Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5\u201374.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care

Linking Employee Stakeholders to Environmental Performance: The Role of Proactive Environmental Strategies and Shared Vision

Drawing on the natural-resource-based view (NRBV), we propose that employee stakeholder integration is linked to environmental performance through firms’ proactive environmental strategies, and that this link is contingent on shared vision. We tested our model with a cross-country and multi-industry sample. In support of our theory, results revealed that firms’ proactive environmental strategies translated employee stakeholder integration into environmental performance. This relationship was pronounced for high levels of shared vision. Our findings demonstrate that shared vision represents a key condition for advancing the corporate greening agenda through proactive environmental strategies. We discuss implications for the CSR and the environmental management literatures, with a particular focus on the NRBV and stakeholder integration debates

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Stakeholder Salience for Small Businesses : A Social Proximity Perspective

This paper advances stakeholder salience theory from the viewpoint of small businesses. It is argued that the stakeholder salience process for small businesses is influenced by their local embeddedness, captured by the idea of social proximity, and characterised by multiple relationships that the owner-manager and stakeholders share beyond the business context. It is further stated that the ethics of care is a valuable ethical lens through which to understand social proximity in small businesses. The contribution of the study conceptualises how the perceived social proximity between local stakeholders and small business owner-managers influences managerial considerations of the legitimacy, power and urgency of stakeholders and their claims. Specifically, the paradoxical nature of close relationships in the salience process is acknowledged and discussed.Peer reviewe

The influence of social disclosure on the relationship between Corporate Financial Performance and Corporate Social Performance*

Esta pesquisa tem como objetivo geral investigar o efeito moderador do disclosure do Corporate Social Performance (D-CSP) na relação entre Corporate Social Performance (CSP - Performance Social Corporativa) e Corporate Financial Performance (CFP - Performance Financeira Corporativa). Com base nesse objetivo, a pesquisa apresentou um modelo no qual o D-CSP atua como moderador em relação aos stakeholders primários (funcionários, comunidade e fornecedores). O D-CSP é um mecanismo pelo qual os diversos aspectos sociais envolvidos nas políticas, ações e atividades discricionárias identificados no gerenciamento para stakeholder podem ser avaliados. Para testar o modelo, utilizou-se uma amostra de 1.147 empresas pertencentes a 10 distintos setores e aos cinco continentes do planeta. Utilizaram-se dados da base Bloomberg de 2010 a 2014, totalizando 5.623 observações. A relação foi testada utilizando-se o modelo de regressão linear múltipla com dados em painel com efeitos fixos, recorrendo-se à correção de Newey-West erro padrão robusto. Para efetuar os testes, utilizaram-se três construtos: D-CSP, CSP e CFP. Empregou-se, como medida de CSP, a CSP dos stakeholders funcionários, fornecedores e comunidade. Como medida do D-CSP, aplicaram-se os scores de disclosure de CSP disponíveis na base de dados e, como medida da CFP, utilizou-se o retorno sobre ativo (ROA). Os testes realizados apontaram a existência do efeito moderador positivo do disclosure na relação entre CSP de stakeholders primários e CFP. Os resultados permitem inferir que, além de apresentar um CSP positivo em relação aos stakeholders primários, é necessário divulgar tais resultados, contribuindo para desempenhos financeiros superiores.This study’s general objective is to investigate the moderating effect of Corporate Social Performance Disclosure (D-CSP) on the relationship between Corporate Social Performance (CSP) and Corporate Financial Performance (CFP). Based on this objective, the study presented a model in which D-CSP acts as a moderator in relation to primary stakeholders (employees, community, and suppliers). D-CSP is a mechanism through which the various social aspects involved in discretionary policies, actions, and activities identified in the management for stakeholders process can be evaluated. A sample of 1,147 companies belonging to 10 different sectors and five continents was used to test the model. Data were collected from the Bloomberg database, totaling 5,735 observations, from 2010 to 2014. The relationship was tested using the multiple linear regression model involving panel data with fixed effects, and the Newey-West robust standard errors correction. Three constructs, D-CSP, CSP, and CFP, were used to perform the tests. As a CSP measure, the CSP of the employee, supplier, and community stakeholders was used. As a D-CSP measure, the CSP disclosure scores available from the database were used, and return on assets (ROA) was used as a CFP measure. The tests carried out indicated the existence of a positive moderating effect of disclosure on the relationship between the CSP of primary stakeholders and CFP. Besides presenting a positive CSP in relation to the primary stakeholders the results enable it to be inferred that these results need to be disclosed, thus contributing to higher corporate financial performance

A community-sourced glossary of open scholarship terms

Supplementary Information: This list of terms represents the ‘Open Scholarship Glossary 1.0’ (available at: https://forrt.org/glossary/. Glossary available under a CC BY NC SA 4.0 license at: https://static-content.springer.com/esm/art%3A10.1038%2Fs41562-021-01269-4/MediaObjects/41562_2021_1269_MOESM1_ESM.pdf).https://static-content.springer.com/esm/art%3A10.1038%2Fs41562-021-01269-4/MediaObjects/41562_2021_1269_MOESM1_ESM.pd

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe