bluuebunny/crossref_metadata_2025 huggingface dataset:
Outside CEOs and restaurant performance: the moderating effect of franchising and recession
Authors: Kim Hong Soon , Jang SooCheong (Shawn)
Published: March 2021

Purpose

This paper aims to explore the effect of hiring outside chief executive officers (CEOs) on restaurant performance. As outside CEOs have a mandate to bring changes but lack internal knowledge, this study expected that outside CEOs impose a significant influence on restaurant performance. It was further expected that the relationship is substantially moderated by franchising and recession.

Design/methodology/approach

The CEO data was manually collected from firms’ annual filings and the EXECOMP database. The COMPUSTAT database was used for company financial data. A two-way panel regression was used to examine the proposed relationships.

Findings

The results revealed that outside CEOs have a positive effect on growth but a negative effect on restaurant profitability. It was further turned out that franchising significantly moderates the outside CEO-performance relationship. However, the moderating effect of recession turned out to be insignificant.

Practical implications

The results suggested that outside CEOs play a critical role in determining restaurant performance. The results further imply that franchising helps to maximize the positive effect of outside CEOs while mitigating the adverse effects of outside CEOs.

Originality/value

This study is one of the first to examine the effect of outside CEOs in the hospitality context. Moreover, this study extended the literature by revealing the relationship in the restaurant industry and highlighting the importance of long-term organizational context.
Authorship trends and collaboration patterns in hospitality and tourism research
Authors: Ramos-Rodriguez Antonio-Rafael , Lechuga Sancho María Paula , Martínez-Fierro Salustiano
Published: March 2021

Purpose

Analyze patterns of co-authorship in hospitality and tourism (H&T) research using bibliometric methods. The purpose of this paper is to answer three questions related to collaborative practices, the number of authors, the order of signatures and the role of the corresponding author.

Design/methodology/approach

The methodology is based on the bibliometric techniques of authorship analyzes published in leading H&T journals. Evaluative techniques provide longitudinal evidence of the evolution of some indicators of authors’ collaboration: the percentage of alphabetized authorships; the percentage of articles were the most relevant author signs in the first, middle or last position; and the position of the corresponding author in the by-line.

Findings

First, the collaborative nature of H&T research is confirmed; almost 80% of articles in the sample are co-authored. Second, over the past 30 years, the alphabetized signature model has been in decline in this field. Today, about 20% of articles indexed in JCR journals are signed alphabetically. Third, the first author’s placement is less consistent than that of the corresponding author.

Practical implications

This work provides relevant information on researchers’ authorship habits that may help evaluators assign credit and accountability and avoid malpractice in the authorial assignment.

Originality/value

This study explores the habits of researchers who collaborate to improve their productivity, impact and reputation. This is often linked to facilitating access to research funding and obtaining recognition from incentive systems. Yet, no research specifically examines trends in signature order or the corresponding author’s role in the H&T field.
Capital structure and earnings quality in microfinance institutions
Authors: Lassoued Naima
Published: March 2021

Purpose

The purpose of this paper is to examine whether capital structure matters for earnings management of microfinance institutions.

Design/methodology/approach

The empirical study is conducted using a sample of 575 MFIs over 2007 to 2015, we determined in the first step the discretionary part of provision for loan impairment. In the second step, we examine the effect of debt and donated equity on discretionary provision for loan impairment.

Findings

We found robust evidence that MFIs manage their earnings for external finance purposes. Debt exhibits a negative effect on earnings management for both profit and nonprofit MFIs. However, donated equity incites managers of MFIs to engage this practice in nonprofit MFIs.

Practical implications

Findings could be valuable to fund providers and investors who should consider accounting information quality in order to reach a better investment decision.

Originality/value

This paper is among the few to explore earnings management motivation of MFIs and to determine the role of external financing on earnings management practice.
A survey of assistive robots and systems for elderly care
Authors: Santhanaraj Karthik Kumar , M.M. Ramya , D. Dinakaran
Published: March 2021

Purpose

The rousing phenomenon of the ageing population is becoming a vital issue and demanding fulminant actions. Population ageing is a resultant of the enhanced health-care system, groovy antibiotics, medications and economic well-being. Old age leads to copious amounts of ailments. Aged people, owing to their reduced mobility and enervating disabilities, tend to rely upon caretakers and/or nursing personnel. With the increasing vogue of nuclear families in the society, the elderly are at the risk of being unveiled to emotional, physical and fiscal insecurities in the years to come. Caring for those seniors will be an enormous undertaking.

Design/methodology/approach

There is a dire need for an intelligent assistive system to meet out the requirements of continuous holistic care and monitoring. Assistive robots and systems used for elderly care are studied. The design motivation for the robots, elderly–robot interaction capabilities and technology incorporated in the systems are examined meticulously.

Findings

From the survey, it is suggested that the subsystems of an assistive robot revamped for better human–machine interactions will be a potential alternative to the human counterpart. Affirmable advancements in the robot design and interaction methodologies that would increase the holistic care and assistance for aged people are analyzed and listed.

