bluuebunny/crossref_metadata_2025 huggingface dataset:
Marketing first? The role of marketing capability in SME growth
Authors: Joensuu-Salo Sanna , Viljamaa Anmari , Kangas Emilia
Published: September 2022

Purpose

This paper aims to examine the growth rates of small- and medium-sized enterprises (SMEs) over a three-year period, the relationship between firm size and firm growth in the context of SMEs, and the effect of marketing capability (MC) on firm growth and how it relates to firm size. The theoretical framework is based on the resource-based view and dynamic capabilities.

Design/methodology/approach

Data were gathered from Finnish SMEs (n = 214) and analyzed with Latent growth curve modeling (structural equation modeling). Respondents were chief executive officers or company owners.

Findings

Results show that firm size is unrelated to the rate of change, and MC has a significant effect on both the intercept and slope parameters. Smaller SMEs have less MC than larger SMEs.

Practical implications

While the overall human resources level of the SME is not linked to the rate of growth, MC is. This is an important point for small business growth studies, for it shows what type of personnel is called for during rapid growth. SMEs could advance significantly and rapidly if they invest in versatile human capital, especially in the marketing area.

Originality/value

Majority of the MC research involves larger corporations. This study brings new insights from SME perspective. In addition, this study suggests that it is imperative to consider different types of growth separately. This study contributes to this need by demonstrating the connection between employee growth rate and MC in SMEs.
The disclosure of sustainable development goals (SDGs) by the top 50 Australian companies: substantive or symbolic legitimation?
Authors: Lodhia Sumit , Kaur Amanpreet , Kuruppu Sanjaya Chinthana
Published: September 2022

Purpose

This study aims to explore how the top 50 Australian companies are disclosing their commitment to addressing the sustainable development goals (SDGs) formulated by the United Nations (UN) in 2015. By investigating the nature and substantiveness of SDG reporting, this study provides exploratory evidence on how companies are taking the initial steps to addressing the SDGs.

Design/methodology/approach

A content analysis of SDG disclosures by the top 50 Australian companies was undertaken. This content analysis was guided by the KPMG (2018) SDG disclosure framework. Legitimacy theory was used to interpret the findings, establishing whether such disclosure was substantive or symbolic.

Findings

This study reports a moderate level of SDG disclosure among Australian companies. The top five most critical SDGs in Australian context are climate action, gender equality, decent work and economic growth, responsible consumption and production and industry, innovation and infrastructure. The findings also highlight that while the focus of Australian companies is on understanding and prioritizing SDGs, the measurement of SDGs performance needs to increase.

Research limitations/implications

This study adds to limited literature on the corporate responses to SDGs by establishing how companies, especially in Australia, are addressing these goals through changes to their reporting systems, thereby communicating their strategic intent in relation to addressing these goals. A focus on symbolic legitimation through SDG disclosure by the Australian companies in this study reaffirms the findings of similar studies and suggests a need for more substantive SDG management and disclosure if these goals are to be adequately addressed by the corporate sector.

Practical implications

The findings of this study provide insights into the current practices and future prospects of corporate responses to SDGs. Policy implications could arise in relation to possible approaches for disclosing social and environmental information and the paper argues for a potential need for regulation of non-financial reporting.

Originality/value

This study contributes to the limited understanding of the corporate response to an urgent sustainability call made by the UN by providing evidence on how Australian companies are embedding, measuring and reporting the SDGs. The research goes beyond a descriptive analysis of SDG disclosure and assesses whether such disclosure is substantive or symbolic.
Financial literacy in for-profit vs pro-social peer-to-peer lending
Authors: Gonzalez Laura
Published: September 2022

Purpose

Peer-to-peer (P2P) lending facilitates direct online lending and aims to provide financial inclusion and investment returns. Lender goals range from for-profit to pro-social and objective information is limited, which highlights the need to examine heuristics.

Design/methodology/approach

This study examines 1,347 lending decisions by finance students on a mock P2P site. Testimonials were used to randomly condition the financially literate lenders towards for-profit or pro-social decision-making. Each investor evaluated three loans. The three loan applications were identical except for a female or male headshot (vs an icon) and random reports of 50% funding for the female or male loan in 3 days (vs 11 days for opposite gender and 7 for icon). Previous research surveys students on a mock platform (Gonzalez, 2020) and reports similar heuristics and lifelike decisions in student and general population samples (Gonzalez and Komarova, 2014).

Findings

Lenders randomly conditioned towards pro-social lending state lower trust in borrowers. However, pro-social investors state lower risk in P2P lending and higher financial literacy. Second, pro-social investors are more confident when lending to borrowers highly trusted by other lenders, especially if the popular loan applicant is female. Third, pro-social conditioning increases lending to male applicants when the popular loan applicant is female. Fourth, pro-social investors who have experienced financial trauma have greater confidence in bad loan recovery.

