bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining relationships among cultural factors and expectations of CSR
Authors: Kim Minsoo , White Candace , Kim Chansouk
Published: September 2019

Purpose

Studies have explored expectations of corporate social responsibility (CSR) among cultures, but findings are mixed. A more nuanced view of cultural dimensions rather than using Hofstede’s aggregate country scores can offer a stronger empirical foundation for studying the effects of culture. Based on two cultural dimensions and Carroll’s four-dimensional model of CSR, the purpose of this paper is to test the relationship between individualistic/collectivistic values and individuals’ expectations of different types of responsibilities (economic, legal, ethical and philanthropic), the relationship between long-term values and individuals’ expectations of different types of responsibilities and the degree of skepticism about CSR related to these values.

Design/methodology/approach

This study surveyed panel participants in two countries, South Korea (collectivistic and long term) and the USA (individualistic and short term), chosen because they are at extreme ends of the cultural values continuum. Multi-dimensional aspects of the cultural variables were tested in the samples rather than using national scores as proxy variables for culture. Data were quantitative and various statistical tests including structural equation modeling were used for analysis.

Findings

The findings show that horizontal collectivism and the planning dimension of long-term orientation are positively associated with CSR expectations, whereas the tradition dimension of long-term orientation is negatively associated with CSR expectations. In addition, vertical individualism is positively associated with skepticism toward CSR activities.

Research limitations/implications

The differences in types of individual-collectivism (horizontal and vertical) as well as the different aspects of long-term orientation had an effect on the results, pointing to the importance of exploring the nuances of the dimensions as well as the importance of testing them within the sample rather than using aggregated national scores.

Originality/value

Previous studies that used a proxy variable for culture assumed that collectivistic cultures have higher expectations for CSR. While empirically supporting the assumption of the relationship between cultural factors and CSR expectations at the individual level, the study found that people who view themselves as autonomous within a group but accept inequality within the group (vertical individualism) are more likely to be skeptical of CSR activities and suggests that skepticism about CSR may be more closely related to individual viewpoints or to particular contexts or particular corporations rather than to cultural factors, which has implications for international corporate communication.
Smart, friendly, biased liars? Exploring motivated reasoning and ethical decision-making in public relations
Authors: Thummes Kerstin , Seiffert-Brockmann Jens
Published: September 2019

Purpose

The purpose of this paper is to present research on motivated bias and self-deception in ethical decision-making in public relations. Self-deception might explain how professionals evade mental stress in conflicting situations and manage to be persuasive even when they have to act contrary to their own morals or to public interests. Since self-deception impedes moral reasoning, the research purpose is to gain insights on its origins so that effective counter-measures can be developed.

Design/methodology/approach

First, the state of research on moral dilemmas in public relations and on self-deception in psychology is outlined. Second, four professionals are interviewed to explore typical conflicts of interest and to develop a realistic scenario that gives rise to a moral dilemma. Third, a small sample of professionals (n=9) is confronted with the developed scenario in a qualitative online questionnaire to analyze their reasoning.

Findings

Results indicate that self-deception in response to moral dilemmas exists in public relations practice. Typical conflicts of interest, boundary conditions for motivated bias and counter-measures are identified. Experienced professionals in leading positions seem to have the confidence to reject mandates they perceive as immoral. Counter-measures against self-deception should therefore address young professionals and practitioners with low advisory influence.

Originality/value

While public relations research mostly presumes professionals as rational actors, this study sheds light on irrational practices. In contrast to common practice of expert interviews, an indirect and implicit methodological approach is applied to capture unconscious processes of motivated reasoning.
A spiral of voice? When employees speak up on internal social media
Authors: Madsen Vibeke Thøis , Johansen Winni
Published: September 2019

Purpose

The purpose of this paper is to explore the discursive tactics that employees use when they speak up on internal social media (ISM) to gain support for their cause, and how this can develop into a “spiral of voice” when organizational members interact with each other on ISM.