Originality/value

This paper reviews the available assistive technologies and suggests a synergistic model that can be adopted for the caring of the elderly.
The influence of gender stereotyping and issue advocacy on consumer sentiment
Authors: Lucka Nina Sissel , Caldieraro Fabio , Zanini Marco Tulio
Published: March 2021

Purpose

This study explores the effect of gender stereotyping and issue advocacy on consumer sentiment toward advertising and brands.

Design/methodology/approach

Drawing from the literature, the study hypothesizes about the impact of gender stereotyping and consumer advocacy on consumer sentiment. A behavioral experiment tests the hypotheses and provides support for the main conclusions.

Findings

Results indicate that issue advocacy can cancel the negative effect of traditional female stereotyping. The results also show that demographics are not necessarily the reason why a person favors or condemns stereotyping and advertising; on the contrary, any reaction is far more linked to personal disposition.

Practical implications

The findings of this research have implications for marketing and advertising practice. While the use of issue advocacy is currently trending up, there is still a lack of understanding about its effect on consumers. Gender stereotyping is also being frequently used, but has caused huge backlashes in recent ad campaigns. Marketing and advertising managers can use insights from this research to shape advertising messages that use these two stimuli in order to enable a brand to better connect with its audience and achieve a more desirable outcome.

Originality/value

The paper contributes to the academic discussion about the effectiveness of using gender stereotyping and issue advocacy to drive advertising outcomes. It challenges the idea that the combination of these two advertising approaches is either detrimental or beneficial to the brand.
Efficacy and safety of i.v. methylprednisolone pulse therapy for vitiligo: A retrospective study of 58 therapy experiences for 33 vitiligo patients
Authors: Wada‐Irimada Moyuka , Tsuchiyama Kenichiro , Sasaki Rui , Hatchome Naokazu , Watabe Akiko , Kimura Yutaka , Yamasaki Kenshi , Aiba Setsuya
Published: March 2021

Systemic corticosteroid is indicated for vitiligo, especially for generalized and progressive vitiligo. However, no consensus exists yet for the dosages and modalities of systemic corticosteroid treatments for vitiligo. The purpose of this study is to validate the efficacy and safety of i.v. methylprednisolone pulse therapy (IVMP) for patients with progressive generalized vitiligo. We retrospectively reviewed the medical records of vitiligo patients treated in our institute for 10 years between January 2010 and December 2019. Among 525 vitiligo patients treated in 10 years, 33 vitiligo patients (aged, 8–78 years; 18 female and 15 males) received IVMP, a single course of daily 500 mg methylprednisolone application (8 mg/kg/day for children) for 3 consecutive days. We observed that 14 of 25 (56%) achieved stable condition without lesion progression, and 12 of 19 (63%) had more than 25% repigmentation at 6 months after IVMP. A group of Vitiligo Area Scoring Index over 10 included more patients with Vitiligo Disease Activity Score of +3 and +4 disease progression at 6 months after the IVMP. We did not observe any severe adverse events relating to the IVMP procedures. In conclusion, IVMP is a safe and effective treatment for progressive generalized vitiligo.
Assemblages of anoxygenic phototrophic bacteria in tank bromeliads exhibit a host‐specific signature
Authors: Vergne Antoine , Darbot Vincent , Bardot Corinne , Enault François , Le Jeune Anne‐Hélène , Carrias Jean‐François , Corbara Bruno , Céréghino Régis , Leroy Céline , Jeanthon Christian , Giraud Eric , Mary Isabelle , Lehours Anne‐Catherine
Published: March 2021

Anoxygenic phototrophic bacteria (APB) are a very significant metabolic functional group in the phytotelmata of tank‐forming Bromeliaceae plants. Considering the close relationships existing between the bromeliad and its tank microbiota, the dominance of APB raises the question of their role in the ecology and evolution of these plants.

Here, using pufM gene sequencing for taxonomic profiling, we investigated the structure of APB communities in the tanks of five bromeliad species exhibiting different habitat characteristics (i.e. physicochemical factors associated with the host), and occurring in different localities of French Guiana.

We found that APB assemblages were specific to plant species and were less dependent on location or on bromeliad habitat characteristics. This convergence suggests that the identity of the bromeliad species per se is more important than habitat filtering or dispersal to control specific assembly rules for APB.

The pufM OTUs were affiliated with five orders of Alpha‐ and Beta‐proteobacteria (Rhodobacterales, Sphingomonadales, Rhizobiales, Burkholderiales and Rhodospirillales), and we assume that they may be major components of the core microbiota of plant‐held waters.

Our findings also revealed that up to 79% of the sequences were affiliated with APB clades possessing nitrogen‐fixing genes suggesting that this metabolic capability is widespread within the APB community inhabiting tank bromeliads. We hypothesized that bromeliads may benefit nutritionally from associations with free‐living APB capable to fix atmospheric nitrogen.

