Dearth of high quality monkeypox guidelines may be hampering care globally

What’s available too often out of date, lacking sufficient detail, not inclusive and contradictory

Peer-Reviewed Publication

BMJ

A dearth of high quality, up to date clinical guidance on monkeypox may be hampering effective and safe treatment of the infection around the world, concludes a review of what’s available to guide patient care and published in the open access journal BMJ Global Health.

Existing guidance, such as it is, too often lacks sufficient detail, fails to include different groups, and is contradictory, say the researchers.

Since the first human case of monkeypox infection was identified in 1970 in the Democratic Republic of Congo, it has mostly been reported in Central and Western African countries. 

The ongoing outbreak in 2022 is the first to affect several non-endemic countries, with 257 confirmed cases in 23 countries reported, as of 26 May 2022. 

The infection is mild in most cases, but younger children may be at higher risk of severe infection. And while the death rate is usually low, evidence from Africa suggests it can be fatal in up to 10% of cases, particularly in younger children.

Complications include painful pustules, secondary infections, bronchopneumonia, encephalitis (brain swelling), keratitis (inflammation of the eye’s surface) and psychological symptoms.

Monkeypox in people is spread through direct contact, such as from bodily fluids and respiratory droplets, indirectly from contaminated surfaces, and vertically from a mother to her fetus through the placenta. 

Even when the evidence base is limited, clinical guidelines are important for informing and standardising the best available care for patients around the world, and for enabling further research to identify new treatments, say the researchers.

They therefore set out to assess the availability, quality, scope and inclusivity of available international clinical guidance on the treatment and supportive care of patients with monkeypox infection.

They searched 6 major research databases for relevant content published up to mid October 2021, plus the ‘grey literature’---policy documents, newsletters, reports, for example, published up to May 2022—in several languages.

They found 14 relevant guidelines. Most were of low quality according to the Appraisal of Guidelines for Research and Evaluation II (AGREE) system, scoring an average of 2 out of a possible 7. And most lacked detail and covered only a narrow range of topics.

There was little provision for different risk groups: only 5 (36%) provided any advice for children; and only 3 (21%) provided advice for pregnant women or for people living with HIV. 

Treatment guidance was mostly limited to advice on antivirals and wasn’t consistent: 7 guidelines advised cidofovir, 4 of which specified this only for severe infection; just 4 (29%) advised tecovirimat, and 1 (7%) brincidofovir. 

More recent guidance, including from the World Health Organization, recommends the use of tecovirimat rather than cidofovir.

While cidofovir and brincidofovir are active against pox viruses in laboratory studies, there are few data on how well they treat pox viruses in people, added to which they are only authorised for use in certain countries, note the researchers.

None of the guidelines detailed optimal dose, timing or length of treatment. And only one guideline provided recommendations on supportive care and the treatment of complications. 

All 14 guidelines recommended vaccination as post-exposure prophylaxis (PEP), but not all of them were up to date on the newer generation vaccines. And PEP guidance for different risk groups was limited and at times contradictory.

The researchers acknowledge that understanding of the monkeypox virus is still evolving, which may account for some of the variability in recommendations they found.

But they say: “Even with a limited evidence base, clinical management guidelines are important tools for guiding decision-making and to reduce risk of inappropriate treatments.” 

They add: “The lack of clarity between guidelines creates uncertainty for clinicians treating patients with [monkeypox] which may impact patient care.”

And they conclude: Our study highlights a need for a rigorous framework for producing guidelines ahead of epidemics and a recognised platform for rapidly reviewing and updating guidance during outbreaks, as new evidence emerges. 

“Human [moneypox] is providing a challenge even in high-resource settings with well-resourced healthcare systems. The lack of guidelines may especially impact clinics with limited previous experience in managing patients with [monkeypox]. 

Given the recent global publicity surrounding monkeypox, this is an opportune moment to harness interest and investment in further research to make sure that everyone is given the best treatment, they say.

