bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel matrix based systematic approach for vulnerability assessment
Authors: Sabouhi Hamed , Doroudi Aref , Fotuhi-Firuzabad Mahmud , Bashiri Mahdi
Published: November 2020

Purpose

This paper aims to propose a novel matrix-based systematic approach for vulnerability assessment.

Design/methodology/approach

The proposed method consists of two major steps. First, the power network is modeled as a topological combination of edges (transmission lines, transformers, etc.) and nodes (buses, substations, etc.). The second step is to use an axiomatic design-based index for topology analysis. This index is based on the systematic counting of possible routes from the start (generators) to destination (loads), considering load importance, before and after a disruption.

Findings

The effectiveness of the proposed method is demonstrated through an illustrative example and the Institute of Electrical and Electronics Engineers (IEEE) 14-bus power system. It was shown that the load’s importance influences the results of the vulnerability analysis. The proposed method has some advantages over traditional graph theory such as an explicit description of multiple transmission nodes and assets with multiple conversion processes. Furthermore, it would help the power grid operators and asset investment managers to be better to assess the vulnerable components.

Research limitations/implications

The proposed method can be used in planning, optimization, robustness and hardening of power systems.

Originality/value

The paper presents a matrix-based systematic approach to evaluate and quantify the vulnerability of the power grid’s components.
How can governments nudge students to become ebook readers? Evidence from Indonesia
Authors: Pratama Ahmad R. , Firmansyah Firman M.
Published: November 2020

Purpose

The purpose of this study is to investigate if and how government intervention can nudge students to become ebook readers.

Design/methodology/approach

A cross-sectional survey research design was adopted for this study. A total of 1,144 students from four middle and high schools in urban and rural areas of Indonesia participated in this study. The results from statistical analyses were further discussed through the lens of the nudge theory.

Findings

This paper founds evidence that government intervention in the form of the Buku Sekolah Elektronik (BSE) policy that has been providing free electronic textbooks for more than a decade can help nudge students to become ebook readers. After controlling for student’s demographic information, this paper founds that their awareness of such a policy is significantly associated with a stronger preference toward ebooks while having no significant effect on their preferences toward printed book format. This paper also founds that mobile device adoption plays an important role where early adopters tend to prefer ebook format, whereas laggards are more associated with printed book format.

Originality/value

Many have studied the benefits of using ebooks in learning, but the literature also shows that most students still prefer reading printed books over ebooks. This is true not only in developing countries where problems with infrastructures can hamper the adoption of ebooks in general but also in developed countries where ebooks are much more prevalent, even among the general population. This paper showed how government interventions have the potency to help tip the scales and nudge students to become ebook readers.
Respect: give it to get it! Does leadership complimented with respect can foster creativity?
Authors: Hai Mahnoor , Latif Shahid , Bilal Ahmad Raza , Ahmad Bilal
Published: November 2020

Purpose

The purpose of this study is to advance the prevalent leadership–creativity perspective by examining respectful engagement as a missing link between transformational leadership and employees creativity in the tourism and hospitality industry of Pakistan.

Design/methodology/approach

Data were collected from 288 supervisor–subordinate dyads of hotel and tourism industry in Pakistan. Partial least square structural equation modeling (PLS-SEM) technique was used to validate the measurement model and to test the proposed hypotheses using SmartPLS 3.0.

Findings

The results suggest that transformational leadership and respectful engagement are significantly related and that respectful engagement fosters employee creativity. The study further confirmed that respectful engagement mediates the relationship between transformational leadership and employee creativity.

Practical implications

Besides theoretical contribution, the study has several managerial implications for the tourism and hospitality industry. Globally, in the tourism and hospitality industry, the service selling proposition is largely based on creativity. Hence, the study suggests the managers of tourism and hospitality industry should adopt a transformational leadership style to achieve a sustainable competitive advantage of creativity. The study further recommends the managers capitalize on their transformational leadership style to observe respectful engagement in the workplace, which in turn can encourage employees to behave creatively.

Originality/value

Theoretically, this paper contributes to the existing body of knowledge in a couple of ways. Firstly, while several empirical studies have discussed the impact of transformational leadership on employee creativity, and various mediating models have also been tested in this regard, little effort has been made to study the links between transformational leadership and employee creativity despite existing awareness about the importance of respectful engagement for employee creativity. Thus, the current study examines employee creativity with the lens of transformational leadership and respectful engagement. Secondly, the study integrates the theories of transformational leadership, employee engagement and employee creativity.
Data-literate citizenry: how US state standards address data and data visualizations in social studies
Authors: Shreiner Tamara L.
Published: November 2020

Purpose

Data literacy – the ability to read, analyze, interpret, evaluate and argue with data and data visualizations – is an essential competency in social studies. This study aims to examine the degree to which US state standards require teachers to teach data literacy in social studies, addressing the questions: to what extent are US social studies teachers required to teach data literacy? If they are required to teach it, are they provided with guidance about competencies to address at each school or grade level and with respect to particular content?

