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AbstractThe empirical literature on the association of cash flow volatility and debt maturity structure is limited and inconclusive. This article investigates the impact of cash flow volatility on debt maturity structure, and the interaction effect of cash flow volatility and fixed assets on debt maturity structure. This article applies the two-step system generalized method of moments (GMM) method and uses 1672 non-financial public listed firms for a 10-year period starting from 2011 to 2020. The findings indicate a significant negative association between cash flow volatility and debt maturity structure of firms in Middle East and North Africa (MENA) and African countries. Moreover, the interaction of cash flow volatility and fixed assets is significantly and negatively related to debt maturity structure in MENA and African countries. These findings suggest the need for firm-managers to effectively manage the cash flow risk and consider collateral benefits of fixed assets when choosing the debt maturity structure.

This paper investigates the direct association between cash flow volatility and capital structure (i.e. debt ratio). This study further examines the moderating role of fixed assets on the association between cash flow volatility and capital structure in the Middle East and North Africa (MENA) and African markets. This study applies a two-step system generalized method of moment regression as the main estimation technique to minimize endogeneity concern. The data consist of non-financial listed firms in 20 MENA and African countries covering 2011 to 2020. The results reveal that cash flow volatility is significantly and positively related to capital structure of MENA and African firms. The results also reveal that fixed assets have a negative moderating impact on the relationship between cash flow volatility and the capital structures of MENA and African firms. The results are robust to different estimation techniques. The findings inform managers to consider cash flow stability as a major factor in corporate risk management and strategic decision making and consider fixed asset investment decisions and the quality of fixed assets as a significant factor in debt choice. Moreover, policymakers should formulate efficient capital structure policies that consider cash flow stability factors and encourage fixed asset investments.

The inhabitant of Ilaporu settlements solely depends on groundwater for domestic and agricultural purpose as a result of scarcity and contamination of surface water. The present study therefore aimed at investigating the physicochemical and geochemical composition of Ilaporu groundwater for domestic and agricultural suitability. Hand-dug well waters were picked randomly from thirty (30) major agricultural settlements with the aid of Global Position Satellite (GPS). The physical parameters such as Hydrogen ion concentration (pH), Electrical conductivity (EC),) and Total Dissolved Solid (TDS) were measured in-situ while the chemical compositions of cations (Ca2+, K+, Mg2+ and Na+) and anions (Cl−, F−, SO42−, NO3−and CO32−) were obtained through laboratory procedure. The water was subjected to an analytical measurement utilizing an Atomic Absorption Spectrometer (AAS) to examine seven heavy metals (Cd, Pb, Ni, Fe, Mn, Co, and Zn). This study was conducted to examine various water geochemical pollution and contamination indicators, including degree of contamination (DoC), modified degree of contamination (mDoC), enrichment factor (ER), accumulation index (Igeo), pollution loading index (PLI), ecological risk potential (ERIP), and health risks related to carcinogenic and non-carcinogenic substances. Water quality indexes such as the permeability index (PI), sodium adsorption ratio (SAR), soluble sodium percentage (SSP), sodium percentage ratio (%Na), residual sodium carbonate and bicarbonate (RSC and RSBC), Kelly's ratio (KR), and magnetic ratio (MR) were also used to evaluate the suitability of the water for irrigation. The geochemical result obtained revealed that the water has no trace of lead (Pb) contamination while other heavy metals obtained are within the acceptable limit of WHO and NSDWQ, except cadmium. The water quality index (WQI) was obtained to range between 1.11 and 23.76%. The result implies that the water falls in the excellent categories of the water quality index, thereby making it suitable for both domestic and irrigation. The PLI, DoC and mDoC water contamination/pollution index revealed PLI

This study extends the literature on the capital structure of corporate social responsibility (CSR) firms by examining the effect of CSR on the firm probability of default using a sample of 496 firms from 17 developing countries for the period 2010–2017. This paper employs the two‐step system generalized method of moments (GMM) technique that mitigates the endogeneity problem. Our findings for the full sample show that high CSR participation reduces the firm probability of default in developing countries. Our results are robust after separating the sample into four regions. Precisely, CSR participation reduces the probability of default in Asian, Latin American, and European regions (except the African and Middle Eastern region). Overall, our findings suggest that as firms in developing countries increase their investments in CSR activities, the probability to default their obligations decreases. [ABSTRACT FROM AUTHOR]