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JOURNAL

BMJ Global Health

DOI

10.1136/bmjgh-2022-009838 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Availability, scope and quality of monkeypox clinical management guidelines globally: a systematic review

ARTICLE PUBLICATION DATE

16-Aug-2022

UBC researchers discover ‘weak spot’ across major COVID-19 variants

Peer-Reviewed Publication

UNIVERSITY OF BRITISH COLUMBIA

 

IMAGE: CRYO-ELECTRON MICROSCOPY REVEALS HOW THE VH AB6 ANTIBODY FRAGMENT (RED) ATTACHES TO THE VULNERABLE SITE ON THE SARS-COV-2 SPIKE PROTEIN (GREY) TO BLOCK THE VIRUS FROM BINDING WITH THE HUMAN ACE2 CELL RECEPTOR (BLUE). view more 

CREDIT: DR. SRIRAM SUBRAMANIAM, UBC

Researchers at the University of British Columbia have discovered a key vulnerability across all major variants of the SARS-CoV-2 virus, including the recently emerged BA.1 and BA.2 Omicron subvariants.

The weakness can be targeted by neutralizing antibodies, potentially paving the way for treatments that would be universally effective across variants.

The findings, published today in Nature Communications, use cryo-electron microscopy (cryo-EM) to reveal the atomic-level structure of the vulnerable spot on the virus’ spike protein, known as an epitope. The paper further describes an antibody fragment called VH Ab6 that is able to attach to this site and neutralize each major variant. 

“This is a highly adaptable virus that has evolved to evade most existing antibody treatments, as well as much of the immunity conferred by vaccines and natural infection,” says Dr. Sriram Subramaniam (he/him), a professor at UBC’s faculty of medicine and the study’s senior author. “This study reveals a weak spot that is largely unchanged across variants and can be neutralized by an antibody fragment. It sets the stage for the design of pan-variant treatments that could potentially help a lot of vulnerable people.”

Identifying COVID-19 master keys

Antibodies are naturally produced by our bodies to fight infection, but can also be made in a laboratory and administered to patients as a treatment. While several antibody treatments have been developed for COVID-19, their effectiveness has waned in the face of highly-mutated variants like Omicron.

“Antibodies attach to a virus in a very specific manner, like a key going into a lock. But when the virus mutates, the key no longer fits,” says Dr. Subramaniam. “We’ve been looking for master keys — antibodies that continue to neutralize the virus even after extensive mutations.”

The ‘master key’ identified in this new paper is the antibody fragment VH Ab6, which was shown to be effective against the Alpha, Beta, Gamma, Delta, Kappa, Epsilon and Omicron variants. The fragment neutralizes SARS-CoV-2 by attaching to the epitope on the spike protein and blocking the virus from entering human cells.

The discovery is the latest from a longstanding and productive collaboration between Dr. Subramaniam’s team at UBC and colleagues at the University of Pittsburgh, led by Drs. Mitko Dimitrov and Wei Li. The team in Pittsburgh has been screening large antibody libraries and testing their effectiveness against COVID-19, while the UBC team has been using cryo-EM to study the molecular structure and characteristics of the spike protein.

Focusing in on COVID-19’s weak points

The UBC team is world-renowned for its expertise in using cryo-EM to visualize protein-protein and protein-antibody interactions at an atomic resolution. In another paper published earlier this year in Science, they were the first to report the structure of the contact zone between the Omicron spike protein and the human cell receptor ACE2, providing a molecular explanation for Omicron’s enhanced viral fitness.

By mapping the molecular structure of each spike protein, the team has been searching for areas of vulnerability that could inform new treatments.

“The epitope we describe in this paper is mostly removed from the hot spots for mutations, which is why it’s capabilities are preserved across variants,” says Dr. Subramaniam. “Now that we’ve described the structure of this site in detail, it unlocks a whole new realm of treatment possibilities.”

Dr. Subramaniam says this key vulnerability can now be exploited by drug makers, and because the site is relatively mutation-free, the resulting treatments could be effective against existing—and even future—variants.

“We now have a very clear picture of this vulnerable spot on the virus. We know every interaction the spike protein makes with the antibody at this site. We can work backwards from this, using intelligent design, to develop a slew of antibody treatments,” says Dr. Subramaniam. “Having broadly effective, variant-resistant treatments would be a game changer in the ongoing fight against COVID-19.”