Design/methodology/approach

The study used content analysis, using a variety of priori and emergent codes, to review social studies standards documents from all 50 states and the District of Columbia.

Findings

Findings indicate that although state standards suggest that data visualizations should play a role in social studies instruction, they provide poor guidance for a coherent, progressive and critical approach across grade levels.

Originality/value

Researchers currently know little about if and how teachers address data literacy in social studies education. This study provides a snapshot of guidance teachers across states are given for teaching data literacy, and by extension, the quality of data literacy instruction recommended for students across the USA.
Home country institutional impact on the choice of direct vs indirect exports: an emerging markets perspective
Authors: Elango B. , Pangarkar Nitin
Published: November 2020

Purpose

This study uses the notions of institutional harshness and uncertainty avoidance in the home country to explain the choice between direct and indirect exporting strategies by emerging market firms.

Design/methodology/approach

This study is based on a dataset of 23,256 observations on firms from 32 countries spread over 11 years (2006–2016). Since only some firms undertake exports, the Heckman procedure is used to control for sample self-selection. In the first stage, we predict which firms will choose to export, and, in the second stage, we examine the factors driving the choice made by firms involved in exports between direct and indirect exports strategies.

Findings

The analyses reveal that firms are more likely to choose direct exports when institutional harshness is high and when they are from countries with low uncertainty avoidance. We also find that the strength of the relationship between institutional harshness and the choice of direct exports is moderated at high levels of uncertainty avoidance.

Research limitations/implications

While this study's empirical models account for many firm-level factors as well as home country differences discussed in the literature, we acknowledge there could be other temporal, firm or country idiosyncratic factors not included in our analysis driving the key choices examined in the paper.

Originality/value

This study makes three contributions to exporting literature. First, it highlights the drivers of the choice between direct and indirect exports. This choice is an important facet of exporting strategy and has received scant attention in prior IB research. Second, it demonstrates how the choice between direct and indirect exports is impacted by the degree of the home country's institutional harshness and uncertainty avoidance. Third, it offers insights on how the interaction of formal and informal home market institutional factors influences export strategy.
Trust as a multidimensional phenomenon in LMX relationships
Authors: Hirvi Sari Kristiina , Laulainen Sanna , Taskinen Helena
Published: November 2020

Purpose

The purpose of this study is to address the construction of trust in leader member exchange (LMX) relationships as a multidimensional phenomenon and identify the importance of emotional and collective factors contributing to this phenomenon.

Design/methodology/approach

Ten health care professionals (five leaders and five members) were interviewed to subject to qualitative thematic analysis.

Findings

Four main themes in the data were identified (work roles, collectivity, interaction and participation) and linked to two main elements of LMX trust relations: core and contextual. The results extend understanding of the construction and maintenance of trust in LMX relationships, indicating that it is a more complex and socially constructed phenomenon than previously described.

Research limitations/implications

Despite identified limitations of the study (the small amount of empirical material, interpretive research method and purposive sampling of participants), the findings reveal that constructing trust in LMX relationships is more multidimensional than generally portrayed in traditional LMX theory and its three-stage continuum. This study suggests that a broader perspective should be adopted in LMX research, treating it not only as a collective phenomenon but also considering leaders and members as emotional individuals.

Practical implications

Understanding the multidimensional nature of LMX relationships is helpful for developing interpersonal relationships in organizations and leadership practices through recognition of the importance of the transparency, practices and adequacy of mutual interaction. The results presented here may contribute to such understanding and help leaders to relate to members as both subjective individuals and parts of a complex social network. The results may also increase members' awareness of possible ways that they can promote the development of good LMX relationships in organizations.

Originality/value

The novelty of the study relates to the identification of the collective, emotional and multidimensional nature of LMX relationships.
Toughest job in the library
Authors: Gordon Ian D.
Published: November 2020

Purpose

The purpose of this article attempts to portray the unique and complex role of library middle managers. This important and influential position can be a proving ground for new and old managers as libraries continue to evolve, adjust policies, introduce new services and meet the needs of their users. Circulation managers as influential middle managers are realistically depicted as busy, overwhelmed and isolated, but welcome the opportunity to provide leadership and enhance their professional development.

Design/methodology/approach

This viewpoint is solely based on the author's varied experiences and personal reflections as a circulation department head providing leadership alongside colleagues in a busy academic library.

Findings

Department heads as managers of circulation departments are pivotal positions in every library. Circulation heads performing as middle managers are responsible for a full range of administrative, managerial and organizational services. Circulation heads are well positioned as change agents simultaneously directing frontline staff members, policies and services while providing valuable insight to library administration. Yet, circulation managers experiencing constantly evolving responsibilities, are too often found to be caught in the middle negotiating inconsistencies. Successful circulation managers require an eclectic mix of essential skills initiating and deploying change, defining success, dealing with people, actively participating in professional development and providing leadership.

