Persistent Levels Research Articles

Diabetic Cardiomyopathy: An Update on Emerging Pathological Mechanisms.

Diabetic Cardiomyopathy (DCM) is a notable consequence of diabetes mellitus, distinguished by cardiac dysfunction that occurs separately from coronary artery disease or hypertension. A recent study has revealed an intricate interaction of pathogenic processes that contribute to DCM. Important aspects involve the dysregulation of glucose metabolism, resulting in heightened oxidative stress and impaired mitochondrial function. In addition, persistent high blood sugar levels stimulate inflammatory pathways, which contribute to the development of heart fibrosis and remodelling. Additionally, changes in the way calcium is managed and the presence of insulin resistance are crucial factors in the formation and advancement of DCM. This may be due to the involvement of many molecular mechanistic pathways such as NLRP3, NF- κB, PKC, and MAPK with their downstream associated signaling pathways. Gaining a comprehensive understanding of these newly identified pathogenic pathways is crucial in order to design precise therapy approaches that can enhance the results for individuals suffering from diabetes. In addition, this review offers an in-depth review of not just pathogenic pathways and molecular mechanistic pathways but also diagnostic methods, treatment options, and clinical trials.

Shaping Career Development Through College Readiness at the High School Level

Career and College Readiness (CCR) generates higher levels of persistence, grit, motivation, and competencies in performing work- or school-related tasks among learners during post-secondary life. One primary limitation defining the present scholarship on CCR is the authentic analysis of the on the ground or field practices high schools perform to increase learners’ CCR competencies. The inadequate research on actual CCR practices in high schools motivated this study. To learn more about how high schools prepare students for post-secondary life, 16 principals from high schools provided detailed narratives on CCR practices in their institutions. Principals completed interviews of one to two hours using Microsoft Teams, supplying the researcher with specific information and examples of how their institutions equip students for future careers and higher education. Manual qualitative thematic analysis of the entire transcript guided the organization and interpretation of the findings, allowing the presentation of meaningful themes supported by a plethora of illustrations. Six themes representing 18 distinct CCR practices emerged, and the themes were rigorous curriculum, content knowledge, key academic behaviors, key cognitive strategies, multiculturalism, and citizenship development. Results partially supported the pervasive CCR model based on Conley’s readiness index. Increasingly, diversity and citizenship learning have defined high schools’ CCR work in preparing learners to become effective local and global citizens. The current investigation paves the way for future observational and field research uncovering whether schools truly prepare students or not, and such preparation varies across community, country, and institutional characteristics.

Persistence and Adherence to GLP-1 RA treatment in Type 2 Diabetes Mellitus: a Nationwide registry study

Abstract Background The use of glucagon-like peptide-1 receptor agonsists (GLP-1 RA) continues to rise and is increasingly important in the treatment of type-2 diabetes mellitus (T2DM). Though the use of GLP-1 RA continues to increase, persistence and adherence to therapy remains suboptimal. Purpose We aimed to assess the level of adherence and persistence to GLP-1 RA using real-world data and to investigate sociodemographic and clinical factors associated with discontinuation of GLP-1 RA therapy. Methods In this retrospective cohort study, all first-time users of GLP-1 RA with T2DM ≥18 years from 2007-2020 were identified using the Danish registries (Figure 1A-1B). All participants had 18 months of follow-up. Medication possession ratio (MPR) was calculated by summing days of medication supply from all dispensed prescription made during the study period divided by number of days in study period. MPR ≥0.80 was used to define adherence. Discontinuation was defined as >90 days between the last day of prescription coverage and the first day of a new dispensed prescription. Adherence to GLP-1 RA therapy and the risk of discontinuing therapy was estimated at 6- and 12-months of follow-up. Multivariable logistic regression was used to identify sociodemographic and clinical factors associated with discontinuing GLP-1 RA therapy. Results In total, 44,343 first-time users of GLP-1 RA with T2DM were identified (mean age: 58.6 years, 42.7% female, 21.3% had cardiovascular disease, median duration of T2DM was 6.8 years, median HbA1c was 65 mmol/mol). The absolute risk of discontinuing GLP-1 RA at 6 and 12 months was 14.2% (95%CI: 13.9-14.6) and 21.4% (95%CI: 21.1-21.8), respectively (Figure 2A). Of the 9,520 (21.5%) who discontinued therapy during the 12-month follow-up, 1,947 (20.5%) occurred within the first 31 days of treatment. At 6 months, 58.5% were adherent to GLP-1 RA therapy with a median MPR of 0.84 [IQR: 0.70-0.95]. At 12 months, 61.1% were adherent to therapy with a median MPR of 0.85 [IQR: 0.71, 0.94]. In the multivariable model, low (<40 years) and high age (>75 years), lower household income, educational level, longer diabetes duration, and higher comorbidity burden were associated with a higher risk of discontinuing GLP-1 RA whereas baseline HbA1c was not (Figure 2B-2E). Conclusion Approximately one in five patients discontinued therapy within 12 months and a little over 60% were adherent. Sociodemographic factors, including household income, age, and comorbidity burden were associated with risk of discontinuing GLP-1 RA therapy. Given the changing landscape of who should be treated with GLP-1 RA, the cardio-renal benefits reported in recent trials, and the ongoing trials in the field, future research into adherence and persistence to GLP-1 RA and possible interventions to improve these, are needed.