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JOURNAL

Nature Communications

DOI

10.1038/s41467-022-32262-8 

IV nutrition risks becoming the norm for athletes, despite no evidence it works

Used to be considered treatment of ‘last resort’. ‘Food first’ and ‘no needle’ messages need to be amplified, urge experts

Peer-Reviewed Publication

BMJ

Intravenous (IV) nutrition, which used to be considered a treatment of ‘last resort’, is threatening to become the norm for competitive athletes, despite no scientific evidence that it works or that it is safe, warn experts in an editorial, published online in the British Journal of Sports Medicine.

‘Food first’ and ‘no needle’ messages need to be amplified among all athletes and their support teams to stop this trend in its tracks, they urge.

The authors, who regularly interact with professional team players in European and American leagues and their support teams, have become increasingly aware of the practice.

And while it’s not known exactly how common it is, anecdotally, some players are hooked up to IV nutrition drips as often as every week as part of a pre- or post-game routine, they say. 

So-called ‘drip bars’ and concierge IV nutrition services claim to boost health and performance, restore hydration, and speed up recovery, offering a menu of B vitamins, amino acids, glutathione, vitamin C and electrolytes, and potentially boosting levels beyond any therapeutic range.

Although easily accessible, these services seem to have escaped regulatory oversight, nor is there any guidance on their use for players or practitioners, point out the authors.

The principle of reducing needle use in sport and a ‘food first’ approach is taught in sports nutrition courses around the world, and a ban on needle use by athletes at the Olympic Games, except for appropriate medical use, and where a therapeutic use exemption (TUE) is obtained, has been in place for all recent Games, they highlight.

IV nutrition drips have traditionally been reserved for serious clinical conditions, such as anaemia, symptoms caused by nutrient deficiencies, or to correct severe dehydration caused by marathon running in a desert, for example. But they are now being used for tiredness, fatigue, or recovery, say the authors.

“But the evidence is sparse and not supportive. We are aware of just two studies assessing vitamin injections in otherwise healthy participants, neither of which yielded an effect for the injection group,” note the authors.

And these drips are not free of risk, potentially interfering with the body’s power houses of detoxification and immunity—the liver and gut microbes—they add.

“Bypassing these mechanisms appears foolhardy unless there is a significant clinical rationale,” they write, adding that IV drips also carry risks of infection at the needle site and of blood clots.

Too much vitamin B6 is associated with peripheral neuropathy, while athletes regularly receiving IV iron risk liver disease, they point out.

“Given that the long-term effects of supratherapeutic doses of B vitamins and other nutrients are unknown in athletes, it does not appear to be worth the risk, especially given the lack of evidence-based benefits,” they write. 

“More than this is the reputational risk to sport if it is normalised for athletes to regularly partake in self-directed IV [nutrition] use with a worrying shift away from what ‘works’ (according to scientific standards), to that which is unproven. 

“Furthermore, some athletes risk an anti-doping violation by participating in self-directed IV [nutrition] use.”

Figures on the prevalence of IV nutrition need to be gathered in tandem with governing bodies and players’ associations in the professional leagues providing guidance on the potential risks of IV nutrition use, say the authors.

“The ‘food first’ and ‘no needle’ messages need to be amplified among all athletes and multidisciplinary support teams to avoid what was previously a ‘last resort’ treatment becoming normal without scientific evidence of benefit,” they warn.

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JOURNAL

British Journal of Sports Medicine

DOI

10.1136/bjsports-2022-105883 

METHOD OF RESEARCH

News article

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Rise of intravenous nutrition products among professional team sport athletes: reasons to be concerned?

ARTICLE PUBLICATION DATE

16-Aug-2022

Scientists create a DNA test that identifies Lyme disease in horses

A test under development by a Rutgers professor could have applications for humans and dogs, too

Peer-Reviewed Publication

RUTGERS UNIVERSITY

A Rutgers scientist aiming to help heal a sick horse created an ultra-sensitive DNA test that could have applications for difficult-to-detect illnesses in humans such as Lyme disease

As described in a study published in the Journal of Veterinary Diagnostic Investigation, a special DNA test devised by Steven Schutzer, a professor of medicine at Rutgers New Jersey Medical School, helped a Cornell University School of Veterinary Medicine team identify Neurologic Lyme disease in a sick 11-year-old Swedish Warmblood mare.

Although Lyme disease was suspected, a standard PCR test didn’t detect the disease agent, the corkscrew-shaped bacterium Borrelia burgdorferi.

