bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the influencing factors and effects of the digitalization of management control
Authors: Fähndrich Jochen , Pedell Burkhard
Published: May 2024

Purpose

This study aims to investigate the influences on the digitalization of management control and the effects of this digitalization on management control tasks performed, management control instruments used and the organization of management control.

Design/methodology/approach

This empirical analysis is based on a survey of 189 management accountants and managers responsible for management control in Germany, Austria and Switzerland. Logistic regression analyses were used to test the investigated effects.

Findings

This study finds that digital competencies, standardization of processes and data management contribute to the digitalization of management control. This study further finds that digitalization significantly increases the coverage of strategic and operational management control tasks and the use of operational management control instruments but not of strategic instruments.

Originality

This study investigates the influence of digitalization in management control on strategic and operational management control tasks, instruments and organizations. In contrast, prior research has focused on single aspects of management control or analyzed the impact on the entire company. This is also the first study, to the best of the authors’ knowledge, to systematically identify potential influences on the digitalization of management control and analyze them empirically.
Word-of-mouth effects in individual investors’ trading: evidence from Korea
Authors: Choi Sujung
Published: May 2024

This paper examines the hypothesis of local herding (i.e. own-area effects) by individual investors on a particular stock-month. Using a unique dataset on online and offline individual investors’ trading records in Korea, we analyze buying and selling transactions involving 10,000 accounts from February 1999 to December 2005. We find that both online and offline investors in the same area tend to exhibit stronger local herding compared to investors’ trades who are geographically remote. Interestingly, online investors not only present stronger own-area effects but also exhibit more pronounced other-area effects compared with offline investors. Furthermore, our analysis indicates that gender and religious affiliation are important in investment behavior, with male and non-religious investors displaying a greater stock market participation in contrast to investors who are female and Protestant.
Female entrepreneurship in the start-up ecosystem of Saudi Arabia
Authors: Aljarodi Abdullah M. , Thatchenkery Tojo , Urbano David
Published: May 2024

Purpose

To date, few studies have incorporated female entrepreneurship into the context of a country that relies heavily on natural resources and still has a wide gender gap due to historically established cultural norms. This study aims to investigate the impact of entrepreneurial ecosystem factors on women’s ability and desire to become entrepreneurs in Saudi Arabia.

Design/methodology/approach

The study applied a quantitative method using secondary data from the Adult Population Survey conducted by Global Entrepreneurship Monitor and built upon the recently proposed “Entrepreneurial Ecosystem Approach,” which has three levels: institutional, organisational and individual.

Findings

The findings demonstrate the significant roles that different entrepreneurial ecosystem dimensions can play in determining female entrepreneurial activity. Relationships were found among the variables of the three dimensions, indicating that broader institutional conditions can impact women becoming entrepreneurs.

Research limitations/implications

A multi-year analysis could not be performed because the country data from one year limited the research to conditions in that time frame.

Originality/value

The findings advance entrepreneurial research by empirically examining the influencers' factors on women becoming entrepreneurs in a fast-growing emerging economy, collectivist society and non-European and non-North American institutional environment. The research tested a framework that gives more insight into the diverse factors affecting women in entrepreneurship at different levels.
FinTech developments and their heterogeneous effect on digital finance for SMEs and entrepreneurship: evidence from 47 African countries
Authors: Sanga Bahati , Aziakpono Meshach
Published: May 2024

Purpose

Lack of access to finance is a major constraint to the growth of small and medium-sized enterprises (SMEs) and entrepreneurship in developing countries. The recent proliferation of mobile phone services, access to the internet and emerging technologies has led to a surge in the use of FinTech in Africa and is transforming the financial sector. This paper aims to examine whether FinTech developments heterogeneously contribute to the growth of digital finance for SMEs and entrepreneurship in 47 African countries from 2013 to 2020.

Design/methodology/approach

The paper uses a novel method of moments quantile regression, which deals with heterogeneity and endogeneity in diverse conditions for asymmetric and nonlinear models.

Findings

The empirical results reveal that the rise of FinTech companies offering services in Africa heterogeneously increases digital finance for SMEs and entrepreneurship in their different stages of growth. FinTech developments have a strong and positive impact in countries with higher levels of digital finance than those with lower levels. FinTech developments and digital finance positively and significantly influence entrepreneurship in Africa, particularly in the nascent and transitional development stages of entrepreneurship. Institutional quality has a considerable positive moderating effect when used as a control rather than an interaction variable.

Practical implications

The results suggest the need to promote FinTech developments in Africa: to provide a wide range of alternative digital finance schemes to SMEs and to promote entrepreneurship, especially in countries where entrepreneurship is in the nascent and transitional development stages. The results also underscore the need to promote FinTech development through supportive regulations and institutional quality to reduce risks related to FinTech and digital financing schemes.