Design/methodology/approach

The study is based on screenshots of four months of coworker communication on ISM in a Danish bank and on semi-structured interviews with 24 employees.

Findings

Employees succeeded in speaking up and gaining support on ISM by using eight different discursive tactics. These tactics helped move organizational issues from an operational to a strategic level, thus making the issues relevant for management as well as gaining the support of other coworkers. The visibility and persistence of communication on ISM forced managers to react.

Research limitations/implications

Further research should investigate whether similar tactics and reactions occur in organizations with a less open communication culture where it might be less safe for employees to speak up.

Practical implications

Organizations need to be aware of the dynamics of the “spiral of voice” and of the way in which the visibility and persistence of communication on ISM forces managers to handle organizational issues.

Originality/value

This study is the first to explore what happens when employees speak up on ISM and to propose the concept of “a spiral of voice” as an extension of the theory of “the spiral of silence” (Noelle-Neumann, 1974).
Decision strategies in reward-based crowdfunding: the role of crowdfunding platforms
Authors: Bi Gongbing , Xiang Qinghua , Geng Botao , Xia Qiong
Published: September 2019

Purpose

The purpose of this paper is to investigate the influence of the crowdfunding platforms on reward-based crowdfunding projects. This study offers guidance for the creator on how to choose among platforms and how to make optimal product and pricing decisions.

Design/methodology/approach

Usually, crowdfunding platforms are able to help creators to lower unit costs and charge platform fees in return. In this paper, the reduction of the unit cost and the platform fee are selected for determining the competitive strength (CS) of a platform. Then, the CS affecting the creators and the backers of the projects is analyzed.

Findings

In the basic model, when the product quality level is exogenous, the optimal price increases in the product quality level and decreases in the difficulty level of the project, while the corresponding expected profit is a unimodal function of the product quality level and the difficulty level. In the endogenous case, the optimal price is exactly twice the unit cost. With the influence of platforms, platforms with higher CS tend to help the creator to lower the prices and to achieve higher profitability. Moreover, platforms with higher CS usually help the creator to offer higher quality products and to charge higher prices.

Research limitations/implications

The opportunity cost is zero in this paper. In reality, backers arrive at the project in different order. Usually, earlier backers bare more opportunity cost and risk.

Originality/value

To the best of authors’ knowledge, this paper is the first one to offer suggestions for creators on how to choose among crowdfunding platforms. The study provides theoretical guidance on product and pricing decisions on an analytical side.
A positioning strategy for a tourist destination, based on analysis of customers’ perceptions and satisfactions
Authors: Saqib Natasha
Published: September 2019

Purpose

The purpose of this paper is to measure the perception and satisfactions of consumers of the tourism product of Kashmir region and identify potential niche markets that could be used in the development of the destination’s positioning strategy.

Design/methodology/approach

The author used a case study methodology. Self-completion questionnaires were distributed to tourists visiting Kashmir region at the peak of the 2018 tourism season. The scales used were adapted from two authoritative sources. Data from 479 completed questionnaires were analysed quantitatively by a variety of statistical techniques, including factor analysis.

Findings

Four possible niche markets are identified that can inform the development of the destination’s positioning strategy: nature based, adventure, cultural and culinary. The overall conclusions and discussion of the findings should provide a case-based framework for the practical planning and implementation of positioning strategies in the tourism context.

Research limitations/implications

The time frame of the study was five summer months in one year, and only actual visitors completed the questionnaire. The study did not assess their evaluation of the quality of the services provided and consumed.

Originality/value

The overall conclusions and discussion of the findings should provide a case-based framework for the practical planning and implementation of positioning strategies in the tourism context.
A partner selection model for collaborative product innovation from the viewpoint of knowledge collaboration
Authors: Jian Jie , Wang Milin , Li Lvcheng , Su Jiafu , Huang Tianxiang
Published: September 2019

Purpose

Selecting suitable and competent partners is an important prerequisite to improve the performance of collaborative product innovation (CPI). The purpose of this paper is to propose an integrated multi-criteria approach and a decision optimization model of partner selection for CPI from the perspective of knowledge collaboration.

