differences were found between the clinical features of the two study groups. Patients with an SII value ≥895.6 had a probability of having NERD with a sensitivity of 30.56%, whereas those with a lower SII had a probability of having asthma with a sensitivity of 92.65%. In the logistic regression analysis, no risk factor was determined for identifying asthma or NERD. The N‐L ratio was found to be the risk factor affecting categorized SII (OR = 264.2, 95% CI 9.9–7046.5, P = 0.001).

Conclusion

This is the first study to evaluate SII as a tool for differentiating asthma phenotypes. The presence of SII below the cutoff value can help exclude the diagnosis of NERD. There is a need for large‐scale prospective studies to compare different phenotypes and determine the optimal cutoff value.