Effects Model Research Articles

Oxytocin and vaginal dinoprostone in labor induction: Asystematic review and meta-analysis.

The comparison between prostaglandin E2 (PGE2) and oxytocin and for induction of labor (IOL) remains controversial. The present study aimed to determine the safety and efficacy of these two agents in IOL. PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov. from the establishment of the database to April 23, 2023. A search was conducted with keywords "labor, induction, prostaglandin E2/PGE2/dinoprostone, and oxytocin". Only randomized clinical trials comparing oxytocin and vaginal dinoprostone in women who were at least late preterm (gestational age [GA] ≥34 weeks), singleton pregnant, and had intact membranes were enrolled for further meta-analysis. We conducted both a descriptive analysis and a meta-analysis. In the meta-analysis, we utilized the Mantel-Haenszel random effects model to analyze dichotomous data, employing the relative risk (RR) as the effect measure along with 95% confidence intervals (CIs). The study quality was evaluated using Cochrane Collaboration's risk of bias assessment tool (RoB 2). A random-effects model was applied for the meta-analysis. After screening 3303 articles from five databases, a total of nine randomized controlled studies composed of 1071 patients were included. Our analysis included 534 patients in the PGE2 group and 537 patients in the oxytocin group. The pooled estimate of vaginal deliveries following PGE2 induction stood at 84.2%, while after oxytocin induction, it was 79.8%. The meta-analysis showed no statistical difference between the two groups in terms of the rate of vaginal delivery (pooled RR, 1.05; 95% CI: 0.95-1.16; P value for Q, 0.001; I2, 71.14%), cesarean section (pooled RR, 0.84; 95% CI: 0.52-1.35; P value for Q, 0.007; I2, 61.69%) and induction-delivery interval (pooled standard mean difference, 0.09; 95% CI: -0.67 to 0.85; P value for Q, 0.000; I2, 96.45%). Since the results for fetal distress and uterine hyperstimulation were consistent across all enrolled studies, no further meta-analysis was conducted. When amalgamating the available literature, it implies that oxytocin was found to have similar effects as PGE2 on delivery outcomes and safety concerns in pregnant women with GA ≥36 weeks. Although the uterine cervix was unfavorable, both low and high doses of oxytocin were feasible for IOL.

The impact of energy security on energy innovation: a non-linear analysis

ABSTRACT Energy security is an important guarantor of national development, while energy innovation is an endogenous driver of sustainable development. This paper examines the impact of energy security on energy innovation, which has important strategic implications. Using original data from 66 countries for 1996–2019, we construct two-way fixed effects models for empirical analysis. The results show that there is a potential non-linear effect of energy security on energy innovation, and this non-linear effect shows a U-shape. In terms of influence mechanisms, the U-shaped effect of energy security on energy innovation is propagated through energy policy as a mediating mechanism. Furthermore, left-wing parties in power have stronger impact effects, and increasing government stability and decreasing financial risk have a stronger impact on the correlation between energy security and energy innovation. This paper provides new insights into understanding the influence of energy security on energy innovation and offers targeted policy recommendations.

How does network structural embedding stimulate the ability of regional green technology innovation: a case study of Hubei province

ABSTRACT Green Technology Innovation (GTI) is widely acknowledged as a pivotal strategy that harmonises economic development and environmental preservation. In parallel, innovation networks have emerged as potent mechanisms empowering regional innovation. Therefore, a pivotal regarding the advancement of GTI revolves around the strategic utilisation of network embedding to foster its development. However, existing research has not provided a comprehensive analysis of the mechanism. Our study leverages both Network Embedding Theory and Game Theory to construct a game model of enterprise GTI under NSE scenarios. Then, utilising Hubei Province as a sample, we undertake empirical testing by using both a negative binomial regression model and a non-equilibrium threshold effect model. The findings suggest that NSE plays a substantial role in augmenting regional GTI, and this effect can be further magnified by the scale of regional enterprises and the level of R&D funding. Across various threshold intervals of NSE, its positive feedback effect exhibits fluctuations. However, it serves to alleviate the hindrances posed by the scale of regional enterprises to GTI and enhances the efficacy of R&D funding utilisation. The results enrich the research of NSE theory in urban GTI, and have important management significance for the formulation of GTI policies globally.