Originality/value

To the best of the authors’ knowledge, this paper is one of the first attempts to account for the often overlooked heterogeneity effects and show that the influence of FinTech developments is not homogenous across the varying development stages of digital finance and entrepreneurship.
Driving success through digital transformation: influence of Industry 4.0 on lean, agile, resilient, green supply chain practices
Authors: Piprani Arsalan Zahid , Khan Syed Abdul Rehman , Yu Zhang
Published: May 2024

Purpose

Growing emphasis on long-term viability prompts researchers and industry professionals to collaborate on innovative approaches for sustainability and survival. Industry 4.0 (I4.0) technology's importance drives active adoption by firms amidst evolving business dynamics. This research examines the influence of I4.0 technologies on lean, agile resilient and green practices and their impact on supply chain performance.

Design/methodology/approach

Survey data from Pakistani manufacturing enterprises were analyzed using SMART PLS to explore the relationship between I4.0 technology, supply chain practices and supply chain performance.

Findings

I4.0 technologies significantly impact all practices, while agile and resilient supply chain approaches partially mediate the relationship with supply chain performance.

Practical implications

Insights from this research guide policymakers and business experts in implementing and managing lean, agile, resilient and green practices. Integrating these principles with digital technology solutions enhances supply chain performance.

Originality/value

This study advances understanding of the interplay between I4.0 technologies, practices and supply chain performance, providing a basis for further research and practical implications.
Improving health service design and delivery for men: does gender targeting matter?
Authors: Friend John M. , Alden Dana L.
Published: May 2024

Purpose

Consumer well-being in health-care settings is often undermined by information asymmetries, uncertainty and complex choices. Men are generally less motivated to adopt support tools designed to facilitate shared decision-making (SDM) and increase involvement in health service delivery. This study aims to examine the effects of sports team metaphors in a male-centered decision aid on empowerment and preparedness within a sleep apnea treatment context, a common disease among men. Individual-level factors that influence the decision aid experience are also considered.

Design/methodology/approach

An online panel sample of 296 US men was randomly assigned to a generic or gender targeted decision aid. The scenario-based method was used to simulate the decision aid experience. A one-way MANOVA tested the effects of gender targeting on SDM-related outcomes. Structural equation modeling was then undertaken to analyze relationships between self-construal and these outcomes.

Findings

Participants who experienced the gender-targeted decision aid reported higher levels of empowerment and preparedness. The positive relationship between collective interdependence and empowerment was stronger among those who received the targeted decision aid. The positive relationship between empowerment and preparedness was also significantly stronger in the targeted group. Empowerment mediated the effect of self-construal on preparedness.

Originality/value

Little to no research has evaluated the effectiveness of sports team metaphors in improving SDM and facilitating health-care value cocreation. Results provide insight into how to enhance service design and delivery for men facing medical decisions.
Family firm performance through transformational CEO leadership and familiness-related team forces
Authors: Neffe Carolin , Wilderom Celeste , Lattuch Frank
Published: May 2024

Purpose

The purpose of this study is to test the role of familiness-related team forces induced by the CEO of family firms. In particular, we report on the effects of the transformational leadership style of CEOs on their respective top-management team (TMT) and firm performance when viewed through a familiness lens.

Design/methodology/approach

Survey measures were taken from a snowballed sample of 72 CEOs of German family firms as well as from 245 members of their TMTs. We tested the aggregated firm-level data with objective performance indicators of the firms they led.

Findings

Support was obtained for the three hypothesized team-force mediations and the four-path mediation model. The relationship between CEO’s transformational style and high family-firm performance is found to be serially mediated by TMT cohesion, behavioral integration and efficacy. Together, these three types of collective forces are assumed to be the familiness effect of a family-member CEO with a transformational leadership style.

Originality/value

With our model, we quantitatively tested familiness-type forces vis-à-vis firm performance. Theoretical and practical implications of these findings are discussed.
Experimental evaluation of ZnO nanorods based eco – friendly sensor for melamine detection in milk
Authors: Venkatachalapathi Shyamala , Shankararajan Radha , Ramany Kiruthika , Gunasekaran Iyappan
Published: May 2024

Purpose

The purpose of this study is to develop a straightforward method for creating a non – toxic metal oxide sensor capable of detecting melamine in milk at ambient temperature.

Design/methodology/approach

A low temperature, straightforward solution-based approach, specifically the hydrothermal method was utilized to apply the active sensing layer onto the substrate. Subsequently, analysis of the cyclic voltammetry (CV) profile was conducted to detect the concentration of melamine and determine its sensitivity.

Findings

An experimental analysis was performed on a nontoxic metal oxide-based sensor fabricated for detecting melamine sensitivity using the CV profile. The sensor’s performance was evaluated under three different concentrations of melamine (0.1 mmol, 0.2 mmol and 0.3 mmol). The results demonstrated a satisfactory sensitivity of 0.0297 µAmM−1cm−2 with a response time of 2 s.