Research limitations/implications

The study and research of library middle managers in public and academic libraries is practically nonexistent. As libraries increasingly create, adjust and reinvent library services, spaces and visions due to increasing digitization, in response to emerging online environments and new service models – middle managers and circulation librarians are excellent and proven pivots to negotiate and successfully implement this change.

Practical implications

As a crafted article written by a former head of a circulation department every staff member, student and librarian serving in access/borrowing/circulation departments should consult this article as required reading.

Social implications

The voices of library middle managers are too often muted, not valued and rarely celebrated. This viewpoint article written in a conversational voice depicts circulation librarians as middle managers that bring value to all libraries and should be heard.

Originality/value

This paper depicts the opportunities and challenges faced by, as well as the skills and competencies required by librarians serving as circulation departments heads.
Foreign direct investment, financial development and economic prosperity in major south Asian economies
Authors: Sethi Narayan , Das Aurolipsa , Sahoo Malayaranjan , Mohanty Saileja , Bhujabal Padmaja
Published: November 2020

Purpose

This paper empirically examines the relationship between foreign direct investment, financial development and other macroeconomic variables like trade openness, domestic investment and labour force and that of GDP per capita in select South Asian countries, i.e. India, Sri Lanka and Pakistan for the period 1990–2018.

Design/methodology/approach

The study uses various econometrics tools such as Pedroni, Kao and Johansen–Fisher panel cointegration test, Panel FMOLS and DOLS and Granger causality in order to analyse the long-run and short-run dynamics among the variables under consideration.

Findings

The results of the panel data estimation techniques employed imply that there is a short-run causality running from GDP per capita to FDI and financial development, and results from FMOLS and DOLS indicate that FDI and financial development have positive impacts on GDP per capita in the countries under consideration.

Originality/value

In this paper, we use a dynamic macroeconomic modelling framework to examine the effect of FDI and financial development on per capita income in three major south Asian economies, which are categorized as three Non-Least Developed Contracting States under the South Asian Free Trade Area (SAFTA), 2006, established with an aim to facilitate free trade among them. Considering the diversity of the level of growth experienced by these economies, the study uses appropriate panel regression techniques. Therefore, in addition to proper formulation of policies directed towards scaling up of export and import levels, the respective authorities should also take care that the political stability and institutional quality are maintained.
Between love and boycott: a story of dual origin brands
Authors: Abdelwahab Dalia , Jiménez Nadia , San-Martín Sonia , Prodanova Jana
Published: November 2020

Purpose

This research aims to address ethnocentric consumers’ willingness to boycott dual origin brands, in the particular case of national brands linked to a very specific regional origin, through analysing the paradox of (unfavourable) regional ethnocentrism versus (favourable) consumer–brand relationship (i.e. brand identification, trust and love) on consumers’ decision to buy or boycott those brands in that circumstances. Building on social identity and cognitive dissonance theories, this study aims to examine the Spanish consumer relationship with national brands originated in Catalonia considering the current conflicting circumstances in the region.

Design/methodology/approach

The authors collected data by means of personal questionnaires, distributed among 277 Spanish consumers of Catalan brands of Cava. The data is analysed by using structural equation modelling and linear structural relations.

Findings

After controlling for brand familiarity, the results of this study reveal that ethnocentrism negatively distorts consumers’ confidence in dual origin brands and highlight the role of identification and trust as brand love antecedents. It also reveals that ethnocentrism has a more profound impact on boycotting decision than brand love.

Originality/value

This study is one of the few to capture the puzzlement created by the paradoxical nature of the brand’s duality of origin. Furthermore, it contributes to the marketing literature by examining the impact of ethnocentrism on two relationship variables (i.e. identification and trust) and exploring their joint impact on consumers’ decision to buy or boycott. The findings of this study can be helpful for companies facing boycotting behaviour triggered by ethnocentric consumer reaction towards dual origin brands.
Role of defects in electron band structure and gas sensor response of La2CuO4
Authors: Roy Chinmay , Ghosh Aparna , Chatterjee Suman
Published: November 2020

Purpose

This paper aims to estimate the relationship between defect structure with gas concentration for use as a gas sensor. The change in defect concentration caused a shift in the Fermi level, which in turn changed the surface potential, which is manifested as the potentiometric response of the sensing element.

Design/methodology/approach

A new theoretical concept based on defect chemistry and band structure was used to explain the experimental gas response of a sensor. The theoretically simulated response was compared with experimental results.

Findings

Understanding the origin of potentiometric response, through the generation of defects and a corresponding shift in Fermi level of sensing surface, by the adsorption of gas. Through this understanding, the design of a sensor with improved selectivity and stability to a gas can be achieved by the study of defect structure and subsequent band analysis.

Research limitations/implications

This paper provides information about various types of surface defects and numerical simulation of material with defect structure. The Fermi energy of the simulated value is correlated with the potentiometric sensor response.