Observer-based adaptive neural network control: the convergence properties analysis under the influence of persistent excitation level

Observer-based adaptive neural network control: the convergence properties analysis under the influence of persistent excitation level

The substantial role of sleep, stress and physical activity in persistent high levels of fatigue in patients with inflammatory bowel disease: A longitudinal trajectory study.

Fatigue is a common and burdensome problem for patients with inflammatory bowel disease (IBD). Previous studies lack insight into the individual variability in fatigue severity and course over time, and the characteristics of patients at risk of severe and persistent fatigue. This study aimed to identify distinct groups of IBD patients based on their level and course of fatigue over five years. Subsequently, we examined the relationship between these trajectories, patient characteristics and trajectories of perceived stress, sleep and physical activity. This longitudinal cohort study used prospectively collected data from the myIBDcoach telemedicine monitoring tool, including 320 IBD patients who completed three or more online consultations between 2016 and 2021. Latent class growth analyses were performed to identify distinct trajectories. We found five subgroups with distinct trajectories of fatigue, differing in level and course over time, with 33% of patients experiencing chronic stable and high levels of fatigue. Few differences in patient characteristics were found between trajectories, yet the chronic high fatigue subgroup was more likely to report persistent stable sleep problems, perceived stress, and little physical activity over time compared to the other groups. Distinct subgroups of IBD patients can be identified based on longitudinal fatigue trajectories. The relatively stable levels of fatigue, stress, sleep, and physical activity suggest that a one-time screening of patients on these topics may be sufficient to identify those at risk. Interventions aiming to reduce fatigue should target persistent stress, sleep problems, and low levels of physical activity.

Heterogeneous survival upon disinfection underlies evolution of increased tolerance.

Disinfection is key to control the spread of infections. But the application of disinfectants bears the risk to promote the evolution of reduced susceptibility to antimicrobials if bacteria survive the treatment. The ability of individual bacteria to survive disinfection can display considerable heterogeneity within isogenic populations and may be facilitated by tolerant persister subpopulations. Using time-kill kinetics and interpreting the data within a mathematical framework, we quantify heterogeneity and persistence in Escherichia coli when exposed to six different disinfectants. We find that the level of persistence, and with this the risk for disinfection failure, depends on the disinfectant. Importantly, evolution experiments under recurrent disinfection provide evidence that links the presence of persisters to the ability to evolve reduced susceptibility to disinfectants. This study emphasizes the impact of heterogeneity within bacterial populations on disinfection outcomes and the potential consequences for the evolution of antimicrobial resistances.