CEO compensation and innovation premium

ABSTRACT The innovation premium of a firm is the excess market value over the shareholder expectation per a unit change in the capital stock. Using fixed effects models and cross-lagged structural equation models that address reverse causality and unobserved firm heterogeneity, we find that an increase in the innovation premium increases CEO compensation, consistent with the notion that innovation premium is shared between shareholders and managers. However, an increase in CEO compensation increases innovation premium when environmental uncertainty or firm innovativeness is high, indicating that an increase in environmental uncertainty or firm innovativeness makes the firm’s growth options more valuable, and CEOs exercise the growth options and seize the valuable growth opportunities that provide the firm the innovation premium. Our results are consistent with the managerial rent model in that the source of the innovation premium is the uncertainty associated with the innovative opportunities, which enhances the value of the firm’s growth options.

The impact of environmental regulations on the upgrading of the industrial structure: Evidence from China

China's economy has transitioned into a phase of high-quality development, with enhancing its industrial structure becoming a critical objective. We gathered panel data from 30 major provinces in China from 2010 to 2020 and employed the fixed effects model to assess the actual influence of environmental regulations on industrial structure upgrading. Our empirical findings show that the impacts of various environmental regulations on industrial structure upgrading in China are significantly different. Mandatory environmental regulation demonstrates an inverted U-shaped nonlinear correlation with the upgrading level of the entire industrial structure. When the intensity of this regulation is low, it significantly accelerates industrial structure upgrading. As the intensity of this regulation rises, its effect on industrial structure upgrading is inhibitory. In contrast, induced environmental regulation exhibits a nonlinear U-shaped relationship with industrial structure upgrading and shows a nonlinear change trend of first decreasing and then rising. When the intensity of induced environmental regulation reaches a certain critical point and continues to increase, it will change from a negative influence on the upgrading of the industrial structure to a promoting effect. The further discussion of threshold regression and the robustness test also led to similar conclusions. The above research is conducive to the Chinese government's rational use of environmental regulation tools to promote industrial structure upgrading. It is also beneficial to developing countries, allowing them to learn from China's experience to improve the effectiveness of environmental regulation and boost their industrial development.

Multi-omics reveal mechanisms of high enteral starch diet mediated colonic dysbiosis via microbiome-host interactions in young ruminant

BackgroundAlthough rumen development is crucial, hindgut undertakes a significant role in young ruminants’ physiological development. High-starch diet is usually used to accelerate rumen development for young ruminants, but always leading to the enteral starch overload and hindgut dysbiosis. However, the mechanism behind remains unclear. The combination of colonic transcriptome, colonic luminal metabolome, and metagenome together with histological analysis was conducted using a goat model, with the aim to identify the potential molecular mechanisms behind the disrupted hindgut homeostasis by overload starch in young ruminants.ResultCompared with low enteral starch diet (LES), high enteral starch diet (HES)-fed goats had significantly higher colonic pathology scores, and serum diamine oxidase activity, and meanwhile significantly decreased colonic mucosal Mucin-2 (MUC2) protein expression and fecal scores, evidencing the HES-triggered colonic systemic inflammation. The bacterial taxa Prevotella sp. P4-67, Prevotella sp. PINT, and Bacteroides sp. CAG:927, together with fungal taxa Fusarium vanettenii, Neocallimastix californiae, Fusarium sp. AF-8, Hypoxylon sp. EC38, and Fusarium pseudograminearum, and the involved microbial immune pathways including the “T cell receptor signaling pathway” were higher in the colon of HES goats. The integrated metagenome and host transcriptome analysis revealed that these taxa were associated with enhanced pathogenic ability, antigen processing and presentation, and stimulated T helper 2 cell (TH2)-mediated cytokine secretion functions in the colon of HES goats. Further luminal metabolomics analysis showed increased relative content of chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA), and decreased the relative content of hypoxanthine in colonic digesta of HES goats. These altered metabolites contributed to enhancing the expression of TH2-mediated inflammatory-related cytokine secretion including GATA Binding Protein 3 (GATA3), IL-5, and IL-13. Using the linear mixed effect model, the variation of MUC2 biosynthesis explained by the colonic bacteria, bacterial functions, fungi, fungal functions, and metabolites were 21.92, 20.76, 19.43, 12.08, and 44.22%, respectively. The variation of pathology scores explained by the colonic bacterial functions, fungal functions, and metabolites were 15.35, 17.61, and 57.06%.ConclusionsOur findings revealed that enteral starch overload can trigger interrupted hindgut host-microbiome homeostasis that led to impaired mucosal, destroyed colonic water absorption, and TH2-mediated inflammatory process. Except for the colonic metabolites mostly contribute to the impaired mucosa, the nonnegligible contribution from fungi deserves more future studies focused on the fungal functions in hindgut dysbiosis of young ruminants.256VYnm1kgM5kPxw6ZAn-oVideo

