Initial Years Research Articles

Overloaded and overwhelmed: Weakened partner aspirations of women public accountants during the COVID‐19 pandemic

AbstractDespite years of initiatives to improve gender equity in public accounting firms, women continue to be underrepresented at the partner level. Supporting women's aspirations to become partner is important to ensure there are more women in the pipeline of potential partners. However, we argue that challenges during the COVID‐19 pandemic are likely to have negative downstream effects on accounting firms' efforts to improve female partner representation. Therefore, using a survey of 192 certified public accountants (CPAs), we develop and test a theoretical model that examines changes in women's partner aspirations during the COVID‐19 pandemic. Using the conservation of resources (COR) theory, we predict that women experienced disproportionately higher role overload during the pandemic compared to men. We also rely upon COR theory to predict that higher levels of role overload will be associated with weakened partner‐track motivations (i.e., less value placed on the advantages of the partner level and lower willingness to make the sacrifices necessary to pursue the partner level) and weakened partner aspirations. Consequently, we expect that women public accountants experienced weakened partner aspirations through higher role overload during the pandemic. Results support our predictions as we find that women experienced higher levels of role overload, which are associated with weakened partner‐track motivations, which in turn are associated with weakened partner aspirations. In sum, our results suggest that the COVID‐19 pandemic exacerbated pre‐pandemic gender equity challenges within public accounting firms. Fortunately, we also find that higher levels of supervisor support and coworker support help limit role overload and mitigate declines in partner aspirations. We discuss several insights that firms can use to mitigate post‐pandemic declines in women's partner aspirations.

The Role of Low Lactose Feeding for Preventing Childhood Malnutrition and Long-Term Gut Damage Caused by Recurrent Diarrhoeal Disease

Even though it has decreased over the past three decades, diarrheal sickness continues to be a major global cause of death for children. There is a strong correlation between childhood rotavirus, diarrhea, climate factors, and malnutrition. On the other hand, a significant nutritional shift (lower levels of undernutrition) among children mal five has been documented in the last ten years, especially in developing nations like Bangladesh, where rotavirus infection has also been on the rise. Given the pathophysiology of rotavirus, there may be a link between the changing diet, the environment, and other artificial factors in urban areas such as Dhaka, Bangladesh, and the rise in rotavirus infections. Under-five malnutrition is still a major problem in Bangladesh, despite significant socioeconomic progress and ten years of initiatives to reduce it. Many research have been conducted in an attempt to identify the primary risk factors for malnutrition; however, none of these have looked into the importance of low birth weight (LBW) 36%. Bangladesh has seen a notable decline in the incidence of pediatric diarrhea deaths in recent decades. Over the past few decades, Bangladesh, a heavily populated country with limited resources, has managed to achieve a notable reduction in the death rate of pediatric diarrhea. Some of the obstacles that still need to be overcome in order to further lower the burden of disease and mortality brought on by diarrhea are enhancing hand hygiene practices, expanding zinc coverage for diarrhea treatment, and maintaining nutritional improvement. To increase intervention coverage and hasten the end of diarrheal mortality among children in Bangladesh, ongoing collaboration with non-governmental organizations and the private sector is necessary, as is the adoption of pluralistic health system platforms for the delivery of preventative and curative services.

Outcome of patients with relapsed or refractory nonrhabdomyosarcoma soft tissue sarcomas enrolled in phase 2 cooperative group clinical trials: A report from the Children's Oncology Group.