Synthesis. Understanding the dominance of APB in tank bromeliads and determining whether a potential interplay exists between these partners is an intriguing aspect of possible mutualistic and coevolving interactions between the two existing forms of chlorophototrophy (i.e. bacteriochlorophyll‐based anoxygenic and chlorophyll‐based oxygenic phototrophy). In the present study, we found that bromeliad species was the main factor that explained variance in APB community composition. These findings suggest that APB and tank bromeliads may have a close, mutualistic relationship and we hypothesize according to our genomic analyses that APB may promote the bromeliad growth by provisioning essential nutrients like nitrogen.
Preventing harm: A balance measure for improving the detection of fetal growth restriction
Authors: Selvaratnam Roshan J. , Wallace Euan M. , Hunt Rodney W. , Davey Mary‐Ann
Published: March 2021

Background

Increasing the detection of fetal growth restriction (FGR), while reducing stillbirth, also leads to unnecessary early intervention, and associated morbidity, for normally grown babies who are incorrectly suspected of FGR.

Aims

We sought to design a balance measure that addresses the specificity of FGR detection.

Methods

A retrospective cohort study on all singleton births ≥32 weeks gestation in 2016 and 2017 in Victoria. We compared two balance measures for the detection of FGR, defined as the proportion of all babies iatrogenically delivered before 39 weeks gestation for suspected FGR that had a birthweight ≥10th centile (balance measure 1) or ≥25th centile (balance measure 2). Hospital level performance on each balance measure was derived and compared to an existing performance measure for severe FGR detection in Victoria.

Results

Of the 38 hospitals analysed, 12 (32%) had a favourable performance on an existing indicator of FGR detection, seven (18%) hospitals had a favourable performance on balance measure 1, and 15 (39%) had a favourable performance on balance measure 2. There was a moderate correlation between hospital performance on the existing indicator and on balance measure 1 (r = 0.447, P = 0.005) but not balance measure 2 (r = −0.063, P = 0.71). There was no difference in perinatal mortality between high performing hospitals and low performing hospitals.

Conclusion

Introducing a balance measure into routine reporting may bring greater awareness to the unintended harm associated with increased detection of FGR.
Opioid prescription at postoperative discharge: a retrospective observational cohort study
Authors: Daliya P. , Adiamah A. , Roslan F. , Theophilidou E. , Knaggs R. D. , Levy N. , Lobo D. N. ,   the opioid prescription at postoperative discharge (OPiOiD) study group
Published: March 2021

Opioid misuse is now considered a major public health epidemic in North America, with substantial social and financial consequences. As well as socio‐economic and commercial drivers, modifiable risk‐factors that have resulted in this crisis have been identified. The purpose of this study was to identify whether, within England, modifiable drivers for persistent postoperative opioid use were present. This was a retrospective cohort study of practice at 14 National Health Service hospitals across England. Data were collected retrospectively and validated for adult patients undergoing elective intermediate and major or complex major general surgical procedures between 1 and 31 March 2019. Of the 509 patients enrolled from 14 centres, 499 were included in the data analysis. In total, 31.5% (157/499) patients were in the intermediate surgery cohort and 68.5% (342/499) were in the major or complex major surgery cohort, with 21.0% (33/157) and 21.6% (74/342) discharged with opioid medicines to be taken at regular intervals, respectively. There were similar median oral morphine equivalent doses prescribed at discharge. Of patients prescribed regular opioid medicines, 76.6% (82/107) had a specified duration at discharge. However, 72.9% (78/107) had no written deprescribing advice on discharge. Similarly, of patients prescribed ‘when required’ opioids, 59.6% (93/156) had a specified duration of their prescription and 33.3% (52/156) were given written deprescribing advice. This study has identified a pattern of poor prescribing practices, a lack of guidance and formal training at individual institutions and highlights opportunities for improvement in opioid‐prescribing practices within England.
Are vancomycin dosing guidelines followed? A mixed methods study of vancomycin prescribing practices
Authors: Carland Jane E. , Stocker Sophie L. , Baysari Melissa T. , Li Crystal , Själin Jacqueline , Moran Maria A. , Tang Sarah , Sandaradura Indy , Elhage Tania , Gilbey Timothy , Williams Kenneth M. , Marriott Deborah J. E. , Day Richard O.
Published: March 2021

Aims

Despite the availability of international consensus guidelines, vancomycin dosing and therapeutic drug monitoring (TDM) remain suboptimal. This study aimed to assess concordance of vancomycin dosing and TDM with institutional guidelines and to identify factors taken into consideration by clinicians when prescribing vancomycin.

Methods

A retrospective audit of 163 patients receiving vancomycin therapy (≥48 hours) was undertaken. Data collected included patient characteristics, dosing history and plasma vancomycin and creatinine concentrations. Concordance of dosing and TDM with institutional guidelines was evaluated. Semi‐structured interviews, including simulated prescribing scenarios, were undertaken with prescribers (n = 17) and transcripts analysed.