Practical implications

Gas sensors are an integral part of vehicular and industrial pollution control. The theory developed shows the origin of response which can help in identifying the best sensing material and its optimum temperature of operation.

Social implications

Low-cost, reliable and highly sensitive gas sensors are highly demanded which is fulfilled by potentiometric sensors.

Originality/value

The operating principle of potentiometric sensors is analyzed through electron band structure analysis. With the change in measured gas concentration, the oxygen partial pressure changes. This results in a change in defect concentration in the sensing surface. Band structure analysis shows that change in defect concentration is associated with a shift in Fermi level. This is the origin of the potentiometric response.
Metabolomics reveal dynamic changes in eicosanoid profile in patients with ST‐elevation myocardial infarction after percutaneous coronary intervention
Authors: Zhang Liuyang , Dai Zhi , Guo Ruifeng , Wang Xiao , Gong Wei , Duan Juanhui , He Zhiqing , Ding Ru , Zhang Xu , Nie Shaoping , Liang Chun
Published: November 2020

Eicosanoids play important roles in the cardiovascular system. The metabolic disorders involving some eicosanoids in the pathophysiologic process include myocardial infarction and myocardial ischaemia–reperfusion injury. Percutaneous coronary intervention (PCI) is often the first‐choice strategy for acute ST‐segment elevation myocardial infarction (STEMI) according to current guidelines. This study aimed to investigate the dynamic eicosanoid metabolic profile in STEMI patients after PCI. The eicosanoid profiles in plasma of 20 patients at seven times (30 minutes before surgery; 6, 12, 24, and 72 hours after surgery; 1 day before discharge; and 28 days after surgery) were studied by using metabolomics. Levels of PGE2, PGD2, and TXA2 were decreased significantly and EETs contents were increased significantly at 6 hours after PCI. EETs were hydrolysed to DHETs within a short time after surgery (12–72 hours). 20‐HETE content was significantly increased. In samples taken at the time of discharge and at follow‐up after discharge, LTB4 level continued to increase. This work suggests that change in content of some functional eicosanoids may be involved in cardiac injury and repair after PCI in a synergistic manner.
Bank Business Model Migrations in Europe: Determinants and Effects
Authors: Ayadi Rym , Bongini Paola , Casu Barbara , Cucinelli Doriana
Published: November 2020

In response to post‐crisis regulatory reforms, the European banking sector has undergone significant changes that have led banks to reconsider their strategies, structures and operations. Based on a sample of over 3,000 banks from 32 European countries during the period 2010–2017, we identify banks' business models based on cluster analysis and track their evolution. We then apply a logistic regression and find that banks with higher risk and lower profitability are more likely to change their business model. Employing a propensity score matching approach, we investigate the effect of migration on bank performance and find that changing the business model affects banks positively (i.e. migrating banks increase their profitability, stability and cost efficiency). The effect of migration differs depending on the target business model. When switches are a consequence of being acquired or motivated by regulatory compliance, the positive impact remains.
Suspicion of Welfare Overuse in Sweden: The Role of Left–Right Ideology, Anti‐Immigrant Attitudes and Gender
Authors: Goossen Mikael , Johansson Sevä Ingemar , Lundström Ragnar
Published: November 2020

In this study, we explore individual differences in suspicion of welfare overuse in Sweden. Focusing on previously underdeveloped areas, we find that the hitherto observed negative relationship between political interest and suspicion of welfare overuse is only valid for those who sympathize with political parties to the left (and to a lesser extent the Green Party). Conversely, individuals who sympathize with centre‐right parties or right‐wing populists differ little internally depending on their level of political interest. We also find a strong positive correlation between anti‐immigrant attitudes and suspicion about welfare overuse. Finally, we find that women are less suspicious of welfare overuse than men are, and that this cannot be attributed to gender differences in material risks or resources, education, experiences of welfare services, general trustfulness, anti‐immigrant sentiment or political orientation. Neither do gender differences vary according to strength of gender identification. Thus, being suspicious about welfare overuse is not likely to be perceived as a typically masculine or feminine posture. Based on our findings, we argue that future studies exploring partisan or ideological differences in perceptions of welfare overuse need to consider these in conjunction with political interest and political context; that rising anti‐immigrant sentiments pose a particularly serious threat to the legitimacy of welfare states, given their strong connectedness to suspicion of welfare overuse; and that gender differences in perceptions of welfare overuse are more fruitfully addressed through a lens of gender relations, rather than gender role stereotypes.
Outcome of collaborative emergency exercises: Differences between full‐scale and tabletop exercises
Authors: Roud Ensieh , Gausdal Anne Haugen , Asgary Ali , Carlström Eric
Published: November 2020