Originality/value

This is the first study of heuristics in pro-social vs for-profit P2P lending. In addition, it shows that testimonials can effectively condition lending goals and affect trust and risk perceptions.
Leveraging resources to improve supervisors’ vision in the remote workplace
Authors: Gong Baiyun , Tobias Perl , Young-Bristol Jessica
Published: September 2022

Purpose

During the COVID-19 pandemic, many organizations adopted remote work policies. Meanwhile, the loss of the collocated work environment made it challenging for the supervisors to have a clear vision of their employees, which may impact the quality of the performance evaluation and developmental decisions. This paper aims to resolve this problem by identifying resources in the remote workplace that can help supervisors restore their capacity for a clear vision of the remote employees.

Design/methodology/approach

The authors take the perspectives of the job resource-demand model and illustrate the theoretical framework that recognizes resources and resource holders at various levels of the organization. The authors see this as the key for supervisors to meet the demand of “seeing” their employees in the remote workplace.

Findings

Specifically, the employees should offer their information resources via skillful communication because supervisors have lost opportunities for in-person observation. Further, the administration is urged to deliver competence resources through training and development because supervisors may lack the experience of remote work management. Moreover, the organizations should provide social support resources by creating avenues for virtual networking activities, so as to make up the random social opportunities available in the collocated work environment.

Research limitations/implications

Improving supervisors’ vision is a new challenge coming with the installation of the remote workplace. Further research is called for to empirically test this theoretical framework and identify more ways to increase the resources and reduce the demands for supervisors; thus, helping them ease into the new ways of supervision in the virtual workplace.

Practical implications

This research informs the organizations to adjust their strategy for management development to adapt to the remote workplace.

Originality/value

The authors noted that increasing concerns of the low visibility of remote workers was partially due to the impaired vision of supervisors, who lost the context of in-person observation. Supervisors’ vision of their employees was taken for granted in the traditional work environment and there was not much research done on this topic. This prompted us to develop a theoretical framework based on the job resource demand model.
Unlocking the black box of sponsorship in participant-based sport
Authors: Koronios Konstantinos , Ntasis Lazaros , Dimitropoulos Panagiotis , Gerke Anna
Published: September 2022

Purpose

The purpose of this research is to develop a more precise evaluation of sport sponsorship efficiency in participant-based sport, by investigating the specific aspects of participants' attitude and behavior toward sponsors. In more detail, this research develops a comprehensive sponsorship model in the participant sport context, integrating the following constructs: sport involvement, sincerity, social media use, beliefs about sponsorship, satisfaction with event, sponsor's image, awareness of sponsors, attitude toward sponsors, purchase and word of mouth intentions.

Design/methodology/approach

A quantitative method was utilized and 1,056 questionnaires were effectively collected and analyzed via SPSS and AMOS. Using structural equation modeling, this research tested a conceptual framework analyzing the role of different factors for sponsorship efficiency in a participant sport context.

Findings

The present research proposes a model of 10 variables which altogether permits a complete comprehension of how to expand the linkages among antecedents and outcomes of sport sponsorship in participant-based sports. The proposed factors assume a critical role in upgrading sponsorship effectiveness, which is reflected through a continuum of responses that regularly begins with sponsorship awareness and, at last, leads to increments in participants' purchase and word of mouth intentions regarding sponsors' products.

Research limitations/implications

Various implications for future studies as well as strategies to boost the advantages for sponsoring firms in participant-based sports, can be drawn from the suggested model.

Originality/value

Up to the present, there is a scarcity of research exploring the effectiveness of sponsorship in participant-based sports. The majority of sponsorship studies measure the impact of sponsorship on spectators, neglecting the role of participants as potential vehicles in the sport sponsorship setting. This study is the first to exploring the role of sport participants in sport sponsorship literature, provides a comprehensive framework, which can guide future studies and enhance sponsorship efficiency in a participant sport context.
The predicaments of environmental impact assessment (EIA) for transport infrastructure: an examination of policy stagnation and progress
Authors: Gharehbaghi Koorosh , Hosseinian-Far Amin , Hilletofth Per
Published: September 2022

Purpose

Environmental impact assessment (EIA) for transport infrastructure should consider geological constraints, legislative regulations, public policy and other strategic considerations. These strategic considerations and constraints that are often seen as the most challenging issues facing transportation planners are critically reviewed. Subsequently, this study aims to evaluate the enviromnetal impacts of civil transport infrastructure.

Design/methodology/approach

Using a mixed-method approach, this study examines the EIA and environmental impact statement (EIS) dimensions of transportation infrastructure.

Findings

Through the development of the EIA and EIS policy framework for transport infrastructure, this paper found that to better enhance the EIA and to effectively calculate various indicator variables, a hybrid approach to the method, known as input–output analysis (IOA), needs to be adopted. Knowing that a feasible cost breakdown is usually available within projects, it can be concluded that it is plausible to add an input–output (I–O) model into an existing EIS to obtain results not only for on-site effects but also for off-site effects. Moreover, some of the benefits of implementing a hybrid IOA can significantly improve the completeness of any conventional EIS for a range of quantifiable indicators, improve the ability to rank alternative options and provide a valuable overview of indirect impacts to be used for streamlining the EIA audit. For these reasons, input–output techniques could be incorporated as optional elements into the EIA standards.