Originality/value

The primary innovation of this research lies in the creation of a nontoxic and environmentally friendly sensor. The synthesis method employed featured significantly lower temperatures compared to existing literatures. Furthermore, the sensor achieved enhanced sensitivity along with rapid response times.
Identification and characterization of uridine diphosphate glycosyltransferases in Dioryctria abietella, with an emphasis on putative roles in olfaction and reproduction
Authors: Chen Dan‐Lu , Yin Ning‐Na , Wang Peng‐Fei , Shen Dan , Wu Chun , Liu Nai‐Yong
Published: May 2024

Multiple physiological processes are involved in the interactions between the herbivore Dioryctria abietella and Pinaceae plants, with a key adaptation being the metabolic detoxification of host plant defensive substances. Moreover, the synthetic insecticides applied to control this coneworm are also shaping genes related to detoxification, such as the uridine diphosphate (UDP) glycosyltransferase (UGT) genes. Yet, the molecular mechanisms underpinning the resistance of D. abietella to toxic compounds remain unknown. In this study, we present an important UGT gene family involved in the detoxification mechanisms of D. abietella. Combining bioinformatic and transcriptomic approaches, a total of 37 UGT‐coding genes were identified from the transcriptome of D. abietella, with 20 full‐length sequences that shared high homology with UGTs found in other pyralid moths. These DabiUGTs were phylogenetically clustered into 12 subfamilies, with the three small clusters in the UGT33 and UGT40 clades mainly contributing to the size of the UGT gene repertoire in D. abietella. Expression profiles obtained from RNA sequencing (RNA‐Seq), reverse transcription PCR (RT‐PCR) and quantitative real‐time PCR (qPCR) revealed that over half of DabiUGTs had a broad tissue expression profile, with 28, 28, 31 and 35 genes detected separately in antennae, legs, abdomens and reproductive tissues. Notably, DabiUGT20, DabiUGT25, DabiUGT28 and DabiUGT34 were all significantly enriched in the antennae. Several DabiUGTs had significant expression levels in reproductive tissues, including DabiUGT6, DabiUGT9, DabiUGT24, DabiUGT26 and DabiUGT32 in female accessory glands, DabiUGT15 in male accessory glands and DabiUGT25 in male testes. Altogether, our results identify candidate DabiUGTs for mediating olfaction and reproduction in D. abietella, warranting further investigation into the roles of DabiUGTs in pesticide resistance, odorant detection and reproduction.
Heterotrophic bacteria trigger transcriptome remodelling in the photosynthetic picoeukaryote Micromonas commoda
Authors: Hamilton Maria , Ferrer‐González Frank Xavier , Moran Mary Ann
Published: May 2024

Marine biogeochemical cycles are built on interactions between surface ocean microbes, particularly those connecting phytoplankton primary producers to heterotrophic bacteria. Details of these associations are not well understood, especially in the case of direct influences of bacteria on phytoplankton physiology. Here we catalogue how the presence of three marine bacteria (Ruegeria pomeroyi DSS‐3, Stenotrophomonas sp. SKA14 and Polaribacter dokdonensis MED152) individually and uniquely impact gene expression of the picoeukaryotic alga Micromonas commoda RCC 299. We find a dramatic transcriptomic remodelling by M. commoda after 8 h in co‐culture, followed by an increase in cell numbers by 56 h compared with the axenic cultures. Some aspects of the algal transcriptomic response are conserved across all three bacterial co‐cultures, including an unexpected reduction in relative expression of photosynthesis and carbon fixation pathways. Expression differences restricted to a single bacterium are also observed, with the Flavobacteriia P. dokdonensis uniquely eliciting changes in relative expression of algal genes involved in biotin biosynthesis and the acquisition and assimilation of nitrogen. This study reveals that M. commoda has rapid and extensive responses to heterotrophic bacteria in ways that are generalizable, as well as in a taxon specific manner, with implications for the diversity of phytoplankton‐bacteria interactions ongoing in the surface ocean.
Nrf2 activation by pyrroloquinoline quinone inhibits natural aging‐related intervertebral disk degeneration in mice
Authors: Xue Qi , Li Jie , Qin Ran , Li Mingying , Li Yiping , Zhang Jing , Wang Rong , Goltzman David , Miao Dengshun , Yang Renlei
Published: May 2024