Results

Plasma vancomycin concentrations (n = 1043) were collected during 179 courses of therapy. Only 24% of courses commenced with a loading dose with 72% lower than recommended. The initial maintenance dose was concordant in 42% of courses with 34% lower than recommended. Only 14% of TDM samples were trough vancomycin concentrations. Dose was not adjusted for 60% (21/35) of subtherapeutic and 43% (18/42) of supratherapeutic trough vancomycin concentrations, respectively. Interview participants reported that patient characteristics (including renal function), vancomycin concentrations, guidelines and expert advice influenced vancomycin prescribing decisions. Despite referring to guidelines when completing simulated prescribing scenarios, only 37% of prescribing decisions aligned with guideline recommendations.

Conclusion

Poor compliance with institutional vancomycin guidelines was observed, despite prescriber awareness of available guidelines. Multifaceted strategies to support prescriber decision‐making are required to improve vancomycin dosing and monitoring.
Changes in vascular function during breast cancer treatment
Authors: Fredslund Stine Overvad , Buus Niels Henrik , Højgaard Skjold Cecilie , Laugesen Esben , Jensen Anders Bonde , Laursen Britt Elmedal
Published: March 2021

Aims

Breast cancer (BC) survivors are at increased risk of cardiovascular disease. We evaluated whether chemotherapy induces early or late vascular dysfunction in vivo.

Methods

Early‐stage BC patients (n = 33) underwent measurements of forearm blood flow (FBF), 24‐hour blood pressure (BP), aortic pulse wave velocity and inflammatory markers before (T0), 14 days after (T1) and 12 months after (T2) chemotherapy. FBF was assessed during intra‐arterial infusion of acetylcholine (ACh), ACh during simultaneous nitric oxide synthase inhibition with L‐NG‐monomethyl arginine, and during infusion of sodium nitroprusside. Controls matched by age and menopausal status were examined for baseline comparison.

Results

At T0, absolute FBF in the BC patients did not differ from controls. At T1, ACh‐induced absolute FBF was higher compared to T0. ACh‐induced FBF decreased significantly at T2, evaluated as area under the dose–response curve, and when corrected for FBF in the contralateral arm (FBF ratio at T0: 4.05, 95% confidence interval [2.54; 5.74] and T2: 2.77 [2.41; 3.50]), without difference evident during L‐NG‐monomethyl arginine infusion. FBF during sodium nitroprusside infusion remained unchanged. Pulse wave velocity and BP remained unchanged. Asymmetric dimethylarginine (T0: 0.68 μmol/L ± 0.17, T1: 0.75 μmol/L ± 0.16) and the inflammation‐related biomarkers Cd163 (T0: 1.86 mg/L [1.68; 2.05], T1: 2.04 mg/L [1.76; 2.4]) and Cd206 (T0: 0.22 mg/L [0.19; 0.26], T1: 0.27 mg/L [0.23; 0.30]) all increased significantly at T1, but returned to baseline values at T2. L‐arginine was significantly increased at both T1 (78.5 μmol/L [68.9; 86.6]) and T2 (76.8 μmol/L [66.9; 90.6]), compared to T0 (59.6 μmol/L [53.7; 68.0]).

Conclusion

Chemotherapy for BC seems associated with early amplification of endothelium‐dependent vasodilation and inflammation. One year after chemotherapy, microvascular dysfunction persists in terms of reduced NO‐dependent vasodilation without alterations in BP or arterial stiffness.
Speciation across theTree ofLife
Authors: Hernández‐Hernández Tania , Miller Elizabeth C. , Román‐Palacios Cristian , Wiens John J.
Published: March 2021

Much of what we know about speciation comes from detailed studies of well‐known model systems. Although there have been several important syntheses on speciation, few (if any) have explicitly compared speciation among major groups across the Tree of Life. Here, we synthesize and compare what is known about key aspects of speciation across taxa, including bacteria, protists, fungi, plants, and major animal groups. We focus on three main questions. Is allopatric speciation predominant across groups? How common is ecological divergence of sister species (a requirement for ecological speciation), and on what niche axes do species diverge in each group? What are the reproductive isolating barriers in each group? Our review suggests the following patterns. (i) Based on our survey and projected species numbers, the most frequent speciation process across the Tree of Life may be co‐speciation between endosymbiotic bacteria and their insect hosts. (ii) Allopatric speciation appears to be present in all major groups, and may be the most common mode in both animals and plants, based on non‐overlapping ranges of sister species. (iii) Full sympatry of sister species is also widespread, and may be more common in fungi than allopatry. (iv) Full sympatry of sister species is more common in some marine animals than in terrestrial and freshwater ones. (v) Ecological divergence of sister species is widespread in all groups, including ~70% of surveyed species pairs of plants and insects. (vi) Major axes of ecological divergence involve species interactions (e.g. host‐switching) and habitat divergence. (vii) Prezygotic isolation appears to be generally more widespread and important than postzygotic isolation. (viii) Rates of diversification (and presumably speciation) are strikingly different across groups, with the fastest rates in plants, and successively slower rates in animals, fungi, and protists, with the slowest rates in prokaryotes. Overall, our study represents an initial step towards understanding general patterns in speciation across all organisms.
Altered inflammasome activation in neonatal encephalopathy persists in childhood
Authors: Kelly L A , O'Dea M I , Zareen Z , Melo A M , McKenna E , Strickland T , McEneaney V , Donoghue V , Boylan G , Sweetman D , Butler J , Vavasseur C , Miletin J , El-Khuffash A F , O'Neill L A J , O'Leary J J , Molloy E J
Published: March 2021