Practical implications

With input from the Australian Bureau of Statistics and national I–O tables of the industry sector, this research was able to determine that indirect effects within transport projects are not being considered for what they are worth. This enables us to answer key questions dealing with the effects of EIAs on the transportation sector. This, in turn, can assist with planning through the commissioning of such projects.

Originality/value

The I–O model introduced in this paper will ultimately lead to better incorporation of various environmental elements. The findings of the paper can thus assist transportation planners in better aligning environmental impacts with EIA. This, in turn, can result in improvements in the completeness of any conventional EIS, enhance the ability to rank alternative options and provide a valuable overview of indirect impacts to be used for streamlining the EIA audit.
Sustainability reporting as a 21st century problem statement: using a quality lens to understand and analyse the challenges
Authors: Ramanathan Swaminathan , Isaksson Raine
Published: September 2022

Purpose

This paper explores quality science and quality management as a potential pathway to resolve the challenges of corporate sustainability reporting (CSR) by establishing the need for a common understanding of sustainability and sustainable development.

Design/methodology/approach

Secondary research on key documents released by regulatory institutions working at the intersection of sustainability, corporate reporting, measurement and academic papers on quality science and management.

Findings

Existing measurement frameworks of CSR are limited. They are neither aligned nor appropriate for accurately measuring a company's ecological footprint for mitigating climate change. Quality for sustainability (Q4S) could be a conceptual framework to bring about an appropriate level of measurability to better align sustainability reporting to stakeholder needs.

Research limitations/implications

There is a lack of primary data. The research is based on secondary literature review. The implications of Q4S as a framework could inform research studies connected to sustainable tourism, energy transition and sustainable buildings.

Practical implications

The paper connects to CSR stakeholders, sustainability managers, company leaderships and boards.

Social implications

The implications of sustainability on people, purpose and prosperity are a part of World Economic Forum's stakeholder capitalism.

Originality/value

This paper fills a research gap on diagnosing and understanding the key reporting challenges emerging from the lack sustainability definitions.
Explosive source signature determination: Two unequal shots in the same hole
Authors: Ziolkowski Anton
Published: September 2022

Buried explosive charges generate seismic waves with unrivalled bandwidth. The source time function is not always repeatable and is difficult to measure, but is required for subsequent data processing including reverse time migration and full waveform inversion. I present a new method for estimating the explosive seismic source time function for every shot, using two unequal shots in the same shot hole. The measured data for each charge are deconvolved for the modelled monopole seismic source time function to recover estimated earth impulse responses or Green's functions. The source model parameters are adjusted to maximize the likeness of the estimated Green's functions from the two shots, applying physical constraints to obtain the prior probability density functions for each parameter. Ten parameters specify the two source models, but only five of these are independent and a grid search is used to find them. The method is tested on an experimental data set, obtained for a different purpose, consisting of a line of single geophones and three in‐line shot holes, each with two unequal charges, the larger one at twice the depth of the smaller. The method works well where the charge size ratio is at least 2: the estimated source time functions are recovered and the estimated Green's functions are more similar than the seismograms before deconvolution. To apply the method in practice, the smaller charge should be deeper than the larger. If the small charge is small enough, the vertical separation between the charges can be reduced to less than 1 m. The Green's functions for the two charges would then be almost identical for frequencies up to 250 Hz, and the differences in the measured data from the two charges would be caused principally by the differences in the two source time functions.
Antibiotic concentrations in raw hospital wastewater surpass minimal selective and minimum inhibitory concentrations of resistant Acinetobacter baylyi strains
Authors: Schuster Dominik , Axtmann Katharina , Holstein Niklas , Felder Carsten , Voigt Alex , Färber Harald , Ciorba Patrick , Szekat Christiane , Schallenberg Anna , Böckmann Matthias , Zarfl Christiane , Neidhöfer Claudio , Smalla Kornelia , Exner Martin , Bierbaum Gabriele
Published: September 2022

Antibiotics are essential for modern medicine, they are employed frequently in hospitals and, therefore, present in hospital wastewater. Even in concentrations, that are lower than the minimum inhibitory concentrations (MICs) of susceptible bacteria, antibiotics may exert an influence and select resistant bacteria, if they exceed the MSCs (minimal selective concentrations) of resistant strains. Here, we compare the MSCs of fluorescently labelled Acinetobacter baylyi strains harboring spontaneous resistance mutations or a resistance plasmid with antibiotic concentrations determined in hospital wastewater. Low MSCs in the μg/L range were measured for the quinolone ciprofloxacin (17 μg/L) and for the carbapenem meropenem (30 μg/L). A 24 h continuous analysis of hospital wastewater showed daily fluctuations of the concentrations of these antibiotics with distinctive peaks at 7–8 p.m. and 5–6 a.m. The meropenem concentrations were always above the MSC and MIC values of A. baylyi. In addition, the ciprofloxacin concentrations were in the range of the lowest MSC for about half the time. These results explain the abundance of strains with meropenem and ciprofloxacin resistance in hospital wastewater and drains.
Gutting fishy empathies off the Shetland Islands, Scotland
Authors: Giraldo Herrera César E.
Published: September 2022

