bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate social responsibility in tourism as a tool for sustainable development
Authors: Hatipoglu Burcin , Ertuna Bengi , Salman Duygu
Published: February 2019

Purpose

This study aims to analyze corporate social responsibility (CSR) programs in tourism as a tool for sustainable development in the CSR program of a multinational enterprise in Turkey.

Design/methodology/approach

This study includes qualitative research on a single company, content analysis of company-originated documents, participant observations, questionnaires for tourism project coordinators and follow-up interviews with company directors and project managers.

Findings

The paper identifies immediate context variables, program management, the complementary nature of interests and the diverse capabilities of the partners and an ongoing evaluation process as the determining factors for creating shared value for CSR programs in tourism.

Research limitations/implications

Despite the challenges of impact assessment and measurement of long-term effects, the study proposes a systematic framework for evaluating shared value creation generated by CSR activity.

Practical implications

The evaluation methodology introduced in this research will be of use to CSR program developers in interpreting and reporting on the anticipated outcomes and impacts of their interventions in sustainable tourism development.

Social implications

A lack of outcome evaluation and impact assessment may affect accountability and, hence, the legitimacy of CSR programs. This study attempts to mitigate that limitation by introducing a novel methodology.

Originality/value

The value of CSR in tourism is a highly contested issue, despite its high potential for contributing to sustainable development. This longitudinal research goes beyond presenting immediate outputs of a CSR program in sustainable tourism; it discusses intermediate outcomes in the form of capitals, community well-being and shared value for society at large.
Investigating the influence of performance measurement on learning, entrepreneurial orientation and performance in turbulent markets
Authors: Taheri Babak , Bititci Umit , Gannon Martin Joseph , Cordina Renzo
Published: February 2019

Purpose

This study aims to examine how comprehensive performance measurement systems (CPMS) influence entrepreneurial orientation, market-focussed learning (MFL) and employees’ perceptions of firm performance within a service-provision context. It also considers the moderating effect of low and high levels of perceived market-turbulence (low-turbulence environments [LMT] vs highly turbulent environments [HMT]) on the relationships between these concepts.

Design/methodology/approach

PLS-SEM was used to test the hypothesised relationships using survey responses from 198 employees of a leading multi-branch travel agency in Iran.

Findings

The findings demonstrate that CPMS positively influence MFL and, in doing so, have a positive effect on perceptions of firm performance. However, the findings also suggest that CPMS negatively influence entrepreneurial orientation, and therefore can also negatively influence perceptions of firm performance. Further, the relationships between CPMS, entrepreneurial orientation, MFL and firm performance are stronger for HMT when compared to LMT for all relationships.

Practical implications

Industry managers should adapt their CPMS to include measures specific to intra-organisational entrepreneurship and innovation and should pursue greater understanding of changing customer preferences.

Originality/value

This study highlights the importance of MFL as a means of avoiding the negative impact of underdeveloped market research on performance in the turbulent Iranian context. Contrary to previous literature, it provides an example of how CPMS can negatively influence entrepreneurial orientation in such environments.
Unethical consumer behavior: the role of institutional and socio-cultural factors
Authors: Agnihotri Arpita , Bhattacharya Saurabh
Published: February 2019

Purpose

The purpose of this study is to explore how institutional trust, frugality and materialism motivate consumers’ unethical behavior.

Design/methodology/approach

The authors conducted the study in two phases – qualitative and quantitative. In the qualitative phase through a content analysis of semi-structured interviews, a list of unethical activities was obtained. In the quantitative phase, a questionnaire was developed, which had questions related to the unethical activities. Data collection for the quantitative phase was achieved through mall intercept surveys. The collected data were subjected to exploratory factor analysis, confirmatory factor analysis and multivariate regression analysis.

Findings

Poor institutional environment, frugal attitude and materialistic values motivate consumers from an emerging economy to indulge in unethical acts some of which were not explored before such as booking a cab but not boarding or stealing electricity.

Originality/value

Research evidence on unethical consumer behavior is lacking from emerging markets. Furthermore, extant studies have used mainly national culture models to explore unethical behavior, and finally, the role of institutional trust and frugality has not been explored in previous studies. The present study tries to fill these gaps by considering these elements as the cornerstone of this study.
A study on behaviour of bullwhip effect in (R, S) inventory control system considering DWT-MGGP demand forecasting model
Authors: Jaipuria Sanjita , Mahapatra Siba Sankar
Published: February 2019

Purpose

The purpose of this paper is to propose a forecasting model to predict the demand under uncertain environment to control the bullwhip effect (BWE) considering review-period order-up-to level ((R, S)) inventory control policy and its different variants such as (R, βS) (R, γO) and (R, γO, βS) proposed by Jakšič and Rusjan, (2008) and Bandyopadhyay and Bhattacharya (2013).

Design/methodology/approach

A hybrid forecasting model has been developed by combining the feature of discrete wavelet transformation (DWT) and an intelligence technique, multi-gene genetic programming (MGGP), denoted as DWT-MGGP. Performance of DWT-MGGP model has been verified under (R, S) inventory control policy considering demand from three different manufacturing companies.