Age‐related intervertebral disk degeneration (IVDD) involves increased oxidative damage, cellular senescence, and matrix degradation. Pyrroloquinoline quinone (PQQ) is a water‐soluble vitamin‐like compound with strong anti‐oxidant capacity. The goal of this study was to determine whether PQQ can prevent aging‐related IVDD, and the underlying mechanism. Here, we found that dietary PQQ supplementation for 12 months alleviated IVDD phenotypes in aged mice, including increased disk height index and reduced histological scores and cell loss, without toxicity. Mechanistically, PQQ inhibited oxidative stress, cellular senescence, and senescence‐associated secretory phenotype (SASP) in the nucleus pulposus and annulus fibrosus of aged mice. Similarly, PQQ protected against interleukin‐1β‐induced matrix degradation, reactive oxygen species accumulation, and senescence in human nucleus pulposus cells (NPCs) in vitro. Molecular docking predicted and biochemical assays validated that PQQ interacts with specific residues to dissociate the Keap1–Nrf2 complex, thereby increasing nuclear Nrf2 translocation and activation of Nrf2‐ARE signaling. RNA sequencing and luciferase assays revealed Nrf2 can transcriptionally upregulate Wnt5a by binding to its promoter, while Wnt5a knockdown prevented PQQ inhibition of matrix metalloproteinase‐13 in NPCs. Notably, PQQ supplementation failed to alleviate aging‐associated IVDD phenotypes and oxidative stress in aged Nrf2 knockout mice, indicating Nrf2 is indispensable for PQQ bioactivities. Collectively, this study demonstrates Nrf2 activation by PQQ inhibits aging‐induced IVDD by attenuating cellular senescence and matrix degradation. This study clarifies Keap1–Nrf2–Wnt5a axis as the novel signaling underlying the protective effects of PQQ against aging‐related IVDD, and provides evidence for PQQ as a potential agent for clinical prevention and treatment of natural aging‐induced IVDD.
2023 Society for Academic Emergency Medicine Consensus Conference on Precision Emergency Medicine: Development of a policy‐relevant, patient‐centered research agenda
Authors: Strehlow Matthew , Gisondi Michael A. , Caretta‐Weyer Holly , Ankel Felix , Brackett Alexandria , Brar Pawan , Chan Teresa M. , Garabedian Adrene , Gunn Bridget , Isaacs Eric , von Isenburg Megan , Jarman Angela , Kuehl Damon , Limkakeng Alexander T. , Lydston Melis , McGregor Alyson , Pierce Ava , Raven Maria C. , Salhi Rama A. , Stave Christopher , Tan Josephine , Taylor Richard Andrew , Wong Hong‐Nei , Yiadom Maame Yaa A. B. , Zachrison Kori S. , Vogel Jody
Published: May 2024

Objectives

Precision medicine is data‐driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM.

Methods

We held a conference to (1) define precision EM, (2) develop an evidence‐based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus‐building process.

Results

A total of 217 individuals participated in this initiative, of whom 115 were conference‐day attendees. Consensus‐building activities yielded a definition of precision EM and key research questions that comprised a new 10‐year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty.

Conclusions

A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain.
Association of temperature and absolute humidity with incidence of exercise‐induced bronchoconstriction in children
Authors: Tikkakoski Anna P. , Reini Markus , Sipilä Kalle , Kivistö Juho E. , Karjalainen Jussi , Kähönen Mika , Tikkakoski Antti , Lehtimäki Lauri
Published: May 2024

Aim

Exercise test outdoors is widely used to diagnose asthma in children, but it is unclear how much outdoor air factors affect the results.

Methods

We analysed 321 outdoor exercise challenge tests with spirometry in children 6–16 years conducted due to suspicion of asthma or for assessing the effect of medication on asthma. We studied the association of FEV1 decrease and incidence of exercise‐induced bronchoconstriction (EIB) with temperature, relative humidity (RH) and absolute humidity (AH).

Results

Asthma was diagnosed in 57% of the subjects. AH ≥5 g/m3, but not RH or temperature, was associated with the EIB incidence (p = 0.035). In multivariable logistic regression, AH ≥5 g/m3 was negatively associated (OR = 0.51, 95% CI [0.28─0.92], p = 0.026) while obstruction before exercise (OR = 2.11, 95% CI [1.16─3.86], p = 0.015) and IgE‐mediated sensitisation were positively associated with EIB (OR = 2.24, 95% CI [1.11─4.51], p = 0.025). AH (r = −0.12, p = 0.028) and temperature (r = −0.13, p = 0.023) correlated with decrease in FEV1. In multivariable linear regression, only AH was associated with FEV1 decrease (coefficient = −0.044, 95% CI [−0.085 to −0.004], p = 0.033).

Conclusion

AH of outdoor air associates with occurrence and severity of EIB in outdoor exercise tests in children. Care should be taken when interpreting negative outdoor exercise test results if AH of air is high.
Letter: Early real‐world evidence from the United Arab Emirates of the persistence, effectiveness and safety of risankizumab for the treatment of Crohn's disease
Authors: Alahmad Maryam , Quraishi Mohammed Nabil , Khan Shaima Wasim , Omar Nadeen Mamon , Malik Talha A.
Published: May 2024

LINKED CONTENT

This article is linked to Yiu et al papers. To view these articles, visit https://doi.org/10.1111/apt.18006 and https://doi.org/10.1111/apt.18057
Liver function and portal‐systemic shunting quantified by the oral cholate challenge test and risk for large oesophageal varices
Authors: Hassanein Tarek , Keaveny Andrew P. , Mantry Parvez , Smith Alastair D. , McRae Michael P. , Kittelson John , Helmke Steve , Everson Gregory T. ,   for the SHUNT‐V Investigators
Published: May 2024

Background

The quantitative HepQuant SHUNT test of liver function and physiology generates a disease severity index (DSI) that correlates with risk for clinical complications, such as large oesophageal varices (LEVs). A derivative test, HepQuant DuO, generates an equivalent DSI and simplifies testing by requiring only oral administration of the test solution and two blood samples at 20 and 60 min.

Aims

Since the DSIs measured from DuO and SHUNT are equivalent, we compared the diagnostic performance for large oesophageal varices (LEVs) between the DSIs measured from DuO and SHUNT tests.