The true age of multi-planet host star HD 110067. Or: Don't be fooled by K0V-type stars

HD 110067 is a near (d = 32.22 pc, V = 8.43 mag) K0V star in Coma Ber that was recently discovered to host a six-planet\ system in stable resonances. The star has a very old age of 8+/-4 Gyrs. However, by the nature of the respective evolution tracks (i.e. with masses of 0.78...0.85 odot $), which run parallel to the zero-age main sequence for approx 8 Gyrs, such age estimates are impossible unless the mass and luminosity are independently known to very high precision. We demonstrate this point using physical parameters derived from two different spectroscopic methods. As an alternative age indicator, we looked at the emission in Ca II H K using TIGRE/HEROS spectra (Guanajuato, Mexico) and 78 archive TNG/HARPS-N spectra from 2021 to 2024. Surprisingly, HD 110067 has a high and persistent activity level of S$_ MWO =0.32$. From the estimated empirical and Rossby number of 0.4, and with the parameterised spin-down timescale, we derive an activity age of approx 2.5($ Similarly, a possible rotation period of 20 days, consistent with TESS photometric variations and our vsin(i), suggests $Ro=0.32$ and an age of just 1.7 Gyrs. Such a relatively young activity age is indeed consistent with a very small lithium signature (the equivalent width of the 6707.8 AA doublet is 1.1pm 0.2m AA ) and implies that HD110067 can be directly compared to its virtual twin sigma Draconis, which has an even weaker lithium presence and an activity cycle around <S>$_ MWO $ approx 0.22.

8788 Implications of NTRK gene fusion in Papillary thyroid cancer

Abstract Disclosure: W. Medina-Torres: None. L. El Musa Penna: None. J. Segarra-Villafane: None. L.R. Sepulveda-Garcia: None. Z. Maisonet -Feliciano: None. I.C. Arroyo: None. M. Ramirez: None. M. Alvarado: None. L.A. Gonzalez-Rodriguez: None. V.J. Carlo: None. Thyroid cancer (TC) is the most common endocrine cancer. Papillary thyroid carcinoma (PTC) is the predominant contributor of this occurrence, comprising approximately 80% of all thyroid carcinomas. PTC has a good prognosis with a 5-year survival rate of more than 90% after resection. Nonetheless, factors such as tumor size, multifocality, nodal and distant metastases, characterize more aggressive cases including tall cell variant, columnar cell variant, and hobnail variant Aside from staging parameters, PTC behavior is mostly determined by morphologic variant. This is the case of 31 y/o female without known past medical history who was evaluated at endocrinology clinic due to a fine needle thyroid aspiration (FNA) positive for PTC, tall cell variant. Total thyroidectomy with central compartment dissection was performed. Pathology report presented a main tumoral mass of 3 cm but permeating multinodular pattern involving the entire gland with focal extrathyroidal extension, positive margins and six level VI positive lymph nodes. As per report, the tumor presented both papillary and follicular patterns of growth and other findings including oncocytic change, foci of clear cell change, low mitotic rate, and most notably "reverse polarization”. This pattern has the pathological features suggestive of the novel NTRK gene fusion mutation. The patient was treated with radioactive iodine (RAI) and one year post treatment there was evidence of elevated Thyroglobulin level at 904 ng/mLand thyroglobulin Ab at 2.48 IU/mL. A WBS +SPECT was done resulting in small uptake at left posterior thyroid bed and pulmonary intake. A chest CT revealed multiple bilateral sub centimeter nodules. Based on this result, a second course of RAI was given. Follow up neck ultrasound and chest CT presented persistent left level VI lymph nodes, increased amount of bilateral sub-centimeter pulmonary nodules and new thoracic(T11) lesion. FNA of left neck lymph nodes were positive for metastatic PTC for which left neck dissection was performed. Evaluation for actionable somatic mutations was requested based on resistance behavior, remarkable for TRIM33-NTRK1 chromosomal rearrangement. Patient was evaluated by Oncology service who started Larotrectinib treatment since it was approved for NTRK driven malignancies. Six-month post therapy patient achieved clinical and biochemical improvement. In the thyroid, NTRK-driven malignancies are rare and aggressive but treatable, in the evolving genomic era. As reviewed in the literature, NTRK fusion-positive TC exhibits distinctive clinicopathological features that could aid in identifying potential patients. Thus, in such patients who have PTC with non-classic pathologic patterns, specific molecular profile of the main tumor may have significant prognostic value that must be integrated into stratification system in order to provide target therapy on time. Presentation: 6/3/2024

A conserved two-component system senses intracellular iron levels and regulates redox balance in Mycobacterium spp.