Design/methodology/approach

First, the criteria for partner selection are presented, considering comprehensively the knowledge matching degree of the candidates, the knowledge collaborative performance among the candidates, and the overall expected revenue of the CPI alliance. Then, a quantitative method based on the vector space model and the synergetic matrix method is proposed to obtain a comprehensive performance of candidates. Furthermore, a multi-objective optimization model is developed to select desirable partners. Considering the model is a NP-hard problem, a non-dominated sorting genetic algorithm II is developed to solve the multi-objective optimization model of partner selection.

Findings

A real case is analyzed to verify the feasibility and validity of the proposed model. The findings show that the proposed model can efficiently select excellent partners with the desired comprehensive attributes for the formation of a CPI alliance.

Originality/value

Theoretically, a novel method and approach to partner selection for CPI alliances from a knowledge collaboration perspective is proposed in this study. In practice, this paper also provides companies with a decision support and reference for partner selection in CPI alliances establishment.
Bioactive composition and promising health benefits of natural food flavors and colorants: potential beyond their basic functions
Authors: Kaur Komalpreet , Sharma Rajan , Singh Sukhwant
Published: September 2019

Purpose

The purpose of this review is to address the consumer’s preferences that have varied greatly in the past decade appraising the use of flavor and aroma compounds in the development of functional foods rather than consuming artificial additives. A growing interest in natural flavoring agents and preservatives have made the researchers to explore the other bio-functional properties of natural flavors beyond their ability to give a remarkable flavor to the food.

Design/methodology/approach

In this review, five major flavoring agents used significantly in food industries have been discussed for their bioactive profile and promising health benefits. Vanilla, coffee, cardamom, saffron and cinnamon, despite being appreciated as natural flavors, have got impressive health benefits due to functional ingredients, which are being used for the development of nutraceuticals.

Findings

Flavoring and coloring compounds of these products have shown positive results in the prevention of several diseases including carcinoma and neurological diseases such as Alzheimer’s and Parkinson’s. Such effects are attributed to the presence of phenolic compounds, which possesses free radical scavenging, anti-inflammatory antiviral and antimicrobial properties. These properties not only show a preventive mechanism against diseases but also makes the food product shelf-stable by imparting antimicrobial effects.

Originality/value

This paper highlights the opportunities to increase the use of such natural flavoring agents over synthetic aroma compounds to develop novel functional foods. Phenols, carotenoids and flavonoids are the major health-promoting components of these highly valued aroma ingredients.
Design-driven innovation, quality, and customer value in manufacturing companies
Authors: Conti Emanuela , Vesci Massimiliano , Crudele Chiara , Pencarelli Tonino
Published: September 2019

Purpose

The purpose of this paper is to present an empirical study which examines the relationships among design-driven innovation, quality and customer value in manufacturing companies.

Design/methodology/approach

A research project was carried out in 193 Italian manufacturing companies, using the questionnaire method. An exploratory research study was conducted with hierarchical cluster analysis and regression analysis.

Findings

The analysis shows the existence of four clusters of manufacturing companies which differ by firm size, expenditure in innovation and type of innovation. Furthermore, the elements of a quality product and a design product have a significant impact on customer value, and the importance of these elements changes within the different cluster.

Research limitations/implications

The small size of the sample and the geographic origin of companies imply limited generalizability and further research on the topic is recommended.

Practical implications

The study suggests that companies should simultaneously pursue quality and innovation to increase customer value. To achieve high levels of innovation, and thus increase their quality standards, manufacturing companies should consider the importance of the elements related to design which have impact on customer value.