As with the treatment of most diseases, early detection is essential with Lyme.

“Early diagnosis leads to immediate treatment,” Schutzer said. “And, naturally, that gives the best chance for a cure.”

The Schutzer team’s “genomic hybrid capture assay,” a highly sensitive test the team has been developing, identified the pathogen in a sample of the horse’s spinal fluid, allowing it to be diagnosed and successfully treated. The test works by first selectively isolating DNA from the microorganism causing the disease.

“The method is like having a special, specific ‘fishhook’ that only grabs Borrelia DNA and not the DNA of other microbes, nor the DNA of the host (animal or human),” Schutzer said. “Detecting DNA of the disease is a direct test, meaning we know you have active disease if it’s circulating in the blood or spinal fluid.”

Lyme disease is the most common vector-borne illness in the U.S., according to the Centers for Disease Control and Prevention (CDC). In humans, a characteristic skin rash may or may not occur, along with fever, headache and fatigue. Unchecked, the infection can move to the nervous system, the joints and the heart.

Similar to humans, horses are incidental, dead-end hosts for B. burgdorferi, meaning the hosts carry the infection but do not infect others. Not all

infected horses develop clinical signs of Lyme disease. If symptoms occur, they can include chronic weight loss, lameness and low-grade fever. Antibody tests usually are administered when a Lyme disease infection is suspected.

In the case described in the study, an antibody test and a PCR test of the mare didn’t indicate an infection. Only Schutzer’s advanced test detected the disease.

Lyme disease in horses can cause long-term complications that include damage to the nervous system, joints, skin and even vision.

“The diagnosis of Lyme neuroborreliosis (Neurologic Lyme disease) in horses is rarely confirmed antemortem and has frustrated veterinarians for years,” said Thomas Divers, the veterinarian who led the equine team on the paper and who is a professor of medicine and co-chief of the Section of Large Animal Medicine at Cornell University’s College of Veterinary Medicine in New York. “This is a very promising technique. Focused treatment against B. burgdorferi administered in this case resulted in the horse’s complete athletic recovery.”

While many illnesses, such as COVID-19 and strep throat, attack humans with many numbers of pathogens, in other diseases, such as Lyme disease, the bacteria slowly reproduce within a host, producing far fewer numbers and making detection more difficult.

Schutzer, an expert in Lyme and other tick-borne diseases, has been working to devise ways to better detect diseases that possess what he terms “low copy numbers” of a pathogen.

According to the CDC, about 476,000 cases of Lyme disease are reported in humans each year. The black-legged tick, also known as the deer tick, is responsible for most cases of Lyme disease in the U.S. and seems to be increasing in abundance and geographic spread.

Other scientists on the study included Claire Fraser and Emmanuel Mongodin of the Institute of Genome Sciences at the University of Maryland School of Medicine; Christopher Miller of Miller and Associates Equine Practice in Brewster, N.Y.; Rodney Belgrave of Mid-Atlantic Equine Hospital in Ringoes, N.J.; and Rachel Gardner of B.W. Furlong and Associates in Oldwick, N.J.

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JOURNAL

Journal of Veterinary Diagnostic Investigation

DOI

10.1177/10406387221112617 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Genomic hybrid capture assay to detect Borrelia burgdorferi: an application to diagnose neuroborreliosis in horses

How young chickens play can indicate how they feel

Peer-Reviewed Publication

LINKÖPING UNIVERSITY

 

IMAGE: YOUNG CHICKENS SPEND LOTS OF TIME PLAYING IN DIFFERENT WAYS – JUST LIKE PUPPIES AND KITTENS – ACCORDING TO RESEARCH FROM LINKÖPING UNIVERSITY. view more 

CREDIT: PER JENSEN

It is common for young animals, in particular mammals, to play. Researchers at Linköping University (LiU), Sweden,  have for the first time mapped the development of play in young chickens. The results show that the young chickens spend lots of time playing in different ways – just like puppies and kittens.

“We studied the development of young chickens from hatching onwards, by offering them a special ‘playground’ several times a week”, says Per Jensen, professor at the Department of Physics, Chemistry and Biology at LiU. Professor Jensen has led the investigation.