For bacteria, an intricate coordination between sensing and regulating iron levels and managing oxidative stress is required as their levels are tightly interlinked. While various oxidative stress and heme-based redox sensors have been reported for both pathogenic and non-pathogenic bacteria, the mechanisms governing the modulation of intracellular iron levels in response to changes in redox status remain unclear. In this study, a gene-inactivated strain of mycobacterial sensor kinase PdtaS showed dysregulated expression of genes associated with iron metabolism, including Fe-S clusters, NADH dehydrogenases, and iron uptake. The strain showed poor growth in nutrient-limiting conditions, a defect rescuable by heme but not by Fe3+ supplementation. This observation was associated with the PAS domain of the PdtaS sensor kinase. Biochemical and biophysical experiments established heme-binding to the PAS domain and its inhibitory effect on PdtaS auto-kinase activity, suggesting that the absence of heme induces activation of this sensor kinase. Interestingly, despite having an endogenous heme biosynthetic pathway or even external heme supplementation, the ∆pdtaS mutant exhibited persistent low intracellular iron levels concomitant with elevated oxidative stress. Antioxidant supplementation mitigated growth defects, emphasizing the link between oxidative stress, intracellular iron levels, and PdtaS activity. RNA-IP identified key targets associated with redox homeostasis and iron metabolism as targets of the PdtaR response regulator. The study proposes a novel role for the PdtaS-PdtaR TCS in sensing heme, regulation of intracellular iron levels, and redox balance.IMPORTANCEThe research article investigates the intricate interplay between bacteria's ability to take and utilize iron without inducing excess iron's toxic effects, including oxidative stress. The study shows that bacteria achieve this by sensing intracellular iron available as heme through a sensory protein PdtaS, which turns off when heme is in excess and prevents iron uptake and iron efflux. The process shields bacteria from generating Fe-dependent free radicals and allows it to maintain viability. The absence of sensor kinase abrogates all these processes, increasing bacteria susceptibility to ROS and thereby slowing growth. This feature of the sensor kinase PdtaS makes it an attractive co-therapeutic target for tuberculosis therapy, where its inhibition will prevent iron uptake, even in the presence of low iron, thereby halting bacterial proliferation.

Locally Adaptive Shrinkage Priors for Trends and Breaks in Count Time Series

Non-stationary count time series characterized by features such as abrupt changes and fluctuations about the trend arise in many scientific domains including biophysics, ecology, energy, epidemiology, and social science domains. Current approaches for integer-valued time series lack the flexibility to capture local transient features while more flexible models for continuous data types are inadequate for universal applications to integer-valued responses such as settings with small counts. We present a modeling framework, the negative binomial Bayesian trend filter (NB-BTF), that offers an adaptive model-based solution to capturing multiscale features with valid integer-valued inference for trend filtering. The framework is a hierarchical Bayesian model with a dynamic global-local shrinkage process. The flexibility of the global-local process allows for the necessary local regularization while the temporal dependence induces a locally smooth trend. In simulation, the NB-BTF outperforms a number of alternative trend filtering methods. Then, we demonstrate the method on weekly power outage frequency in Massachusetts townships. Power outage frequency is characterized by a persistent low level trend with occasional spikes. These illustrations show the estimation of a smooth, non-stationary trend with adequate uncertainty quantification.

Imaging assessment of prostate cancer recurrence: advances in detection of local and systemic relapse.