Methods

This study combined the data from two prospectively conducted US studies: HALT‐C and SHUNT‐V. A total of 455 subjects underwent both the SHUNT test and esophagogastroduodenoscopy (EGD).

Results

DSI scores correlated with the probability of LEVs (p < 0.001) and demonstrated a stepwise increase from healthy lean controls without liver disease to subjects with chronic liver disease and no, small or large varices. Furthermore, a cutoff of DSI ≤ 18.3 from DuO had a sensitivity of 0.98 (missing only one case) and, if applied to the endoscopy (EGD) decision, would have prevented 188 EGDs (41.3%). The AUROC for DSI from DuO did not differ from that of the reference SHUNT test method (0.82 versus 0.81, p = 0.3500).

Conclusions

DSI from HepQuant DuO links liver function and physiology to the risk of LEVs across a wide spectrum of patient characteristics, disease aetiologies and liver disease severity. DuO is minimally invasive, easy to administer, quantitative and may aid the decision to avoid or perform EGD for LEVs.
Editorial: Exclusive enteral nutrition: Positioning in the ever‐growing landscape of inflammatory bowel disease therapy
Authors: Dutt Krishneel , Vasudevan Abhinav
Published: May 2024

LINKED CONTENT

This article is linked to Plotkin et al papers. To view these articles, visit https://doi.org/10.1111/apt.18028
Sodium para‐aminosalicylic acid attenuates combined manganese/iron‐induced cortical synaptic damage in rats
Authors: Song Han‐Xiao , Xie Yu‐Han , Fang Yuan‐Yuan , Lin Jun‐Jie , Wang Lei‐Lei , Gan Cui‐liu , Aschner Michael , Jiang Yue‐Ming
Published: May 2024

We established experimental models of manganese (Mn) and iron (Fe) exposure in vitro and in vivo, and addressed the effects of manganese and iron combined exposure on the synaptic function of pheochromocytoma derived cell line 12 (PC12) cells and rat cortex, respectively. We investigated the protective effect of sodium para‐aminosalicylate (PAS‐Na) on manganese and iron combined neurotoxicity, providing a scientific basis for the prevention and treatment of ferromanganese combined neurotoxicity. Western blot and reverse transcription‐quantitative polymerase chain reaction (RT‐qPCR) were performed to detect the expression levels of protein and mRNA related to synaptic damage. Y‐maze novelty test and balance beam test were used to evaluate the motor and cognitive function of rats. Haematoxylin and eosin (H&E) and Nissl staining were performed to observe the cortical damage of rats. The results showed that the combined exposure of Mn and Fe in rats led to a synergistic effect, attenuating growth and development, and altering learning and memory as well as motor function. The combination of Mn and Fe also caused damage to the synaptic structure of PC12 cells, which is manifested as swelling of dendrites and axon terminals, and even lead to cell death. PAS‐Na displayed some antagonistic effects against the Mn‐ and Fe‐induced synaptic structural damage, growth, learning and memory impairment.
Neonatal morbidity and mortality in birth centers in the United States 2018–2021: An observational study of low‐risk birthing individuals
Authors: Hoehn‐Velasco Lauren , Ross Lisa , Phillippi R. David , Niemczyk Nancy A. , Cammarano Dominic , Calvin Steven , Phillippi Julia C. , Alliman Jill , Stapleton Susan Rutledge , Wright Jennifer , Fisch Stanley , Jolles Diana
Published: May 2024

Background

Many studies reporting neonatal outcomes in birth centers include births with risk factors not acceptable for birth center care using the evidence‐based CABC criteria. Accurate comparisons of outcomes by birth setting for low‐risk patients are needed.

Methods

Data from the public Natality Detailed File from 2018 to 2021 were used. Logistic regression, including adjusted and unadjusted odds ratios, compared neonatal outcomes (chorioamnionitis, Apgar scores, resuscitation, intensive care, seizures, and death) between centers and hospitals. Covariates included maternal diabetes, body mass index, age, parity, and demographic characteristics.

Results

The sample included 8,738,711 births (8,698,432 (99.53%) in hospitals and 40,279 (0.46%) in birth centers). There were no significant differences in neonatal deaths (aOR 1.037; 95% CI [0.515, 2.088]; p‐value 0.918) or seizures (aOR 0.666; 95% CI [0.315, 1.411]; p‐value 0.289). Measures of morbidity either not significantly different or less likely to occur in birth centers compared to hospitals included chorioamnionitis (aOR 0.032; 95% CI [0.020, 0.052]; p‐value < 0.001), Apgar score < 4 (aOR 0.814, 95% CI [0.638, 1.039], p‐value 0.099), Apgar score < 7 (aOR 1.075, 95% CI [0.979, 1.180], p‐value 0.130), ventilation >6 h (aOR 0.349; [0.281,0.433], p‐value < 0.001), and intensive care admission (aOR 0.356; 95% CI [0.328, 0.386], p‐value < 0.001). Birth centers had higher odds of assisted neonatal ventilation for <6 h as compared to hospitals (aOR 1.373; 95% CI [1.293, 1.457], p‐value < 0.001).