The aim of this study was to estimate the event-free survival (EFS) of children and young adults with relapsed or refractory nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) treated in nonrandomized phase 2 studies conducted by the Children's Oncology Group (COG) and predecessor groups to establish a benchmark EFS for future phase 2 NRSTS trials evaluating the activity of novel agents. A retrospective analysis of patients with recurrent or refractory NRSTS prospectively enrolled in nonrandomized phase 2 COG and predecessor group trials between 1994 and 2015 was conducted. EFS was defined as disease progression/relapse or death and calculated via the Kaplan-Meier method. The log-rank test and relative risk regression were used to compare EFS distribution by age at enrollment, sex, race, NRSTS histology, prior lines of therapy, calendar year of trial, and type of radiographic response. In total, 137 patients were enrolled in 13 phase 2 trials. All trials used radiographic response rate as a primary outcome, and none of the agents used were considered active on the basis of trial-specified thresholds. The estimated median EFS and 6-month EFS of the entire study cohort was 1.5 months (95% confidence interval [CI], 1.3-1.8 months) and 19.4% (95% CI, 12.7%-26%), respectively. No difference in EFS was observed by age at enrollment, sex, race, NRSTS histology subtype, prior lines of therapies, and trial initiation year. EFS significantly differed by radiographic response. The EFS for children and young adults with relapsed or refractory NRSTS remains suboptimal. Established EFS can be referenced as a benchmark for future single-agent phase 2 trials incorporating potentially active novel agents in this population.

Residual estimation of spirotetramat and its metabolites in chilli and soil by LC-MS/MS.

Two applications of spirotetramat were done to study the dissipation and persistence of spirotetramat and its four different metabolites in chilli and soil at 10days interval. Total spirotetramat residues were estimated by LC-MS/MS instrument. The mean initial deposits of total spirotetramat after application of spirotetramat 15.31 OD @ 60 (X dose), 75 (1.25 × dose) and 120 (2 × dose) g a.i. ha-1 on green chilli were found to vary from 0.38 to 0.83mgkg-1 during the initial year. Spirotetramat and its metabolite residues in green chilli were found to be below limit of quantification (0.01mgkg-1) after 15days of application. The spirotetramat cis enol (the major metabolite) was formed in both the soil and the plant. The residues of spirotetramat-monohydroxy were below LOQ irrespective of any substrate during the estimation. In soil, the total initial spirotetramat deposits for the 1st year were found 0.09 for X dose, 0.12 for 1.25 × dose and 0.20mgkg-1 for 2 × dose. After 3days for both X and 1.25 × doses and 5days for 2 × dose, the total spirotetramat residues were below LOQ. The spirotetramat's half-life values have been determined to be between 3.19 and 3.93days and 1.00 and 1.59days, respectively, in soil and green chilli fruits. One day waiting period is proposed for the safe consumption of green chilli when the spirotetramat was applied irrespective of the dose.

Erasmus’ Cambridge Years (1511–1514)

Abstract Despite the clear attestation of Erasmus’ three-year period in Cambridge from 1511 to 1514, the reason for and nature of his stay—including whether he was also the official incumbent of the Lady Margaret’s professorship, created in 1502 as the first established chair at the university—are still contested. This paper argues that three issues have not been (sufficiently) taken on board in these discussions: namely, the statutes for the ‘lecture of sacred Theology founded by Margaret, Countess of Richmond’; the fact that in December 1512, Erasmus was paid to compose the epitaph for Lady Margaret’s tomb in Westminster Abbey; and the nature of Erasmus’ work whilst he was at Cambridge, which he describes in a letter as teaching ‘Greek and sacred literature’ (Ep. 296). Our new proposal is that Erasmus’ three-year stay in Cambridge began with an initial year in which he taught Greek, explored his opportunities, and prepared himself for the competition surrounding the election for the Lady Margaret’s professorship. Yet the Cambridge theologians did not support him in the election, and he ultimately lost to a competitor. Erasmus’ failure to secure the Lady Margaret’s professorship is closely related to his understanding of theology as ‘sacred literature’, which allows it to be compared to ‘the (good) literature’ and philosophy of Greek and Roman authors. His defeat constitutes its own episode in the series of tensions between Christian biblical humanism and what Erasmus saw as modernist scholastic theology.

Characterizing changes to older adults' care transition patterns from hospital to home care in the initial year of COVID-19.

