Abstract
Background
The numbers of coronavirus disease 2019 (COVID-19) deaths per million people differ widely across countries. Often, the causal effects of interventions taken by authorities are ...unjustifiably concluded based on the comparison of pure mortalities in countries where interventions consisting different strategies have been taken. Moreover, the possible effects of other factors are only rarely considered.
Methods
We used data from open databases (European Centre for Disease Prevention and Control, World Bank Open Data, The BCG World Atlas) and publications to develop a model that could largely explain the differences in cumulative mortality between countries using non-interventional (mostly socio-demographic) factors.
Results
Statistically significant associations with the logarithmic COVID-19 mortality were found with the following: proportion of people aged 80 years and above, population density, proportion of urban population, gross domestic product, number of hospital beds per population, average temperature in March and incidence of tuberculosis. The final model could explain 67% of the variability. This finding could also be interpreted as follows: less than a third of the variability in logarithmic mortality differences could be modified by diverse non-pharmaceutical interventions ranging from case isolation to comprehensive measures, constituting case isolation, social distancing of the entire population and closure of schools and borders.
Conclusions
In particular countries, the number of people who will die from COVID-19 is largely given by factors that cannot be drastically changed as an immediate reaction to the pandemic and authorities should focus on modifiable variables, e.g. the number of hospital beds.
PurposeThe purpose of this paper is to analyse 100 of the largest family firms and their personnel costs and employee numbers compared to non-family firms in the Czech Republic and confirm if there ...exist differences between personnel costs for family and non-family firms.Design/methodology/approachThe sample consisted of 100 family firms and 97 non-family firms from the Czech Republic for the comparison. Four hypotheses about relation between personnel costs for family and non-family firms and their governing body were set. Descriptive statistics were calculated, and t-tests and Kruskal–Wallis test for confirmation of set hypothesis were used.FindingsSales volume and production consumption results are used as variables, which were compared between family and non-family firms to achieve the most relevant possible conclusions. Based on our results, it can be stated that differences between personnel costs, which, in this study, comprise employee wages, are not statistically significant in the largest Czech family firms. There are significant differences in personnel costs for company boards. In comparing employee numbers and the number of members of statutory bodies, however, no significant difference was ascertained.Originality/valueThis study responds to a gap in the literature, by exploring the differences between personnel costs (for employees and governing body) in the area of the Czech Republic. This study also contributes to the understanding of the remuneration within family firms, by assessing the role of executive remuneration in family firms.
Studies showing a substantial frequency of dermatologic complications in paediatric Crohn’s disease (CD) patients on anti-tumour necrosis factor (TNF) therapy preferentially include patients treated ...with infliximab. We aimed to identify risk factors for the cumulative incidence of skin complications in a paediatric cohort receiving either adalimumab or infliximab and found an association between current skin complications and the patient’s current clinical condition. This study retrospectively evaluated dermatologic complications in an inception cohort of 100 paediatric CD patients receiving the first anti-TNF (Motol PIBD cohort). Patient data were collected every 3 months. The lesions were classified as psoriatic, atopic dermatitis, or others. We used Cox regression to evaluate the association between predefined variables and the time to complication and a generalised linear mixed model to assess the association between the patient’s current condition and the occurrence of complications. Among the 89 included children, 35 (39%) presented with dermatologic lesions. The only predictor associated with any complication was infliximab (versus adalimumab) therapy (hazard ratio HR: 2.07; 95% confidence interval CI: 1.03–4.17;
p
= 0.04). Infliximab therapy (HR: 5.5; 95%CI: 1.59–19.06;
p
= 0.01) and a family history of atopy (HR: 3.4; 95%CI 1.35–8.57,
p
= 0.002) were associated with early manifestation of atopic dermatitis. Lower C-reactive protein levels (odds ratio OR, 0.947; 95% CI, − 0.898 to 0.998;
p
= 0.046) and infliximab (versus adalimumab) were associated with the occurrence of any dermatologic complications (OR, 5.93; 95% CI, 1.59–22.07;
p
= 0.008).
Conclusion
: The frequency of skin complications seems high in paediatric CD patients treated with anti-TNF and is even higher in those treated with infliximab.
What is Known:
•
The dermatologic complications occur during treatment with anti-tumour necrosis factor
.
•The frequency of skin complications in paediatric patients with Crohn’s disease is high
.
What is New:
•
Infliximab (vs. adalimumab) was identified as a strong risk factor for the cumulative incidence of skin complications
.
•Lower C-reactive protein levels were associated with the current occurrence of dermatologic complications
.