Conclusion

Neonatal deaths and seizures were not significantly different between freestanding birth centers and hospitals. Chorioamnionitis, Apgar scores < 4, and intensive care admission were less likely to occur in birth centers.
Implementing equitable and intersectionality‐aware ML in education: A practical guide
Authors: Mangal Mudit , Pardos Zachary A.
Published: May 2024

The greater the proliferation of AI in educational contexts, the more important it becomes to ensure that AI adheres to the equity and inclusion values of an educational system or institution. Given that modern AI is based on historic datasets, mitigating historic biases with respect to protected classes (ie, fairness) is an important component of this value alignment. Although extensive research has been done on AI fairness in education, there has been a lack of guidance for practitioners, which could enhance the practical uptake of these methods. In this work, we present a practitioner‐oriented, step‐by‐step framework, based on findings from the field, to implement AI fairness techniques. We also present an empirical case study that applies this framework in the context of a grade prediction task using data from a large public university. Our novel findings from the case study and extended analyses underscore the importance of incorporating intersectionality (such as race and gender) as central equity and inclusion institution values. Moreover, our research demonstrates the effectiveness of bias mitigation techniques, like adversarial learning, in enhancing fairness, particularly for intersectional categories like race–gender and race–income.

Practitioner notes

What is already known about this topic

AI‐powered Educational Decision Support Systems (EDSS) are increasingly used in various educational contexts, such as course selection, admissions, scholarship allocation and identifying at‐risk students.

There are known challenges with AI in education, particularly around the reinforcement of existing biases, leading to unfair outcomes.

The machine learning community has developed metrics and methods to measure and mitigate biases, which have been effectively applied to education as seen in the AI in education literature.

What this paper adds

Introduces a comprehensive technical framework for equity and inclusion, specifically for machine learning practitioners in AI education systems.

Presents a novel modification to the ABROCA fairness metric to better represent disparities among multiple subgroups within a protected class.

Empirical analysis of the effectiveness of bias‐mitigating techniques, like adversarial learning, in reducing biases in intersectional classes (eg, race–gender, race–income).

Model reporting in the form of model cards that can foster transparent communication among developers, users and stakeholders.

Implications for practice and/or policy

The fairness framework can act as a systematic guide for practitioners to design equitable and inclusive AI‐EDSS.

The fairness framework can act as a systematic guide for practitioners to make compliance with emerging AI regulations more manageable.

Stakeholders may become more involved in tailoring the fairness and equity model tuning process to align with their values.
Biallelic FANCA variants detected in sisters with isolated premature ovarian insufficiency
Authors: Tucker Elena J. , Sharp Michael F. , Lokchine Anna , Bell Katrina M. , Palmer Catherine S. , Kline Brianna L. , Robevska Gorjana , van den Bergen Jocelyn , Dulon Jérôme , Stojanovski Diana , Ayers Katie L. , Touraine Philippe , Crismani Wayne , Jaillard Sylvie , Sinclair Andrew H.
Published: May 2024

Premature ovarian insufficiency is a common form of female infertility affecting up to 4% of women and characterised by amenorrhea with elevated gonadotropin before the age of 40. Oocytes require controlled DNA breakage and repair for homologous recombination and the maintenance of oocyte integrity. Biallelic disruption of the DNA damage repair gene, Fanconi anemia complementation group A (FANCA), is a common cause of Fanconi anaemia, a syndrome characterised by bone marrow failure, cancer predisposition, physical anomalies and POI. There is ongoing dispute about the role of heterozygous FANCA variants in POI pathogenesis, with insufficient evidence supporting causation. Here, we have identified biallelic FANCA variants in French sisters presenting with POI, including a novel missense variant of uncertain significance and a likely pathogenic deletion that initially evaded detection. Functional studies indicated no discernible effect on DNA damage sensitivity in patient lymphoblasts. These novel FANCA variants add evidence that heterozygous loss of one allele is insufficient to cause DNA damage sensitivity and POI. We propose that intragenic deletions, that are relatively common in FANCA, may be missed without careful analysis, and could explain the presumed causation of heterozygous variants. Accurate variant curation is critical to optimise patient care and outcomes.
The Effects of Linear Order in Category Learning: Some Replications of Ramscar et al. (2010) and Their Implications for Replicating Training Studies
Authors: Viviani Eva , Ramscar Michael , Wonnacott Elizabeth
Published: May 2024

Ramscar, Yarlett, Dye, Denny, and Thorpe (2010) showed how, consistent with the predictions of error‐driven learning models, the order in which stimuli are presented in training can affect category learning. Specifically, learners exposed to artificial language input where objects preceded their labels learned the discriminating features of categories better than learners exposed to input where labels preceded objects. We sought to replicate this finding in two online experiments employing the same tests used originally: A four pictures test (match a label to one of four pictures) and a four labels test (match a picture to one of four labels). In our study, only findings from the four pictures test were consistent with the original result. Additionally, the effect sizes observed were smaller, and participants over‐generalized high‐frequency category labels more than in the original study. We suggest that although Ramscar, Yarlett, Dye, Denny, and Thorpe (2010) feature‐label order predictions were derived from error‐driven learning, they failed to consider that this mechanism also predicts that performance in any training paradigm must inevitably be influenced by participant prior experience. We consider our findings in light of these factors, and discuss implications for the generalizability and replication of training studies.
Clinical and cost‐effectiveness of telemedicine among patients with type 2 diabetes in primary care: A systematic review and meta‐analysis
Authors: Alfarwan Nawwarah , Hodkinson Alexander , Panagioti Maria , Hassan Lamiece , Kontopantelis Evangelos
Published: May 2024

Aims

Telemedicine has been promoted as an effective way of managing type‐2 diabetes (T2DM) in primary care. However, the effectiveness of telemedicine is unclear. We investigated the clinical and cost‐effectiveness of different telemedicine interventions for people with T2DM, compared to usual care.