Skilled home healthcare (HH) provided in-person care to older adults during the COVID-19 pandemic, yet little is known about the pandemic's impact on HH care transition patterns. We investigated pandemic impact on (1) HH service volume; (2) population characteristics; and (3) care transition patterns for older adults receiving HH services after hospital or skilled nursing facility (SNF) discharge. Retrospective, cohort, comparative study of recently hospitalized older adults (≥ 65 years) receiving HH services after hospital or SNF discharge at two large HH agencies in Baltimore and New York City (NYC) 1-year pre- and 1-year post-pandemic onset. We used the Outcome and Assessment Information Set (OASIS) and service use records to examine HH utilization, patient characteristics, visit timeliness, medication issues, and 30-day emergency department (ED) visit and rehospitalization. Across sites, admissions to HH declined by 23% in the pandemic's first year. Compared to the year prior, older adults receiving HH services during the first year of the pandemic were more likely to be younger, have worse mental, respiratory, and functional status in some areas, and be assessed by HH providers as having higher risk of rehospitalization. Thirty-day rehospitalization rates were lower during the first year of the pandemic. COVID-positive HH patients had lower odds of 30-day ED visit or rehospitalization. At the NYC site, extended duration between discharge and first HH visit was associated with reduced 30-day ED visit or rehospitalization. HH patient characteristics and utilization were distinct in Baltimore versus NYC in the initial year of the COVID-19 pandemic. Study findings suggest some older adults who needed HH may not have received it, since the decrease in HH services occurred as SNF use decreased nationally. Findings demonstrate the importance of understanding HH agency responsiveness during public health emergencies to ensure older adults' access to care.

Factor Xa inhibitors versus warfarin in severely obese patients with venous thromboembolism or atrial fibrillation

Objectives: Clinical data for the safety and efficacy of Factor Xa (FXa) inhibitors in severely obese patients is limited. Additional information is needed to assess the risks and benefits of using FXa inhibitors in this patient population. Materials and Methods: A single-center and retrospective chart review was conducted in severely obese patients (body mass index [BMI] >40 kg/m2 or weight >120 kg), who received rivaroxaban, apixaban or warfarin for venous thromboembolism (VTE) treatment or prevention of stroke and systemic embolism in non-valvular atrial fibrillation (AF). The primary endpoint was treatment failure, defined as recurrent VTE in VTE treatment or stroke, transient ischemic attack or systemic embolism in AF within one year of anticoagulation initiation. Secondary endpoints included a composite of major bleeding rates and clinically relevant non-major bleeding (CRNMB) rates. Results: Seventy-three patients were included in the final analysis consisting of 43 patients in the FXa inhibitor arm (apixaban [n = 33] and rivaroxaban [n = 10]) and 30 patients in the warfarin arm. The rate of treatment failure was similar between the FXa inhibitor and warfarin groups (4.7% vs. 6.7%; P = 0.814). Although not statistically significant, major bleeding and CRNMB occurred less frequently in patients receiving FXa inhibitors compared to warfarin (9.3% vs. 23.3%; P = 0.182). Subgroup analysis in patients with BMI >50 kg/m2 or weight >150 kg demonstrated similar efficacy and safety outcomes. The use of non-recommended dosing was more common in the apixaban group compared to the rivaroxaban group. Conclusion: FXa inhibitors (apixaban and rivaroxaban) appear to have similar efficacy and safety compared to warfarin in severely obese patients. Larger prospective studies are needed to confirm these results.

Changes in atherosclerotic cardiovascular disease risk over time among people living with HIV.

To describe changes in atherosclerotic cardiovascular disease (ASCVD) risk over time among people living with HIV (PLHIV). We used data from the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD). Five-year ASCVD risk was calculated using the D:A:D equation. Individuals were eligible for inclusion if they were aged ≥18 years, had started ART, had no previous history of ASCVD and had complete ASCVD risk factor data available within the first 5 years of ART initiation. A total of 3368 adults contributed data, 3221 were from TAHOD and 147 were from AHOD. The median age at ART initiation was 36 [IQR 31-43] years for TAHOD participants, and 42 [IQR 35-50] years for AHOD participants. Most TAHOD (70.4%) and AHOD (91.8%) participants were male. Overall, ASCVD risk increased from 0.84% (95% CI 0.81%-0.87%) at ART initiation to 1.34% (95% CI 1.29%-1.39%) after 5 years on ART. After adjusting for traditional and HIV-associated ASCVD risk factors, ASCVD risk increased at a similar rate among sub-populations defined by HIV exposure (heterosexuals, men who have sex with men, people who inject drugs), race/ethnicity (Caucasian and Asian) and nadir CD4 at ART initiation (<200 and ≥200 cells/mm3). These findings emphasize the growing burden of ASCVD risk among PLHIV and the need to develop interventions that are effective across a broad range of HIV sub-populations.