Findings

A comparison between DWT-MGGP model and autoregressive integrated moving average forecasting model has been done by estimating forecast error and BWE. Further, this study has been extended with analysing the behaviour of BWE considering different variants of (R, S) policy such as (R,βS) (R, γO) and (R,γO,βS) and found that BWE can be moderated by controlling the inventory smoothing (β) and order smoothing parameters (γ).

Research limitations/implications

This study is limited to different variants of (R, S) inventory control policy. However, this study can be further extended to continuous review policy.

Practical implications

The proposed DWT-MGGP model can be used as a suitable demand forecasting model to control the BWE when (R, S), (R,βS) (R,γO) and (R,γO,βS)inventory control policies are followed for replenishment.

Originality/value

This study analyses the behavior of BWE through controlling the inventory smoothing (β) and order smoothing parameters (γ) when demand is predicted using DWT-MGGP forecasting model and order is estimated using (R, S), (R,βS) (R,γO) and (R,γO,βS) inventory control policies.
Design of a bi-manual haptic interface for skill acquisition in surface mount device soldering
Authors: James Jose , Rao R. Bhavani , Neamtu Gabriel
Published: February 2019

Purpose

Offering unskilled people training in engineering and vocational skills helps to decrease unemployment rate. The purpose of this paper is to augment actual hands-on conventional vocational training methods with virtual haptic simulations as part of computer-based vocational education and training.

Design/methodology/approach

This paper discusses the design of a bi-manual virtual multi-modal training interface for learning basic skills in surface mount device hand soldering. This research aims to analyze human hand dexterity of novices and experts at micro level skill knowledge capture by simulating and tracking the users’ actions in the manual soldering process through a multi-modal user interface.

Findings

Haptic feedback can enhance the experience of a virtual training environment for the end user and can provide a supplementary modality for imparting tangible principles to increase effectiveness. This will improve the teaching and learning of engineering and vocational skills with touch-based haptics technology, targeted toward teachers and students of various disciplines in engineering. Compared with the traditional training methods for learning soldering skills, the proposed method shows more efficiency in faster skill acquisition and skill learning.

Originality/value

In this study, the authors proposed a novel bi-manual virtual training simulator model for teaching soldering skills for surface mount technology and inspection. This research aims to investigate the acquisition of soldering skills through virtual environment, with and without haptic feedback. This acts as a basic-level training simulator that provides introductory training in soldering skills and can help initially unskilled people find educational opportunities and job offers in the electronics industry.
Differential responses of ecosystem carbon flux components to experimental precipitation gradient in an alpine meadow
Authors: Zhang Fangyue , Quan Quan , Ma Fangfang , Tian Dashuan , Zhou Qingping , Niu Shuli
Published: February 2019

Changes in precipitation have the potential to cause dramatic changes in ecosystem carbon (C) cycling; however, it remains unclear whether different components of the net ecosystem exchange (NEE) (e.g., C uptake vs. release, plant vs. microbe respiration, above‐ground vs. below‐ground plant respiration) have similar or differential sensitivity to precipitation gradients.

We conducted a manipulative field experiment (from 2015 to 2017) with six precipitation treatments, including 1/12 annual precipitation (P), 1/4 P, 1/2 P, 3/4 P, P and 5/4 P in an alpine meadow to investigate the responses of the NEE components.

Over the 3 years, all C fluxes showed a nonlinear response to the precipitation gradients, except for root respiration. The most extreme drought treatment (1/12 P) caused strong reductions in NEE by 15.57%, gross primary productivity by 17.26% and ecosystem respiration by 19.05%, in contrast to the control. Plant respiration was more sensitive to precipitation change than microbe respiration, and above‐ground plant respiration was more susceptible than below‐ground respiration. Structural equation models revealed that the response of C fluxes under precipitation changes was primarily due to changes in the soil water content and above‐ground net primary productivity.

Our findings indicate that future precipitation changes, particularly extreme drought, will decrease ecosystem C fluxes with different magnitudes, leading to a consequent reduction of NEE. These emergent ecosystem properties are essential for the improved elucidation of carbon cycle dynamics and benchmarking models, to predict ecosystem responses to precipitation changes.

A plain language summary is available for this article.
Elastic properties of sands, Part 2: Implementation of contact‐based model to determine the elasticity of the grains from ultrasonic measurements
Authors: Ahmed Zubair , Lebedev Maxim
Published: February 2019

The prediction of effective elastic properties of a granular medium using ultrasonic data based on contact models has been studied widely in both laboratory experiments and numerical simulations. In contrast, a calculation of the elastic properties of the constituent grains using similar data by inverting the equations from those models is a rather new concept. To do so, we have developed a controlled experiment technique that includes a uniaxial compaction test and measures ultrasonic velocities of four unconsolidated quartz sand samples with different sorting and grain shapes. We observe that both P‐ and S‐wave velocities are significantly influenced by the microstructure or internal arrangement of the grains. Well sorted and more spherical and rounded samples show higher velocities than the poorly sorted and less spherical and rounded samples. A microstructural parameter – namely coordination number – we have calculated from high resolution micro computed tomography images provides a good match between the model and dynamic effective bulk moduli of the sand pack. Combining this coordination number with a frictional parameter calculated from the measured velocity ratios has been very effective to fit the model with the dynamic effective shear moduli. Using these two key parameters along with the experiment results in the contact model we have been able to obtain the elastic parameters of the quartz sand grains in the sample. Elastic parameters obtained thus are very close to the actual values of the quartz grains found in the literature. This technique can be useful in hard rock mineral exploration where missing core samples or an absence of well logs can be replaced by laboratory measurements of powders to find the elasticity or velocities of the rocks. Moreover, the elastic properties of the solid phase calculated using this technique can be used as input parameters for the fluid substitution and rock physics characterization of unconsolidated reservoir sands.
Development of a Protein‐based Human Identification Capability from a Single Hair
Authors: Mason Katelyn E. , Paul Phillip H. , Chu Fanny , Anex Deon S. , Hart Bradley R.
Published: February 2019

