bluuebunny/crossref_metadata_2025 huggingface dataset:
Working capital management and board diversity towards firm performances in Indonesia's LQ45
Authors: Hatane Saarce Elsye , Winoto Jennie , Tarigan Josua , Jie Ferry
Published: April 2022

Purpose

This study examines the effect of working capital management and board diversity on firm profitability and firm value for a sample of Indonesian firms listed in the LQ45 index. The interaction of board diversity components with working capital management adds a comprehensive discussion to enhancing working capital management efficiency.

Design/methodology/approach

This study engages a panel multiple regression method. Data from a sample of LQ45 companies from 2010 to 2016 are analysed using a fixed and a common effect model. Board diversity is further analysed in interaction variables, whether it holds the moderating role in the relationship of working capital and firm performances. This study operates return on capital employed (ROCE) as the proxy of profitability performance and EVA-Spread for the firm's value performance. The simultaneous effect test is used for the robustness test.

Findings

The results indicate that working capital management and board diversity have no significant impact towards profitability. However, they significantly positively impact firm value, meaning that the market is attracted by effective working capital management and board diversity. However, the interaction variable analysis shows that gender diversity and education level diversity weaken the impact of working capital management towards firm value.

Research limitations/implications

This study is not limited to one industry; therefore, future studies may focus on one industry and detect the pattern of working capital components in the particular industry. This study focuses on quantitative numbers to explain board diversity's interaction in working capital management to maximise shareholders' wealth. Future studies may consider a qualitative discussion to describe the quality of women's presence on the board, education level and educational background of board members.

Originality/value

Unlike most studies in which authors relate working capital and board diversity to firm performances separately, this study combines both components and analyses whether board diversity can act as a moderator effect. As part of corporate governance, it is expected that board diversity can enhance working capital management efficiency.
The moderating role of cultural controls on the relationship between traditional formal sales controls and inside salesperson performance
Authors: Conde Richard , Prybutok Victor , Thompson Kenneth
Published: April 2022

Purpose

For the past several decades, the sales control literature has focused on the outside sales context. This study aims to extend sales control research by examining formal and informal sales controls, embodied by cultural controls, used by sales managers in an inside sales context, where the sales agent’s performance focus extends beyond sales outcomes to include the influence of operational phone outcomes.

Design/methodology/approach

Based on 232 B2C and B2B inside sales agent survey responses, this study presents evidence that in an inside sales department, this study focuses on the congruent effect of formal sales and cultural sales controls on inside sales agent overall performance.

Findings

Based on 232 B2C and B2B inside sales agent survey responses, this study presents evidence that in an inside sales department, the operational focus of sales activities and resultant operational performance mediates the relationship between sales controls and inside sales agent sales performance, whereas cultural controls centered on maximizing inside sales autonomous motivation positively moderates the effect of operational outcomes on an inside sales agent’s sales performance.

Practical implications

By focusing on the tenants of an inside sales agent’s overall performance, this research provides practitioners a holistic view of the inherent conflict inside sales managers must balance between the impact of formal sales controls and the benefits of cultural controls.

Originality/value

By being the only study to examine sales controls in an inside sales context, with a broad definition of overall performance to include both sales and operational phone outcomes, this study extends sales control research to a new sales context. The need to jointly focus on operational results, as well as sales outcomes, illustrate the importance of cultural controls compared to other sales processes and outcome controls
The production and distribution of face masks to other countries: a strategic approach of Taiwan during COVID-19 outbreak
Authors: Kumar Vimal , Nguyen Ha Thi The , Mittal Ankesh , Lai Kuei-Kuei
Published: April 2022

Purpose

COVID-19 pandemic has exposed that even the best of the developed nations have surrendered to the devastations imposed on the global supply chains. The purpose of this study is to explore how COVID-19 has exaggerated the supply chain of production and distribution of Taiwan-based face masks and also investigate the conscientious factors and subfactors for it.

Design/methodology/approach

In this study, an analytical hierarchy processes (AHP)-based approach has been used to assign the criterion weights and to prioritize the responsible factors. Initially, based on 26 decision-makers, successful factors were categorized into five main categories, and then main categories and their subcategories factors were prioritized through individual and group decision-maker’s contexts by using the AHP approach.

Findings

The results of this AHP model suggest that “Safety” is the most important and top-ranked factor, followed by production, price, work environment and distribution. The key informers in this study are stakeholders which consist of managers, volunteers, associations and non-governmental organizations. The results showed that good behavior of the employees under the “Safety” category is the top positioned responsible factor for successful production and distribution of face masks to the other countries with the highest global percentage of 15.7% and using sanitizers to protect health is the second most successful factor with the global percentage of 11.7%.

Research limitations/implications

The limitations faced in this study were limited to only Taiwan-based mask manufacturing companies, and it was dependent on the decisions of the limited company’s decision-makers.

Originality/value

The novelty of this study is that the empirical analysis of this study has been based on a successful Taiwan masks manufacturing company and evaluates the responsible factors for the production and distribution of Taiwan masks to other countries during COVID-19.
Impact of COVID-19 pandemic on auditors’ responsibility: evidence from European listed companies on key audit matters
Authors: Hategan Camelia-Daniela , Pitorac Ruxandra-Ioana , Crucean Andreea Claudia
Published: April 2022

Purpose

This research seeks to assess the impact of the COVID-19 pandemic on the quality of financial reporting and the auditor's responsibility. This paper aims to investigate how the auditors identified the impact of COVID-19 on the companies' annual financial statements and considered this impact as a key audit matters (KAM) in the reports issued and the factors that influenced their reporting.