Prostate cancer (PCa) relapse, defined either by persistent PSA levels (after RP) or biochemical recurrence (BCR), is a common occurrence. The imaging evaluation of patients experiencing PCa relapse has undergone significant advancements in the past decade, notably with the introduction of new Positron Emission Tomography (PET) tracers such as Prostate-specific membrane antigen (PSMA), and the progress in functional Magnetic Resonance Imaging (MRI). This article will explore the role of traditional imaging, the evolution of MRI towards the development of the Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR) scoring system, and how next-generation imaging is enhancing diagnostic accuracy in the setting of PCa relapse, which is essential for adopting personalized strategies that may ultimately impact outcomes.

PTH may predict early mortality in incident patients on hemodialysis: results from a large cohort.

Parathyroid hormone (PTH) is merit as a risk factor for mortality in patients with chronic kidney disease in prevalent hemodialysis patients in a U shape. Most studies, however, do not focus on incident patients and those who died within the first 90days of therapy. We evaluated PTH as a risk factor for mortality in a large cohort population in Brazil. This is an observational cohort study that included 4317 adult patients who initiated hemodialysis between July 1st, 2012 and June 30, 2017. The main outcome was all-cause mortality. Fine-gray sub-distribution hazard models were used to evaluate survival in the presence of a competing event (kidney transplant). Median PTH levels of 252 (118, 479) pg/mL. There were 331 deaths during the first 90days of therapy (6.7%), 430 in a 1-year follow-up (10.7%) and 1282 (32%) during the 5-year study period. Deaths according to PTH < 150, 150-600 and > 600pg/mL corresponded to 38.1%, 33.0% and 28.5%, respectively (p < 0.001). In an adjusted model, patients who started dialysis with PTH < 150pg/mL had a higher mortality risk within the first 90days, but not in 1year and 5years after starting dialysis. Analyses in a subset of patients with a repeated PTH in 1year (N = 1954) showed that although persistent PTH low levels (< 150pg/mL) at 1year were significantly associated with all-cause mortality, this result was not sustained after multiple adjustments. PTH < 150pg/mL confers a high mortality risk in the first 90days of dialysis. If this result reflects poor nutritional conditions, it deserves further investigations.

A Systematic Review of the Effectiveness of Rehabilitation Programmes or Strategies to Treat People With Persistent Knee Pain Following a Total Knee Replacement.

Persistent high levels of knee pain after a total knee replacement have been estimated to affect 5%-10% of people and this is related to dissatisfaction with surgery, reduced function and reduced quality of life. This systematic review aims to evaluate the effectiveness of rehabilitation programs or strategies to reduce persistent pain and improve function and quality of life in people following a total knee replacement. The systematic review was conducted following PRISMA guidelines with a search of relevant online databases up to 17 July 2024. The search criteria included English language randomised controlled trials of rehabilitation programs or strategies in any setting to treat people with persistent knee pain more than 3 months after a total knee replacement. Rehabilitation could include exercise, education, cognitive strategies and self-management programs and excluded medication trials, procedural techniques and complementary therapies. After removal of duplicates, there were 468 abstracts screened for eligibility with 23 remaining for full-text screening and finally, one study meeting the eligibility criteria. This study's interventions were pain neuroscience education alone and pain neuroscience education plus neuromuscular exercise. There were no statistically significant between-group differences for pain reduction or functional improvement. The evidence examining the value of rehabilitation programs or strategies for pain reduction and functional improvement in people with persistent pain following total knee replacement is deficient. Given the high number of people affected annually, further research concerning both prevention and management of persistent pain after knee replacement is warranted.

Change and coincidence risk analysis of floods in the Mahanadi River Basin, India

ABSTRACT Coincidence flood risk due to the simultaneous flood occurrences on both mainstream and its tributary results in downstream inundation of a confluence. Therefore, this study was taken up for coincidence flood risk analysis of Mahanadi River basin considering the annual maximum (AM) and the peak over threshold (POT) series. In this study, the Mann–Kendall trend test was performed to analyze the trend in flood magnitudes, while circular statistics was used to analyze the persistence in flood timing. The joint distributions between the streams were established using bivariate copula functions considering flood magnitudes and occurrence dates as variables. The results of MK test revealed a mixture of significant and insignificant trends for AM series for the selected stations, while the trends were insignificant for POT series. Additionally, the flood occurrence dates showed a high level of persistence. It is evident from the results that the coincidence risk is high for Seorinarayan–Bamnidhi confluence point with a risk value of 7.63 × 10−3. The coincidence risk increases mostly from late July to mid-September, and the coincidence risk is high for more frequently occurring flood events. The obtained results will help in prioritizing flood hazard zones for effective flood mitigation strategies in Mahanadi River basin.