Effect of Electronic Fraud on the Financial Performance of Banks in Nigeria

The study investigated the effect of electronic fraud on the financial performance of banks in Nigeria. The specific objectives were to investigate the effect of electronic fraud through online web transactions, evaluate the effect of electronic fraud through automated teller machine, to determine the effect of fraud through point of sale machine, and to investigate the effect of fraud through mobile phone USSD transactions on the financial performance of selected deposit money banks in Nigeria. Panel Generalized method of moments (GMM) was used to analyze the panel series of the model. The Hausman test indicated the random effect model as most fit for the estimation. The major findings of the study revealed that fraud through the automated teller machine (AEF) has significant negative impact on the financial performance of the deposit money banks in Nigeria. The panel regression result also revealed that fraud through the mobile phone channel (MPEF), and fraud through the online banking channel (OBEF) had significant negative effect on the financial performance of the banks studied. The study concluded that electronic fraud has significant negative relationship with the performance of banks. The policy implication of these findings holds for both management of banks and the financial sector authorities to engineer strategic fraud mitigation technology to strengthen confidence in the financial system. Based on the findings, the study recommended that there is an urgent need for effective monitoring of bank fraud which will allow for the growth of Nigeria deposit banks performance. This is necessary especially this period that the world is going cashless and e payment instrument are used for cashless banking system. And failure to do that, will affect customer’s confidence in the industry. It is also recommended that Bank fraud shall be reduced through effective supervision and regulation of banks by the monetary authorities so that financial industry will contribute to the economy.

CREDIT RISK MANAGEMENT AND FINANCIAL PERFORMANCE: A COMPARATIVE STUDY OF BRICS SELECTED BANKS

The financial sector plays an important role in the overall growth of the nation but the banks are the main players in this field. For understanding the risks faced by these banks, this study attempted to analyse the impact of credit risk on the financial performance of BRICS-selected banks which are conducted for the period 2018-2022. Twenty-two state-owned banks have been taken for this study. Descriptive statistics, Correlation matrix, Hausman test, Variation Inflation Factor Test, and Random Effect Model have been used for analysis. The results of the study showed that NPLR and CIR have a significant impact on the ROA of selected banks and CAR and LDR do not have any significant impact on the ROA of selected banks of BRICS. KEYWORDS: Financial Performance, Credit Risk, BRICS, Banks, Random Effect Model (REM)

Relationship among the scale of university funding, structure of revenue and expenditure, and academic output: evidence from China’s 36 World-Class universities under construction, 2013–2022

ABSTRACT To investigate the relationship between Chinese university funding and academic output, we collected data on the scale and the structure of funding and academic output of 36 World-Class universities under construction in China during 2013–21 and 2014–22. Furthermore, we empirically analyzed the effects of funding scale and structure on academic output using ordinary least squares (OLS) regression, random effects, and fixed effects models. This study demonstrates that the scale and structure of funding have a significant effect on academic output. Among them, the scale of total budget revenue has a significant effect on academic output, and its influence on highly-cited researchers (HiCi) is greater than the other indicators. The scale of total budget expenditure also has a significant positive influence on academic output, and its influence on N&S is greater than the other indicators in order. The structure of revenue has a significant influence on academic output, and business revenue has the greatest influence on PUB. The structure of horizontal expenditure has a significant influence on academic output. The vertical expenditure structure has a significant impact on academic output, and educational expenditure has the greatest impact on PUB. Based on the results, we discuss implications for researchers and for policymakers to improve the construction effect of World-Class universities under construction in China.