Design/methodology/approach

The empirical research consists of a qualitative analysis of KAMs and a quantitative one based on a panel data econometric model using a random effects maximum likelihood regression. The sample includes companies listed on the primary market on European stock exchanges in 2019–2020.

Findings

The results suggest a direct positive correlation between numbers of KAMs and the auditor's size, frequency of the event and going concern uncertainty. Two of the variables were not validated: auditor rotation and audit fees.

Research limitations/implications

The limitation of research can be the sample structure, and the model we proposed does not take into account all possible influencing factors.

Practical implications

This study will help researchers, policymakers and business owners have a deeper understanding of auditors' responsibility in their work. As practical implications of the COVID-19 impact following the implementation of telework, audit firms have begun to invest in digital programs to assist them in their teamwork and communication with clients. One impact on regulators has been to relax reporting requirements by extending deadlines.

Originality/value

This research contributes to the academic literature by providing a synthesis and econometric model of the effects identified by auditors, following the COVID-19 pandemic, expressed by KAMs in their reports.
Inner and outer, psychology and Wittgenstein's painted curtain
Authors: Standish Paul
Published: April 2022

Much thinking in psychology and related forms of psychotherapy is in the grip of a conception of inner–outer relationships that distorts the reality of our lives and world. In his later work, and in the last years of his life especially, Wittgenstein battled against this. In the course of his criticism, he developed vivid images that challenge this picture, revealing its limitations and opening the way to better understanding. Although 70 years have passed since Wittgenstein died, it remains the case that psychology and psychotherapy can be strengthened through more careful attention to his criticism. The present discussion endeavours to show why and how this is so.
A review of gynaecological surgical practices for trainees and certified specialists in Australia by volume using MBS and AIHW databases
Authors: McCormack Lalla , Nesbitt‐Hawes Erin , Deans Rebecca , Alonso Anais , Lim Claire , Li Fiona , Knapman Blake , Abbott Jason A.
Published: April 2022

Background

There is a finite volume of surgery performed annually by trainees and certified specialists alike. The detailed assessment of this surgical substrate is important, since it guides true exposure in gynaecological surgical training and practice after fellowship.

Aims

This study quantifies the volume and profile of major gynaecological surgical procedures performed in Australia within a specified five‐year period and discusses the implications for training and practice.

Materials and Methods

Australian Institute of Health and Welfare data were examined to quantify the total number of major gynaecological procedures performed between 2013 and 2018. Medicare data were analysed to quantify the number of billed procedures. These data were compared with published Australian RANZCOG trainees and operative gynaecologists, to estimate the potential annual average exposure for each procedure.

Results

Major open, laparoscopic and vaginal surgeries constitute less than 27% of the 600 000 gynaecological procedures performed annually in Australia. Most major gynaecological surgeries are performed at rates lower than 12 cases per year for both trainees and specialists. Over the study period, laparotomies, vaginal hysterectomies and continence procedures decreased, and operative laparoscopies and laparoscopic hysterectomies increased.

Conclusions

The volume of available major gynaecological procedures in Australia may not allow sufficient exposure for optimal training and practice for all trainees and specialists in operative gynaecology. This shortfall may compromise the ability to obtain and maintain proficiency in some core gynaecological operative procedures.
Quantitative analysis of the serum proteome during early pregnancy in mares
Authors: Deng Liang , Li Zheng , Tang Chi , Han Yuwei , Zhang Linxi , Liao Qingchao
Published: April 2022

Equine pregnancy is currently diagnosed by rectal palpation, ultrasonographic examination, or by measuring changes in hormones in the blood. In the present study, we identified proteins that are differentially expressed in the sera of early pregnant and non‐pregnant mares in order to develop a novel method for diagnosing equine pregnancy. Serum samples were obtained from 18 adult mares, pregnancy at day 32 after ovulation (n = 9) and in diestrus (n = 9). Proteomic analysis of the samples was conducted using liquid chromatography–electrospray ionization–tandem mass spectrometry. We identified 467 proteins from a total of 3514 peptides. Thirty‐two proteins (15 upregulated and 17 downregulated) were significantly differentially expressed between the two groups. The Gene Ontology enrichment analysis revealed that they are related to extracellular matrix assembly, blood coagulation, and hemostasis, and the prominent molecular functions were integrin binding, cell adhesion molecule binding, and glycine C‐acetyltransferase activity. The pathway analysis of Kyoto Encyclopaedia of Genes and Genomes showed that the top three pathways identified were glycine, serine, and threonine metabolism; cysteine and methionine metabolism; and ether lipid metabolism. The selected five serum proteins were newly potential candidates for pregnancy diagnosis in mares.
Vaptans for oedematous and hyponatraemic disorders in childhood: A systematic literature review
Authors: Piffer Arianna , Bianchetti Mario G. , Leoni‐Foglia Corinna , Simonetti Giacomo D. , Milani Gregorio P. , Lava Sebastiano A. G.
Published: April 2022

Aims

The aim of this study was to systematically review the use of vaptans (nonpeptide vasopressin receptor antagonists) in children.

Methods

Through a database search (Web of Science, the National Library of Medicine, Excerpta Medica), we identified case series and case reports and extracted clinical and laboratory data.