Methods

We searched Medline, Embase, Cochrane, CINHAL, ProQuest and EconLit for randomized controlled trials (RCTs) that examined the effectiveness of telemedicine interventions on clinical outcomes (HbA1c, body mass index [BMI], weight, diastolic blood pressure [DBP], systolic blood pressure [SBP], fasting blood glucose, high‐density lipoprotein [HDL] cholesterol, low‐density lipoprotein [LDL] cholesterol, total cholesterol and triglyceride) in adults with T2DM, published in English from inception until 31 December 2022. Meta‐analyses were conducted using random‐effects models pooling mean differences, heterogeneity was quantified using the I2 statistic. Publication bias was assessed using funnel plots, Egger tests and trim and fill. Subgroup analyses included type of telemedicine intervention, telemedicine mode of delivery and type of healthcare professionals. This study was registered with PROSPERO, CRD 42022375128.

Results

Of the 4093 records identified, 21 RCTs, 10,732 participants from seven regions, were included. Reported interventions included telephone (k = 16 studies), internet‐based (k = 2), videoconference (k = 2) and telephone and emails (k = 1). We observed no statistically significant differences between synchronous or asynchronous telemedicine interventions compared to usual care for HbA1c (−0.08% (−0.88 mmol/mol); 95% CI: −0.18, 0.02), BMI (0.51 kg/m2; 95% CI: −0.21, 1.22), SBP (−1.48 mmHg; 95% CI: −3.22, 0.26), DBP (3.23 mmHg; 95% CI: −0.89, 7.34), HDL‐cholesterol (0.01 mmol/L; 95% CI: −0.03, 0.05), LDL‐cholesterol (0.08 mmol/L; 95% CI: −0.22, 0.37), triglycerides (−0.08 mmol/L, 95% CI: −0.31, −0.15), total cholesterol (−0.10 mmol/L; 95% CI: −0.25, 0.04) and weight (−0.50 kg; 95% CI: −1.21, 0.21).

Conclusions

Telemedicine was as effective as usual care in improving health outcomes of people with T2DM. They can provide a safe solution in times of rising demands for primary healthcare services, or in extreme events, like a global pandemic. More high‐quality RCTs are needed on the cost evaluation of telemedicine.
The prognostic value of metabolic dysfunction‐associated steatotic liver disease in acute myocardial infarction: A propensity score‐matched analysis
Authors: Kong Gwyneth , Cao Grace , Koh Jaycie , Chan Siew Pang , Zhang Audrey , Wong Esther , Chong Bryan , Jauhari Silingga Metta , Wang Jiong‐Wei , Mehta Anurag , Figtree Gemma A. , Mamas Mamas A. , Ng Gavin , Chan Koo Hui , Chai Ping , Low Adrian F. , Lee Chi Hang , Yeo Tiong Cheng , Yip James , Foo Roger , Tan Huay Cheem , Huang Daniel Q. , Muthiah Mark , Chan Mark Yan‐Yee , Loh Poay‐Huan , Chew Nicholas W. S.
Published: May 2024

Aim

Patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) are at increased risk of incident cardiovascular disease. However, the clinical characteristics and prognostic importance of MASLD in patients presenting with acute myocardial infarction (AMI) have yet to be examined.

Methods

This study compared the characteristics and outcomes of patients with and without MASLD presenting with AMI at a tertiary centre in Singapore. MASLD was defined as hepatic steatosis, with at least one of five metabolic criteria. Hepatic steatosis was determined using the Hepatic Steatosis Index. Propensity score matching was performed to adjust for age and sex. The Kaplan‐Meier curve was constructed for long‐term all‐cause mortality. Cox regression analysis was used to investigate independent predictors of long‐term all‐cause mortality.

Results

In this study of 4446 patients with AMI, 2223 patients with MASLD were matched with patients without MASLD using propensity scores. The mean follow‐up duration was 3.4 ± 2.4 years. The MASLD group had higher rates of obesity, diabetes and chronic kidney disease than their counterparts. Patients with MASLD had early excess all‐cause mortality (6.8% vs. 3.6%, p < .001) at 30 days, with unfavourable mortality rates sustained in the long‐term (18.3% vs. 14.5%, p = .001) compared with those without MASLD. After adjustment, MASLD remained independently associated with higher long‐term all‐cause mortality (hazard ratio 1.330, 95% confidence interval 1.106‐1.598, p = .002).