Shed human hair (lacking root nuclear DNA) frequently contributes important information to forensic investigations involving human identification. Detection of genetic variation observed in amino acid sequences of hair proteins provides a new suite of identity markers that augment microscopic hair analysis and mitochondrial DNA sequencing. In this study, a new method that completely dissolves single hairs using a combination of heat, ultrasonication, and surfactants was developed. Dissolved proteins were digested and genetically variant peptide (GVP) profiles were obtained for single hairs (25 mm) via high‐resolution nanoflow liquid chromatography‐based mass spectrometry and a novel exome‐driven bioinformatic approach. Overall, 6519 unique peptides were identified and a total of 57 GVPs were confirmed. Random match probabilities ranged between 2.6 × 10−2 and 6.0 × 10−9. The new bioinformatic strategy and ability to analyze GVPs in forensically relevant samples sizes demonstrate applicability of this approach to distinguish individuals in forensic contexts.
Fluorescence of 1,2‐Indanedione with Amino Acids Present in the Fingerprint Residue: Application in Gender Determination
Authors: Mekkaoui Alaoui Ismail , Halamek Jan
Published: February 2019

1,2‐indanedione is used for latent fingerprint visualization on porous surfaces. In this paper, fluorescence spectra of 1,2‐indanedione after reacting with 21 individual amino acids present in latent fingerprints residue were measured in water‐methanol solutions. The fluorescence intensity depends on the amino acid used, while the fluorescence peak does not change much. The concentration of amino acids in fingerprint residue in females is almost the double of their concentration in males. This property combined with fluorescence of 1,2‐indanedione‐amino acids compounds is used for gender determination, by comparing the fluorescence intensity peaks in the same experimental conditions. In this preliminary study, the fluorescence signal from the samples representing females was almost two times the signal for samples representing males. In addition to the reduction by almost 50% of the number of suspects in a criminal research case, these results could be helpful in gaining some knowledge about the papillary residue composition.
Bioaerosol biomonitoring: Sampling optimization for molecular microbial ecology
Authors: Ferguson Robert M. W. , Garcia‐Alcega Sonia , Coulon Frederic , Dumbrell Alex J. , Whitby Corinne , Colbeck Ian
Published: February 2019

Bioaerosols (or biogenic aerosols) have largely been overlooked by molecular ecologists. However, this is rapidly changing as bioaerosols play key roles in public health, environmental chemistry and the dispersal ecology of microbes. Due to the low environmental concentrations of bioaerosols, collecting sufficient biomass for molecular methods is challenging. Currently, no standardized methods for bioaerosol collection for molecular ecology research exist. Each study requires a process of optimization, which greatly slows the advance of bioaerosol science. Here, we evaluated air filtration and liquid impingement for bioaerosol sampling across a range of environmental conditions. We also investigated the effect of sampling matrices, sample concentration strategies and sampling duration on DNA yield. Air filtration using polycarbonate filters gave the highest recovery, but due to the faster sampling rates possible with impingement, we recommend this method for fine ‐scale temporal/spatial ecological studies. To prevent bias for the recovery of Gram‐positive bacteria, we found that the matrix for impingement should be phosphate‐buffered saline. The optimal method for bioaerosol concentration from the liquid matrix was centrifugation. However, we also present a method using syringe filters for rapid in‐field recovery of bioaerosols from impingement samples, without compromising microbial diversity for high ‐throughput sequencing approaches. Finally, we provide a resource that enables molecular ecologists to select the most appropriate sampling strategy for their specific research question.
Clinicopathological characteristics and prognostic factors of pulmonary large cell neuroendocrine carcinoma: A large population‐based analysis
Authors: Yang Qiao , Xu Zihan , Chen Xiewan , Zheng Linpeng , Yu Yongxin , Zhao Xianlan , Chen Mingjing , Luo Bangyu , Wang Jianmin , Sun Jianguo
Published: February 2019

Background

The study was conducted to compare the clinicopathological characteristics, survival outcomes, and metastatic patterns between pulmonary large cell neuroendocrine carcinoma (LCNEC) and other non‐small cell lung cancer (ONSCLC), and to identify the prognostic factors of LCNEC.

Methods

Data of patients diagnosed with LCNEC and ONSCLC from 2004 to 2014 were obtained from the Surveillance, Epidemiology, and End Results dataset. Pearson’s chi‐square tests were used to compare differences in clinicopathological characteristics. The Kaplan–Meier method was used for survival analysis. A propensity score was used for matching and a Cox proportional hazards model was used for multivariate and subgroup analyses.