Results

Twenty‐six articles, published since 2008, reported on 226 patients. Among 115 children with hyponatraemic (n = 63) and oedematous disorders (n = 52), a 48 hour course of tolvaptan with an initial dose of 0.38 ± 0.27 mg/kg was administered in 106 cases, while intravenous conivaptan was reported in nine cases. An increase (P < .02) in urine output was shown in both oedematous (from 3.2 ± 2.0 to 5.3 ± 6.7 mL/kg/day) and hyponatraemic (from 3.0 ± 1.5 to 4.4 ± 2.3 mL/kg/day) patients. In these latter, sodium increased from 125 ± 6 to 133 ± 6 mmol/L (P < .0001). The increase in sodium level correlated with its basal value, but not with the administered vaptan dose. Among 111 children undergoing cardiac surgery, after tolvaptan 0.21 ± 0.01 mg/kg/day, mostly combined with conventional diuretics, an increase in diuresis by 41 ± 4% was seen within 24 hours (P < .0001). Similarly, a single add‐on dose of tolvaptan 0.45 mg/kg allowed a reduced additional intravenous furosemide administration (0.26 ± 0.23 vs 0.62 ± 0.48 mg/kg, P < .005). Side effects were rarely reported, and included excessive thirst and xerostomia in seven, skin rash in one and elevated aminotransferases in one patient(s).

Conclusion

Vaptans appear to be safe for oedematous and hyponatraemic disorders also in children. Although they increase diuresis and natraemia, no superiority to traditional diuretics and sodium supplements has been demonstrated. Reported side effects are rare and non‐serious.
3D FIB‐SEM structural insights into the architecture of sub‐pellicular microtubules of Trypanosoma cruzi epimastigotes
Authors: Vidal Juliana C. , De Souza Wanderley
Published: April 2022

Background information

Trypanosomatidae, which includes eukaryotic species agents of diseases like leishmaniasis, sleeping sickness, and Chagas disease, have special structures and organelles not found in mammalian cells. They present a layer of microtubules, known as subpellicular microtubules (SPMT), located underneath the plasma membrane and responsible for preserving cell morphology, cell polarity, the position of single copy organelles, and morphological changes that occur throughout the protozoan life cycle. Even though a lot of knowledge about the SPMT is available, we still do not know exactly how each microtubule in the system is organized in three dimensions. Here, we use focused ion beam scanning electron microscopy (FIB‐SEM) to analyze the tridimensional organization of epimastigotes SPMT.

Results

The high‐resolution 3D analyses revealed that certain microtubules of the SPMT end more prematurely than the neighboring ones.

Conclusions

These microtubules could (1) be shorter or (2) have the same length as the neighboring ones, assuming that those end up earlier at their other end, might be treadmilling/catastrophe events that have not yet been described in trypanosomatids.
The PERKs of mitochondria protection during stress: insights for PERK modulation in neurodegenerative and metabolic diseases
Authors: Almeida Liliana M. , Pinho Brígida R. , Duchen Michael R. , Oliveira Jorge M. A.
Published: April 2022

Protein kinase RNA‐like ER kinase (PERK) is an endoplasmic reticulum (ER) stress sensor that responds to the accumulation of misfolded proteins. Once activated, PERK initiates signalling pathways that halt general protein production, increase the efficiency of ER quality control, and maintain redox homeostasis. PERK activation also protects mitochondrial homeostasis during stress. The location of PERK at the contact sites between the ER and the mitochondria creates a PERK–mitochondria axis that allows PERK to detect stress in both organelles, adapt their functions and prevent apoptosis. During ER stress, PERK activation triggers mitochondrial hyperfusion, preventing premature apoptotic fragmentation of the mitochondria. PERK activation also increases the formation of mitochondrial cristae and the assembly of respiratory supercomplexes, enhancing cellular ATP‐generating capacity. PERK strengthens mitochondrial quality control during stress by promoting the expression of mitochondrial chaperones and proteases and by increasing mitochondrial biogenesis and mitophagy, resulting in renewal of the mitochondrial network. But how does PERK mediate all these changes in mitochondrial homeostasis? In addition to the classic PERK–eukaryotic translation initiation factor 2α (eIF2α)–activating transcription factor 4 (ATF4) pathway, PERK can activate other protective pathways – PERK–O‐linked N‐acetyl‐glucosamine transferase (OGT), PERK–transcription factor EB (TFEB), and PERK–nuclear factor erythroid 2‐related factor 2 (NRF2) – contributing to broader regulation of mitochondrial dynamics, metabolism, and quality control. The pharmacological activation of PERK is protective in models of neurodegenerative and metabolic diseases, such as Huntington's disease, progressive supranuclear palsy and obesity, while the inhibition of PERK was protective in models of Parkinson's and prion diseases and diabetes. In this review, we address the molecular mechanisms by which PERK regulates mitochondrial dynamics, metabolism and quality control, and discuss the therapeutic potential of targeting PERK in neurodegenerative and metabolic diseases.
Mepolizumab decreases tissue eosinophils while increasing type‐2 cytokines in eosinophilic chronic rhinosinusitis
Authors: Walter Sophie , Ho Jacqueline , Alvarado Raquel , Smith Greg , Croucher David R. , Liang Sharron , Grayson Jessica W. , Mangussi‐Gomes João , Van Es Simone L. , Earls Peter , Rimmer Janet , Campbell Raewyn , Kalish Larry , Sacks Raymond , Harvey Richard J.
Published: April 2022

Background

Eosinophilic chronic rhinosinusitis is an often treatment‐resistant inflammatory disease mediated by type‐2 cytokines, including interleukin (IL)‐5. Mepolizumab, a monoclonal antibody drug targeting IL‐5, has demonstrated efficacy and safety in inflammatory airway disease, but there is negligible evidence on direct tissue response. The study's aim was to determine the local effect of mepolizumab on inflammatory biomarkers in sinonasal tissue of eosinophilic chronic rhinosinusitis patients.