Neonatal encephalopathy (NE) is characterized by altered neurological function in term infants and inflammation plays an important pathophysiological role. Inflammatory cytokines interleukin (IL)-1β, IL-1ra and IL-18 are activated by the nucleotide-binding and oligomerization domain (NOD)-, leucine-rich repeat domain (LRR)- and NOD-like receptor protein 3 (NLRP3) inflammasome; furthermore, we aimed to examine the role of the inflammasome multiprotein complex involved in proinflammatory responses from the newborn period to childhood in NE. Cytokine concentrations were measured by multiplex enzyme-linked immunosorbent assay (ELISA) in neonates and children with NE in the absence or presence of lipopolysaccharide (LPS) endotoxin. We then investigated expression of the NLRP3 inflammasome genes, NLRP3, IL-1β and ASC by polymerase chain reaction (PCR). Serum samples from 40 NE patients at days 1 and 3 of the first week of life and in 37 patients at age 4–7 years were analysed. An increase in serum IL-1ra and IL-18 in neonates with NE on days 1 and 3 was observed compared to neonatal controls. IL-1ra in NE was decreased to normal levels at school age, whereas serum IL-18 in NE was even higher at school age compared to school age controls and NE in the first week of life. Percentage of LPS response was higher in newborns compared to school-age NE. NLRP3 and IL-1β gene expression were up-regulated in the presence of LPS in NE neonates and NLRP3 gene expression remained up-regulated at school age in NE patients compared to controls. Increased inflammasome activation in the first day of life in NE persists in childhood, and may increase the window for therapeutic intervention.
Can in vivo confocal microscopy differentiate between sub‐types of dry eye disease? A review
Authors: Hwang Jodi , Dermer Harrison , Galor Anat
Published: March 2021

Many studies utilised in vivo confocal microscopy (IVCM) to associate variations in corneal structures with dry eye disease (DED). However, DED is an umbrella term that covers various aetiologies and presentations. This review analyses populations by DED aetiology to determine the relationships between IVCM parameters and specific DED sub‐types. It focuses on the most commonly examined structures, sub‐basal nerves and dendritic cells. Across the literature, most studies found individuals with immune‐mediated DED had lower sub‐basal nerve fibre number and density than controls, with smaller differences between non‐immune DED and controls. However, wide ranges of values reported across studies demonstrate considerable overlap between DED sub‐types and controls, rendering these metrics less helpful when diagnosing an individual patient. Dendritic cell density was considerably higher in individuals with immune‐mediated DED than in non‐immune DED or controls. As such, dendritic cell density may be a better indicator of DED associated with a systemic immune‐mediated process.
Electronic health record and patterns of care for children with cerebral palsy
Authors: Kurowski Brad G , Greve Kelly , Bailes Amy F , Zahner Janet , Vargus‐Adams Jilda , Mcmahon Mary A , Aronow Bruce J , Mitelpunkt Alexis
Published: March 2021

Aim

To characterize the patterns of care of children with cerebral palsy (CP) in a tertiary healthcare system.

Method

Electronic health record data from 2009 to 2019 were extracted for children with CP. Machine learning hierarchical clustering was used to identify clusters of care. The ratio of in‐person to care coordination visits was calculated for each specialty.

Results

The sample included 6369 children with CP (55.7% males, 44.3% females, 76.2% white, 94.7% non‐Hispanic; with a mean age of 8y 2mo [SD 5y 10mo; range 0–21y; median 7y 1mo]) at the time of diagnosis. A total of 3.7 million in‐person visits and care coordination notes were identified across 34 specialties. The duration of care averaged 5 years 5 months with five specialty interactions and 21.8 in‐person visits per year per child. Seven clusters of care were identified, including: musculoskeletal and function; neurological; high‐frequency/urgent care services; procedures; comorbid diagnoses; development and behavioral; and primary care. Network analysis showed shared membership among several clusters.

Interpretation

Coordination of care is a central element for children with CP. Medical informatics, machine learning, and big data approaches provide unique insights into care delivery to inform approaches to improve outcomes for children with CP.

What this paper adds

Seven primary clusters of care were identified: musculoskeletal and function; neurological; high‐frequency/urgent care services; procedures; comorbid diagnoses; development and behavioral; and primary care.

The in‐person to care coordination visit ratio was 1:5 overall for healthcare encounters.

Most interactions with care teams occur outside of in‐person visits.