Changes in opioid prescribing and prescription drug monitoring program utilization following electronic health record integration-Massachusetts, 2018.

In this study, we explored key prescription drug monitoring program-related outcomes among clinicians from a broad cohort of Massachusetts healthcare facilities following prescription drug monitoring program (PDMP) and electronic health record (EHR) data integration. Outcomes included seven-day rolling averages of opioids prescribed, morphine milligram equivalents (MMEs) prescribed, and PDMP queries. We employed a longitudinal study design to analyze PDMP data over a 15-month study period which allowed for six and a half months of pre- and post-integration observations surrounding a two-month integration period. We used longitudinal mixed effects models to examine the effect of EHR integration on each of the key outcomes. Following EHR integration, PDMP queries increased both through the web-based portal and in total (0.037, [95% CI = 0.017, 0.057] and 0.056, [95% CI = 0.035, 0.077]). Both measures of clinician opioid prescribing declined throughout the study period; however, no significant effect following EHR integration was observed. These results were consistent when our analysis was applied to a subset consisting only of continuous PDMP users. Our results support EHR integration contributing to PDMP utilization by clinicians but do not support changes in opioid prescribing behavior.

Efficacy and safety of electroacupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.

This study aimed to evaluate the efficacy and safety of electroacupuncture (EA) in the treatment of benign prostatic hyperplasia. Seven databases were searched from the inception of each database to March 31, 2023, including PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang, and China Biology Medicine. The modified Jadad scale was used to assess literature quality, and literature inclusion and exclusion were conducted in strict accordance with the criteria of a score of ≥4. The risk of bias was evaluated using the Cochrane risk of bias tool. The pooled effect size of the binary data was measured by odds ratio (OR) and 95% confidence interval (CI), and the pooled effect size of the continuous data was presented as weighted mean difference (WMD) and 95% CI. If I² was larger than 50%, a random effects model was adopted, and otherwise, a fixed effects model was used. Additionally, publication bias assessment and sensitivity analysis were conducted. A total of 325 records were retrieved, and finally 9 randomized controlled trial studies were included, involving 1045 patients. Meta-analysis revealed that the EA group had better improvement than the control group in terms of clinical effective rate (odds ratio = 3.92, 95% CI = 2.38 to 6.47, I² = 0%, P < .001), International Prostate Symptom Score (WMD = -4.99, 95% CI = -6.15 to -3.84, I² = 76.9%, P < .001), maximum urinary flow rate (WMD = -4.99, 95% CI = -6.15 to -3.84, I² = 87.4%, P < .001), and post-void residual volume (WMD = -17.12, 95% CI = -29.49 to -4.75, I² = 89.1%, P < .01). There was no statistical significance in prostate volume and adverse events between the EA group and the control group (P > .05). EA is effective in the treatment of benign prostatic hyperplasia with acceptable overall safety.

The effect of oral supplementation of Paricalcitol on C-reactive protein levels in chronic kidney disease patients: GRADE-assessed systematic review and dose-response meta-analysis of data from randomized controlled trials

BackgroundPrevious studies investigating the effect of oral supplementation of paricalcitol on reactive protein levels in chronic kidney disease (CKD) patients reported inconsistent findings. In this systematic review and meta-analysis, we have analyzed and interpreted the results obtained from previous randomized clinical trials on the effect of paricalcitol on C-reactive protein in CKD patients in the literature.MethodsMEDLINE, SciVerse Scopus, and Clarivate Analytics Web of Science databases were searched until January 2023 and related articles were obtained through a careful screening process allowing extraction of required data from selected articles. The effect size was calculated using a random effect model and weighted mean differences (WMD) and 95% confidence intervals (CI). Heterogeneity among studies was evaluated using Cochran’s Q test and I2.ResultsAmongst the 182 articles obtained from the initial search, 4 studies (6 arms) were finally included in the meta-analysis. Pooled analysis shows that C-reactive protein levels significantly decrease after oral supplementation with paricalcitol (WMD: -2.55 mg/L, 95% CI (-4.99 to -0.11; P = 0.04). The studies used in this meta-analysis showed significant heterogeneity (I2 = 66.3% and P = 0.01).ConclusionOral paricalcitol supplementation in CKD patients can significantly reduce C-reactive protein levels, which may prevent CKD progression.