Aim. Detection of possible predictive factors of endoscopic recurrence after ileocecal resection in Crohn's disease could be very beneficial for the individual adjustment of postoperative therapy. ...The aim of this study was to verify, whether immunohistochemical detection of calprotectin in resection margins is useful in diagnostics of endoscopic recurrence. Methods. In this study we included pediatric patients with Crohn's disease who underwent ileocecal resection, regardless of pre-operative or post-operative therapy (n=48). We collected laboratory, clinical, surgical, endoscopic and histopathological data at the time of surgery and at 6 months after surgery. The immunohistochemical staining of calprotectin antigen was performed on all paraffin blocks from the resection margins. Results. Out of 48 patients 52% had endoscopic recurrence in the anastomosis (defined by Rutgeerts score) within 6 months after surgery. The number of cells positive for calprotectin in the proximal resection margin was negatively associated with recurrence (P=0.008), as was the elevated level of total calprotectin (from both resection margins). There was no correlation of calprotectin in distal resection margin and endoscopic recurrence. Fecal calprotectin over 100 ug/g (P=0.0005) and high CRP (P<0.001) at 6 months after ileocecal resection and peritonitis (P=0.048) were associated with endoscopic recurrence. Conclusion. Approximately half of the patients developed endoscopic recurrence within 6 months after ileocecal resection. The predictive value of tissue calprotectin is questionable, as it is negatively associated with endoscopic recurrence. There are other potentially useful predictors, such as CRP and fecal calprotectin at 6 months after resection and the presence of peritonitis.
Two antitumor necrosis factor therapies (infliximab IFX and adalimumab ADA) have been approved for the treatment of pediatric Crohn's disease (CD) but have not been compared in head-to-head trials. ...The aim of this study was to compare the efficacy and safety of ADA and IFX by propensity score matching in a prospective cohort of pediatric patients with luminal CD and at least a 24-month follow-up.
Among 100 patients, 75 met the inclusion criteria, and 62 were matched by propensity score. We evaluated time to treatment escalation as the primary outcome and primary nonresponse, predictors of treatment escalation and relapse, serious adverse events, pharmacokinetics, and effect of concomitant immunomodulators as secondary outcomes.
There was no difference between ADA and IFX in time to treatment escalation (HR = 0.63 95% CI 0.31-1.28 P = 0.20), primary nonresponse (P = 0.95), or serious adverse events. The median (interquartile range) trough levels at the primary outcome were 14.05 (10.88-15.40) and 6.15 (2.08-6.58) µg/mL in the ADA and IFX groups, respectively. On a multivariate analysis, the combination of anti-Saccharomyces cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity was a strong independent predictor of treatment escalation (HR 5.19, 95% CI 2.41-11.18, P < 0.0001). The simple endoscopic score for CD, L3 disease phenotype, and use of concomitant immunomodulators for at least the first 6 months revealed a trend toward significance on a univariate analysis.
Propensity score matching did not reveal substantial differences in efficacy or safety between ADA and IFX. The anti-S. cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity combination is a strong predictor of treatment escalation.
This article looks at the working expectations and motivations of Generation Y members working in their parents’ businesses. The goal of this article is to identify how the working expectations and ...motivations of Generation Y members working in their parents’ businesses differ from the working expectations and motivations of Generation Y overall. Qualitative research design and in-depth unstructured interviews with 31 respondents were used to obtain the opinions of Generation Y members working in their parents’ businesses. Three main dimensions of working motivation were surveyed: the reasons for entering a family business, what work in a family business means, and general motivation to work. The principal findings of the article are the importance of work-life balance, flexibility, the opportunity for career development and the drive to continue one’s family tradition for Generation Y members working in their parents’ businesses. A sample of respondents added that they expect to be more involved in the operation of the family business in the future. A sample of our respondents also expected to be more involved in the operation of the family business in the future.
Exclusive enteral nutrition (EEN) has been recommended as the first-line therapy in children with active Crohn disease (CD). The primary aim of our study was to determine whether it is possible to ...use the difference between basal fecal calprotectin (F-CPT) and the value at week 2 of EEN to predict clinical response at week 6. We prospectively collected stool samples for F-CPT analysis and clinical and laboratory parameters during EEN from 38 pediatric patients (28 boys, median age 12.8 years) with newly diagnosed active luminal CD. The difference between F-CPT concentrations before EEN and at week 2 did not predict clinical non-response at week 6 (OR 0.9996 95% CI 0.9989–1.0002,
p
= 0.18); however, it predicted patients who did not achieve clinical remission at week 6 (OR 0.9993, 95% CI 00.9985–0.9998,
p
= 0.006) with sensitivity of 58%, and specificity of 92% for cut-off of F-CPT increase by 486 μg/g.