Originality/value

Focusing on the relationship between design-driven innovation and quality which has not yet been investigated, the present study reveals many common elements of product design and quality product and their positive influence on the perception of customer value.
Quality management, innovation capability and firm performance
Authors: Sahoo Saumyaranjan
Published: September 2019

Purpose

Many organizations are facing competitive challenges due to the rapid pace of technological changes. Both quality management (QM) and innovation are the competitive factors that are intensely embedded into organizational products, services and processes. In order to achieve higher firm performance, manufacturing firms are needed to adopt QM practices as well as develop innovation capability. Therefore, the purpose of this paper is to examine the relationship among QM, innovation capability (IC) and firm performance under both mediation and moderation models using structural equation modeling.

Design/methodology/approach

The approach of this study is quantitative. The data used to test the hypotheses were gathered from Indian small- and medium-sized enterprises (SMEs) interviewing senior managers with a structured questionnaire. These hypothesized relationships are tested with data collected from 134 Indian manufacturing firms by using SPSS and AMOS statistical software.

Findings

Overall, the findings clearly show that QM through the firm’s IC is indirectly associated with a firm’s business performance. It supported the notion that QM practices encourage the definition of innovation strategies of products and processes within a manufacturing setup, which positively affected different aspects of firm performance. More importantly, this study supports the findings of past studies that questioned the role of QM practices in improving a firm’s IC.

Research limitations/implications

Some limitations of this study include: although a cross-sectional survey has been applied, the research does not permit us to account for the lag between implementation and performance. It also brings the opinion of a limited number of senior managers of Indian manufacturing SMEs, and hence both the sample size could be increased and the nationality of the respondent/responding firms could be expanded for future research.

Practical implications

In light of the obtained results, several recommendations were introduced to assist decision makers in manufacturing companies. The paper contains suggestions for improving manufacturing firm’s performance through developing IC and adopting QM practices.

Originality/value

This paper extends theoretical contribution in production and operations management literature, highlighting how QM practices and firm’s IC have to interact in determining an organization’s success and sustaining its global competitiveness.
Ranking model of total quality management enablers in healthcare establishments using the best-worst method
Authors: Talib Faisal , Asjad Mohammad , Attri Rajesh , Siddiquee Arshad Noor , Khan Zahid A.
Published: September 2019

Purpose

Recent years have witnessed a significant rise in Indian healthcare establishments (HCEs) which indicate that there is a constant need to improve the healthcare quality services through the adoption and implementation of TQM enablers. The purpose of this paper is to identify such enablers and then propose a ranking model for TQM implementation in Indian HCEs for improved performance.

Design/methodology/approach

The study identifies 20 TQM enablers through comprehensive literature survey and expert’s opinion, and classifies them into five main categories. The prominence of these enablers is established using a recently developed novel multi-criteria decision making (MCDM) method, i.e. best-worst method (BWM). The importance of the various main category and sub-category enablers is decided on the basis of their weights which are determined by the BWM. In comparison to other MCDM methods, such as analytical hierarchy process, BWM requires relatively lesser comparison data and also provides consistent comparisons which results in both optimal and reliable weights of the enablers considered in this paper. Further, a sensitivity analysis is also carried out to ensure that the ranking (based on the optimal weights) of the various enablers is reliable and robust.

Findings

The results of this study reveal that out of five main category enablers, the “leadership-based enablers (E1)” and the “continuous improvement based enablers (E5)” are the most and the least important enablers, respectively. Similarly, among the 20 sub-category enablers, “quality leadership and role of physicians (E14)” and “performing regular survey of customer satisfaction and quality audit (E52)” are the most and the least dominating sub-category enablers, respectively.

Research limitations/implications

This study does not explore the interrelationship between the various TQM enablers and also does not evaluate performance of the various HCEs based on the weights of the enablers.

Practical implications

The priority of the TQM enablers determined in this paper enables decision makers to understand their influence on successful implementation of the TQM principles and policies in HCEs leading to an overall improvement in the system’s performance.