Geriatric Nutritional Risk Index and First-Year Mortality in Incident Hemodialysis Patients.

The Geriatric Nutritional Risk Index is a simple nutritional screening method, and this study aimed to investigate the association between the initial Geriatric Nutritional Risk Index and all-cause mortality in incident patients in the first year after the initiation of hemodialysis. This study is a retrospective cohort study and used the Korean Renal Data System database. Patients who were eligible for Geriatric Nutritional Risk Index assessment and underwent hemodialysis from January 2016 to December 2019 were included. The primary outcome was all-cause mortality, and outcome evaluation was performed in December 2020. A Cox proportional hazard model was used to analyze the association between the Geriatric Nutritional Risk Index and mortality. A total of 10,545 patients were included, and the mean age was 63.9 ± 3.7 years. The patients were divided into four groups by the quartile of the Geriatric Nutritional Risk Index with a mean value of 96.2 ± 8.2. During the study period, 545 (5.2%) deaths occurred. The surviving patients had higher Geriatric Nutritional Risk Index values than ones who died in the first year of hemodialysis initiation (96.6 ± 7.5 vs. 88.2 ± 9.3, p < 0.001). Quartile 1 (Geriatric Nutritional Risk Index < 91.8) showed a significantly increased risk of all-cause (Hazard Ratio: 2.56; 95% Confidence Interval: 2.13-3.09; p < 0.001) and cardiovascular mortality (Hazard Ratio: 22.29; 95% Confidence Interval: 1.71- 3.08; p < 0.001) at the first year in comparison with Quartile 4 (Geriatric Nutritional Risk Index ≥ 101.3). In areas under the receiver-operating characteristic curves of all-cause mortality, the Geriatric Nutritional Risk Index model improved predictive values, compared to the baseline model. The area with the Geriatric Nutritional Risk Index model was significantly higher than the one with a model including albumin or body mass index (p < 0.001). These findings suggest that a low Geriatric Nutritional Risk Index (<91.8) is associated with first-year all-cause and cardiovascular mortality in patients who start hemodialysis and may be a useful and reproducible tool for assessing prognoses in this population.

Quality of life of patients treated with robotic surgery in the oral and maxillofacial region: a scoping review of empirical evidence

BackgroundThere is a blooming trend in the application of robotic surgery in oral and maxillofacial care, and different studies had evaluated the quality of life (QoL) outcomes among patients who underwent robotic surgery in the oral and maxillofacial region. However, empirical evidence on the QoL outcomes from these procedures is yet to be mapped. Thus, this study was conducted to evaluate the available scientific evidence and gaps concerning the QoL outcomes of patients treated with robotic surgery in the oral and maxillofacial region.MethodsThis study adopted a scoping review design, and it was conducted and reported based on the Arksey and O’Malley, PRISMA-ScR, and AMSTAR-2 guidelines. SCOPUS, PubMed, CINAHL Complete, and APA PsycINFO were searched to retrieve relevant literature. Using Rayyan software, the retrieved literature were deduplicated, and screened based on the review’s eligibility criteria. Only the eligible articles were included in the review. From the included articles, relevant data were charted, collated, and summarized.ResultsA total of 123 literature were retrieved from the literature search. After deduplication and screening, only 18 heterogeneous original articles were included in the review. A total of 771 transoral robotic surgeries (TORSs) were reported in these articles, and the TORSs were conducted on patients with oropharyngeal carcinomas (OPC), recurrent tonsillitis, and obstructive sleep apnoea (OSA). In total, 20 different QoL instruments were used in these articles to assess patients’ QoL outcomes, and the most used instrument was the MD Anderson Dysphagia Inventory Questionnaire (MDADI). Physical functions related to swallowing, speech and salivary functions were the most assessed QoL aspects. TORS was reported to result in improved QOL in patients with OPC, OSA, and recurrent tonsillitis, most significantly within the first postoperative year. Notably, the site of the lesion, involvement of neck dissections and the characteristics of the adjuvant therapy seemed to affect the QOL outcome in patients with OPC.ConclusionCompared to the conventional treatment modalities, TORS has demonstrated better QoL, mostly in the domains related to oral functions such as swallowing and speech, among patients treated with such. This improvement was most evident within the initial post-operative year.