Large-scale fossil records analysis reveals prehistoric extinction mechanisms of woolly rhinoceros (Coelodonta antiquitatis).

Climate oscillations and prehistoric human activity during the Middle-Late Pleistocene profoundly affected the population fluctuations and extinctions of megafauna, especially the extinctwoolly rhinoceros. Fordham etal. (2024) recently proposed new solutions based on fossil records, paleoclimates, and prehistoric human activities data to reconstruct an explicit process-driven model, resulting in high-resolution population dynamics of the woolly rhinoceros. This study revealed the mechanisms of the woolly rhinoceros extinction: climate-driven habitat fragmentation combined with low but persistent levels of human hunting weakened metapopulation processes, leading to their extinction.

PA job satisfaction: Why so happy?

A characteristic of physician associates/assistants (PAs) observed consistently is their high degree of career satisfaction. Over 6 decades, national surveys showed that PA job satisfaction levels (either satisfied or very satisfied) consistently were in the mid-80% positive range. This analysis explains this remarkable, consistent, and persistent level of satisfaction among practicing PAs. A review of the literature on PA job satisfaction shows that autonomy in clinical practice appears to be a major correlate with job and career satisfaction.

Estimation and determinants of transient and persistent efficiency of rice production in Spain

AbstractRice is a basic component in the diet of more than half of the world's population, with 95% of its production destined for human consumption. Spain is the second rice producer in the European Union (EU), geographically located in four autonomous communities contributing to the local economy. This study aims at assessing the productive efficiency of rice farms in this country. To our knowledge, no previous work has dealt with the performance of rice framers in the EU in general and in Spain in particular. We used the Generalized True Ramdom‐effects model to estimate the persistent and transient efficiency levels of farms and identifying the production risk factors using a sample of 158 rice farms over the period 2014–2017. Empirical findings reveal an overall efficiency level of 0.81 on average, mainly explained by the long‐term efficiency component. Moreover, results show an important room for efficiency improvement at the short‐term to enhance productive management skills of farmers. Finally, labor, fertilizer, water and insurance spending are likely to be risk‐decreasing factors. [EconLit Citations: C13, D22, Q12].

Environmental Changes of the Temirnik River in Rostov-on-Don

General Background: The increasing anthropogenic impact on river ecosystems has raised concerns about water quality and its effects on surrounding communities. Specific Background: This study focuses on the Temirnik River, located in the northern part of the city, particularly assessing pollution levels in the beaches of "Druzhba" and "Surp Khash." Historical data from 2000-2001 and recent analyses from 2017-2019 reveal significant fluctuations in chemical and biological toxicity. Knowledge Gap: While previous studies have documented pollution levels, a comprehensive comparison of historical and recent data to understand long-term changes and community impacts remains insufficiently explored. Aims: This study aims to track changes in pollution levels over time, evaluate the chemical and biological toxicity, and assess the anthropogenic impacts on the Temirnik River. Results: Chemical analysis revealed increased hardness of water due to the accumulation of calcium and magnesium sulfates and chlorides. The river, heavily impacted by untreated industrial and municipal waste, showed high toxicity levels, especially in the years 2017-2019. Bioassays using Chlorella vulgaris, Raphanus sativus, and Daphnia magna confirmed these findings. Novelty: This study provides a detailed comparative analysis of historical and contemporary pollution data, highlighting the persistent and worsening impact of anthropogenic activities on the Temirnik River. Implications: The findings underscore the critical need for ongoing monitoring and intervention to mitigate pollution. They advocate for implementing effective cleaning operations and regulatory measures to protect water quality and community health. Highlights: Increased water hardness from industrial and municipal waste. Persistent high toxicity levels impacting ecosystems. Urgent need for continuous monitoring and pollution control. Keywords: Temirnik River, chemical pollution, biological toxicity, historical data, anthropogenic impact