Conclusion

MASLD embodies a higher burden of metabolic dysfunction and is an independent predictor of long‐term mortality in the AMI population. Its early identification may be beneficial for risk stratification and provide therapeutic targets for secondary preventive strategies in AMI.
Forecasting the UK top 1% income share in a shifting world
Authors: Castle Jennifer L. , Doornik Jurgen A. , Hendry David F.
Published: May 2024

UK top income shares have varied hugely over the past two centuries, ranging from more than 30% to less than 7% of pre‐tax national income allocated to the top 1 percentile. We build a congruent dynamic linear regression model of the top 1% income share allowing for economic, political and social factors. Saturation estimation is used to model outliers and trend breaks, proxying underlying structural changes driving income inequality in the UK. We use the model to forecast the top 1% income share over the last 15 years, and compare to a range of forecast devices. Despite a well‐specified constant parameter model conditioning on significant explanatory variables, the best performing forecasts are obtained from a random walk and a smoothed random walk. These results are explained by the presence of shifts in the income share over the forecast period, resulting in forecasts from equilibrium correction models converging to the wrong equilibrium. Our best prediction for 2026 based on the most recent data from 2021 (a 5‐year ahead projection) is that the pre‐tax top 1% income share will remain at the most recent realized value of 12.7%, but there is a large degree of uncertainty, with a 95% confidence band ranging from 10% to 15.7%.
Austerity and elections
Authors: Alesina Alberto , Ciminelli Gabriele , Furceri Davide , Saponaro Giorgio
Published: May 2024

This paper revisits the conventional but unproven wisdom that voters penalize governments for adopting fiscal austerity in a sample of advanced economies. We consider the composition of the austerity package and the economic manifesto of the implementing government, and find that austerity packages consisting mostly of tax hikes have a significant electoral cost, which is larger for government parties that campaigned on a free‐market manifesto. Conversely, expenditure‐based austerity is costlier for government parties that did not run on a small‐government platform, but may be beneficial for those that did.
New insights into the therapeutic options to lower lipoprotein(a)
Authors: Baragetti A. , Da Dalt L. , Norata G. D.
Published: May 2024

Background

Elevated levels of lipoprotein(a) [Lp(a)] represent a risk factor for cardiovascular disease including aortic valve stenosis, myocardial infarction and stroke. While the patho‐physiological mechanisms linking Lp(a) with atherosclerosis are not fully understood, from genetic studies that lower Lp(a) levels protect from CVD independently of other risk factors including lipids and lipoproteins. Hereby, Lp(a) has been considered an appealing pharmacological target.

Results

However, approved lipid lowering therapies such as statins, ezetimibe or PCSK9 inhibitors have a neutral to modest effect on Lp(a) levels, thus prompting the development of new strategies selectively targeting Lp(a). These include antisense oligonucleotides and small interfering RNAs (siRNAs) directed towards apolipoprotein(a) [Apo(a)], which are in advanced phase of clinical development. More recently, additional approaches including inhibitors of Apo(a) and gene editing approaches via CRISPR‐Cas9 technology entered early clinical development.

Conclusion

If the results from the cardiovascular outcome trials, designed to demonstrate whether the reduction of Lp(a) of more than 80% as observed with pelacarsen, olpasiran or lepodisiran translates into the decrease of cardiovascular mortality and major adverse cardiovascular events, will be positive, lowering Lp(a) will become a new additional target in the management of patients with elevated cardiovascular risk.
Rapid response system for critically ill patients with haematological malignancies: A pre‐ and post‐intervention study
Authors: Mauz N. , Bouisse M. , Cahn J. Y. , Kaphan E. , Truche A.‐S. , Thiebaut‐Bertrand A. , Carré M. , Bulabois C.‐E. , Hamidfar‐Roy R. , Schwebel C. , Park S. , Labarere J. , Terzi N.
Published: May 2024

Background

This study aimed to determine whether implementing a rapid response system (RRS) is associated with improved short‐term outcomes in critically ill patients with haematological malignancies.

Methods

Our monocentric pre‐ versus post‐intervention study was conducted between January 2012 and April 2020. RRS was activated at early signs of haemodynamic or respiratory failure. The primary outcome was the reduction in Sequential Organ Failure Assessment (SOFA) score on Day 3 after intensive care unit (ICU) admission. Secondary outcomes included time to ICU admission and mortality.

Results

A total of 209 patients with a median age of 59 years were enrolled (108 in the pre‐intervention period and 101 in the post‐intervention period). 22% of them had received an allogeneic transplant. The post‐intervention period was associated with a shorter time to ICU admission (195 vs. 390 min, p < .001), a more frequent favourable trend in SOFA score (57% vs. 42%, adjusted odds ratio, 2.02, 95% confidence interval, 1.09 to 3.76), no significant changes in ICU (22% vs. 26%, p = .48) and 1‐year (62% vs. 58%, p = .62) mortality rates.

Conclusion

Detection of early organ failure and activation of an RRS was associated with faster ICU admission and lower SOFA scores on Day 3 of admission in critically ill patients with haematological malignancies.