Association between social vulnerability index and admission urgency for transcatheter aortic valve replacement

BackgroundTranscatheter aortic valve replacement (TAVR) are not offered equitably to vulnerable population groups. Adequate levels of insurance may narrow gaps among patients with higher social vulnerability index (SVI). Among a national population of individuals with commercial or Medicare insurance, we sought to determine whether SVI was associated with urgency of receipt of TAVR for aortic stenosis. Methods and resultsUsing Optum's de-identified Clinformatics Data Mart Database (CDM), we identified admissions for TAVR with aortic stenosis between January 2018 and March 2022. Admission urgency was identified by CDM claims codes. SVI was cross-referenced to patient zip codes and grouped into quintiles. Generalized linear mixed effects models were used to predict the probability of a TAVR admission being urgent based on SVI quintiles, adjusting for patient and hospital-level covariates. ResultsAmong 6680 admissions for TAVR [median age 80 years (interquartile range 75–85), 43.9 % female], 8.5 % (n = 567) were classified as urgent. After adjusting for patient and hospital-level variables, there were no significant differences in the odds of urgent admission for TAVR according to SVI quintiles [OR 5th (greatest social vulnerability) vs 1st quintile (least social vulnerability): 1.29 (95 % CI: 0.90–1.85)]. ConclusionsAmong commercial or Medicare beneficiaries with aortic stenosis, SVI was not associated with admission urgency for TAVR. To clarify whether cardiovascular care delivery is improved across SVI with higher paying beneficiaries, future investigation should identify whether relationships between SVI and TAVR urgency vary for Medicaid beneficiaries compared to commercial beneficiaries.

Gender and global production network: De-feminization of the Indonesian apparel industry

This paper aims to measure the involvement of women in the global apparel industry. This article also examines the declining role of women in the apparel industry in Indonesia, even though exports have increased. This article also aims to analyze the phenomenon of the decline of women in the Indonesian apparel industry in the last fifteen years by using survey data for medium and large enterprises conducted by Statistics Indonesia. This study uses the Fixed Effect Model's regression analysis method for panel data. The results show that the apparel industry in Indonesia in the past fifteen years has shown a downward trend, which has led to the phenomenon of de-feminization. The phenomenon of de-feminization is a term used to describe the process of the exclusion of women from specific jobs or roles in society. The results also show that this phenomenon can have a significant impact on women's economic opportunities as well as their ability to participate in the community. According to the rising number of skilled workers and rising fixed capital employed in this industry, the phenomenon of de-feminization is a result of greater mechanization and an increase in skilled workers. Indonesia has a high female workforce, so this research has practical implications; female workers need to be maximally absorbed by industry to avoid high unemployment rates based on the theory of de-feminization in developing countries.

Effects of internet-based exercise intervention on depression and anxiety: A systematic review and meta-analysis.

While exercise is acknowledged for its positive effects on depression and anxiety symptoms, the benefits of internet-based exercise on mental health have not been extensively examined. This study seeks to systematically review and quantify the outcomes of high-quality randomized controlled trials (RCTs) that investigate the impact of internet-based exercise on depression and anxiety symptoms. Following the PRISMA 2020 guidelines, we conducted a comprehensive meta-analysis of RCTs. Databases, including Web of Science Core Collection, PubMed, PsycINFO, Medline, BIOSIS Previews, SPORTDiscus, and Education Source, were scoured through in September 2023. After quality assessment and data extraction, the analysis was performed using R. Using random effects models, effect sizes were determined and subsequently represented as standardized mean differences (SMD). Our analysis incorporated data from 11 RCTs, involving a cohort of 1009 participants. We observed a modest yet significant reduction in depression and anxiety symptoms, with an SMD of -0.44 [95% confidence interval (CI) (-0.63, -0.26), I^2 = 79.3%, P < .01]. Interestingly, the effects were more pronounced in individuals diagnosed with depression, as indicated by an SMD of -0.96 [95% CI (-1.55, -0.37), I^2 = 82%, P < .01]. Furthermore, participants utilizing smartphone applications as part of their intervention reported a meaningful reduction in their symptoms, evidenced by an SMD of -0.52 [95% CI (-0.90, -0.14), I^2 = 87%, P < .01]. Additionally, short-term interventions, specifically those lasting <12 weeks, indicated a notable alleviation in depression symptoms, with an SMD of -0.76 [95% CI (-1.38, -0.14), I^2 = 86%, P < .01]. Internet-based exercise interventions yield significant amelioration in depression and anxiety symptoms, with heightened efficacy observed among individuals with depression. Notably, short-term interventions, specifically those under 12 weeks, demonstrate enhanced benefits for depression relief.