The degree to which exercises improve the collaboration among different organizations during an emergency is under debate. This study aims to contribute to the scarce research on this topic by giving insight into the perceived effects of exercises on collaboration, learning, usefulness and interorganizational trust. In particular, this quantitative study looked into the differences between the effects of tabletop and full‐scale exercises. A questionnaire assessing collaboration, learning, usefulness and trust—the CLUT instrument—was developed. Data were collected from 173 full‐time emergency management personnel in Norway and Canada. Usefulness, learning and collaboration outcomes were perceived to be high for both types of exercises, but full‐scale exercises were perceived to have greater learning and usefulness outcomes than tabletop exercises. Stronger relationships were identified between the perceived effects on learning and usefulness, collaboration and trust in tabletop compared to full‐scale exercise, whereas the relationship between the perceived effects upon collaboration and trust was stronger in full‐scale exercises. Multiple regression analysis showed that the variables used to measure exercise usefulness can better predict tabletop exercise outcomes.
Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres: a retrospective observational study
Authors: Gurney L , Al Wattar BH , Sher A , Echevarria C , Simpson H
Published: November 2020

Objective

To compare rates of vaginal delivery and adverse outcomes of instrumental delivery trials in obstetric theatre compared to primary emergency full dilation caesarean section.

Design

Retrospective cohort study.

Setting

University teaching hospital.

Population

Women with singleton, non‐anomalous, pregnancy undergoing instrumental delivery trial in obstetric theatre.

Methods

Data were collected from consecutive cases during 2014 until 2018 using clinical records. Multivariate regression analysis was used comparing outcomes per first delivery method.

Main Outcome Measures

Primary outcome was completion of vaginal delivery between all methods of instrumental delivery. Secondary outcome was a composite of immediate perinatal adverse outcomes for instrumental delivery modes and primary full dilation caesarean section.

Results

From 971 deliveries analysed: ventouse delivery was significantly less likely to achieve vaginal delivery compared with Keilland’s forceps delivery (odds ratio [OR] 0.42, 95% CI 0.22–0.79). Once confounding factors were adjusted for, adverse outcome rates were less frequent in the Keilland’s forceps group than with primary full dilation caesarean section (OR 0.37, 95% CI 0.16–0.81); however, the receiver operating characteristic curve produced from this model demonstrated a low predictive value (AUC 0.64).

Conclusions

Attempting instrumental delivery in delivery suite theatre, as an alternative to primary emergency full dilation caesarean section, is both reasonable and safe. In this study, ventouse delivery performed poorly in comparison with other modes of instrumental delivery. Further research in the form of randomised controlled trials to identify the optimal mode of second stage delivery is paramount.

Tweetable abstract

Instrumental delivery trials in theatre are safe but use of ventouse was associated with a higher rate of failure.
Thymoma‐associated myasthenia gravis: Clinical features and predictive value of antiacetylcholine receptor antibodies in the risk of recurrence of thymoma
Authors: De Rosa Anna , Fornili Marco , Maestri Tassoni Michelangelo , Guida Melania , Baglietto Laura , Petrucci Loredana , Chella Antonio , Melfi Franca , Lucchi Marco , Ricciardi Roberta
Published: November 2020

Background

Thymoma‐associated myasthenia gravis (TAMG) is one of the subtypes of myasthenia gravis with autoantibodies against the acetylcholine receptor (AChR‐Ab). We analyzed the clinical features of our cohort of TAMG patients and the changes in AChR‐Ab titer before and after thymectomy in order to identify factors predicting thymoma relapses.

Methods

We retrospectively assessed: age of MG onset, MG clinical status according to MGFA (Myasthenia Gravis Foundation of America), epoch of thymectomy, post‐thymectomy status, oncological features and surgical approach. AChR‐Ab dosages were measured both before and after thymectomy. Linear regression models were applied to identify clinical determinants of AChR‐Ab titers and the Cox regression model was fitted to estimate the factors associated with the risk of thymoma recurrence.

Results

The study sample included 239 MG patients, 27 of whom experienced one or more recurrences (median follow‐up time: 4.8 years). The AChR‐Ab titers decreased after first thymectomy (P < 0.001); the decrease was more pronounced in female patients (P = 0.05), in patients diagnosed with MG at an older age (P = 0.003), and in those who had lower MG stage before surgery (P = 0.02) or higher Masaoka‐Koga stage (P = 0.005). The risk of relapse was closely linked with the age of the patient, the Masaoka‐Koga stage and the surgical approach.

Conclusions

Presurgery levels of AChR‐Ab or their change after surgery were not associated with thymoma recurrence. The reduction of AChR‐Ab titers after thymectomy confirms an immunological role of thymoma in the pathogenesis of MG.

Key points

Significant findings of the study: Young MG patients with an advanced Masaoka staging score of the primary tumor who underwent thymectomy with approaches different from sternotomy and VATS should be monitored for high risk of recurrence.