Uncovering heterogeneity in mental health changes among first-year medical students

ABSTRACT Introduction The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school. Methods Students from eight German medical schools (N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school. Results We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester. Conclusions Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.

Survival analysis of PLWHA undergoing combined antiretroviral therapy: exploring long-term prognosis and influencing factors.

The survival time of human immunodeficiency virus (HIV)-infected individuals or patients with acquired immunodeficiency syndrome (AIDS) is influenced by multiple factors. Studying survival and influential factors after antiretroviral therapy (ART) contributes to improving treatment protocols, management strategies, and prognosis for people living with HIV/AIDS (PLWHA). This retrospective cohort study collected case data and follow-up records of PLWHA who received ART in Dazu District, Chongqing City, between 2007 and 2022. Cumulative survival rates were calculated using life tables. Survival curves were plotted using the Kaplan-Meier method. Uni-variable and multivariable Cox proportional hazards models analyzed factors influencing survival. The study included 5,237 PLWHA receiving ART. Within the first year of ART initiation, 146 AIDS-related deaths occurred, accounting for 29.49% (146/495) of total deaths. Cumulative survival rates at 1, 5, 10, and 15 years were 0.97, 0.90, 0.85, and 0.79, respectively. During the observation period, male patients who received ART had a 1.89 times higher risk of death compared to females (aHR, 1.89; 95%; CI, 1.50-2.37). Patients aged ≥60 years had a 3.44-fold higher risk of death than those aged <30 years (aHR, 3.44; 95% CI, 1.22-9.67). Injection drug users (aHR, 4.95; 95% CI, 2.00-12.24) had a higher risk of death than those with heterosexual (aHR, 1.60; 95% CI, 0.69-3.72) and homosexual transmission. Patients with a baseline CD4+ T lymphocyte count <200 cells/μL (aHR, 8.02; 95% CI, 4.74-13.57) and between 200 and 349 cells/μL (aHR, 2.14; 95% CI, 1.26-3.64) had a higher risk of death than those with ≥350 cells/μL. Patients with ART initiation at WHO clinical stage IV had a 2.48-fold higher risk of death than those at stage I (aHR, 2.48; 95% CI, 1.17-5.23). The first year following ART initiation is critical in HIV/AIDS treatment, emphasizing the need for intensified follow-up and monitoring to facilitate successful immune system reconstruction. Older age, male sex, injection drug use, baseline CD4+ T lymphocyte count <200 cells/μL, and WHO clinical stage IV are associated with an increased risk of death. Tailored treatment and management strategies should be implemented for patient populations at higher risk of mortality and with a poorer prognosis.

Discontinuous transtensional rupture during the Mw 7.2 1995 Gulf of Aqaba earthquake

The Gulf of Aqaba earthquake occurred on 22 November 1995 in the Northern Red Sea and is the largest instrumentally recorded earthquake in the region to date. The event was extensively studied during the initial years following its occurrence. However, it remained unclear which of the many faults in the gulf were activated during the earthquake. We present results from multi-array back projection that we use to inform Bayesian kinematic rupture models constrained by geodetic and teleseismic data. Our results indicate that most of the moment release was on the Aragonese fault via left-lateral strike slip and shallow normal faulting that may have been dynamically triggered by an early rupture phase on the Arnona fault. We also identified a predominantly normal fault-segment on the eastern shore of the gulf that was activated in the event. We dismiss the previously proposed hypothesis of a co-seismic sub-event on the western shore of the gulf and confirm that observed deformation can be rather attributed to post-seismic activity. In conclusion, the gulf shows many signs of active tectonic extension. Therefore, more events close to the shorelines are to be expected in the future and should be considered conducting infrastructure projects in the region.

Initial and continuing education of the pedagogue: what researches involving the teaching of mathematics indicate

The process of acquiring formal knowledge begins in the first stages of basic education, which makes the teacher in the early years of elementary school, the Pedagogue, the professional responsible for this process. Understanding the training of these professionals for teaching mathematical concepts, such as geometric concepts, at this level of education is necessary. In this sense, in this production, an excerpt from a larger research developed during the doctorate of the first author, under the guidance of the second, it is proposed to carry out a bibliographic research, in order to answer the following question: How does the training, both initial and education, from the pedagogue for the teaching of Mathematics/Geometry in the early years of elementary school is presented in research carried out from 2017 to 2021? To this end, a survey was carried out regarding the approach to this theme in research carried out in dissertations and theses, available on the Capes portal. In this way, it can be said that these studies point to the importance of initial and continuing education for the performance of the pedagogue, with regard to the teaching of Mathematics/Geometry in the Initial Years of Elementary School, as such training makes it possible to remedy possible gaps still on the understanding of these concepts, in addition to providing access to resources and methodologies aimed at the teaching process of this area of knowledge and the exchange of experience between these professionals.

Continuing teacher education with a view to education for sustainable development: challenges of integration between mathematics and science

Environmental education has been discussed worldwide throughout society, therefore an increase in actions that promote environmental awareness is essential and the need for the formation of critical, collective and sustainable thinking is emerging. Based on municipal, state and federal laws, the National Curricular Parameters and the National Common Curricular Base report that good academic performance would be of no use apart from the perception of the impact of individual and collective human actions on the environment. However, society has been facing challenges in the continued training of teachers, and developing tools that support the work of these professionals, including those in the Science area, through interdisciplinarity in the initial years, becomes essential. This article reinforces the need to provide such programs, which aim to develop methodological practices that seek lesson plans focused on environmental themes. The research was based on the challenges that teachers face when they propose to develop environments in their classrooms that are favorable to promoting social contexts. In addition to investigating what characteristics are necessary for the development of activities that support collaborative work, allowing the teacher to develop a role as a mediator and not just a transmitter of knowledge.

New Kids on the Democracy Block: Europeanisation of Interest Groups in Central and Eastern Europe

The 2004 EU enlargement and related Europeanisation processes supported the development of stagnated interest group systems in many ways, including with respect to the professionalisation of mainly voluntary-based organisations in Central and Eastern Europe. In the pre-membership period and initial years after joining the EU, national interest groups from Central and Eastern Europe chiefly relied on EU-level interest groups for important information, knowledge, and know-how concerning EU policymaking, whereas 20 years of membership has today established them as equal partners and co-decision-makers. The article elaborates on the Europeanisation of interest groups in the Central and Eastern Europe region from the start of the process of accession to the EU, with three case studies in focus: Lithuania, Poland, and Slovenia. The main research question is: In which different ways has the Europeanisation process influenced interest groups in the region? To address it, the article builds on Johansson and Jacobsson’s (2016) typology of the Europeanisation of interest groups. Six exploratory factors were examined in this regard: (a) contacts with EU policymakers and institutions, (b) interest in EU policymaking, (c) funding received from EU projects and programmes, (d) networking with EU umbrella organisations, (e) participation in open consultations, and (f) the relationship of the group with members. To study the effects of Europeanisation processes in selected countries, web survey data gathered from national interest groups as part of the Comparative Interest Groups Survey project were used. Our results show that interest groups from Central and Eastern Europe have become “European” in a range of ways. Regulatory and discursive Europeanisation is most typical for Polish interest groups, identity Europeanisation for Lithuanian interest groups, and financial and participatory Europeanisation for Lithuanian and Polish interest groups, while organisational Europeanisation has the strongest effect on interest groups in Slovenia.

Triple vasodilator therapy in pulmonary arterial hypertension associated with congenital heart disease

ObjectiveThis study assessed the long-term effects of triple therapy with prostanoids on patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD), as there is limited information on the...