Arterial oxygen desaturation during moderate hypoxia hinders sensorimotor performance.

Moderate hypoxia may impact cognitive and sensorimotor performance prior to self-recognized impairments. Therefore, rapid and objective assessment tools to identify people at risk of impaired function during moderate hypoxia is needed. Test the hypothesis that reductions in arterial oxygen saturation during moderate normobaric hypoxia (FiO2 = 14%) decreases gamified sensorimotor performance as measured by alterations of motor acuity. Following three consecutive days of practice, thirty healthy adults (25 ± 5 y, 10 females) completed three bouts of the tablet-based gamified assessment (Statespace Labs, Inc.) of motor acuity at Baseline and 60 and 90 min after exposure to 13.8 ± 0.2% (hypoxia) and 20.1 ± 0.4% (normoxia) oxygen. The gamified assessment involved moving the tablet to aim and shoot at targets. Both conditions were completed on the same day and were administered in a single-blind, block randomized manner. Performance metrics included shot time and shot variability. Arterial oxyhemoglobin saturation estimated via forehead pulse oximetry (SpO2). Data were analyzed using linear mixed effects models. Compared to normoxia (99±1%), SpO2 was lower (p<0.001) at 60 (89±3%) and 90 (90±2%) min of hypoxia. Shot time was unaffected by decreases in SpO2 (0.012, p = 0.19). Nor was shot time affected by the interaction between SpO2 decrease and baseline performance (0.006, p = 0.46). Shot variability was greater (i.e., less precision, worse performance) with decreases in SpO2 (0.023, p = 0.02) and depended on the interaction between SpO2 decrease and baseline performance (0.029, p< 0.01). Decreases in SpO2 during moderate hypoxic exposure hinders sensorimotor performance via decreased motor acuity, i.e., greater variability (less precision) with no change in speed with differing decreases in SpO2. Thus, personnel who are exposed to moderate hypoxia and have greater decreases in SpO2 exhibit lower motor acuity, i.e., less precise movements even though decision time and movement speed are unaffected.

Systematic review and meta-analysis of right subclavian artery variants and their correlation with cervical-thoracic clinical conditions.

A high incidence of anatomical variations in the origin of the branches of the aortic arch has been reported, Nowadays, this variation is considered the most frequent in the aortic arch, its prevalence being estimated between 0.5% and 2.5% of the population. To understand its origin, knowledge of embryonic development is necessary. We searched the MEDLINE, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, and Latin-American literature and caribean of health sciences databases with dates ranging from their inception to June 2023. Study selection, data extraction, and methodological quality were assessed with the guaranteed tool for anatomical studies (Anatomical Quality Assurance). Finally, the pooled prevalence was estimated using a random effects model. Thirty-nine studies were found that met the eligibility criteria. Twenty studies with a total of 41,178 subjects were included in the analysis. The overall prevalence of an ARSA variant was 1% (95% confidence interval = 1%-2%), the clinical findings found are that if ARSA is symptomatic it could produce changes in the hemodynamic function of the thoracocervical region in addition to other associated symptomatic complications in surrounding structures. ARSA can cause several types of alterations in the cervical or thoracic region, resulting in various clinical complications, such as lusory dysphagia. Hence, knowing this variant is extremely important for surgeons, especially those who treat the cervico-thoracic region. The low prevalence of ARSA means that many professionals are completely unaware of its existence and possible course and origin. Therefore, this study provides detailed knowledge of ARSA so that professionals can make better diagnoses and treatment of ARSA.