This article builds upon Amerindian epistemologies and develops a perspectival ethnography of industrial Northwestern European skilled modes of engaging with wild fish. It explores Amerindian perspectivism as an ethnographic methodology grounded on animic premises: subject or object status are relative and relational, experience is intersubjective; the body is permeable, and its perspectives can be exchanged through tools and mimetic processes. Thus subjectivity is collectively constituted and the fundamental means of knowing, leading to the acknowledgement of subjectivity in others. Documenting a perspectival exchange guided by Shetland fishers trawling for monkfish, the article focuses on some possible dynamics and affective affordances involved in gutting processes. Gutting is physically and emotionally taxing labour that involves brief but intimate encounters with responsive beings that may offer effective resistance, affecting fishers or damaging their own value as catch. It entails the possibility of developing an intimate knowledge of fish anatomy, ecology, and behaviour, as well as potentially awareness of fish suffering and fishiness, an empathic quality. The research reveals how Shetland fishers maintain animic modes of learning and being in their understandings of the body and fish. The ethnography presents first‐hand insights into ‘relations of trust’, which, although widely reported, continue to be dismissed as implausible. These relations and their dynamics are further attested through Shetlands háfwords and other language practices that establish synecdochical relations between fishers and fish, restricting violence and making it endurable. These insights problematize violence, illustrating the social skills of fishing and the political dynamics of predation, suggesting paths towards addressing cruelty.
A nativist divide? Anti‐immigration attitudes and diffuse support for democracy in Western Europe
Authors: KOKKONEN ANDREJ , LINDE JONAS
Published: September 2022

Earlier research has shown a strong connection between anti‐immigration attitudes and political trust in Western Europe. In this research note, we examine if nativists’ low levels of specific political support translate into a more general scepticism about democracy as a system of government. Using comparative data from the European Social Survey (ESS) and the European Values Study (EVS), we investigate the relationship between nativist attitudes and several indicators of principled, or diffuse, support for democracy. The findings testify to a nativist divide in diffuse political support. We find a systematic and significant difference in support for democracy between strong nativists and other citizens. West European nativists are less likely than other citizens to view their country as democratic. They also tend to perceive living in a democracy as less important than people with a more positive outlook on immigrants. Moreover, and maybe more worrying, nativists express lower levels support for democracy in relation to non‐democratic regime alternatives, that is, they are less likely to be “principled” democrats. The found negative associations remain also after controlling for nativists’ levels of specific support, which indicates that there may be a more fundamental opposition between nativism and diffuse support for democracy than previously acknowledged. We believe that these findings have important implications for research trying to understand challenges to liberal democracy in a time when nativist parties have been successful in politicizing immigration and continue to score electoral victories all over Europe.
Reconciling Socio‐economic and Environmental Sustainability in Agri‐food Development: A Critical Appraisal of Irish Strategies
Authors: Balaine Lorraine , Läpple Doris , Buckley Cathal , Dillon Emma
Published: September 2022

In the face of growing environmental issues associated with food production, arbitrating between multiple and sometimes conflicting aspirations for European agriculture is a complex undertaking. This article critically assesses potential national strategies for sustainable agri‐food development by using Ireland as an example. Facilitated by national and European policies, the Irish agri‐food sector has experienced significant growth over the last decade. Initially, an efficiency‐based strategy was applied at farm and industry levels to increase output while limiting adverse environmental impacts of agri‐food production. However, this strategy proved insufficient to offset the additional environmental pressure caused by agricultural intensification and expansion. More recently, the failure to reconcile economic and environmental targets in Irish agri‐food development encouraged a move away from the efficiency‐based strategy towards the EU‐inspired food systems framework. While this approach incorporates sustainability objectives in a more comprehensive manner, it will require a substantial transition in the way we produce and consume food. Hence, the challenge of designing policy tools that will support its implementation still remains. This article discusses issues arising from reactive policy responses, and highlights the need to better co‐ordinate all levels of the food system.
#Healthpromotion: A qualitative exploration of how dietitians can use social media to positively influence women aged 18–35 years
Authors: Shine Danielle , Minehan Michelle , Knight‐Agarwal Cathy
Published: September 2022

Aims

To understand how young adult women use social media, including which nutrition and health‐related content they prefer to view and why. Findings are intended to support dietitians to use social media more effectively for health promotion to reach, educate and positively influence young adult women.