Results

A total of 2368 LCNEC cases and 231 672 ONSCLC cases were identified. LCNEC incidence increased slightly over time. Except for marital status, LCNEC patients had obviously different biological features to ONSCLC patients. Survival analysis showed that LCNEC had poorer outcomes than ONSCLC. Multivariate analysis revealed that female gender, black race, surgery, radiation, and chemotherapy were protective factors for LCNEC. Matched subgroup analysis further demonstrated that most subgroup factors favored ONSCLC, especially in early stage. Early‐stage LCNEC patients had a higher risk of lung cancer‐specific death than early‐stage ONSCLC patients. Moreover, metastatic patterns were different between LCNEC and ONSCLC. LCNEC patients with isolated liver metastasis or combined invasion to other organs had poorer survival rates.

Conclusions

LCNEC has totally different clinicopathological characteristics and metastatic patterns to ONSCLC. LCNEC also has poorer survival outcomes, primarily because of isolated liver metastasis or combined invasion to other organs. Most subgroup factors are adverse factors for LCNEC.
Unusual radiologic manifestation of pseudoprogression in pulmonary metastases after durvalumab treatment in metastatic bladder urothelial cancer
Authors: Kim Eun Young , Park Inkeun , Kim Young Saing , Ahn Hee Kyung , Lee Hee Young , Kim Jeong Ho
Published: February 2019

Durvalumab is an immune checkpoint inhibitor that blocks PD‐L1. Unlike cytotoxic chemotherapy or molecularly targeted agents, immune checkpoint inhibitors occasionally present distinct response patterns, including radiologic pseudoprogression (initial tumor enlargement with subsequent tumor regression) and immune‐related adverse events in normal tissues. We report a case of unusual computed tomography (CT) findings of pseudoprogression of pulmonary metastases in a patient with metastatic bladder cancer after durvalumab treatment: multiple pulmonary metastases turned into ground‐glass opacity on first follow‐up CT; on second follow‐up CT, and after sustained treatment of the PD‐L1 inhibitor, the lesion was resolved.
Earnings Momentum, Adaptation Value, and Nonlinearities in the Valuation of Chinese Equity Stocks
Authors: Dong Yizhe , Lubberink Martien , MA Diandian , Tippett Mark
Published: February 2019

We demonstrate that when the variables comprising a firm's investment opportunity set depend on their past values then the present value of the cash flows the firm expects to earn will be stated in terms of the levels and the momentum of the affected variables. It is also shown that the market value of a firm's equity is comprised of the present value of the cash flows it expects to earn from operating under its existing investment opportunity set plus the value of the real options the firm possesses to modify or even completely change its existing investment opportunity set. Our empirical analysis, based on both Chinese and US data, shows that earnings momentum and the adaptation and growth options typically available to firms all appear to have a significant impact on equity prices.
Age‐dependent changes and biomarkers of aging in Caenorhabditis elegans
Authors: Son Heehwa G. , Altintas Ozlem , Kim Eun Ji E. , Kwon Sujeong , Lee Seung‐Jae V.
Published: February 2019

Caenorhabditis elegans is an exceptionally valuable model for aging research because of many advantages, including its genetic tractability, short lifespan, and clear age‐dependent physiological changes. Aged C. elegans display a decline in their anatomical and functional features, including tissue integrity, motility, learning and memory, and immunity. Caenorhabditis elegans also exhibit many age‐associated changes in the expression of microRNAs and stress‐responsive genes and in RNA and protein quality control systems. Many of these age‐associated changes provide information on the health of the animals and serve as valuable biomarkers for aging research. Here, we review the age‐dependent changes in C. elegans and their utility as aging biomarkers indicative of the physiological status of aging.
Assessment of Skin Blood Flow Following Acute Intravenous Alcohol, and Association with Subjective Perceptions, in Social Drinkers
Authors: Vatsalya Vatsalya , Stangl Bethany L. , Ramchandani Vijay A.
Published: February 2019

Background

The objective of this study was to determine the effect of acute intravenous (IV) alcohol infusion on skin blood flow (SBF) response, measured at fingertip and earlobe, and subjective responses associated with SBF in social drinkers.

Methods

Twenty‐four social drinkers underwent a computer‐assisted alcohol self‐infusion study. SBF was measured continuously using laser Doppler flow meter, with the probe placed on the fingertip or earlobe. Perfusion recordings were collected at baseline, and at 0‐minute (0 to 5 minutes), 10‐minute (10 to 15 minutes), and 20‐minute (20 to 25 minutes) time points during the priming phase of IV alcohol self‐administration paradigm at low breath alcohol levels of approximately 30 mg%. Subjective response was measured using the Drug Effects Questionnaire (DEQ) and Biphasic Alcohol Effects Scale.

Results

Overall SBF (collective data from both fingertip and earlobe) and SBF by each site showed significant drop at 0 minutes and then subsequent significant elevation with alcohol self‐administration. Males showed higher overall SBF at baseline and 0 minutes than the females. At fingertip site, lowering in 0‐minute SBF compared to baseline, and subsequent significant increase at the 10‐ and 20‐minute SBF recordings were observed. DEQ measures of “like” and “want more” alcohol were significantly associated with 10‐ and 20‐minute SBF recordings collected at fingertip site.