Methods

Adult patients with eosinophilic chronic rhinosinusitis received 100mg mepolizumab subcutaneously at four‐weekly intervals for 24 weeks in this prospective phase 2 clinical trial. Tissue eosinophil counts, eosinophil degranulation (assessed as submucosal eosinophil peroxidase deposition by immunohistochemistry) and cytokine levels (measured in homogenates by immunoassay) were evaluated in ethmoid sinus tissue biopsies collected at baseline and at weeks 4, 8, 16 and 24.

Results

Twenty patients (47.7 ± 11.7 years, 50% female) were included. Sinonasal tissue eosinophil counts decreased after 24 weeks of treatment with mepolizumab (101.64 ± 93.80 vs 41.74 ± 53.76 cells per 0.1 mm2; p = .035), eosinophil degranulation remained unchanged (5.79 ± 2.08 vs 6.07 ± 1.20, p = .662), and type‐2 cytokine levels increased in sinonasal tissue for IL‐5 (10.84 ± 18.65 vs 63.98 ± 50.66, p = .001), IL‐4 (4.48 ± 3.77 vs 9.38 ± 7.56, p = .004), IL‐13 (4.02 ± 2.57 vs 6.46 ± 3.99, p = .024) and GM‐CSF (1.51 ± 1.74 vs 4.50 ± 2.97, p = .001).

Conclusion

Mepolizumab reduced eosinophils in sinonasal tissue, demonstrating that antagonism of IL‐5 suppresses eosinophil trafficking. With reduced tissue eosinophils, a local type‐2 inflammatory feedback loop may occur. The study exposes mechanistic factors which may explain incomplete treatment response.
How parenting pre‐teens compares to other child stages: Identifying opportunities to enhance adolescent mental health and wellbeing
Authors: Wade Catherine , Almendingen Alexander , Robinson Elly
Published: April 2022

Background

Early adolescence is a key stage for parents and children before increasing child independence, yet little research has explored parents' experiences during this time.

Methods

Secondary analysis using a broadly representative survey of 2600 parents explored challenges and opportunities for parents of 10–12 year‐olds relative to other child ages.

Results

Parents of pre‐teens are mostly confident in their parenting, satisfied with children's sleep and they were more confident in knowing where to seek professional help than parents of younger and older children. Nevertheless, there were several challenges, including the use of positive discipline and partner support. Parents of adolescents reported less favourable experiences in several areas, including concerns about children's use of electronic devices, confidence and help‐seeking.

Conclusions

Findings highlight the importance of pre‐adolescence as an opportune time to support parents prior to major developmental transitions associated with adolescence.
Differences in parasite community composition support ecological differentiation in a freshwater gadoid fish
Authors: Karvonen Anssi , Horppila Petteri , Kuitunen Jere , Miettinen Miikka , Ryynänen Lauri , Marjomäki Timo J.
Published: April 2022

Several northern freshwater fishes have gone through rapid adaptive radiation after the last glacial period, resulting in new species or intraspecific morphs with distinct life histories. Parasite infections can promote adaptive radiations and spatiotemporal differences in patterns of infections can potentially reveal incipient or ongoing speciation processes. We investigated intraspecific differentiation in a freshwater gadoid fish, burbot (Lota lota), by exploring differences in parasite infections between two potential life‐history morphs in Lake Konnevesi, Central‐Finland, one reproducing species characteristically in shallow littoral waters in February and the other possibly in deep profundal zone roughly a month later. By conducting a sampling campaign on reproducing fish over two consecutive years, we found significant differences in infections between the fish captured from littoral and profundal sites. More specifically, larval trematode and cestode infections were consistently less abundant in profundal fish, tracking long‐term exposure differences in shallow waters. In contrast, trophically transmitted metazoan infections in the fish gut, reflecting shorter‐term differences in feeding, showed higher variation between sampling years rather than depths. We also found suggestive evidence of higher trematode‐inflicted tissue damage per parasite in the profundal fish, implying lower tolerance to the infection. These results offer further evidence that burbot captured from littoral and profundal sites represent differentiated life‐history morphs. We propose that ecological and evolutionary differentiation within burbot populations across its circumpolar distribution may be more widespread than previously acknowledged.
Acoustic restoration: Using soundscapes to benchmark and fast‐track recovery of ecological communities
Authors: Znidersic Elizabeth , Watson David M.
Published: April 2022

We introduce a new approach—acoustic restoration—focusing on the applied utility of soundscapes for restoration, recognising the rich ecological and social values they encapsulate. Broadcasting soundscapes in disturbed areas can accelerate recolonisation of animals and the microbes and propagules they carry; long duration recordings are also ideal sources of data for benchmarking restoration initiatives and evocative engagement tools.
Health‐related lifestyle of Spanish informal caregivers: Results from two national health surveys
Authors: García‐Mayor Jesús , Moreno‐Llamas Antonio , De la Cruz‐Sánchez Ernesto
Published: April 2022

Objective

We examine the health‐related lifestyle behaviors of informal Spanish caregivers while controlling for sociodemographic characteristics.