What this study adds: No other study has ever investigated the changes in AChR‐Ab titers before and after thymectomy in a large cohort of TAMG patients. The reduction of AChR‐Ab titers after thymectomy suggests an immunological role of thymoma in the pathogenesis of MG.
Optimizing care for younger women with hormone receptor‐positive, HER2‐negative metastatic breast cancer
Authors: de Boer Richard , Hui Rina , Lim Elgene , Yeo Belinda , Zdenkowski Nicholas
Published: November 2020

Treatment strategies for hormone receptor‐positive (HR+), human epidermal growth factor receptor 2‐negative (HER2–) metastatic breast cancer in young women (<40 years at diagnosis) have traditionally been extrapolated from data obtained from trials conducted either exclusively or predominantly in the postmenopausal setting. These young patients are usually treated with ovarian function suppression (OFS) + endocrine therapy (ET) ± targeted therapy, except if there is a concern about endocrine resistance or a need to gain rapid disease control due to the onset of visceral crisis. This review examines evidence that supports the use of a cyclin‐dependent kinase 4/6 inhibitor, in combination with OFS and ET, when treating premenopausal or perimenopausal women with HR+/HER2–metastatic breast cancer. This includes data from the MONALEESA‐7 study (treating only premenopausal/perimenopausal women in the first‐line setting), and the results of subgroup analyses from the PALOMA‐3 and MONARCH‐2 trials. We also consider a number of age‐specific challenges that younger breast cancer patients can face, highlighting the importance of a multidisciplinary approach to ongoing care.
The use of intravenous lidocaine for postoperative pain and recovery: international consensus statement on efficacy and safety
Authors: Foo I. , Macfarlane A. J. R. , Srivastava D. , Bhaskar A. , Barker H. , Knaggs R. , Eipe N. , Smith A. F.
Published: November 2020

Intravenous lidocaine is used widely for its effect on postoperative pain and recovery but it can be, and has been, fatal when used inappropriately and incorrectly. The risk‐benefit ratio of i.v. lidocaine varies with type of surgery and with patient factors such as comorbidity (including pre‐existing chronic pain). This consensus statement aims to address three questions. First, does i.v. lidocaine effectively reduce postoperative pain and facilitate recovery? Second, is i.v. lidocaine safe? Third, does the fact that i.v. lidocaine is not licensed for this indication affect its use? We suggest that i.v. lidocaine should be regarded as a ‘high‐risk’ medicine. Individual anaesthetists may feel that, in selected patients, i.v. lidocaine may be beneficial as part of a multimodal peri‐operative pain management strategy. This approach should be approved by hospital medication governance systems, and the individual clinical decision should be made with properly informed consent from the patient concerned. If i.v. lidocaine is used, we recommend an initial dose of no more than 1.5 mg.kg‐1, calculated using the patient’s ideal body weight and given as an infusion over 10 min. Thereafter, an infusion of no more than 1.5 mg.kg‐1.h‐1 for no longer than 24 h is recommended, subject to review and re‐assessment. Intravenous lidocaine should not be used at the same time as, or within the period of action of, other local anaesthetic interventions. This includes not starting i.v. lidocaine within 4 h after any nerve block, and not performing any nerve block until 4 h after discontinuing an i.v. lidocaine infusion.
Decision‐making around admission to intensive care in the UK pre‐COVID‐19: a multicentre ethnographic study
Authors: Griffiths F. , Svantesson M. , Bassford C. , Dale J. , Blake C. , McCreedy A. , Slowther A‐M.
Published: November 2020

Predicting who will benefit from admission to an intensive care unit is not straightforward and admission processes vary. Our aim was to understand how decisions to admit or not are made. We observed 55 decision‐making events in six NHS hospitals. We interviewed 30 referring and 43 intensive care doctors about these events. We describe the nature and context of the decision‐making and analysed how doctors make intensive care admission decisions. Such decisions are complex with intrinsic uncertainty, often urgent and made with incomplete information. While doctors aspire to make patient‐centred decisions, key challenges include: being overworked with lack of time; limited support from senior staff; and a lack of adequate staffing in other parts of the hospital that may be compromising patient safety. To reduce decision complexity, heuristic rules based on experience are often used to help think through the problem; for example, the patient’s functional status or clinical gestalt. The intensive care doctors actively managed relationships with referring doctors; acted as the hospital generalist for acutely ill patients; and brought calm to crisis situations. However, they frequently failed to elicit values and preferences from patients or family members. They were rarely explicit in balancing burdens and benefits of intensive care for patients, so consistency and equity cannot be judged. The use of a framework for intensive care admission decisions that reminds doctors to seek patient or family views and encourages explicit balancing of burdens and benefits could improve decision‐making. However, a supportive, adequately resourced context is also needed.
From Disruption to Transformation: Politicisation at a Distance from the State
Authors: Swyngedouw Erik
Published: November 2020