Neighborhood built and food environment in relation to glycemic control in people with type 2 diabetes in the moving to health study

ObjectiveTo examine whether built environment and food metrics are associated with glycemic control in people with type 2 diabetes.Research Design and Methods: We included 14,985 patients with type 2 diabetes using electronic health records from Kaiser Permanente Washington. Patient addresses were geocoded with ArcGIS using King County and Esri reference data. Built environment exposures estimated from geocoded locations included residential unit density, transit threshold residential unit density, park access, and having supermarkets and fast food restaurants within 1600-m Euclidean buffers. Linear mixed effects models compared mean changes of HbA1c from baseline at 1, 3 (primary) and 5 years by each built environment variable. ResultsPatients (mean age = 59.4 SD = 13.2, 49.5% female, 16.6% Asian, 9.8% Black, 5.5% Latino/Hispanic, 57.1% White, 20% insulin dependent, mean BMI = 32.7±7.7) had an average of 6 HbA1c measures available. Participants in the 1st tertile of residential density (lowest) had a greater decline in HbA1c (−0.42, −0.43, and −0.44 in years 1, 3, and 5 respectively) than those in the 3rd tertile (HbA1c = −0.37 at 1- and 3-years and −0.36 at 5-years; all p-values <0.05). Having any supermarkets within 1600 m of home was associated with a greater decrease in HbA1c at 1-year and 3-years compared to having none (all p-values <0.05). ConclusionsLower residential density and better proximity to supermarkets may benefit HbA1c control in people with people with type 2 diabetes. However, effects were small and indicate limited clinical significance.

Reconstructive Techniques in Pediatric Congenital Microtia: A Systematic Review and Meta-analysis.

Autografts and allografts are commonly used in microtia reconstruction. We aimed to systematically review and compare these reconstructive materials in pediatric congenital microtia reconstruction. A systematic review of the literature was performed. MEDLINE, Embase, PubMed, Web of Science, and CINAHL databases were searched for original studies on congenital microtia reconstruction in pediatric patients since database inception to 2021. Microtia grade was stratified as high or low. Meta-analysis of pooled proportions and continuous variables was performed using inverse variance weighting with a random effects model to compare between the autograft and allograft groups. Sixty-eight studies with a total of 5,546 patients used autografts (n = 5,382) or alloplastic implants (n = 164). Four other studies used prosthesis, cadaveric homografts, or tissue engineering. The allograft group was on average younger than the autograft group (8.4 vs. 11.1 years). There were no syndromic patients in the allograft group, compared to 43% in the autograft group. Patients treated with allografts had higher microtia grade than those treated with autograft (98 vs. 72%). Autografts were more commonly utilized by plastic surgeons and allografts by otolaryngologists (95 vs. 38%). No autografts and 41% of allografts were done concurrently with atresiaplasty or bone conduction implant. Satisfaction rates were similarly high (>90%) with similar complication rates (<10%). Microtia reconstruction using autografts and allografts had similar satisfaction and complication rates. Allografts were preferred for younger patients and concurrent hearing restoration. Further large-scale studies are required to evaluate the long-term efficacy of these reconstructive techniques.

Towards sustainable management: Exploring the role of internal monitoring in pollution prevention.

Researchers in the field of sustainable management have recently dedicated significant efforts to understand why organizations exhibit diverse responses to environmental responsibilities. Ethical scholars assert that internal management plays a pivotal role in promoting sustainability because of its attitude toward sustainable issues. In alignment with this perspective, our study formulates a framework for internal monitoring that underscores the significance of independent, female, international, and politically connected directors. We investigate how these internal monitors influence a company's commitment to promote sustainable investments for pollution prevention. By employing fixed effect model and generalized method of moments (GMM) on a dataset obtained from the largest emerging market-China over the period 2012 to 2019, our findings indicate that the mentioned monitors demonstrate a stronger commitment to pollution prevention by promoting corporate sustainable investments. In addition, our analysis reveals that when the government withdraws its involvement in enterprises, it has a notable negative impact on the connection between internal monitors and a company's efforts in pollution prevention. Our results imply that implementation of sustainable policies for pollution prevention fundamentally result from not only internal management, but also from powerful stakeholders (like government involvement). Moreover, our study educates the policy makers regarding the social consequences of governmental withdrawal.