Conclusions

The changes in SBF following acute IV alcohol exposure are consistent with the sympathetic response of alcohol on the cardiovascular system. This acute hemodynamic effect characterizes differences in blood flow that are sensitive to relatively low levels of acute alcohol exposure. The association of subjective perceptions with the SBF response provides evidence of the psychophysiological effects of alcohol at low levels of exposure.
The Impact of Past and Current Alcohol Consumption Patterns on Progression of Carotid Intima‐Media Thickness Among Women and Men Living with HIV Infection
Authors: Chichetto Natalie E. , Plankey Michael W. , Abraham Alison G. , Sheps David S. , Ennis Nicole , Chen Xinguang , Weber Kathleen M. , Shoptaw Steven , Kaplan Robert C. , Post Wendy S. , Cook Robert L.
Published: February 2019

Background

The relationship between alcohol consumption and atherosclerosis has not been sufficiently examined among people living with HIV (PLWH).

Methods

We analyzed data from PLWH in the Women's Interagency HIV Study (WIHS; n = 1,164) and the Multicenter AIDS Cohort Study (MACS; n = 387) with no history of cardiovascular disease (CVD). Repeated measures of intima‐media thickness of the right common carotid artery (CCA‐IMT) were assessed using B‐mode ultrasound from 2004 to 2013. Current alcohol consumption was collected at time of CCA‐IMT measurement and was categorized according to gender‐specific weekly limits. Group‐based trajectory models categorized participants into past 10‐year consumption patterns (1994 to 2004). Multivariate generalized estimating equations were conducted to assess the association of past and current alcohol use patterns on change in CCA‐IMT by cohort, controlling for age, race, cigarette and illicit drug use, probable depression, HIV RNA viral load, antiretroviral therapy exposure, and hepatitis C coinfection.

Results

Among the WIHS, past heavy alcohol consumption was associated with increased CCA‐IMT level over time (β = 8.08, CI 0.35, 15.8, p = 0.04), compared to abstinence. Among the MACS, compared to abstinence, all past consumption patterns were associated with increased CCA‐IMT over time (past low: β = 15.3, 95% CI 6.46, 24.2, p < 0.001; past moderate: β = 14.3, CI 1.36, 27.2, p = 0.03; past heavy: β = 21.8, CI 4.63, 38.9, p = 0.01). Current heavy consumption was associated with decreased CCA‐IMT among the WIHS (β = −11.4, 95% CI −20.2, −2.63, p = 0.01) and MACS (β = −15.4, 95% CI −30.7, −0.13, p = 0.04). No statistically significant time by consumption pattern effects were found.

Conclusions

In both cohorts, 10‐year heavy consumption was associated with statistically significant increases in carotid artery thickness, compared to abstinence. Long‐term patterns of drinking at any level above abstinence were particularly significant for increases in IMT among men, with heavy consumption presenting with the greatest increase. Our results suggest a potentially different window of risk among past and current heavy drinkers. Further studies are needed to determine whether alcohol consumption level is associated with intermediate measures of atherosclerosis. Alcohol screening and interventions to reduce heavy consumption may benefit PLWH who are at risk of CVD.
N‐acetylcysteine yields sex‐specific efficacy for cue‐induced reinstatement of nicotine seeking
Authors: Goenaga Julianna , Powell Gregory L. , Leyrer‐Jackson Jonna M. , Piña Jose , Phan Sandy , Prakapenka Alesia V. , Koebele Stephanie V. , Namba Mark D. , McClure Erin A. , Bimonte‐Nelson Heather A. , Gipson Cassandra D.
Published: February 2019

Women report greater craving during certain phases of the menstrual cycle. As well, research indicates that pharmacotherapies for smoking may be less efficacious in women compared with men, which may be due to interactions with natural fluctuations in ovarian hormone levels. N‐Acetylcysteine (NAC) is a glutamatergic compound that has shown some efficacy in treating substance use disorders and aids in the prevention of relapse. However, it is unclear whether NAC has sex‐specific effectiveness for nicotine relapse treatment. Given that NAC has shown promise to reduce nicotine reinstatement in preclinical models using male rats, the exploration of potential sex differences in the efficacy of NAC is warranted. Using a rat model, we first investigated the ability of NAC treatment (100 mg/kg, ip) during nicotine withdrawal with extinction training to reduce cue‐induced nicotine seeking in male and female rats. Next, we assessed whether NAC's effects were estrous cycle–dependent for female rats. Results show that following NAC treatment during extinction, reinstatement of nicotine seeking was significantly decreased in males but not females, indicating a sex‐specific effect of NAC. Furthermore, for females, both vehicle‐ and NAC‐treated groups significantly reinstated nicotine‐seeking behavior compared with extinction, regardless of estrous cycle phase. These results suggest that NAC is inefficacious in reducing nicotine relapse in females regardless of estrous cycle phase at the dose evaluated here. These collective findings could have important clinical implications for use and efficacy of NAC as a pharmacotherapy for freely cycling women smokers.
Is the association between maternal alcohol consumption in pregnancy and pre‐school child behavioural and emotional problems causal? Multiple approaches for controlling unmeasured confounding
Authors: Lund Ingunn Olea , Moen Eilertsen Espen , Gjerde Line C. , Røysamb Espen , Wood Mollie , Reichborn‐Kjennerud Ted , Ystrom Eivind
Published: February 2019

Background and aims

Hazardous drinking (i.e. alcohol consumption that places drinkers at risk for adverse health outcomes) during pregnancy is associated with adverse child outcomes. To address whether the associations are causal, we aimed to estimate the effect of maternal hazardous drinking during the first trimester on offspring emotional and behavioural problems throughout the pre‐school age. We adjusted for: (1) measured confounding (e.g. smoking), (2) familial risk factors by sibling control design and (3) non‐shared environmental risk factors by using hazardous drinking the 3 months before pregnancy as an instrumental variable.