In this afterword to the symposium on processes of politicisation of activist struggles of undocumented migrants and their allies, I first briefly outline a number of key commonalities that run through the symposium. I subsequently explore some of the wider theoretical and practical lessons to be drawn from the arguments advanced in its papers, and suggest a number of key themes and concerns to be explored further. In particular, this afterword suggests some possible avenues to both think through the limits of and tensions within forms of undocumented migrant activism, and chart theoretical and practical trajectories to move from the limitations of “the political event” to the possibilities of “a political sequence” that may actually change the instituted order.
Experiences of induction of labor with a catheter – A prospective randomized controlled trial comparing the outpatient and inpatient setting
Authors: Haavisto Henna , Polo‐Kantola Päivi , Anttila Ella , Kolari Terhi , Ojala Elina , Rinne Kirsi
Published: November 2020

Introduction

Approximately every fourth labor is induced. In Finland, when labor is induced, it is commonly carried out with a catheter in the inpatient (IP) setting. However, in uncomplicated, full‐term pregnancies, induction of labor (IOL) in the outpatient (OP) setting is also possible. Nevertheless, there is only a limited amount of information about the experiences of IOL in OP setting. Our study compared the experiences of catheter IOL in OP and IP settings.

Material and methods

We performed a prospective randomized study, including 113 women with uncomplicated full‐term pregnancies with planned IOL. After catheter insertion, women were randomized into OP or IP settings: after dropouts, there were 53 women in the OP group and 54 in the IP. The experiences of IOL were evaluated with three sets of visual analog scale (VAS) questionnaires: the general experience questionnaire (eight questions), the concurrent induction experience questionnaire (1, 5, 9, 13 hours; nine questions) and the postpartum experience questionnaire (14 questions).

Results

Both groups had low VAS scores, indicating good experiences of IOL. Women in the OP group were less satisfied (mean VAS difference Δ = 7.8, P = .015) and more anxious (Δ = 4.8, P = .008) than were women in the IP group. In the course of the IOL, all women became less satisfied (Δ = 8.4, P = .001), had more contraction pain (Δ = 8.9, P = .020) and had a higher frequency of contractions (Δ = 9.9, P = .004) but they were more relaxed and experienced less fear (Δ = 6.9, P = .036, Δ = 5.3, P = .001, respectively). There was no interaction between group and time. According to the postpartum experience questionnaire, both groups had a similar good general experience of IOL (P = .736) but the OP group had more fear (Δ = 9.5, P = .009) and was more anxious (Δ = 9.0, P = .007). Most of the women would choose catheter IOL in a subsequent pregnancy (OP 82.6%, IP 87.0%).

Conclusions

The women in the OP setting were less satisfied and more anxious than were the women in the IP setting. However, the differences were marginal and the general experience after IOL was good. IOL in an OP setting is thus a viable option in low‐risk full‐term pregnancies. Therefore, when using catheter IOL, both setting options should be available.
Psychotherapy training in Iran: A survey of Iranian early career psychiatrists and psychiatric trainees
Authors: Eissazade Negin , Shalbafan Mohammadreza , Eftekhar Ardebili Mehrdad , Pinto da Costa Mariana
Published: November 2020

Introduction

Psychiatry's postgraduate training curriculum in Iran has been revised and one of the core revisions has been the incorporation of full‐time 9‐months of psychotherapy training. However, little is known about psychotherapy training in Iran.

Methods

An online anonymous survey was developed by the Early Career Psychiatrists (ECP) Section of the World Psychiatric Association (WPA). The survey included 16 questions about the: (a) quality of psychotherapy training (supervision, type of psychotherapy training available, barriers in accessing training); (b) organizational aspects of psychotherapy training (compulsoriness, payment, and assessment); (c) satisfaction with training in psychotherapy; (d) self‐confidence in the use of psychotherapy. This survey was circulated to Iranian early career psychiatrists and psychiatric trainees.

Results

112 early career psychiatrists and psychiatric trainees from across Iran responded to the survey; 98.2% of which stated that psychotherapy training is included in their psychiatry training, and cognitive behavioral therapy and psychodynamic psychotherapy were the most reported modalities integrated into their psychiatric training. Moreover, 43.3% of the participants reported that they were satisfied or very satisfied with their psychotherapy training during the training years.

Discussion

Psychotherapy is integrated into psychiatric training programs in most educational centers in Iran. The modalities and satisfaction of trainees are similar to that of high‐income countries in other continents. Supervision and training in modalities like family therapy could be further implemented and adapted to the Iranian culture.
The role of community engagement in addressing bystander risks in research: The case of a Zika virus controlled human infection study
Authors: Shah Seema K. , Miller Franklin , Fernandez Lynch Holly
Published: November 2020