AbstractThe study aims to analyze the effect of internal CSR practices on firm efficiency, focusing on the moderating role of women board members. Using a sample set of 5,997 firms from 39 countries between 2008 and 2019, this study performs Data Envelopment Analysis (DEA) to measure firm efficiency and applies a panel regression to investigate the moderation effect of women board members. The empirical results show that women board members play a crucial moderating role in the relationship between internal CSR and firm efficiency. In general, the link between internal CSR and firm efficiency becomes more positive as the proportion of women board members grows. Similar results were reported in the group of developed country. In the developing status group, however, the role of women board members in the positive relationship between internal CSR and firm efficiency was not significant. This study is novel since no prior research has examined the relationship between the presence of women board members in internal CSR-firm efficiency relationships. Moreover, this study employs a broader range of research data, making the conclusions more representative. We recommend investigating additional characteristics of top management, such as experience, education, and age, for future studies.

This article analyses the effect of fixed assets and goodwill assets on South African firms’ debt ratios. The difference and system generalized method of moment estimation results reveal that fixed assets and goodwill assets have significant and positive relationship with firms’ debt ratios. To secure long-term debt, fixed assets and goodwill assets are required as collateral by creditors. Our results show firms’ adjust to long-run optimal debt level, but at a slow adjustment rate. Our results suggest there are costs preventing South African firms from adjusting faster to their long-run optimal debt level. The practical implication of the paper is that policy makers should promote policies that encourage further development of the capital market. Moreover, firms need both fixed assets and goodwill assets as collateral to raise the desired optimal debt that maximizes firm value.

Introduction: Management of penetrating thoracoabdominal (PTA) injuries with signs of hemorrhage have warranted operative intervention but improved imaging capabilities have redefined interventions required. We examined outcomes of hemodynamically stable patients undergoing preoperative CT imaging with the hypothesis that CT imaging would decrease OR time without delaying OR arrival., Methods: A retrospective multicenter study was performed amongst four urban trauma centers examining hemodynamically stable patients with PTA injuries requiring operative intervention from January 2017-December 2021. The primary outcome was OR time. Secondary outcomes included length of stay (LOS), ICU LOS, and mortality. A multivariable logistic regression with random intercept for trauma center was fit to assess whether preoperative CT affected time in the OR., Results: Of 534 hemodynamically stable patients with penetrating injuries, 322 (60.3 ​%) received preoperative CT. The median time in OR were 130 (IQR: 84,180) and 140 (IQR: 100, 180) minutes for patients with and without preoperative CT, respectively. Median time to OR was 68 (IQR: 47, 110) and 26 (IQR 17,38) minutes in patients with and without preop CT, respectively. Median ICU LOS were 0 vs 1 day, the median hospital LOS were 7 vs 8 days for patients with and without pre-op imaging respectively. The multivariable model showed that obtaining a pre-op CT scanning was not independently associated with time spent in OR. (Adjusted OR:0.94; 95 ​% CI: 0.85, 1.04)., Conclusion: In patients with PTA injuries and hemodynamic stability, preoperative CT scanning was not associated with decreased OR time, postoperative complications, or mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)