Design

Prospective cohort study. Participants were recruited between 1999 and 2009 at ultrasound examination offered to all pregnant women in Norway. Data were collected during the 17th and the 30th weeks of gestation, and when the children were aged 1.5, 3 and 5 years.

Setting

Norway, 1999–2015.

Participants

The sample consisted of 14 639 mothers with 25 744 offspring siblings from the Norwegian Mother and Child Cohort Study.

Measurements

Respondents self‐reported on: alcohol consumption, children's emotional problems (i.e. emotional reactive, anxiety/depression, somatic complaints) and children's behavioural problems (i.e. attention and aggressive behaviour) throughout pre‐school age. We used longitudinal latent growth curve models to estimate the effect of maternal drinking during the first trimester on offspring emotional and behavioural problems.

Findings

Most associations were strongly reduced after controlling for both familial and measured environmental risk factors. After adjustment, exposed children were more emotionally reactive [β = 2.33; 95% confidence interval (CI) = 0.13–4.53] and had more somatic complaints (β = 1.93; 95% CI = 0.09–3.77) at age 3, but not at age 5. Exposed children were less aggressive than unexposed siblings at age 5 (β = −2.27; 95% CI = –4.02 to –0.52).

Conclusions

Children exposed to their mothers’ hazardous drinking during the first trimester appear to be more emotionally reactive and have more somatic complaints at age 3, but not at age 5, and are less aggressive at age 5 compared with unexposed siblings.
Ultrastructural observations on the platelets of the Arabian oryx (Oryx leucoryx)
Authors: Al‐Amri Ahmed Saif Hilal , Al‐Marzooqi Waleed , Al‐Abri Mohammed , Johnson Eugene H.
Published: February 2019

An ultrastructural study on the platelets from peripheral blood samples from 20 healthy adult Arabian oryx (Oryx leucocoryx) was performed. Characteristic was the extreme polymorphism of both the platelets, as well as their alpha granules. They vary in size from 100 to 800 nm in diameter and their numbers typically are less than those reported for humans and other animal species. Also, the alpha granules in contrast to those of humans and animals, such as the Arabian tahr, do not have nucleoids. Typically, the oryx platelets exhibit only 1–2 electron‐dense bodies per cell and they lack an open canalicular system. Of particular interest is the presence of Type I multivesicular bodies, which have previously only been described in human megakaryocytes and are hypothesized as being intermediate development stages of alpha and dense granules.
Intravenous immunoglobulin G use in patients with chronic inflammatory demyelinating polyneuropathy: An uncommon cause of drug‐induced discoid lupus erythematosus
Authors: Jennings Tara , Ahmed Sarah , Aphale Abhishek , Lee Jason , Valdes‐Rodriguez Rodrigo
Published: February 2019

Drug‐induced chronic cutaneous lupus erythematosus, or drug‐induced discoid lupus erythematosus, is a rare cutaneous phenomenon. Various medications have been associated with drug‐induced discoid lupus erythematosus including fluorouracile agents, especially tegafur and uraciltegafur, and TNF‐α antagonists such as infliximab or etanercept. Recent literature has described a case series of six patients receiving IgG immunoglobulin for chronic inflammatory demyelinating polyneuropathy with subsequent presentations of discoid lupus erythematosus. We present a patient with chronic inflammatory demyelinating polyneuropathy who developed discoid lupus erythematosus secondary to IgG immunoglobulin.
The immunophenotype of decidual macrophages in acute atherosis
Authors: Gill Navleen , Leng Yaozhu , Romero Roberto , Xu Yi , Panaitescu Bogdan , Miller Derek , Arif Afrah , Mumuni Salma , Qureshi Faisal , Hsu Chaur‐Dong , Hassan Sonia S. , Staff Anne Cathrine , Gomez‐Lopez Nardhy
Published: February 2019

Problem

Acute atherosis is a uteroplacental arterial lesion that is associated with pregnancy complications such as preeclampsia and preterm birth, the latter being the leading cause of perinatal morbidity and mortality worldwide. However, the immunobiology of acute atherosis is poorly understood.

Method of study

Placental basal plate samples were collected from women who delivered with (n = 11) and without (n = 31) decidua basalis lesions of acute atherosis. Multicolor flow cytometry was used to quantify M1‐ and M2‐like macrophage subsets and the expression of iNOS and IL‐12 by decidual macrophages. Multiplex fluorescence staining and phenoptics were performed to localize M1‐, MOX‐, and Mhem‐like macrophages in the decidual basalis.