Do different cooling-off modes affect audit quality? A study based on the audit rotation system in China

ABSTRACT Using a sample from China’s regime, we find that, longitudinally, whether auditors treat former clients favorably after rotation-back depends on the cooling-off modes. Relative to the year before rotation, audit quality after rotation-back is higher if the auditors use the ‘substantive’ cooling-off mode, whereas the audit quality decreases if the auditors use the ‘non-substantive’ cooling-off mode. Horizontally, audit quality in the initial year after auditor rotation-back increases with increased length of the cooling-off period. These effects vary based on the audit firm quality control system. Furthermore, our analysis reveals that auditors exhibit a greater propensity to employ ‘non-substantive’ cooling-off strategies in instances where the client – auditor relationship is more intimate, clients have fewer business risks, and audit firms/auditors contend with constrained audit resources. We further find some evidence of client – auditor collusion under ‘non-substantive’ cooling-off modes. Our findings carry implications for application of mandatory auditor rotation requirements.

A Rare Case of Recurrent Dasatinib-Induced Chylothorax Years After Initial Treatment

Background: Chronic myeloid leukemia (CML) is characterized by the Philadelphia chromosome containing the BCR-ABL protein with deregulated tyrosine kinase activity. Tyrosine kinase inhibitors (TKIs) were developed to target this oncogene. Dasatinib, a TKI, has rarely been associated with spontaneous chylothorax. The majority occur within 1 year of dasatinib initiation and resolve after drug cessation. In contrast, we present a patient with CML on dasatinib therapy for 8 years who developed recurrent unilateral chylothorax even after cessation of dasatinib. Case: A 57-year-old male with a history of CML on dasatinib therapy presented to the hospital for nausea and vomiting. A computed tomographic scan revealed a large right-sided pleural effusion with thoracentesis yielding 1.5 liters of chylous fluid. The patient’s hospital course was complicated by intracranial hemorrhage and subsequent admission to the intensive care unit. Dasatinib was stopped during this time. The patient experienced multiple recurrences of this effusion with significant output via thoracentesis and chest tube despite dietary changes. Lymphangiography was performed but revealed no evidence of thoracic duct leakage. Conclusions: Chylothorax from dasatinib is rare, usually occurs within 1 to 2 years of treatment onset, and resolves with discontinuation. However as supported by this case and others, it may occur as late as 8 years from treatment onset and chylothorax may continually re-accumulate or persist up to 1 year from dasatinib cessation. It is imperative to rule out underlying thoracic duct disruption prior to attributing etiology to dasatinib as a misdiagnosis may result in treatment delays.

Comparison of Incidence or Recurrence of Anterior Uveitis in Patients with Ankylosing Spondylitis Treated with Tumor Necrosis Factor Inhibitors

Background: Anterior uveitis (AU) is a significant concern in patients with ankylosing spondylitis (AS), and the choice of tumor necrosis factor inhibitors (TNFi) as a treatment modality raises questions regarding its effects on AU. We compared the effects of TNFi on AU in patients with AS. Methods: Patients diagnosed with AS and treated with at least one TNFi, including anti-TNFα antibodies (adalimumab and infliximab) or a soluble TNF receptor molecule (etanercept), between January 2010 and December 2022, were retrospectively reviewed. We compared the recurrence rate of AU in patients with a history of uveitis and the incidence of new-onset AU in those without a history of uveitis among the three TNFi groups. We also compared the effects of two different TNFi agents in patients who underwent TNFi switching. Results: Within two years of treatment initiation, there was no significant difference in AU recurrence among the three TNFi groups. However, the incidence of new-onset AU was significantly higher in the etanercept group than in the adalimumab group (26.4% vs. 6.3%; p = 0.024). After two years, the AU recurrence rate was significantly lower in the adalimumab group than in the other groups (p &lt; 0.001). Among patients who underwent anti-TNFi switching, adalimumab treatment was associated with a significantly lower incidence of uveitis than etanercept (p = 0.023). Conclusion: In the short-term period following TNFi therapy, etanercept induced new-onset AU more frequently than adalimumab in patients with AS. Adalimumab recipients experienced fewer AU recurrences during the subsequent long-term period compared to other TNFi recipients.