Methods

Qualitative research was conducted through semi‐structured interviews involving 10 women aged 18–35 years via Zoom videoconferencing. The interviews were recorded, transcribed verbatim and analysed using an interpretative phenomenological approach.

Results

Young adult women use social media daily to view a wide variety of content, including nutrition and health‐related content. Three themes were identified: authenticity, engaging content, and affecting trust through selling products.

Conclusion

To effectively use social media for health promotion, dietitians need to share their authentic voice while maintaining professional standards. Recommendations for effective social media engagement include using engaging content, infographics, and videos with closed captions. More research is needed to assess whether health promotion deployed via social media is effective at increasing nutrition knowledge, improving health literacy, and producing behaviour change.
Identifying key factors and strategies for reducing oil content in fried instant noodles
Authors: Obadi Mohammed , Li Yuntong , Xu Bin
Published: September 2022

Fried instant noodles have become a popular instant food in recent years, favored by consumers for their unique flavor and taste. Unfortunately, the oil content of instant noodles is generally high, so the rise of fat‐related diseases poses a major health issue. From the perspective of the cost of instant noodle manufacturers and the health of consumers, it is of great significance to reduce the oil content of instant noodles. The aim of this review article is to provide an overview of the main factors, such as raw materials and production processes, affecting oil content in instant noodles in order to suggest specific strategies to reduce the oil content in the end product. From the literature reviewed, adding acetylated potato starch/carboxymethyl cellulose, hydroxypropyl methylcellulose, or preharvest‐dropped apple powder in the noodle formulation could be a better choice to reduce oil uptake by 5%–20%. Instant noodles with lower oil content can be produced using novel alternative frying technologies, including microwave and vacuum frying. The proper management of the production processes and the implementation of enhancement strategies may result in a reduction of oil content in the end product.
The association between hydroxychloroquine use and future development of systemic lupus erythematosus in patients with primary Sjögren's syndrome
Authors: Hsu Bo‐Chueh , Chen Yi‐Hsing , Lin Ching‐Heng , Tang Kuo‐Tung
Published: September 2022

Aim

Hydroxychloroquine (HCQ), commonly used to treat patients with primary Sjögren's syndrome (pSS), has been shown to delay the development of systemic lupus erythematosus (SLE). This study aimed to explore the association between HCQ use and future development of SLE in pSS patients based on a nationwide nested case–control study.

Method

Based on the National Health Insurance Research Database of Taiwan, those patients who were diagnosed with SLE at least 1 year after the diagnosis of pSS were identified as cases. Matched controls were randomly selected from pSS patients without a later diagnosis of SLE in a 1:10 ratio. The odds ratios (ORs) of HCQ exposure between cases and controls were analyzed by unconditional logistic regression after adjustment for age.

Results

A cohort of 11 772 pSS patients were extracted from the database during the period from January 1, 2000 to December 31, 2010. A total of 111 (0.9%) pSS patients developed SLE during the follow‐up period. Most (79%) of them developed SLE within 5 years after the diagnosis of pSS. There was no significant difference in the odds of HCQ exposure between cases and controls, with an adjusted OR of 2.43 (95% CI: 0.73–8.05). Neither did we observe a significant difference in the odds of exposure to a higher average dose of HCQ (≥100 mg/d vs non‐exposed) between cases and controls in the sensitivity analysis.

Conclusion

Nearly 1% of pSS patients may develop SLE. HCQ use in pSS patients was not associated with a lower possibility of the future development of SLE.
Airway management in patients with suspected or confirmed traumatic spinal cord injury: a narrative review of current evidence
Authors: Wiles M. D.
Published: September 2022

Around 1 million people sustain a spinal cord injury each year, which can have significant psychosocial, physical and socio‐economic consequences for patients, their families and society. The aim of this review is to provide clinicians with a summary of recent studies of direct relevance to the airway management of patients with confirmed or suspected traumatic spinal cord injury to promote best clinical practice. All airway interventions are associated with some degree of movement of the cervical spine; in general, these are very small and whether these are clinically significant in terms of impingement of the spinal cord is unclear. Manual in‐line stabilisation does not effectively immobilise the cervical spine and increases the likelihood of difficult and failed tracheal intubation. There is no clear evidence of benefit of awake tracheal intubation techniques in terms of prevention of secondary spinal cord injury. Videolaryngoscopy appears to cause a similar degree of cervical spine displacement as flexible bronchoscope‐guided tracheal intubation and is an appropriate alternative approach. Direct laryngoscopy does cause a slightly greater degree of cervical spinal movement during tracheal intubation than videolaryngoscopy, but this does not appear to increase the risk of spinal cord compression. The risk of spinal cord injury during tracheal intubation appears to be minimal even in the presence of gross cervical spine instability. Depending on the clinical situation, practitioners should choose the tracheal intubation technique with which they are most proficient and that is most likely to minimise cervical spine movement.
Transport of the patient with trauma: a narrative review
Authors: Spoelder E. J. , Slagt C. , Scheffer G. J. , van Geffen G. J.
Published: September 2022