Results

Macrophages displayed diverse phenotypes in the decidua basalis with acute atherosis. M2‐like macrophages were the most abundant subset in the decidua; yet, this macrophage subset did not change with the presence of acute atherosis. Decidual M1‐like macrophages were increased in acute atherosis, and such macrophages displayed a pro‐inflammatory phenotype, as indicated by the expression of iNOS and IL‐12. Decidual M1‐like pro‐inflammatory macrophages were localized near both transformed and non‐transformed vessels in the decidua basalis with acute atherosis. MOX and Mhem macrophages were also identified near transformed vessels in the decidua basalis with acute atherosis. Finally, monocyte‐like cells were present on the vessel wall of non‐transformed decidual vessels, indicating a possible intravascular source for macrophages in acute atherosis.

Conclusion

Decidual macrophages display different phenotypes, namely M1‐like, M2‐like, MOX, and Mhem subsets. Yet, pro‐inflammatory macrophages are enriched in the decidua basalis with acute atherosis. These findings provide a molecular foundation for future mechanistic inquiries about the role of pro‐inflammatory macrophages in the pathogenesis of acute atherosis.
Female genital mutilation: Obstetric outcomes in metropolitan Sydney
Authors: Davis Georgina , Jellins Jessica
Published: February 2019

Background

Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery.

Aims

To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes.

Methods

Retrospective cohort study of women affected by FGM who delivered at a metropolitan hospital in Sydney over a five‐year period. The primary outcome was mode of delivery and secondary outcomes addressed maternal morbidity and neonatal nursery admission compared with women unaffected by FGM.

Results

A full data set was available for 141/142 women affected by FGM. The overall prevalence of FGM was 1.64%. The majority of women affected by FGM were documented to have FGM 3 (41.1%). There was no difference in caesarean section rate. Women with FGM were less likely to be delivered by vacuum or forceps (11.1% vs 2.8%; P = 0.0009). There was no difference in perineal trauma, postpartum haemorrhage and neonatal nursery admission. Women with FGM 3 were more likely to have an episiotomy (4.8% vs 25.9%; P = 0.0007) without an increase in anal sphincter injury (P = 0.7). Documentation complying with local policy and guidelines was poor.

Conclusions

FGM is increasingly common in Australia. This study adds to the Australian literature quantifying the effects on obstetric outcomes in these high‐risk women.
Iris suture fixation of out‐of‐the‐bag dislocated three‐piece intraocular lenses
Authors: Armonaite Laura , Löfgren Stefan , Behndig Anders
Published: February 2019

Purpose

To evaluate the efficacy and safety of iris suture fixation of out‐of‐the‐bag dislocated three‐piece intraocular lenses (IOL).

Methods

In a retrospective interventional consecutive case series, a chart review was performed in two groups of patients: fourteen patients with a dislocated out‐of‐the‐bag three‐piece IOL that underwent IOL fixation to the iris using the Siepser sliding knot technique (Iris group) and 18 patients with in‐the‐bag dislocation that underwent IOL exchange with a new scleral‐sutured IOL (Exchange group). The Iris and Exchange groups were compared regarding surgical safety and efficacy. The median follow‐up time was 13.5 months [interquartile range (IQR), 10–20] in the Iris group and 12.5 (IQR, 10–14) in the Exchange group.

Results

The best corrected visual acuity (BCVA) improved significantly in both groups (p = 0.005 and 0.00006, respectively). No difference in final BCVA was seen between the groups. Significantly less surgically induced astigmatism (p = 0.03) and a lower number of postoperative visits (p = 0.0006) was noted in the Iris group. Considering the type of surgery, there were few complications in the present material.

Conclusion

In the study, suturing dislocated three‐piece IOLs to the iris appeared to be an acceptable surgical management with less surgically induced corneal astigmatism and fewer postoperative visits than IOL exchange. A larger study with a longer follow‐up time would be desirable to confirm the results.
Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease
Authors: Shivaji Uday N. , Sharratt Caroline L. , Thomas Tom , Smith Samuel C. L. , Iacucci Marietta , Moran Gordon W. , Ghosh Subrata , Bhala Neeraj
Published: February 2019

Background

Biological therapy is currently widely used to treat IBD. Infliximab, adalimumab and golimumab are currently licensed anti‐TNF therapies. Biosimilar anti‐TNF monoclonal antibodies are increasingly used. Anti‐TNF therapies are widely used and their adverse effects are well characterised, and may cause significant morbidity and mortality in a small proportion of exposed patients. Gastroenterologists need to understand the mechanisms for these effects, recognise these swiftly and manage such events appropriately.

Aim

To cover the range of potential adverse reactions as a result of biologic therapy and specifically management of these events.

Methods

A Medline and Pubmed search was undertaken. Search terms included were “anti‐TNF,” “infliximab” or “adalimumab” or “golimumab” combined with the keywords “ulcerative colitis” or “Crohn's disease” or “inflammatory bowel disease” and then narrowed to articles containing the keywords “complications,” “side effects” or “adverse events” or “safety profile.” International guidelines were also reviewed where relevant.

Results

Adverse events discussed in this review include infusion reactions, blood disorders and infections (including bacterial, viral, fungal and opportunistic infections) as well as autoimmune, dermatological disorders, cardiac and neurological conditions. Malignancies including solid organ, haematological and those linked to viral disease are discussed.