The researchers filmed the young chickens’ behaviour and identified, in total, 14 different kinds of play. For example, the young chickens picked up objects in their beaks and chased each other around, or conducted “play fighting” by jumping and bumping their chests against one another. The intensity of the play reached its peak around 6–7 weeks of age, just before the young chickens would have become independent from their parents in the wild.  

To see how play is affected in the transition from living in the wild to being tame, modern and domesticated laying young chickens were compared with their ancestors, red junglefowl. 

“We discovered that both played in exactly the same way. So almost 10,000 years of domestication hadn’t changed their play behaviour. However, the tame young chickens played a lot more than their ancestors. This supports the theory that domestication often leads to animals becoming more ‘childish’ in their behaviour”, says Rebecca Oscarsson, who worked on the study during her master’s programme.

In many animals, playing is affected by their mental state, and animals play less when they experience stress or discomfort. Therefore, another study looked at young chickens who were subject to stress during hatching.

“The hypothesis was that the experience of early stress would make the young chickens less likely to play. But instead, we saw the complete opposite. Maybe stressed animals have an unmet need for an outlet for positive behaviour. But it’s up to future research to show that”, says Gabrielle Lundén, who also was a master’s student during the experiment.

Per Jensen believes that how animals play can indicate how they feel, and that play is used to improve their lives.

“We’re planning a study in which we will stimulate stressed animals into playing, in order to increase their wellbeing. This could be a way of improving the quality of life of animals used in food production”, says Per Jensen.

The study has received funding from the research council Formas and the Swedish Research Council.

The article: Play ontogeny in young chickens is affected by domestication and early stress, Gabrielle Lundén, Rebecca Oscarsson, Louise Hedlund, Johanna Gjøen, Per Jensen, Scientific Reports 12:13576, published online 9 August 2022, DOI: 10.1038/s41598-022-17617-x

For further information, please contact:

Per Jensen, professor, per.jensen@liu.se, +46 13 28 12 98

Karin Söderlund Leifler, press information officer, karin.soderlund.leifler@liu.se, +46 13 28 13 95

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JOURNAL

Scientific Reports

DOI

10.1038/s41598-022-17617-x 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Play ontogeny in young chickens is affected by domestication and early stress

Wireless tech measures soil moisture at multiple depths in real time

Peer-Reviewed Publication

NORTH CAROLINA STATE UNIVERSITY

Researchers from North Carolina State University have developed a wireless system that uses radio transmitters and receivers to estimate soil moisture in agricultural fields at multiple depths in real time, improving on existing technologies that can be used to inform irrigation practices that both improve crop yield and reduce water consumption.

“Estimating soil moisture is important because it can be used by growers to irrigate their fields more efficiently – only irrigating fields when and where the water is needed,” says Usman Mahmood Khan, first author of a paper on the work and a Ph.D. student at NC State. “This both conserves water resources and supports things like smart agriculture technologies, such as automated irrigation systems. What’s more, conserving water resources can also help reduce carbon emissions, because less energy is used to pump water through the irrigation system.”

The new technology, called Contactless Moisture Estimation (CoMEt), does not require any in-ground sensors. Instead, CoMEt assesses soil moisture using something called “phase,” which is a characteristic of radio waves that is affected by both the wavelength of the radio waves and the distance between the radio wave’s transmitter and the wave’s receiver.

Wireless signals are radio waves, and the medium that these signals are traveling through affects the wavelength of those radio waves. When the signal travels through a medium like air, it will have a specific wavelength. But when the signal travels through a different medium, such as soil, its wavelength changes.

“We know that these phase shifts are also influenced by the amount of water in the soil. If we know how far the signal has traveled, and we measure how a wireless signal’s wavelength has changed, we can determine the phase shift of the signal,” Khan says. “This, in turn, allows us to estimate the amount of water in the soil.”

CoMEt relies on an above-ground wireless device that transmits radio waves into the soil. Some portion of the radio waves passes through the soil before being reflected back into the air, where the wireless device can receive the signal and measure the phase shift. The system allows users to assess soil moisture at multiple depths by increasing the power of the transmitted signal – the more powerful the signal, the deeper the assessment.