Cross-sectional and longitudinal associations of PAHs exposure with serum uric acid and hyperuricemia among Chinese urban residents: The potential role of oxidative damage

A few studies found polycyclic aromatic hydrocarbons (PAHs) were associated with serum uric acid (SUA) or hyperuricemia (HUA). However, the longitudinal study is vacant, and the underlying mechanisms remain unclear. We aimed to assess the cross-sectional and longitudinal associations of urinary PAHs metabolites with SUA levels and HUA risk, and explore the mediating effects of oxidative stress and inflammation. 10 urinary mono-hydroxylated PAHs metabolites and SUA levels were measured among 4047 Chinese urban residents at baseline and 1496 individuals at 6-year follow-up. Biomarkers of oxidative damage and inflammation in urine/plasma were determined at baseline. We adopted generalized linear mixed models and logistic regression to assess the associations of PAHs metabolites with SUA and HUA, weighted quantile sum regression and adaptive elastic net regression to evaluate the overall effects of multi-PAHs mixture, and mediation analysis to estimate the mediating roles of the biomarkers. In the cross-sectional study, each 1-unit increase in the ln-transformed values of 2-OHNa, 2-OHFlu, 4-OHPh, 9-OHPh, 3-OHPh, 2-OHPh, ΣOHNa, ΣOHPh, and ΣOHPAHs was associated with a 4.10-, 3.90-, 6.42-, 7.33-, 4.85-, 5.43-, 4.47-, 7.67-, and 5.22-μmol/L increase in SUA, respectively. Meanwhile, each 1-unit increase in the ln-transformed values of 1-OHNa, 2-OHNa, 4-OHPh, 9-OHPh, 3-OHPh, 2-OHPh, ΣOHNa, ΣOHPh, and ΣOHPAHs was associated with a 17, 14, 15, 22, 14, 19, 18, 27, and 21% increment in HUA risk, respectively. After 6 years, individuals with persistent high level of 9-OHPh had a 12.5 μmol/L increase in SUA compared with those with persistent low level. The overall effects of multi-PAHs mixture on SUA and HUA remain positive. 8-hydroxy-deoxyguanosine mediated the associations of PAHs metabolites with SUA and HUA, and the mediated proportion ranged from 5.39% to 15.34%. PAHs exposure was associated with the elevated SUA levels and increased HUA risk, and oxidative DNA damage may be one of the underlying mechanisms.

Shariah compliance fatigue and earnings quality: evidence from MENA

PurposeThis research aims to examine the relations between Shariah compliance and earnings quality.Design/methodology/approachThe authors study three Shariah features: Shariah compliance status, level of Shariah compliance (H-Score) and Shariah compliance persistence. The sample consists of 463 firms from the Middle East and North Africa from 2011 to 2018. A variable determining the level of Shariah compliance was created in accordance with the methodology of S&P 500 Shariah and its underlying index, S&P 500. Then, a probate relapse study was created to identify the link between Shariah compliance and earnings quality.FindingsResults show that Shariah-compliant firms engage in lower earnings management compared to their Shariah-non-compliant counterparts. This paper reveals that Shariah compliance status and high level of Shariah compliance have significant positive association with earnings quality. The authors also find novel evidence that persistence of the Shariah-compliant status has a significant negative association with earnings quality.Practical implicationsThis study only examines firms listed on MENA stock markets. It is recommended to further study different markets in addition to the emerging Arab markets in order to compare and contrast the results. Further, larger sample observations from a greater date range can be used.Originality/valueFew studies have examined the earnings management behavior of Shariah-compliant firms vs Shariah-non-compliant ones in emerging markets; however, no study has focused on Shariah-compliant firms and their level of Shariah compliance. To the best of our knowledge, this is the first study which uses all four proxies for earnings quality in association with Shariah compliance and used new Shariah variables such as Level of Shariah Compliance and Persistent Shariah Compliance status.