Conclusions

Anti‐TNF therapy has wide‐ranging effects on the immune system resulting in a spectrum of potential adverse events in a small proportion of patients. Research advances are improving the understanding, recognition and management of these adverse events.
Systematic review with meta‐analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease
Authors: Shah Ayesha , Morrison Mark , Burger Daniel , Martin Neal , Rich Justin , Jones Mike , Koloski Natasha , Walker Marjorie M. , Talley Nicholas J. , Holtmann Gerald J.
Published: February 2019

Background

Current data on small intestinal bacterial overgrowth (SIBO) in patients with inflammatory bowel diseases (IBD) are controversial.

Aim

To conduct a systematic review and meta‐analysis to determine the prevalence of SIBO in patients with ulcerative colitis (UC) and Crohn's disease (CD).

Methods

Electronic databases were searched up to May 2018 for studies reporting prevalence of SIBO in IBD patients. The prevalence rate of SIBO among IBD patients and the odds ratio (OR) and 95% CI of SIBO in IBD patients compared with controls were calculated.

Results

The final dataset included 11 studies (1175 adult patients with IBD and 407 controls), all utilising breath test for diagnosis of SIBO. The proportion of SIBO in IBD patients was 22.3% (95% CI 19.92‐24.68). The OR for SIBO in IBD patients was 9.51 (95% CI 3.39‐26.68) compared to non‐IBD controls, and high in both CD (OR = 10.86; 95% CI 2.76‐42.69) and UC (OR = 7.96; 95% CI 1.66‐38.35). In patients with CD, subgroup analysis showed the presence of fibrostenosing disease (OR = 7.47; 95% CI 2.51‐22.20) and prior bowel surgery (OR = 2.38; 95% CI 1.65‐3.44), especially resection of the ileocecal valve, increased the odds of SIBO. Individual studies suggest that combined small and large bowel disease but not disease activity may be associated with SIBO.

Conclusions

Overall, there is a substantial increase in the prevalence of SIBO in IBD patients compared to controls. Prior surgery and the presence of fibrostenosing disease are risk factors for SIBO in IBD.
Circulating microRNA146b‐5p is superior to C‐reactive protein as a novel biomarker for monitoring inflammatory bowel disease
Authors: Chen Peng , Li Ying , Li Li , Yu Qiao , Chao Kang , Zhou Gaoshi , Qiu Yun , Feng Rui , Huang Shanshan , He Yao , Chen Baili , Chen Minhu , Zeng Zhirong , Zhang Shenghong
Published: February 2019

Background

Owing to the importance of early treatment, simple and reliable methods for monitoring inflammatory bowel disease (IBD) are needed.

Aims

To determine whether circulating microRNAs are reliable biomarkers for IBD monitoring.

Methods

Serum levels of 17 candidate microRNAs were measured by quantitative real‐time polymerase chain reaction in a discovery cohort (n = 120). Differentially expressed serum microRNAs were further investigated in an independent training cohort (n = 341). Correlations between relative microRNA levels and disease activity were evaluated. A disease control group was included to investigate the specificity of microRNA. Logistical regression was used to construct a microRNA classifier to identify endoscopic activity. Its predictive value was explored in the validation cohort (n = 66) using the area under the receiver operating characteristic curve (AUC).

Results

Serum microRNA146b‐5p (miR‐146b‐5p) expression was 2.87‐ and 2.72‐fold higher in patients with Crohn's disease and ulcerative colitis, respectively, than in healthy controls. Serum miR‐146b‐5p was significantly correlated with disease activity and was more specific than C‐reactive protein (CRP). A classifier was built for Crohn's disease, ie P [Endoscopically active] = , with a greater AUC of 0.869 [0.764‐0.940] than that for CRP (0.680 [0.554‐0.790]) (P = 0.0043).

Conclusions

MiR‐146b‐5p may better reflect mucosal inflammation in IBD than CRP. The Crohn's disease classifier developed in this study may be valuable for identifying endoscopic activity in patients with Crohn's disease.
Thoracoscopic rib resection and reconstruction of chest wall: Our clinical experience
Authors: Ueda Yuichiro , Nakagawa Tatsuo , Tomioka Yasuaki , Toyazaki Toshiya , Gotoh Masashi
Published: February 2019

Chest wall resection is traditionally performed via open thoracotomy, a procedure that increases surgical morbidity and reduces postoperative quality of life. Conversely, thoracoscopic chest wall resection may minimize invasiveness but the optimal procedure remains uncertain. We previously reported rib resection using a pneumatic high‐speed power drill during video‐assisted thoracoscopic surgery for selected lung cancer patients. In this report, we present two cases of chest wall tumor resected using the drill via the thoracoscopic approach. We also report thoracoscopic chest wall reconstruction in one patient using a patch sheet.
The positive value of moral distress
Authors: Tigard Daniel W.
Published: February 2019

Moral distress in healthcare has been an increasingly prevalent topic of discussion. Most authors characterize it as a negative phenomenon, while few have considered its potentially positive value. In this essay, I argue that moral distress can reveal and affirm some of our most important concerns as moral agents. Indeed, the experience of it under some circumstances appears to be partly constitutive of an honorable character and can allow for crucial moral maturation. The potentially positive value, then, is twofold; moral distress carries both aretaic and instrumental value. Granted, this position is not without its caveats, but by making these clear, I provide a novel framework for policy recommendations regarding when, if ever, we should work to reduce moral distress.