Background

Informal caregiving is an essential, albeit invisible, component of any health care delivery system that results in vast savings for national economies. Nevertheless, it remains unknown whether healthy lifestyle behaviors and the subsequent well‐being of informal caregivers may compromise their ability to continue providing their essential service.

Method

We compared the health‐related lifestyle behaviors between informal caregivers and non‐caregivers, applying generalized estimating equations analysis.

Results

We observed no significant differences in self‐rated health status between caregivers and non‐caregivers. Women and men older than 44 years of age with less than 20 hours of care per week were more likely to eat fruit and engage in physical activity. Younger women caregivers (18–44 years) with less than 20 hours of care per week were also more physically active. However, younger men with less than 20 hours of care per week smoked more, and women were more likely to use alcohol. No differences were observed between non‐caregivers and caregivers with 20 or more of care per week.

Conclusions

Informal caregiving affects women and men equally, being hours of care per week a determinant of caregiver/non‐caregiver differences on diet, physical activity, smoking, and drinking.

Implications

The results from these nationally representative data suggest both a healthy and unhealthy lifestyle caregiver effect for both women and men. This effect differs on the different health‐related behaviors and is related to the amount of time devoted to care.
Predictors of tooth loss in Brazilian older adults: An 8‐year follow‐up
Authors: Tôrres Luísa Helena do Nascimento , Hilgert Juliana Balbinot , Hugo Fernando Neves , Sousa Maria da Luz Rosário de , De Marchi Renato José
Published: April 2022

Objective

To investigate the risk factors for tooth loss after 8 years among community‐dwelling older adults in a southern Brazilian city.

Methods

In 2004, 388 dentate community‐dwelling older adults from Carlos Barbosa, southern Brazil, were selected using simple random sampling. In 2012, the follow‐up consisted of 199 (51.3%) participants. Data collection comprised an interview with data about socio‐demographic, behavioural and access to services and an oral examination. The outcome variable of this study is the ratio between the sum of the teeth lost during the 8‐year period of follow‐up, and the sum of the teeth present in 2004, per person, modelled through binomial regression analysis.

Results

Being older (IOR = 1.03, 95% CI: 1.00–1.06), living in a rural area (IOR = 1.56, 95% CI: 1.17–2.07), earning two or more monthly minimum wages (IOR = 1.46, 95% CI: 1.09–1.96), living alone (single, widowed or divorced; IOR = 1.36, 95% CI: 1.00–1.85), having more gingival bleeding sites (IOR = 1.01, 95% CI: 1.00–1.02) and wearing partial removable prosthesis (IOR = 2.82, 95% CI: 2.15–3.71) were risk factors for tooth loss. Approximately 48% of the participants lost one or more teeth over the 8‐year follow‐up period.

Conclusion

Socio‐demographic, economic and clinical variables were associated with the risk for tooth loss. This might be a result of social determinants of health influencing people’s access to oral health care, oral health behaviours and oral health status. Public policy aimed at older adults living in rural areas, living alone and using removable dentures may contribute to reducing the risk of tooth loss.
Question prompt lists and endorsement of question‐asking support patients to get the information they seek—A longitudinal qualitative study
Authors: Tracy Marguerite , Ayre Julie , Mac Olivia , Copp Tessa , Trevena Emerita Lyndal , Shepherd Heather
Published: April 2022

Introduction

Question prompt lists (QPLs) have been found to support patients to ask questions and improve the information they receive from doctors. However, some QPL tools, which have been available online for almost 15 years, have little published data on their impact in real‐world settings. This study's aim was to understand patients' attitudes and experiences accessing health information and to assess the impact of introducing two generic QPLs over 3 months.

Methods

A longitudinal qualitative study consisting of three semi‐structured interviews over a three‐month period was conducted with 31 purposively selected participants, adults ≥18 years, recruited online and through social media. Participants were introduced to two different QPLs currently available online (‘Question Builder’; ‘AskShareKnow’). Inductive thematic analysis of a total of 92 semi‐structured telephone interviews was conducted during May–November 2020.

Results

Three main themes are described. (1) Participants described barriers and facilitators to accessing health information: navigating a complex health system; difficulty asking questions of their healthcare professionals and that they value doctors with good communication skills. (2) QPLs helped some participants recognize the role of question‐asking in consultations, made them feel more empowered and helped them prepare and prioritize. (3) Participants wanted QPLs to be easier to use, be accessible when needed and that question‐asking and QPLs should be normalized in medical consultations.

Conclusions

Well‐designed and easily accessible QPLs can empower people to ask questions and be more involved in decisions about their health care. Endorsement of question‐asking in consultations by healthcare professionals and providing QPL tools at the point of contact with health services will be key to realizing the potential of QPLs.

Patient or Public Contribution

This study was completed in conjunction with a reference group consisting of a consumer representative, representatives from the Australian Commission on Safety and Quality in Health Care, Healthdirect Australia Ltd., and the research team.
The solid variant of papillary thyroid carcinoma: a multi‐institutional retrospective study
Authors: Xu Bin , Viswanathan Kartik , Zhang Lingxin , Edmund Liz N , Ganly Olivia , Tuttle R Michael , Lubin Daniel , Ghossein Ronald A.
Published: April 2022

Aims

The definition of papillary thyroid carcinoma, solid variant (PTC‐SV) varies from >50% to 100% of solid/trabecular/insular growth (STI). We aimed to identify prognostic factors and to establish an appropriate STI cutoff for PTC‐SV in this multi‐institutional study of 156 PTCs with STI.