“This process allows us to assess soil moisture at multiple depths using a single signal, without using any sensors in the soil or in contact with the ground surface,” says Muhammad Shahzad, co-author of the paper and an associate professor of computer science at NC State. “For example, we’ve demonstrated in experimental testing that if we use a signal that is powerful enough to penetrate 38 centimeters into the soil, we are able to assess how the phase of the signal changed at the surface level of soil, 38 centimeters beneath the surface, and at an intermediate level between those two.”

This is possible because the CoMEt device contains multiple antennas, allowing it to capture a significant amount of data from the radio waves that “bounce” out of the soil. The measurements collected by the device’s suite of antennas are then plugged into an algorithm that can determine both changes in the signal’s wavelength and how deep the signal traveled into the soil. This allows the CoMEt device to accurately assess the phase change of the signal, which in turn gives users a soil moisture estimate for the relevant depths.

“Estimating the soil moisture at multiple depths is important, because farmers often need to maintain certain levels of moisture at different depths depending on the crop and where they are in the crop-cycle,” Khan explains.

“We think CoMEt could be used in multiple ways,” says Shahzad. “Growers could manually move the CoMEt device to measure soil moisture at various points in the field; they could use CoMEt in conjunction with a manually operated drone to assess soil moisture; or they could use CoMEt with an automated drone that flies a defined pattern over the field.”

Technologies that are currently in use by growers to measure soil moisture rely on in-ground sensors. However, this approach requires farmers to place multiple sensors around the field in order to capture moisture levels, since moisture levels vary due to differences in drainage, proximity to irrigation lines, and so on. For large fields, growers need a lot of sensors – and that gets expensive.

“We think it would be possible to manufacture CoMEt devices for about the same amount of money as an accurate in-ground sensor,” says Khan. “But where a grower would only need one CoMEt device, they would have to buy quite a few in-ground sensors to collect the same amount of information on soil moisture. In short, we think CoMEt would be significantly more cost effective.

“What’s more, installation and maintenance of in-ground sensors is time-consuming and inconvenient. And CoMEt requires neither.”

“At this point, we’re looking for industry partners to explore how we can get this technology into the hands of growers who will be able to make use of it,” Shahzad says.

The paper, “Estimating Soil Moisture using RF Signals,” will be presented at the 28th Annual International Conference On Mobile Computing And Networking (ACM MobiCom), being held Oct. 17–21 in Sydney, Australia.

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METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Estimating Soil Moisture using RF Signals

New research uncovers favoritism in order assignment

Peer-Reviewed Publication

WILEY

An elusive behavior long overlooked by social scientists is order determination: in many types of competitions, the ranking of contestants is affected by the order in which they are evaluated, so placing a preferred contestant in a favorable spot in the order is a subtle way to boost their chances. A recent paper in Economic Inquiry generates statistical methods of detecting this behavior and applies them to numerous contests, including primary elections in Texas and West Virginia. There, law requires the order that candidates are placed on the ballot to be randomly determined, but often this did not happen.

“In those elections, randomness was violated in many different ways,” said author Darren Grant, PhD, an economics professor at Sam Houston State University. “Figuring out the reasons why was like being in a mystery novel. It often came down to some minor detail I had long overlooked.”

In contrast, Grant found no violations of randomness in the TV show American Idol or in Powerball lottery drawings. “The thread connecting these three very different situations is that things are done in an order,” said Grant. “So many things in life are like that. This research has wide applicability.”

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JOURNAL

Economic Inquiry

DOI

10.1111/ecin.13114 

ARTICLE TITLE

Uncovering Bias in Order Assignment

ARTICLE PUBLICATION DATE

17-Aug-2022

Promotion doesn’t add up to gender equity at leading accounting firms

Peer-Reviewed Publication

WASHINGTON STATE UNIVERSITY

PULLMAN, Wash. – Often instead of making partner, women in public accounting firms appear to be sidelined into less prestigious, less powerful director positions, a study has found.

Examining public audits from the seven largest firms, including Deloitte and KPMG, researchers found that directors signing audit reports for nonprofit entities were twice as likely to be women than men, despite the fact that there are fewer female directors.

The analysis of this data, which is accessible because the audit clients are public institutions like nonprofits or universities, provides a window into promotion practices, said Kathleen Harris, an accounting assistant professor with Washington State University’s Carson College of Business.

“Women and men are hired into these public accounting firms at a very equal ratio, but at the partner level, it's disproportionate,” said Harris, the corresponding author on the study published in the Journal of Accounting and Public Policy. “If we want equity in accounting, then both men and women need to be at the table making decisions.”