Trauma and injury place a significant burden on healthcare systems. In most high‐income countries, well‐developed acute pre‐hospital and trauma care systems have been established. In Europe, mobile physician‐staffed medical teams are available for the most severely injured patients and apply a wide variety of lifesaving interventions at the same time as ensuring patient comfort. In trauma systems providing pre‐hospital care, medical interventions are performed earlier in the patient journey and do not affect time to definite care. The mode of transport from the accident scene depends on the organisation of the healthcare system and the level of hospital care to which the patient is transported. This varies from ‘scoop and run’ to a basic community care setting, to advanced helicopter emergency medical service transport to a level 4 trauma centre. Secondary transport of trauma patients to a higher level of care should be avoided and may lead to a delay in definitive care. Critically injured patients must be accompanied by at least two healthcare professionals, one of whom must be skilled in cardiopulmonary resuscitation and advanced airway management techniques. Ideally, the standard of care provided during transport, including the level of monitoring, should mirror hospital care. Pre‐hospital care focuses on the critical care patient, but the majority of injured patients need only close observation and pain management during transport. Providing comfort and preventing additional injury is the responsibility of the whole transport team.
Major haemorrhage: past, present and future
Authors: Shah A. , Kerner V. , Stanworth S. J. , Agarwal S.
Published: September 2022

Major haemorrhage is a leading cause of morbidity and mortality worldwide. Successful treatment requires early recognition, planned responses, readily available resources (such as blood products) and rapid access to surgery or interventional radiology. Major haemorrhage is often accompanied by volume loss, haemodilution, acidaemia, hypothermia and coagulopathy (factor consumption and fibrinolysis). Management of major haemorrhage over the past decade has evolved to now deliver a ‘package’ of haemostatic resuscitation including: surgical or radiological control of bleeding; regular monitoring of haemostasis; advanced critical care support; and avoidance of the lethal triad of hypothermia, acidaemia and coagulopathy. Recent trial data advocate for a more personalised approach depending on the clinical scenario. Fresh frozen plasma should be given as early as possible in major trauma in a 1:1 ratio with red blood cells until the results of coagulation tests are available. Tranexamic acid is a cheap, life‐saving drug and is advocated in major trauma, postpartum haemorrhage and surgery, but not in patients with gastrointestinal bleeding. Fibrinogen levels should be maintained > 2 g.l−1 in postpartum haemorrhage and > 1.5 g.l−1 in other haemorrhage. Improving outcomes after major traumatic haemorrhage is now driving research to include extending blood‐product resuscitation into prehospital care.
Mortality, incidence and seasonality of canine and feline patients treated with tick antiserum in three far North Queensland veterinary clinics from 2000 to 2020
Authors: Thomas RP , Greening SS , Hill KE
Published: September 2022

Tick paralysis is a paralysis caused by bites from Ixodes holocyclus, affecting an estimated 10,000 companion animals in Australia annually. Despite tick antiserum being the cornerstone of treatment, there are no large‐scale general practice studies that examine survival outcomes in tick antiserum‐treated animals. In this retrospective study, clinical records from three far north Queensland general practice veterinary clinics were searched for tick antiserum‐treated canine and feline patients were seen between 2000 and 2020. Patient records were assessed for survival outcomes, then logistic regression and Bayesian structural time‐series model were used to assess trends in incidence and mortality and the relationship between these and time of year, rainfall, and species. The study included 2019 dog and 953 cat records. When patients with unknown outcomes were removed, canine mortality was 11.8% (213/1799) and feline mortality was 5.3% (46/872). Dogs were found to have 2.41 odds of dying following treatment than cats. August and September had the highest mean number of monthly treatments, and rainfall in the previous 5–8 months was positively correlated with the number of patients treated in each month. The odds of mortality did not vary significantly by month or season, and from 2015 onwards, there was a significant decrease in the proportion of dogs treated by the clinics. Overall, this study provides new information on tick antiserum treatment outcomes in general practice as well as new information on tick paralysis incidence in far north Queensland.
Predictors of thrombosis and bleeding in 1613 myelofibrosis patients from the Spanish Registry of Myelofibrosis
Authors: Hernández‐Boluda Juan‐Carlos , Pastor‐Galán Irene , Arellano‐Rodrigo Eduardo , Raya José‐María , Pérez‐Encinas Manuel , Ayala Rosa , Ferrer‐Marín Francisca , Velez Patricia , Mora Elvira , Fox María‐Laura , Hernández‐Rivas Jesús‐María , Xicoy Blanca , Mata‐Vázquez María‐Isabel , García‐Fortes María , Pérez‐López Raúl , Angona Anna , Cuevas Beatriz , Senín Alicia , Ramírez María‐José , Ramírez‐Payer Angel , Gómez‐Casares María‐Teresa , Martínez‐Valverde Clara , Magro Elena , Steegmann Juan‐Luis , Durán María‐Antonia , García‐Hernández Carmen , Gasior Mercedes , de Villambrosia Sonia González , Alvarez‐Larrán Alberto , Pereira Arturo ,   the Spanish MPN Group (GEMFIN)
Published: September 2022