Results

Nodal metastases were seen in 18% and were associated with a higher percentage of papillary and STI. When substratified by infiltration/encapsulation status, the STI percentage did not impact the risk of nodal metastasis. pN1 stage was seen in 51% of infiltrative tumours and 1% of encapsulated lesions. Overall, PTC with STI had an excellent prognosis. The 10‐year disease‐free survival (DFS) was 87% in the entire cohort, 94% in encapsulated lesions, and 76% in infiltrative tumours. The STI percentage did not impact DFS. Fifty‐four patients had noninvasive encapsulated lesions with 2–100% STI. None developed recurrence. Encapsulated lesions were enriched with RAS mutations (54%), whereas infiltrative lesions lacked RAS mutations (4%). The BRAF V600E mutation was an infrequent event, being seen in 11% of the entire cohort.

Conclusion

In PTC with STI, the determining factor for nodal metastasis and DFS is the encapsulation/infiltration status rather than the STI percentage. Encapsulated noninvasive tumours with STI follow an indolent course with a very low risk of nodal metastasis and recurrence. Overall, PTC with STI has an excellent prognosis, with a 10‐year disease‐specific survival (DSS) and DFS of 96% and 87%, respectively. Therefore, the classification of SV‐PTC as an aggressive PTC subtype may be reconsidered.
Nomogram for predicting survival of renal cell carcinoma with tumor thrombus based on perioperative clinicopathological factors from a Chinese high‐volume center
Authors: Li Yuxuan , Liu Zhuo , Zhao Xiaoyu , Hong Peng , Zhao Xun , Zhu Guodong , Tang Shiying , Ge Liyuan , Zhang Shudong , Liu Cheng , Wang Shumin , Zhang Hongxian , Ma Lulin
Published: April 2022

Objectives

To investigate perioperative clinicopathological predictors and establish a predictive nomogram for survival in patients with renal cell carcinoma and venous tumor thrombus undergoing nephrectomy and thrombectomy.

Methods

Patients with renal cell carcinoma and venous tumor thrombus undergoing nephrectomy and thrombectomy were included in the study between January 2014 and June 2020. Cox regression analysis was used for univariate and multivariate survival analyses. A predictive nomogram for survival was established and internally validated using bootstrap resampling method.

Results

A total of 228 patients were enrolled in this study. The median age was 60 years (interquartile range 53–66 years), consisting of 174 (76.3%) males and 54 (23.7%) females. The median follow‐up time was 17.5 months (range 1–74 months), 26.8% (61 of 228) patients died of all causes. In multivariable analysis, hemoglobin less than the lower limit of normal (hazard ratio 1.73; 95% confidence interval 1.01–2.96; P = 0.045), sarcomatoid feature (hazard ratio 3.67; 95% confidence interval 1.97–6.82; P < 0.001), perirenal fat invasion (hazard ratio 1.80; 95% confidence interval 1.05–3.09; P = 0.033), histological subtype (hazard ratio 2.74; 95% confidence interval 1.39–5.41; P = 0.004), and metastasis at surgery (hazard ratio 1.71; 95% confidence interval 1.01–2.90; P = 0.047) were independently associated with overall survival. The result of internal validation presented that the predictive performance of the nomogram for survival measured by C‐index was 0.77.

Conclusions

We developed a predictive nomogram with well‐internal validation for survival in patients with renal cell carcinoma and venous tumor thrombus, which can greatly promote risk stratification and treatment planning.
COVID‐19 vaccination status and testing rates in Finland—A potential cause for bias in observational vaccine effectiveness analysis
Authors: Kuitunen Ilari , Uimonen Mikko , Seppälä Santeri J. , Ponkilainen Ville T.
Published: April 2022

COVID‐19 vaccination effectiveness has been monitored in observational studies (test‐negativity design or traditional cohort design), but these studies have not addressed the potential behavioral bias between vaccinated and unvaccinated individuals. We aimed to address this by comparing COVID‐19 testing rates between vaccination status and whether vaccination changes the testing rates. We found that three times vaccinated had least tests performed during the pandemic and unvaccinated had the highest testing rate. Each vaccination dose increased the testing rate. In conclusion the observational studies addressing vaccine effectiveness should also present testing rates between vaccinated and unvaccinated to address the potential behavioral bias.
Risk factors and medical resource utilization in US adults hospitalized with influenza or respiratory syncytial virus in the Hospitalized Acute Respiratory Tract Infection study
Authors: Hartnett Jessica , Donga Prina , Ispas Gabriela , Vandendijck Yannick , Anderson David , House Stacey , Suner Selim
Published: April 2022

Background

Influenza and respiratory syncytial virus (RSV) are associated with substantial morbidity and mortality in the United States. We assessed risk factors for severe disease and medical resource utilization (MRU) among US adults hospitalized with influenza or RSV in the Hospitalized Acute Respiratory Tract Infection (HARTI) study.