The ratio of in‐person to care coordination activities differ by specialty.
Association of estimated plasma volume and weight loss after long‐term administration and subsequent discontinuation of the sodium‐glucose cotransporter‐2 inhibitor tofogliflozin
Authors: Matsubayashi Yasuhiro , Yoshida Akihiro , Suganami Hideki , Oe Momoko , Sato Takaaki , Yaguchi Yuta , Fujihara Kazuya , Yamada Takaho , Tanaka Shiro , Kaku Kohei , Sone Hirohito
Published: March 2021

Sodium‐glucose cotransporter‐2 inhibitors (SGLT2) are drugs that have been reported to have several effects through the regulation of plasma volume, for example, antihypertensive effects. This study aimed to clarify the impact of long‐term administration and subsequent discontinuation of the SGLT2 inhibitor tofogliflozin on estimated plasma volume (ePV), brain natriuretic peptide (BNP) and the relationship between changes in ePV, BNP and body weight (BW). Data from 157 participants with type 2 diabetes receiving tofogliflozin monotherapy in a phase 3 study were analysed. Changes in variables or correlations among them during a 52‐week administration and a 2‐week post‐treatment period were investigated. Percent change in ePV was calculated using the Strauss formula. Significant decreases in BW, ePV and ln‐transformed BNP (ln‐BNP) were noted by week 52. %ΔBW was not significantly correlated with %ΔePV and Δln‐BNP, while %ΔePV was significantly correlated with Δln‐BNP. Two weeks after discontinuation of tofogliflozin, BW, ePV and ln‐BNP were significantly increased. %ΔBW was significantly correlated with %ΔePV and Δln‐BNP. Furthermore, ePV and BNP were significantly higher than baseline levels.
Evaluating the message of an ongoing communication campaign to reduce the duration of untreated psychosis in a Latinx community in the United States
Authors: Calderon Vanessa , Cain Rosalba , Torres Eva , Lopez Steven R.
Published: March 2021

Aim

Initiatives aimed at reducing the duration of untreated psychosis (DUP) attempt to increase the community's level of psychosis literacy. Most of these efforts, however, have failed to reduce DUP. One plausible explanation is that the campaigns do not actually increase psychosis literacy. To date, there have been few efforts to assess whether the campaign messaging does indeed increase psychosis literacy prior to or during the campaign. This study evaluated whether the message of the La CLAve DUP reduction program delivered during the campaign increased the psychosis literacy of a U.S. Latinx community.

Methods

The sample consisted of 81 Latinx community residents aged 15–84. Two community health educators of the La CLAve campaign facilitated workshops using a narrative film to initiate a conversation in the community about the signs of psychosis and the importance of professional help‐seeking early in the illness course. Psychosis literacy was assessed via questionnaires pertaining to a hypothetical vignette administered before and after the workshops.

Results

The psychosis literacy of participants increased after the workshops in several domains. Participants' knowledge of multiple psychotic symptoms, self‐efficacy in their ability to recognize psychosis in others, and correct attributions of a hypothetical vignette's psychotic symptoms significantly increased. No changes were observed in recommendations for professional help‐seeking.

Conclusions

These findings provide support for the effectiveness of the La CLAve messaging in increasing psychosis literacy of U.S. Latinx community residents. Evidence‐based campaign messaging is needed to increase the success of DUP reduction programs especially among underserved communities.
Personality disorder among youth with first episode psychotic mania: An important target for specific treatment?
Authors: Hasty Melissa K. , Macneil Craig A. , Cotton Sue M. , Berk Michael , Kader Linda , Ratheesh Aswin , Ramain Julie , Chanen Andrew M. , Conus Philippe
Published: March 2021

Aim

Personality disorder is a common co‐occurrence ('comorbidity') among patients with bipolar disorder and appears to affect outcome negatively. However, there is little knowledge about the impact of this comorbidity in the early phases of bipolar disorder. We examined the prevalence and effect of personality disorder co‐occurrence on outcome in a cohort of youth with first episode mania with psychotic features.

Methods

Seventy‐one first episode mania patients, aged 15–29, were assessed at baseline, 6, 12, and 18 months as part of a randomized controlled trial of olanzapine and chlorpromazine as add‐on to lithium in first episode mania with psychotic features. The current study involved secondary analysis of trial data.

Results

A co‐occurring clinical personality disorder diagnosis was present in 16.9% of patients. Antisocial and narcissistic personality disorders were the most common diagnoses. Patients with co‐occurring personality disorder had higher rates of readmission to hospital, lower rates of symptomatic recovery and poorer functional levels at 6 months, but these differences disappeared after 12 and 18 months.

Conclusions

In the early phase of bipolar disorder, patients with personality disorder comorbidity display delayed symptomatic and functional recovery and increased likelihood to need hospital readmissions. These observations suggest that routine assessment for personality disorder and specific interventions are important in order to improve short‐term treatment efficacy in this subgroup.
Analyses of peripheral blood dendritic cells and magnetic resonance spectroscopy support dysfunctional neuro‐immune crosstalk in Tourette syndrome
Authors: Sarchioto Marianna , Howe Franklyn , Dumitriu Ingrid E. , Morgante Francesca , Stern Jeremy , Edwards Mark J. , Martino Davide
Published: March 2021

Background

Evidence supports that neurodevelopmental diseases, such as Tourette syndrome (TS), may involve dysfunctional neural‐immune crosstalk. This could lead to altered brain maturation and differences in immune and stress responses. Dendritic cells (DCs) play a major role in immunity as professional antigen‐presenting cells; changes in their frequency have been observed in several autoimmune conditions.