There is limited guidance on how to assess the ethical acceptability of research risks that extend beyond research participants to third parties (or “research bystanders”). Community or stakeholder engagement has been proposed as one way to address potential harms to community members, including bystanders. Despite widespread agreement on the importance of community engagement in biomedical research, this umbrella term includes many different goals and approaches, agreement on which is ethically required or recommended for a particular context. We analyse the case of a potential Zika virus human challenge trial to assess whether and how community engagement can help promote the ethical acceptability of research posing risks to bystanders. We conclude that, in addition to having intrinsic value, community engagement can improve the identification of bystander risks, effective approaches to minimizing them, and transparency about bystander risks for host communities.
Mitomycin C induces pulmonary vascular endothelial‐to‐mesenchymal transition and pulmonary veno‐occlusive disease via Smad3‐dependent pathway in rats
Authors: Zhang Chenting , Lu Wenju , Luo Xiaoyun , Liu Shiyun , Li Yi , Zheng Qiuyu , Liu Wenyan , Wu Xuefen , Chen Yuqin , Jiang Qian , Zhang Zizhou , Gu Guoping , Chen Jiyuan , Chen Haixia , Liao Jing , Liu Chunli , Hong Cheng , Tang Haiyang , Sun Dejun , Yang Kai , Wang Jian
Published: November 2020

Background and Purpose

Pulmonary veno‐occlusive disease (PVOD) is a rare disease characterized by the obstruction of small pulmonary veins leading to pulmonary hypertension. However, the mechanisms underlying pulmonary vessel occlusion remain largely unclear.

Experimental Approach

A mitomycin C (MMC)‐induced PVOD rat model was used as in vivo animal model, and primarily cultured rat pulmonary microvascular endothelial cells (PMVECs) were used as in vitro cell model.

Key Results

Our data suggested an endothelial‐to‐mesenchymal transition (EndoMT) may be present in the pulmonary microvessels isolated from either PVOD patients or MMC‐induced PVOD rats. In comparison to the control vessels, vessels from both PVOD patients and PVOD rats had co‐localized staining of specific endothelial marker von Willebrand factor (vWF) and mesenchymal marker α‐smooth muscle actin (α‐SMA), suggesting the presence of cells that co‐express endothelial and mesenchymal markers. In both the lung tissues of MMC‐induced PVOD rats and MMC‐treated rat PMVECs there were decreased levels of endothelial markers (e.g. VE‐cadherin and CD31) and increased mesenchymal markers (e.g. vimentin, fibronectin and α‐SMA) were detected indicating EndoMT. Moreover, MMC‐induced activation of the TGFβ/Smad3/Snail axis, while blocking this pathway with either selective Smad3 inhibitor (SIS3) or small interfering RNA (siRNA) against Smad3, dramatically abolished the MMC‐induced EndoMT. Notably, treatment with SIS3 remarkably prevented the pathogenesis of MMC‐induced PVOD in rats.

Conclusions and Implications

Our data indicated that targeted inhibition of Smad3 leads to a potential, novel strategy for PVOD therapy, likely by inhibiting the EndoMT in pulmonary microvasculature.
Coastal peat‐beds and peatlands of the southern North Sea: their past, present and future
Authors: Waller Martyn , Kirby Jason
Published: November 2020

Peat layers are well represented in the Holocene coastal deposits of the southern North Sea and provide evidence as to the extent and nature of the fens and bogs that occupied the region in the mid and late Holocene. While natural processes contributed to their demise, without human interference extensive areas of peatland would remain. We review the characteristics of the vegetation of these peatlands along with the processes that influenced their development. Spatial and temporal trends are explored through the use of palaeogeographic maps from three areas: the East Anglian Fenland, the Romney Marsh area and the Netherlands. The palaeoecological evidence indicates that eutrophic vegetation promoted by rising relative sea level (RSL) dominated in the mid Holocene, with a trend towards the development of oligotrophic and ombrotrophic vegetation in the late Holocene as the rate of RSL rise declined. Nevertheless, areas of eutrophic vegetation appear capable of long‐term stability with areas of fen woodland and herbaceous fen persisting at some locations for several thousand years in the mid and late Holocene. Areas of active peat growth in the region are now largely confined to small remnants within agricultural settings. To retain their characteristic biodiversity these remnants have been managed using traditional practices, although their small size and fragmented distribution limits their biodiversity value. Biodiversity concerns and the ecosystem services peatlands provide, notably carbon sequestration and flood attenuation, underlie recent restoration projects. These efforts are likely to receive additional impetus as a consequence of rising water levels, given projected rates of RSL rise. Future large‐scale restoration can be informed by a greater understanding of the processes that formed and sustained coastal peatlands in the past. We identify advances in palaeoenvironmental research that could enhance restoration efforts and help maximise the ecosystem services delivered through such projects.
Should algorithms be regulated by government?
Authors: Smith Robert A. , Desrochers Pierre R.
Published: November 2020

There has been, and continues to be, an explosion in the use of algorithms across the economy and society. There are growing concerns about how algorithms are being used and whether they are accountable. This article reviews the literature on the issue of algorithms in several key areas, such as fairness, accountability, and transparency. The article examines arguments on why algorithms should be regulated, and it explores the available literature to identify how a potential Canadian regulatory framework may be developed.