Methods

HARTI was a prospective global (40 centers, 12 countries) epidemiological study of adults hospitalized with acute respiratory tract infections conducted across the 2017–2019 epidemic seasons. Patients with confirmed influenza or RSV were followed up to 3 months post‐discharge. Baseline characteristics, prevalence of core risk factors (CRFs) for severe disease (age ≥65 years, chronic heart or renal disease, chronic obstructive pulmonary disease, or asthma), and MRU were summarized descriptively.

Results

The US cohort included 280 influenza‐positive and 120 RSV‐positive patients. RSV patients were older (mean: 63.1 vs. 59.7 years) and a higher proportion had CRFs (87.5% vs. 81.4%). Among those with CRFs (influenza, n = 153; RSV, n = 99), RSV patients required longer hospitalizations (median length of stay: 4.5 days) and a greater proportion (79.8%) required oxygen supplementation during hospitalization compared with influenza patients (4.0 days and 59.5%, respectively). At 3 months post‐discharge, a greater proportion of RSV patients with CRFs reported use of antibiotics, antitussives, bronchodilators, and inhaled and systemic steroids versus those with influenza and CRFs. Many patients with CRFs reported hospital readmission at 3 months post‐discharge (RSV: 13.4%; influenza: 11.9%).

Conclusions

MRU during and post‐hospitalization due to RSV in adults is similar to or greater than that of influenza. Enhanced RSV surveillance and preventive and therapeutic interventions are needed.
Observations by health care professionals about wound healing in Ghanaian patients who skin‐bleach
Authors: La‐Anyane Okensama M , Feinn Richard S , Hill David J , Copes Lynn , Kwakye Gifty , Seshie Bernard K
Published: April 2022

Skin‐bleaching is a common practice globally and is associated with many cutaneous and systemic health risks. Anecdotally, skin‐bleaching is linked to impairments in wound healing, but there are little data to support the claim. This cross‐sectional survey of health care professionals serving the Greater Accra Region, Ghana region investigates their observations of wound healing in patients who skin‐bleach and their methods for screening skin‐bleach use in patients. A 25‐item self‐administered questionnaire using 5‐point Likert scale was distributed with convenient sampling to physicians and nurses employed at Ghanaian hospitals. Fifty‐seven electronic and 78 paper responses were collected (total = 135). Most respondents agreed that wounds in skin‐bleaching patients heal more slowly (4.22), are more prone to infection (4.11), haemorrhage (3.89), wound dehiscence (3.9), and are more difficult to manage (4.13). No respondent reported universal screening of all patients for skin‐bleaching, but most ask about skin‐bleaching if there is suspicion of it (42.2%). Our findings support the anecdotes about observable wound healing impairments in patients who skin‐bleach. There is also wide variation in skin‐bleaching screening practices, suggesting a need for guidelines to properly identify these patients and facilitate early risk prevention.
The role of cardiac surgeon in transvenous lead extraction: Experience from 3462 procedures
Authors: Tułecki Łukasz , Czajkowski Marek , Targońska Sylwia , Polewczyk Anna , Jacheć Wojciech , Tomków Konrad , Karpeta Kamil , Nowosielecka Dorota , Kutarski Andrzej
Published: April 2022

Introduction

The professional society guidelines recommend that transvenous lead extraction (TLE) operating teams collaborate closely with cardiac surgeons in the management of life‐threatening complications.

Methods

We assessed the role of cardiac surgeons participating in 3462 TLE procedures at a high‐volume center between 2006 and 2021. The roles for cardiac surgery in TLE can be categorized into five areas: emergency surgical interventions for the management of cardiac laceration and severe bleeding (1.184%), cardiac surgery complementing partially successful TLE or vegetation removal (0.693%), delayed surgical treatment of TLE‐related tricuspid valve dysfunction (0.751%), epicardial pacemaker implantation through sternotomy during emergency, complementing or delayed surgical interventions (0.607%), and delayed epicardial lead implantation (0.491%).

Results

Isolated damage to the wall of the right atrium was the most common cause of cardiac tamponade (53.66% of emergency surgeries) followed by injury to the right ventricle and vena cava (both 7.317%).

Conclusions

Emergency cardiac surgery for the management of severe hemorrhagic complications is still the most common treatment option. The remaining areas include surgery complementing partially successful TLE: repair of tricuspid valve or epicardial ventricular lead placement to achieve permanent cardiac resynchronization. The experience at a single high‐volume TLE center indicates the necessity of close collaboration with the cardiac surgeons whose roles appear broader than the mere surgical standby. Mortality in patients who survived cardiac surgery during TLE does not differ from the survival of other patients after TLE without complications requiring surgical intervention.
Discordantly high glycated hemoglobin might assist in diagnosing α‐thalassemia, but not diabetes: A case report
Authors: Gao Wei , Jin Yanwen , Huang Yan , Tang Huairong
Published: April 2022

Glycated hemoglobin (HbA1c) is an important method for monitoring blood glucose and diagnosing diabetes. High‐performance liquid chromatography is more commonly used in the laboratory for the detection of HbA1c. Although HbA1c detected by high‐performance liquid chromatography is susceptible to abnormal hemoglobin, there are few reports that it is affected by α‐thalassemia. Previous reports have generally concluded that α‐thalassemia does not affect or lower HbA1c. Here, we report a case of discordantly high HbA1c inconsistent with fasting blood glucose. Finally, the patient was diagnosed with α‐thalassemia and insulin resistance. α‐Thalassemia might lead to a discordantly high HbA1c result, which could be attributed to elevated hemoglobin H. In this case, glycated albumin might accurately reflect the real average level of blood glucose. When finding discordant HbA1c, patients should be advised to undergo thalassemia and hemoglobinopathy screening by diabetologists/endocrinologists or primary care physicians to avoid a missed diagnosis of hematopathy.
30‐day mortality following COVID‐19 and influenza hospitalization among US veterans aged 65 and older
Authors: Seligman Benjamin , Charest Brian , Ho Yuk‐Lam , Gerlovin Hanna , Ward Rachel E. , Cho Kelly , Driver Jane A. , Gaziano J. Michael , Gagnon David R. , Orkaby Ariela R.
Published: April 2022