Available data have proved insufficient to develop consensus recommendations on the prevention of thrombosis and bleeding in myelofibrosis (MF). We evaluated the incidence and risk factors of vascular complications in 1613 patients from the Spanish Myelofibrosis Registry. Over a total of 6981 patient‐years at risk, 6.4% of the study population had at least one thrombotic event after MF diagnosis, amounting to an incidence rate of 1.65 per 100 patient‐years. Prior history of thrombosis, the JAK2 mutation, and the intermediate‐2/high‐risk International Prognostic Scoring System (IPSS) categories conferred an increased thrombotic risk after adjustment for the risk‐modifying effect of anti‐thrombotic and cytoreductive treatments. History of thrombosis and the JAK2 mutation allowed us to pinpoint a group of patients at higher risk of early thrombosis. No decreased incidence of thrombosis was observed while patients were on anti‐thrombotic or cytoreductive treatment. An increased risk of venous thrombosis was found during treatment with immunomodulatory agents. A total of 5.3% of patients had at least one episode of major bleeding, resulting in an incidence rate of 1.5 events per 100 patient‐years. Patients in the intermediate‐2/high‐risk IPSS categories treated with anti‐coagulants had an almost sevenfold increased risk of major bleeding. These findings should prove useful for guiding decision‐making in clinical practice.
Immunoglobulin‐like transcript 2 blockade restores antitumor immune responses in glioblastoma
Authors: Lorenzo‐Herrero Seila , Sordo‐Bahamonde Christian , Martínez‐Pérez Alejandra , Corte‐Torres Mª. Daniela , Fernández‐Vega Iván , Solís‐Hernández Mª. Pilar , González Segundo
Published: September 2022

Glioblastoma stands as the most frequent primary brain tumor. Despite the multimodal therapy for glioblastoma patients, the survival rate is very low, highlighting the need for novel therapies that improve patient outcomes. Immune checkpoint blockade strategies are achieving promising results in a myriad of tumors and several studies have reported its efficacy in glioblastoma at a preclinical level. ILT2 is a novel immune checkpoint that exerts an inhibitory effect via the interaction with classical and non‐classical HLA class‐I molecules. Herein, we report that ILT2 blockade promotes antitumor responses against glioblastoma. In silico and immunohistochemical analyses revealed that the expression of ILT2 and its ligands HLA‐A, ‐B, ‐C, and ‐E are highly expressed in patients with glioblastoma. Disruption of ILT2 with blocking monoclonal antibodies increased natural killer cell‐mediated IFN‐γ production and cytotoxicity against glioblastoma, partially reverting the immunosuppression linked to this malignancy. In addition, co‐treatment with temozolomide strengthened the antitumor capacity of anti‐ILT2‐treated immune cells. Collectively, our results establish the basis for future studies regarding the clinical potential of ILT2 blockade alone or in combination regimens in glioblastoma.
Fewer non‐native insects in freshwater than in terrestrial habitats across continents
Authors: Sendek Agnieszka , Baity‐Jesi Marco , Altermatt Florian , Bader Martin K.‐F. , Liebhold Andrew M. , Turner Rebecca M. , Roques Alain , Seebens Hanno , Spaak Piet , Vorburger Christoph , Brockerhoff Eckehard G.
Published: September 2022

Aim

Biological invasions are a major threat to biodiversity in aquatic and terrestrial habitats. Insects represent an important group of species in freshwater and terrestrial habitats, and they constitute a large proportion of non‐native species. However, while many non‐native insects are known from terrestrial ecosystems, they appear to be less represented in freshwater habitats. Comparisons between freshwater and terrestrial habitats of invader richness relative to native species richness are scarce, which hinders syntheses of invasion processes. Here, we used data from three regions on different continents to determine whether non‐native insects are indeed under‐represented in freshwater compared with terrestrial assemblages.

Location

Europe, North America, New Zealand.

Methods

We compiled a comprehensive inventory of native and non‐native insect species established in freshwater and terrestrial habitats of the three study regions. We then contrasted the richness of non‐native and native species among freshwater and terrestrial insects for all insect orders in each region. Using binomial regression, we analysed the proportions of non‐native species in freshwater and terrestrial habitats. Marine insect species were excluded from our analysis, and insects in low‐salinity brackish water were considered as freshwater insects.

Results

In most insect orders living in freshwater, non‐native species were under‐represented, while they were over‐represented in a number of terrestrial orders. This pattern occurred in purely aquatic orders and in orders with both freshwater and terrestrial species. Overall, the proportion of non‐native species was significantly lower in freshwater than in terrestrial species.