Methods

In 18 TS patients (15 on stable pharmacological treatment, three unmedicated) and 18 age‐matched healthy volunteers (HVs), we explored circulating blood‐derived DCs and their relationship with clinical variables and brain metabolites, measured via proton magnetic resonance spectroscopy (1H‐MRS). DC subsets, including plasmacytoid and myeloid type 1 and 2 dendritic cells (MDC1, MDC2), were studied with flow cytometry. 1H‐MRS was used to measure total choline, glutamate plus glutamine, total creatine (tCr), and total N‐acetylaspartate and N‐acetylaspartyl‐glutamate levels in frontal white matter (FWM) and the putamen.

Results

We did not observe differences in absolute concentrations of DC subsets or brain inflammatory metabolites between patients and HVs. However, TS patients manifesting anxiety showed a significant increase in MDC1s compared to TS patients without anxiety (p = 0.01). We also found a strong negative correlation between MDC1 frequency and tCr in the FWM of patients with TS (p = 0.0015), but not of HVs.

Conclusion

Elevated frequencies of the MDC1 subset in TS patients manifesting anxiety may reflect a proinflammatory status, potentially facilitating altered neuro‐immune crosstalk. Furthermore, the strong inverse correlation between brain tCr levels and MDC1 subset frequency in TS patients suggests a potential association between proinflammatory status and metabolic changes in sensitive brain regions.
The history and distribution of nodulating Paraburkholderia, a potential inoculum for Fynbos forage species
Authors: Beukes Chrizelle W. , Venter Stephanus N. , Steenkamp Emma T.
Published: March 2021

Legumes in the Fynbos vegetation of the Western Cape of South Africa have emerged as candidates for domestication, particularly for their adaptation to acidic and infertile soils. However, South African rhizobia have been shown to be very diverse and unique, and a detailed understanding of them is essential to success in forage breeding programs that seek to exploit these “new” legumes. Symbionts of legumes in South Africa that belong to traditional rhizobial genera have been shown to have a unique origin for their symbiotic loci in comparison to members sampled from other regions of the world. Some of the legume tribes in the Fynbos have also been shown to associate predominantly with unique species in the Betaproteobacterial genus Paraburkholderia. The rhizobial members of this genus have two main centres of diversity, of which South Africa is one. In this centre, the legume hosts are principally from the Papilionoideae subfamily while hosts from the mimosoid clade (now in the Caesalpinioideae) are abundant in the South American centre. Not only do these rhizobia differ in terms of host, but their symbiotic loci also show separate origins. The dominance and uniqueness of the Paraburkholderia symbionts, in the context of indigenous South African legumes, makes understanding the history and factors that affect the distribution of this genus essential if successful adaptation and effective nodulation of these legumes in Agriculture are to be achieved globally.
P300/CBP‐associated factor (PCAF) attenuated M1 macrophage inflammatory responses possibly through KLF2 and KLF4
Authors: Wang Xiuling , Li Haiyan , Chen Shanshan , He Jinrong , Chen Weiqun , Ding Yu , Huang Jin
Published: March 2021

Macrophages exhibit distinct phenotypes in response to environmental signals. The polarization of M1 macrophages plays an essential role in the inflammatory response. However, the specific molecular mechanisms regulating the inflammatory response during M1 macrophage polarization remain to be further understood. Here, we found that the histone acetyltransferase P300/CBP‐associated factor (PCAF) was a potential negative regulator of the M1 macrophage inflammatory response. During M1 macrophage polarization, the inflammatory response gradually reduced, but PCAF expression increased. Furthermore, the overexpression of PCAF significantly inhibited the expression of the M1 macrophage‐related pro‐inflammatory genes TNF‐α, IL‐6 and CXCL10, while PCAF deficiency enhanced the expression of these genes. Furthermore, we found that PCAF overexpression suppressed the NF‐κB signaling pathway and promoted the expression of the Krüppel‐like factors (KLF) KLF2 and KLF4 through regulating their transcriptional levels. In addition, KLF2 and KLF4 deficiency reversed the PCAF‐induced inhibition of the expression of pro‐inflammatory genes in M1 macrophages. Collectively, the present results demonstrate a potential negative regulatory mechanism of the inflammatory response during M1 macrophage polarization and propose a novel mechanism of inflammation resolution for maintaining homeostasis.
Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan
Authors: Takahara Mitsuyoshi , Watanabe Hirotaka , Shiraiwa Toshihiko , Maeno Yoshifumi , Yamamoto Kaoru , Shiraiwa Yuka , Yoshida Yoko , Nishioka Norio , Katakami Naoto , Shimomura Iichiro
Published: March 2021

Aims/Introduction

This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID‐19) pandemic in Japan.

Materials and Methods

We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID‐19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model.

Results

Leisure time and other outside physical activities were decreased in one‐quarter of patients during the COVID‐19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15).