Conclusions
: An early decrease in F-CPT levels in children with newly diagnosed active luminal CD did not predict clinical response at week 6 of EEN induction therapy, and clinical remission was predicted with low accuracy. Therefore, F-CPT cannot be used as a predictor to select the patients in whom EEN should be terminated.
What is Known:
•
The fecal calprotectin (F-CPT) is an important marker of intestinal inflammation.
•
Approximately 25% of pediatric patients with Crohn disease (CD) do not achieve clinical remission, and there is still no sufficient predictor of response to exclusive enteral nutrition (EEN) treatment.
What is New:
•
The difference between the F-CPT concentrations before EEN treatment and at week 2 did not predict clinical response to treatment at week 6, even if it predicted clinical remission, however, with low accuracy. F-CPT is not a suitable predictor to select the patients for discontinuing of EEN induction therapy.
The oxidative stress is thought to play an important role in Crohn's disease (CD). As serum bilirubin represents the major endogenous antioxidant, this article aimed to evaluate in a clinical study, ...whether serum bilirubin levels and genes affecting its systemic concentrations are associated with CD.
This exploratory case-control study was based on pediatric (n = 119) and adult (n = 504) patients with CD and 370 appropriate healthy control subjects. The (GT)n and (TA)n dinucleotide variations in heme oxygenase 1 (HMOX1) and bilirubin UDP-glucuronosyl transferase (UGT1A1) gene promoters were determined by fragment analysis. Serum bilirubin levels were compared in a subset of 90 cases and 229 controls, for whom biochemical data were available.
Substantially lower serum bilirubin levels were detected in patients with CD compared with controls (7.4 versus 12.1 μmol/L, P < 10). Serum bilirubin levels were significantly lower in patients with CD within all UGT1A1*28 genotypes (P < 0.05). UGT1A1*28 homozygotes with wild-type NOD2 gene variant exhibited significant delay in CD manifestation (P = 0.004), while the protective effect of UGT1A1*28 homozygosity was lost in those patients with mutated NOD2 gene. No associations between CD risk and individual HMOX1 gene variants were observed.
CD is associated with significantly low serum bilirubin levels, most likely as a result of increased oxidative stress accompanying this inflammatory disease. UGT1A1*28 allele homozygosity, responsible for higher bilirubin levels, seems to be an important modifier of CD manifestation.
Current studies indicate a link between the intake of exclusive enteral nutrition (EEN) and the induction of complex changes in the intestinal microbiota, as well as the clinical improvement of ...Crohn's disease (CD). The first aim of this study was to test the ability of various commensal bacterial strains (
= 19) such as bifidobacteria, lactobacilli, and
to grow on three different polymeric EN
. Tested EN formulas were found to be suitable growth media for tested commensals. Furthermore, the counts of these bacteria and total counts of anaerobic bacteria in the fecal samples of children with CD (
= 15) before and after 6 weeks of EEN diet administration were determined using cultivation on selective media. The counts of cultivable commensal bacteria in the fecal samples of CD children were not significantly affected by EEN. However, tested bacteria showed some individual shifts in counts before and after EEN therapy. Moreover, cultured bifidobacteria were found to be in reduced counts in CD children. Therefore, the application of bifidogenic prebiotic compounds to EN for CD patients might be considered.
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•Enteral nutrition (EN) formulas contain variable nutrient and prebiotic compounds.•Cultivable commensal bacteria of faecal microbiota are able to use EN formulas like growth media in ...vitro.•Composition differences of EN formulas affecting individual microbial shift and metabolite profile after cultivation.•Functional components should be personalised based on individual host microbiota.
Enteral nutrition (EN) formulas of polymeric type ordinarily have similar content of intact macronutrients but may vary in prebiotic saccharides and micronutrients. These components can play an important role in the intestinal microbiota modulation. The aim of this study was to investigate microbial changes of faecal samples after their in vitro anaerobic cultivation in four polymeric EN formulas using plate technique method, metabolite analysis, and microbiota profiling using 16S rRNA sequencing. Detected cultivable commensal groups (bifidobacteria, lactobacilli, Escherichia coli) in faecal samples of donors were able to grow in EN formulas. However, their counts varied depending on the individual donor and the type of EN formula. Similar trend was found in detected metabolites such as acetate, lactate, and butyrate. Also, taxonomic composition and diversity of original and cultivated faecal microbiota of one individual on different EN formula indicate a possible effect of the prebiotics and micronutrients to modulate gut microbiota.
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