Main conclusions

Despite the numerical and ecological importance of insects among all non‐native species, non‐native insect species are surprisingly rare in freshwater habitats. This is consistent across the three investigated regions. We review hypotheses concerning species traits and invasion pathways that are most likely to explain these patterns. Our findings contribute to a growing appreciation of drivers and impacts of biological invasions.
Neurodivergence‐informed therapy
Authors: Chapman Robert , Botha Monique
Published: September 2022

The neurodiversity movement is a social movement that emerged among autistic self‐advocates. It has since spread and has been joined by many with diagnoses of attention‐deficit/hyperactivity disorder, dyslexia, and developmental coordination disorder among others. By reconceptualizing neurodiversity as part of biodiversity, neurodiversity proponents emphasize the need to develop an ‘ecological’ society that supports the conservation of neurological minorities through the construction of ecological niches—that is, making space for all. This is an alternative to the drive to eliminate diversity through attempts to ‘treat’ or ‘cure’ neurodivergence. So far, neurodiversity theory has not been formally adapted for psychotherapeutic frameworks, and it is not the role of the therapist to make systemic changes to societal organization. Still, there is room for fruitfully drawing on a neurodiversity perspective for therapists working with neurodivergent people in clinical settings. Here, we draw on the example of autism and synthesize three key themes to propose the concept of neurodivergence‐informed therapy. First, the reconceptualization of dysfunction as relational rather than individual. Second, the importance of neurodivergence acceptance and pride, and disability community and culture to emancipate neurodivergent people from neuro‐normativity. Third, the need for therapists to cultivate a relational epistemic humility regarding different experiences of neurodivergence and disablement.
Mediation of the total effect of cystic fibrosis‐related diabetes on mortality: A UK Cystic Fibrosis Registry cohort study
Authors: Tanner Kamaryn T. , Daniel Rhian M. , Bilton Diana , Simmonds Nicholas J. , Sharples Linda D. , Keogh Ruth H.
Published: September 2022

Aim

To investigate whether the effect of cystic fibrosis‐related diabetes (CFRD) on the composite outcome of mortality or transplant could act through lung function, pulmonary exacerbations and/or nutritional status.

Methods

A retrospective cohort of adult cystic fibrosis (CF) patients who had not been diagnosed with CFRD were identified from the UK Cystic Fibrosis Registry (n = 2750). Rate of death or transplant was compared between patients who did and did not develop CFRD (with insulin use) during follow‐up using Poisson regression, separately by sex. Causal mediation methods were used to investigate whether lung function, pulmonary exacerbations and nutritional status lie on the causal pathway between insulin‐treated CFRD and mortality/transplant.

Results

At all ages, the mortality/transplant rate was higher in both men and women diagnosed with CFRD. Pulmonary exacerbations were the strongest mediator of the effect of CFRD on mortality/transplant, with an estimated 15% [95% CI: 7%, 28%] of the effect at 2 years post‐CFRD diagnosis attributed to exacerbations, growing to 24% [95% CI: 9%, 46%] at 4 years post‐diagnosis. Neither lung function nor nutritional status were found to be significant mediators of this effect. Estimates were similar but with wider confidence intervals in a cohort that additionally included people with CFRD but not using insulin.

Conclusion

There is evidence that pulmonary exacerbations mediate the effect of CFRD on mortality but, as they are estimated to mediate less than one‐quarter of the total effect, the mechanism through which CFRD influences survival may involve other factors.
Patterns of craniomaxillofacial trauma among helmeted cyclists
Authors: Stanbouly Dani , Selvi Firat , Patel Neel , Ro Deborah Christina , Kocaelli Humeyra
Published: September 2022

Background/Aim

The head and face are prone to injury in bicycle accidents and helmets are proven to be helpful in decreasing injuries to some extent. The aim of this study was to determine whether certain craniomaxillofacial regions are at increased risk of injury (fracture) during bicycle accidents among helmeted cyclists.

Materials and methods

This retrospective cohort study was conducted using data from the National Electronic Injury Surveillance System (NEISS). Data concerning craniomaxillofacial injuries as a result of cycling accidents between 2019 and 2020 were reviewed. The primary predictor variables were the craniomaxillofacial region and a craniofacial bone. The co‐variates included patient characteristics (age, gender, race) and injury characteristics (location, season). The primary outcome variable was a fracture. Logistic regression was used to determine any independent risk factors for a fracture.

Results

Five hundred patients reported helmet use at the time of injury. Fractures of the face region were 75 times (p < .01) more likely than the head region. No particular craniofacial bone was at greater risk of fracture relative to the maxilla. Adults (OR 24.0, p < .01) and seniors (OR 38.6, p < .01) were each at greater risk for fracture relative to children.

Conclusions

The facial region was at increased risk of fracture relative to the head during a bicycle accident. Adults and seniors were at increased risk of suffering craniofacial fractures relative to children.