Partners and directors can both lead audits of nonprofit entities, but there are considerable differences between the two groups. Partners are the top leaders of their firms. They buy into the firm, hold voting power and help strategically plan how the firm goes forward. It is a high risk, high reward position, Harris said. Directors, while highly skilled and compensated, are salaried employees without voting power.

Both leadership levels lack gender equity with women making up 32% of directors but just 18% of partners, according to self-reports by large firms in 2016. This “vertical segregation,” where men are clustered at higher levels than women, was also noted in earlier research in 2011 with the director-level dubbed a “pink-collar ghetto.”  

The current study shows that division is persisting. Harris and her co-authors, Elizabeth Almer of Portland State University as well as Julia Higgs and Joe Rakestraw of Florida Atlantic University, analyzed more than 1500 audit engagements from 2017 Federal Audit Clearinghouse data for the seven largest public accounting firms. They found that among audit signers, directors were more often women, and partners more often men.

In addition, audit clients paid more for female partners who signed audits versus female directors or even male partners and directors. This study could not determine exactly why that was the case, but Harris said it is possible that some audit clients with goals for increasing diversity may be specifically asking for women partners to lead their audits, driving up demand for a limited supply.

It is also hard to pinpoint the reasons for the continued gender equity problems in accounting leadership. Harris said it could involve unconscious bias, lack of opportunity for women to develop the necessary skills, or women themselves choosing not to take on leadership roles that require long hours away from family.  

“The first point of change is awareness,” Harris said. “Once you identify a problem, the next step is to discuss what opportunities there are to develop equity in the firm.”

For instance, Harris suggested firms address work-life balance for both men and women versus assuming it is just an issue for one gender, which might help level the playing field. Advocacy and sponsorship are also key to helping women and other underrepresented employees advance into top leadership roles, and once more of them are there, it can help improve diversity overall.

“You can't really hire diversity. You have to create an environment that attracts diversity,” Harris said. “For anybody going into accounting, if they can see themselves as a success story because they can see a partner that looks like them, then, it's more attractive for them to enter that field.”

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JOURNAL

Journal of Accounting and Public Policy

DOI

10.1016/j.jaccpubpol.2022.106941 

ARTICLE TITLE

Gender equity in public accounting: Evidence from single audit partner and director engagement leaders

Will your university still exist in the future?

Find out how universities and colleges should prepare for survival in this new book

Book Announcement

WORLD SCIENTIFIC

 

IMAGE: COVER OF "DIGITAL TRANSFORMATION FOR THE UNIVERSITY OF THE FUTURE" view more 

CREDIT: WORLD SCIENTIFIC

With the COVID-19 pandemic, we have seen universities worldwide having to pivot quickly to transform their education delivery to an online environment, as well as conduct their business operations virtually and remotely. For the universities who embraced digital transformation, they were able to adapt quickly to this new learning environment. Many others were not as successful. Part of the formula for success is for universities and other institutions of higher education to apply digital transformation technologies, processes, and leadership in this “new normal”.

Looking towards the future, how should universities and colleges prepare for survival? Dr. Jay Liebowitz and his colleagues, some of the leading authorities on the subject worldwide, provide some of the key answers and insights in Digital Transformation for the University of the Future.

Targeted at administrative and faculty staff, and students at institutes of higher learning, the inaugural volume of the new World Scientific book series, Digital Transformation: Accelerating Organizational Intelligence highlights what is needed in for digital transformation in terms of technologies, processes, culture, and leadership considerations.

Digital Transformation for the University of the Future retails for US$98 / £85 (hardcover) and is also available in electronic formats. To order or know more about the book and editor, visit http://www.worldscientific.com/worldscibooks/10.1142/12773.