Background

COVID‐19 and influenza are important sources of morbidity and mortality among older adults. Understanding how outcomes differ for older adults hospitalized with either infection is important for improving care. We compared outcomes from infection with COVID‐19 and influenza among hospitalized older adults.

Methods

We conducted a retrospective study of 30‐day mortality among veterans aged 65+ hospitalized with COVID‐19 from March 1, 2020–December 31, 2020 or with influenza A/B from September 1, 2017 to August 31, 2019 in Veterans Affairs Health Care System (VAHCS). COVID‐19 infection was determined by a positive PCR test and influenza by tests used in the VA system. Frailty was defined by the claims‐based Veterans Affairs Frailty Index (VA‐FI). Logistic regressions of mortality on frailty, age, and infection were adjusted for multiple confounders.

Results

A total of 15,474 veterans were admitted with COVID‐19 and 7867 with influenza. Mean (SD) ages were 76.1 (7.8) and 75.8 (8.3) years, 97.7% and 97.4% were male, and 66.9% and 76.4% were white in the COVID‐19 and influenza cohorts respectively. Crude 30‐day mortality (95% CI) was 18.9% (18.3%–19.5%) for COVID‐19 and 4.3% (3.8%–4.7%) for influenza.

Combining cohorts, the odds ratio for 30‐day mortality from COVID‐19 (versus influenza) was 6.61 (5.74–7.65). There was a statistically significant interaction between infection with COVID‐19 and frailty, but there was no significant interaction between COVID‐19 and age.

Separating cohorts, greater 30‐day mortality was significantly associated with older age (p: COVID‐19: <0.001, Influenza: <0.001) and for frail compared with robust individuals (p for trend: COVID‐19: <0.001, Influenza: <0.001).

Conclusion

Mortality from COVID‐19 exceeded that from influenza among hospitalized older adults. However, odds of mortality were higher at every level of frailty among those admitted with influenza compared to COVID‐19. Prevention will remain key to reducing mortality from viral illnesses among older adults.
Efficacy and toxicity of surufatinib in neuroendocrine tumors: A systematic review and meta‐analysis
Authors: Ali Muhammad Ashar , Shah Syed S. , Tahir Nayha , Rehman Sana , Saeed Memoona , Bajwa Shammas Farooq , Ali Rimsha , Aiman Wajeeha , Anwar Muhammad Yasir
Published: April 2022

The incidence and prevalence of neuroendocrine neoplasms (NENs) has increased in the US in recent decades. These are well‐vascularized tumors, but no antiangiogenic drug has been approved for treatment of extra‐pancreatic NENs. The aim is to assess efficacy and safety of surufatinib in pancreatic and extra‐pancreatic NETs. We searched PubMed, Embase, Cochrane Library, Web of Science and Clinicaltrials.gov. Clinical trials and observational studies that provided safety and efficacy data in clinical terms were included. Characteristics of the study, baseline characteristics of participants, treatment drugs, measures of efficacy, and toxicity (≥grade 3 adverse effects) were extracted. The meta‐analysis was performed using the “R” programming language. Risk ratio (RR) of objective response (OR)/partial response (PR) was 8.55 (95% CI: 1.68–43.66, I2 = 0) in favor of surufatinib. The hazard ratio (HR) of progression‐free survival (PFS) was 0.48 (95% CI: 0.25–0.92, I2 = 77%) in favor of surufatinib. The risk of ≥grade 3 adverse effects: diarrhea, hypertension, hypertriglyceridemia, proteinuria, and vomiting were high with the use of surufatinib. Quality of life (QoL) was similar in surufatinib and placebo groups except for the diarrhea that was high with surufatinib. Lack of randomized clinical trials in non‐Chinese population. Surufatinib is well tolerated and is more effective than placebo in both pancreatic and extra‐pancreatic NETs. More multicenter randomized, double‐blinded clinical trials are needed to confirm these results.
Vaccine and inclusion
Authors: Nganmeni Zéphirin , Pongou Roland , Tchantcho Bertrand , Tondji Jean‐Baptiste
Published: April 2022

In majoritarian democracies, popular policies may not be inclusive, and inclusive policies may not be popular. This dilemma raises the crucial question of when it is possible to design a policy that is both inclusive and popular. We address this question in the context of vaccine allocation in a polarized economy facing a pandemic. In such an economy, individuals are organized around distinct networks and groups and have in‐group preferences. We provide a complete characterization of the set of inclusive and popular vaccine allocations. The findings imply that the number of vaccine doses necessary to generate an inclusive and popular vaccine allocation is greater than the one necessary to obtain an allocation that is only popular. The analysis further reveals that it is always possible to design the decision‐making rule of the economy to implement an inclusive and popular vaccine allocation. Under such a rule, the composition of any group endowed with the veto power should necessarily reflect the diversity of the society.