Conclusions

A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID‐19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.
Taxonomy of the Apicomplexan Symbionts of Coral, including Corallicolida ord. nov., Reassignment of the Genus Gemmocystis, and Description of New Species Corallicolaaquarius gen. nov. sp. nov. and Anthozoaphilagnarlus gen. nov. sp. nov.
Authors: Kwong Waldan K. , Irwin Nicholas A.T. , Mathur Varsha , Na Ina , Okamoto Noriko , Vermeij Mark J.A. , Keeling Patrick J.
Published: March 2021

Corals (Metazoa; Cnidaria; Anthozoa) have recently been shown to play host to a widespread and diverse group of intracellular symbionts of the phylum Apicomplexa. These symbionts, colloquially called “corallicolids”, are mostly known through molecular analyses, and no formal taxonomy has been proposed. Another apicomplexan, Gemmocystis cylindrus (described from the coral Dendrogyra cylindrus), may be related to corallicolids, but lacks molecular data. Here, we isolate and describe motile trophozoite (feeding) corallicolids cells using microscopic (light, SEM, and TEM) and molecular phylogenetic analysis to provide the basis for a formal description. Phylogenetic analyses using nuclear and plastid rRNA operons, and three mitochondrial protein sequences derived from single cell transcriptomes, all confirm that these organisms fall into a discrete deep‐branching clade within the Apicomplexa not closely related to any known species or major subgroup. As a result, we assign this clade to a new order, Corallicolida ord. nov., and family, Corallicolidae fam. nov. We describe a type species, Corallicola aquarius gen. nov. sp. nov. from its Rhodactis sp. host, and also describe a second species, Anthozoaphila gnarlus gen. nov. sp. nov., from the coral host Madracis mirabilis. Finally, we propose reassigning the incertae sedis taxon G. cylindrus from the order Agamococcidiorida to the Corallicolida, based on similarities in morphology and host localization to that of the corallicolids.
Prevalence of high‐risk medications in patients enrolled in the Hospital Elder Life Program
Authors: Macias Tejada Jonny A. , Klumph Marianne , Heslin Kayla , Khan Ariba , Malone Michael L.
Published: March 2021

Objective

The study aimed to assess the prevalence of newly prescribed antipsychotic/benzodiazepine medication, as well as 30‐day readmissions, among Hospital Elder Life Program (HELP)‐enrolled patients.

Design

Retrospective case–control study.

Setting

HELP intervention took place in eight hospital units. The standard care group was selected from eight additional hospital units.

Participants

Hospitalized patients, aged 65 years and older, enrolled in HELP during between January 1, 2017 to December 31, 2018 were included in the HELP cohort. Patients hospitalized in eight additional units during the same time frame were part of the standard care group.

Measurements

Antipsychotic/benzodiazepine medications were pulled from the electronic health record. History of chronic mental illnesses were classified by ICD10 codes. Basic descriptive statistics were used to analyze patient characteristics and comorbidities. Chi‐squared and t‐tests were performed to detect statistical differences as appropriate.

Results

There were 1411 patients in the HELP group and 10,807 patients in the standard care group. The HELP group was likely to be older, female and to have a shorten length of stay (all p ≤ 0.02). Our study demonstrated that approximately 8.9% (n = 125) of patients enrolled in HELP received an order for antipsychotics during their hospital admission, while 31.5% (n = 3400) from the standard care group (p < 0.001). The difference in benzodiazepine prescription in patients enrolled in HELP was also less when comparing the two groups (22.8% HELP vs 25.6% standard care; p = 0.02).

Conclusions

Patients enrolled in the HELP group were less likely to receive a prescription for antipsychotics or benzodiazepines. The majority of patients enrolled in HELP were discharged to a more independent environment (home or assisted living) and there was a relatively low 30‐day readmission rate among HELP patients.
Consumer resource integration in the subsistence marketplace: A comparative study of urban and rural consumers
Authors: Jayawickramarathna Wasana , Mulye Rajendra , Rahman Kaleel , Fry Tim
Published: March 2021

Ongoing research on resource integration highlights the central role of resources and describes all social and economic actors, including consumers, as resource integrators who actively engaged in experiences. How consumers integrate their resources is particularly important in the subsistence marketplace, which operates in a limited resource setting. The objective of this study is to examine how subsistence consumers integrate resources in achieving their life satisfaction goals. Data was collected using a semi‐structured questionnaire from a sample of 244 urban and rural consumers in Sri Lanka. The results demonstrate that resource integration significantly influences the life satisfaction of subsistence marketplace consumers, although its influence is not uniform across the urban and rural sectors. While “operand” resources are found to have most influence, the low usage of “operant” resources suggests that there is underutilisation of skills, competencies and intangible resources involved in creating value in the subsistence marketplace. The study found substantial differences in the way urban and rural consumers integrate their resources. Contrary to previous research, consumer aspirations had minimal effect on life satisfaction goals of consumers. The study provides implications for marketers to identify the types of consumer resources owned by subsistence marketplace consumers and their usage in different sectors.