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About the Editor

Dr. Jay Liebowitz is the Executive-in-Residence for Public Service at Columbia University’s Data Science Institute, as of September 6, 2022. He is currently a Visiting Professor in the Stillman School of Business and the MS-Business Analytics Capstone & Co-Program Director (External Relations) at Seton Hall University. He previously served as the Distinguished Chair of Applied Business and Finance at Harrisburg University of Science and Technology. Before HU, he was the Orkand Endowed Chair of Management and Technology in the Graduate School at the University of Maryland University College (UMUC). He served as a Full Professor in the Carey Business School at Johns Hopkins University. He was ranked one of the top 10 knowledge management researchers/practitioners out of 11,000 worldwide, and was ranked #2 in KM Strategy worldwide according to the January 2010 Journal of Knowledge Management. At Johns Hopkins University, he was the founding Program Director for the Graduate Certificate in Competitive Intelligence and the Capstone Director of the MS-Information and Telecommunications Systems for Business Program, where he engaged over 30 organizations in industry, government, and not-for-profits in capstone projects.

About World Scientific Publishing Co.

World Scientific Publishing is a leading international independent publisher of books and journals for the scholarly, research and professional communities. World Scientific collaborates with prestigious organisations like the Nobel Foundation and US National Academies Press to bring high quality academic and professional content to researchers and academics worldwide. The company publishes about 600 books and over 140 journals in various fields annually. To find out more about World Scientific, please visit www.worldscientific.com.

For more information, contact WSPC Communications at communications@wspc.com.

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DOI

10.1142/12773 

More than a little chemistry

New full-color graphic novel for teens and adults presents all one needs to know about the history of chemistry, why it is important, and how it is central to everyday life

Book Announcement

WORLD SCIENTIFIC

 

IMAGE: COVER OF "O MG! HOW CHEMISTRY CAME TO BE" view more 

CREDIT: WORLD SCIENTIFIC

The history of chemistry is often missing from many modern science libraries for the layman and learner. O Mg! How Chemistry Came to Be

Author Stephen M. Cohen, who has a Ph.D. in chemistry and has done comic strips and editorial cartoons in the past, discusses major chemical ideas and important scientists from around the world—from the conservation of matter to the existence of atoms and molecules, to Antoine Lavoisier and Marie Curie, and from environmental chemistry to polymers.

The “emcee” of the book’s historical tour is the molecular-shaped Ben Zene, with an eccentric sidekick in the form of ancient Greek philosopher Democritus, who first postulated atoms. The chemists presented in O Mg! often speak a phrase in their local language; contextual art, literature, music, history, politics, and even occasional dad-jokes and weird chemical facts also make an appearance in the panels.

Also in the work are occasional sidebars on chemical-related history and the arts, and factoids such as how US President A Herbert Hoover and Isreali President Chaim Weizmann influenced chemistry; how personal politics may have denied Gilbert Lewis the Nobel Prize; a Japanese tale of intrigue mingling with chemistry; and which chemist was the first living person to have an element named after him.

O Mg! How Chemistry Came to Be retails for US$39.95 / £30 (paperback) and US$78 / £60 (hardcover) and is also available in electronic formats. To order or know more about the book, visit http://www.worldscientific.com/worldscibooks/10.1142/12670.

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About the Author

Stephen Cohen has a Ph.D. in Chemistry from Rice University, has traveled around the USA, Europe, and Middle East, and spent one year as a chemistry researcher in the UK. A free-lance writer and technical writer, he has published articles in both general-interest and peer-reviewed journals dealing with chemistry, chemical history, chemical literature in Yiddish, and genealogy. His other books include What’s in a Name?: A Young Person’s Jewish Genealogy Workbook, Introductory Electrochemistry, and America’s Scientific Treasures: A Travel Companion, 2nd ed. Dr. Cohen also is a member of the Board of the Royal Society of Chemistry—US Section. As an undergraduate at the University of Pennsylvania, he drew a daily comic strip, “Buffer’s Solutions,” for the Daily Pennsylvanian, and was Art Editor for Punch Bowl, the student humor magazine. One of his editorial cartoons appeared in a Union of Concerned Scientists calendar, and his articles appeared in the Journal of Irreproducible Results.

About World Scientific Publishing Co.

World Scientific Publishing is a leading international independent publisher of books and journals for the scholarly, research and professional communities. World Scientific collaborates with prestigious organisations like the Nobel Foundation and US National Academies Press to bring high quality academic and professional content to researchers and academics worldwide. The company publishes about 600 books and over 140 journals in various fields annually. To find out more about World Scientific, please visit www.worldscientific.com.

For more information, contact WSPC Communications at communications@wspc.com.

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DOI

10.1142/12670