Is there a trade-off between inventories and trade credit? The role of the sovereign debt crisis

Using a panel of 72,172 manufacturing firms from 11 euro-area countries over the period 2006- 2015, we investigate how the stock of inventories relates to the extension of trade credit. Consistent with the inventory-management motive for offering trade credit, we find an inverse relationship between the two variables. This association is stronger for firms producing differentiated goods and during the recent sovereign debt crisis. Furthermore, financial intermediation mitigates the inventory-management motive, especially during the crisis period. Our results are robust to using different definitions of trade credit and of the crisis

Why do firms extend trade credit? The role of inventories

We are the first to explore the role of inventories as a trade credit driver in an economic/financial crisis setting. To this end, we make use of a panel of 198,024 manufacturing firms from eleven euro-area countries over the period 2006–2022. We find an inverse relationship between the stock of inventories and trade credit extended, which is magnified during the recent sovereign debt crisis. These results are robust to using different definitions of trade credit extended and of the crisis. Furthermore, we find that the association between inventories and trade credit extended is driven by financially constrained firms and firms producing differentiated products

Desempenho de uma população brasileira no teste de alfabetização funcional para adultos na área de saúde

OBJECTIVE: To analyze the scoring obtained by an instrument, which evaluates the ability to read and understand items in the health care setting, according to education and age. METHODS: The short version of the Test of Functional Health Literacy in Adults was administered to 312 healthy participants of different ages and years of schooling. The study was conducted between 2006 and 2007, in the city of São Paulo, Southeastern Brazil. The test includes actual materials such as pill bottles and appointment slips and measures reading comprehension, assessing the ability to read and correctly pronounce a list of words and understand both prose passages and numerical information. Pearson partial correlations and a multiple regression model were used to verify the association between its scores and education and age. RESULTS: The mean age of the sample was 47.3 years(sd=16.8) and the mean education was 9.7 years(sd=5; range: 1 - 17). A total of 32.4% of the sample showed literacy/numeracy deficits, scoring in the inadequate and marginal functional health literacy ranges. Among the elderly (65 years or older) this rate increased to 51.6%. There was a positive correlation between schooling and scores (r=0.74; pOBJETIVO: Analizar los escores de instrumento que evalúa habilidad de lectura y comprensión de materiales del área de salud según escolaridad y edad. MÉTODOS: Fueron evaluados 312 participantes saludables de diferentes edades por medio de la versión reducida del instrumento Test of Functional Health Literacy in Adults. El estudio fue realizado entre 2006 y 2007 en la ciudad de Sao Paulo (Sureste de Brasil). El instrumento incluye materiales como frascos de medicamentos y cartones de para marcar consultas, evaluando la comprensión de lectura y de conceptos numéricos. Las pruebas de correlación parcial y de Pearson y un modelo de regresión múltiple fueron usados para verificar la asociación entre los escores en el instrumento, escolaridad y edad. RESULTADOS: Los promedios de edad y de escolaridad de la muestra fueron respectivamente 47,3 (dp=16,8) y 9,7 (dp=5; de uno a 17 años de estudio). El total de 32,4% de la muestra mostraron déficit de alfabetización funcional/uso de conceptos numéricos en el área de salud, con desempeño inadecuado o limítrofe en el instrumento. Entre ancianos (65 años o más) esta tasa afectó 51,6%. Se encontró correlación positiva entre años de estudio y escores en el instrumento (r=0,740; p< 0,01) y correlación negativa entre edad y escores en el instrumento (r=-0,259; p< 0,01).La correlación entre escores en el instrumento y edad no fue significativa cuando los efectos de la escolaridad fueron controlados (r=-0,031, p=0,584). Una asociación significativa (B=3,877, Beta=0,733; p< 0,001) fue encontrada entre años de estudio y escores en el instrumento. La edad no fue una variable predictiva en el modelo (B=-0,035, Beta=-0,22; p=0,584). CONCLUSIONES: El instrumento es adecuado para evaluar la alfabetización funcional en salud en la población brasilera. El elevado número de individuos clasificados como analfabetos funcionales indica la importancia de adopción de medidas especiales para ayudar estos individuos a comprender correctamente las orientaciones para cuidados de salud.OBJETIVO: Analisar os escores de instrumento que avalia habilidade de leitura e compreensão de materiais da área da saúde segundo escolaridade e idade. MÉTODOS: Foram avaliados 312 participantes saudáveis de diferentes idades por meio da versão reduzida do instrumento Test of Functional Health Literacy in Adults. O estudo foi realizado entre 2006 e 2007 na cidade de São Paulo (SP). O instrumento envolve materiais como frascos de medicamentos e cartões de agendamento de consultas, avaliando a compreensão de leitura e de conceitos numéricos. Os testes de correlação parcial e de Pearson e um modelo de regressão múltipla foram usados para verificar a associação entre os escores no instrumento, escolaridade e idade. RESULTADOS: As médias de idade e de escolaridade da amostra foram respectivamente 47,3 (dp=16,8 ) e 9,7 (dp=5; de um a 17 anos de estudo). O total de 32,4% da amostra mostraram déficits de alfabetização funcional/ uso de conceitos numéricos na área de saúde, com desempenho inadequado ou limítrofe no instrumento. Entre idosos (65 anos ou mais) esta taxa atingiu 51,6%. Encontrou-se correlação positiva entre anos de estudo e escores no instrumento (r=0,740;

Reliability intra-and inter-examiner of the head postural assessment by computerized photogrammetry

Scientific articles about reliability of photogrammetry for cervical spine posture evaluation are infrequent. The aim of the present investigation is to verify intra-and inter-examiner reliability of the computerized photogrammetry method for head postural evaluation in lateral view. Twenty-five young women, between 20 and 30 years old, were positioned seated in an upright position and photographed in lateral view. The photographs were imported to Corel Draw X13 program for postural evaluation by computerized photogrammetry. Analyses of intra-and inter-examiner reliability were performed for the angles: condyle-acromion (ACA), menton-sternum (AME) and Frankfurt (AF). The photogrammetry was performed by two examiners: EA and EB. For intra-examiner analyses, EA assessed the pictures twice (A1 and A2) for the same angles within 3 months. For the inter-examiner analyses, EB performed the photogrammetry for the same angles (B1) in order to compare with the data from EA. Using the interclass correlation coefficient (ICC) we observed an excellent correlation in the intra-examiner analysis (A1 and A2) for the angles: ACA and AME (both with ICC=1.0); and AF (ICC=0.78). For the inter-examiner analyses between A1 and B1, it was observed: ACA (ICC=0.24), AME (ICC=0.26) and AF (ICC=0.00). For the comparison between A2 and B1, the ICC values were: 0.23; 0.27 and 0.00, respectively for ACA, AME and AF, classified as weak correlations. In conclusion, the photogrammetry is reliable when performed by the same examiner. The inter-examiner assess showed low reliability, what could have been compromised by the reduced experience of the EB in applying the method

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research