Originality/value

This study identifies the various TQM enablers in HCEs and categorizes them into five main categories and ranks them using the BWM. The findings of this research are quite useful for management of the HCEs to properly understand the relative importance of these enablers so that managers can formulate an effective and efficient strategy for their easy and smooth implementation which is necessary for continuous improvement.
Assumptions and goals for least squares migration
Authors: Trad Daniel
Published: September 2019

Least squares migration uses the assumption that, if we have an operator that can create data from a reflectivity function, the optimal image will predict the actual recorded data with minimum square error. For this assumption to be true, it is also required that: (a) the prediction operator must be error‐free, (b) model elements not seen by the operator should be constrained by other means and (c) data weakly predicted by the operator should make limited contribution to the solution. Under these conditions, least squares migration has the advantage over simple migration of being able to remove interference between different model components. Least squares migration does that by de‐convolving or inverting the so‐called Hessian operator. The Hessian is the cascade of forward modelling and migration; for each image point, it computes the effects of interference from other image points (point‐spread function) given the actual recording geometry and the subsurface velocity model. Because the Hessian contains illumination information (along its diagonal), and information about the model cross‐correlation produced by non‐orthogonality of basis functions, its inversion produces illumination compensation and increases resolution. In addition, sampling deficiencies in the recording geometry map to the Hessian (both diagonal and non‐diagonal elements), so least squares migration has the potential to remove sampling artefacts as well. These (illumination compensation, resolution and mitigating recording deficiencies) are the three main goals of least squares migration, although the first one can be achieved by cheaper techniques. To invert the Hessian, least squares migration relies on the residual errors during iterations. Iterative algorithms, like conjugate gradient and others, use the residuals to calculate the direction and amplitudes (gradient and step size) of the necessary corrections to the reflectivity function or model. Failure of conditions (a), (b) or (c) leads the inversion to calculate incorrect model updates, which translate to noise in the final image. In this paper, we will discuss these conditions for Kirchhoff migration and reverse time migration.
Amplitude‐compensated Laplacian filtering of reverse time migration and its application
Authors: Yang Renhu , Chang Xu , Ling Yun , Feng Ye E. , Qu Lijian
Published: September 2019

Reverse time migration is an advanced seismic migration imaging method. When the source wavefield and the receiver wavefield are cross‐correlated, the cross‐correlations of direct arrivals, backscattered waves and overturned waves will produce a lot of low‐frequency noise, which will mask the final imaging results. Laplacian filtering, as a common method to suppress low‐frequency noise, can adapt to any complex media, just adding a little computational cost. However, simple direct Laplacian filtering will destroy the characteristics of the useful signals. Therefore, the amplitude needs to be compensated before filtering when using the Laplacian filtering method. Zhang and Sun proposed an improved Laplacian filtering method and gave a simple calculation formula and explanation. This method can effectively suppress the low‐frequency noise in reverse time migration while retaining the useful signal characteristics, but lacks detailed and strict mathematical derivation. Therefore, this paper gives a detailed and rigorous mathematical derivation of the amplitude‐compensated Laplace filtering method from the point of view of amplitude‐preserved filtering. The source wavelet is used instead of the source wavefield to compensate amplitude, just adding a little calculation cost. Finally, the amplitude‐compensated Laplace filtering method is verified by two theoretical models and compared with the direct Laplacian filtering method.
Wiltshire Council v Cooper Estates Strategic Land Ltd: Development Plans and the Restriction of Town and Village Green Applications
Authors: Ronan Harley
Published: September 2019

The Court of Appeal has, for the first time, considered the scheme of ‘trigger events’ introduced in the Growth and Infrastructure Act 2013 which preclude the registration of land as a town or village green (or TVG). The event in question concerned identification for potential development in a development plan document. The court was required to determine what constitutes ‘identification for potential development’ for the purposes of the statute. This note suggests that the court's interpretation of ‘identification for potential development’ is unconvincing, and was motivated primarily by policy: to render it more difficult to register land as a TVG. It argues that the judgment constitutes a further and significant restriction on the future viability of TVG applications, rendering entire settlements liable to lose the application of TVG law.
Prevalence and outcomes of prenatal recreational cannabis use in high‐income countries: a scoping review
Authors: Singh S , Filion KB , Abenhaim HA , Eisenberg MJ
Published: September 2019

Background

With expanding recreational cannabis legalisation, pregnant women and their offspring are at risk of potentially harmful consequences.