Background: Underrepresented minority groups (URMs) in surgery are not significantly increasing despite evidence suggesting that diversity in health care providers leads to excellent patient outcomes and care. Efforts to increase URM representation in surgical residency programs are essential for addressing disparities and improving health care delivery., Methods: This retrospective study outlines a three-phase strategy implemented at a large academic-affiliated hospital to increase URM representation in its general surgery residency program. The strategy encompassed interview selection with a holistic review and implicit bias training for interviewers, modification of the interview scoring rubric, and post-interview recruitment efforts, including a virtual second look event for URM applicants., Results: Following the implementation of these strategies, the URM match rate improved from 0 to 33.3% in the first year and was sustained at 33.3% in the subsequent year. Consequently, the representation of URMs in the residency program rose from 6.7% before our intervention to 13.3% afterwards., Discussion: This structured approach successfully increased URM representation in a surgical residency program, affirming the success of targeted recruitment strategies. By promoting a diverse and inclusive environment, the program better reflects the community it serves, with aims at improved patient care and patient satisfaction., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Complex duodenal trauma is a rare injury with an incidence of 1-4.7% of all abdominal trauma. Historically, varied approaches have been used in the management of these complex injuries and the prevention of complications. This is a review of the current management methodology of complex duodenal injury., Methods: A review of the medical literature to include the past and current management of duodenal trauma was performed. Google scholar (1970-2022) and PubMed (1970-2022) were searched using the keywords: complex duodenal trauma, surgical management, and duodenal complications., Discussion: Complex duodenal trauma can be classified using the AAST grading scale as those encompassing grades III-V. Multiple studies and review articles characterize the difficulty in managing complex duodenal injuries. The tenets of operative management of duodenal trauma include the decision for damage control, resection of non-viable tissue, restoring gastrointestinal continuity, diversion of gastrointestinal contents, bile and pancreatic enzymes, allowing the repair to heal, and providing feeding access. The variety of both historic and current approaches attempt to address these tenets. The incidence of complications are as high as 65% with the most common complications including abscess formation, suture line dehiscence and fistula formation. The overall mortality ranges from 5 to 30%., Conclusions: Many different approaches and strategies have been proposed to repair complex duodenal injuries, all of which address important tenets of its management. The risk of complications remains high, therefore, it is vital to have a thoughtful and multidisciplinary approach when treating these injuries., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Firearm violence within Delaware has been concentrated in the City of Wilmington and rates disproportionately affect populations, with the highest disparity and inequity in mortality among young Black men. This commentary provides an update to a prior review from 2018 with an analysis of the factors contributing to a surge in 2020 and the years beyond.

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance.  We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was evacuated during a resuscitative thoracotomy. Further thoracotomy in the operating room was done with repairs of the penetrating injuries to the heart and lungs. No bullet was identified after careful inspection of the entire chest in the operating room. However, upon further postoperative imaging, a bullet was identified on chest X-ray and CT, lodged in the anterior aspect of the subepicardial right ventricular outflow tract. After a complicated hospital course, the patient was discharged by hospital day 30 in a stable condition with outpatient follow-up. The decision to leave or retrieve a bullet should be made on a case-by-case basis depending on the clinical picture. In this case report, we have shown that leaving the bullet in place with close observation and appropriate imaging is feasible for selected patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Bolaji et al.)

Arbuscular mycorrhizal fungi (AMF) are ubiquitous in agroecosystems, but their role in mediating agricultural yield remains contested. Field experiments testing effects of realistic agronomic practices of intensification on AM fungus composition and yields are scarce, especially in the low-input systems of sub-Saharan Africa. A large, full-factorial field experiment was conducted in South-Kivu (DR Congo), testing effects of fallow duration (6 vs. 12 months), genotype (landrace vs. improved), and fertilizer management (control vs. five combinations omitting N, P, K, and/or secondary macro- and micronutrients) on yields of cassava, an important staple crop strongly colonized by AMF. Furthermore, we used DNA-metabarcoding to evaluate effects of these agronomic practices on the AM fungal communities on the roots. The shorter fallow duration strongly increased diversity and richness of AMF, but this did not correspond with increased yields. Cassava yield was mainly determined by genotype, being largest for the improved genotype, which coincided with a significantly higher sum of AM fungal sequences. Effects of fertilizer or genotype on community composition were minor to absent. We found no evidence that increased AMF richness and diversity enhanced cassava yields. In contrast, the use of the improved genotype and mineral fertilizers strongly benefitted yields, without compromising richness or diversity of AMF. Cassava-AMF associations in this work appear robust to fertilizer amendments and modern genotype improvement.