Objectives

To assess the prevalence of recreational cannabis use among pregnant women, health outcomes associated with prenatal recreational cannabis use, and the potential impact of recreational cannabis legalisation on this population.

Search strategy

Five databases and the grey literature were systematically searched (2000–2019).

Selection criteria

Human studies published in English or French reporting on the prevalence of prenatal recreational cannabis use in high‐income countries.

Data collection and analysis

Data on study characteristics, prenatal substance use, and health outcomes were extracted and qualitatively synthesised.

Main results

Forty‐one publications met our inclusion criteria. The overall prevalence of prenatal cannabis use varied substantially (min–max: 0.24–22.6%), with the greatest use in the first trimester. In the three studies with temporal data available, rates of prenatal cannabis use increased across years. Only 7/41 and 5/41 studies provided information on gestational age of exposure and frequency of use, respectively. The concomitant use of alcohol, illicit drugs, and tobacco was higher among cannabis users than nonusers. Prenatal cannabis use was associated with select neonatal, but not maternal, health outcomes. There were insufficient data to compare prenatal cannabis use between the pre‐ and post‐legalisation periods.

Conclusion

Cannabis use among pregnant women is prevalent and may be associated with adverse neonatal outcomes. Future studies should assess the gestational age and frequency of cannabis exposure, and usage patterns prior to and following legalisation.

Tweetable abstract

Women who consume cannabis during pregnancy could risk predisposing their newborns to poor birth outcomes.
Anaplastic thyroid carcinoma mimicking a malignant pleural mesothelioma: Clues for diagnosis
Authors: Capron Thibaut , Giusiano Sophie , Bourinet Valerian , Laroumagne Sophie , Dutau Hervé , Astoul Philippe
Published: September 2019

Pleural metastasis of thyroid carcinoma is very rarely encountered in the evaluation of pleural effusion and diagnosis may be challenging. However, an anaplastic transformation of papillary thyroid carcinoma (PTC), although a rare condition, should be considered even after a prolonged period of patient follow‐up. Here we report a case of anaplastic thyroid carcinoma mimicking malignant pleural mesothelioma diagnosed nine years after the initial diagnosis of PTC and detail the clues used to orient and confirm the diagnosis.
segRDA: An r package for performing piecewise redundancy analysis
Authors: Vieira Danilo Cândido , Brustolin Marco Colossi , Ferreira Fábio Cop , Fonseca Gustavo
Published: September 2019

Redundancy analysis is widely used to correlate species matrix against environmental descriptors. This analysis assumes that the response variables have the same continuous linear trend over the whole gradient, which is often not the case. To overcome this issue, we propose the piecewise redundancy analysis (pwRDA).

The pwRDA allows the relationship between the response and explanatory variables to break into pieces. The breakpoint between communities is assessed by the split‐moving‐window (SMW) approach. Both analyses are within segRDA package for the R environment. We illustrate the use of segRDA using simulated and empirical examples with a varying degree of discontinuity among communities.

SMW results provide consistent estimates for both, number and location of community breakpoints along the gradient. In communities with a sharp transition, the pwRDA models were significantly more informative than the traditional RDA model. For smooth transitions between communities, the pwRDA did not differ from the traditional RDA.

The combined use of SMW and pwRDA allows one to identify breakpoints and transition zones among ecological communities along environmental gradients. This approach is particularly relevant when species–habitat associations may differ among communities.
Genome‐wide association study identifies loci linked to serum electrolyte traits in Chinese Holstein cattle
Authors: Gan Q. F. , Li Y. R. , Lund M. , Su G. S. , Liang X. W.
Published: September 2019

We aimed to identify QTL for serum electrolyte traits by performing a GWAS of calcium, chloride, sodium, potassium and magnesium ion concentrations in Chinese Holstein cattle. We detected five SNPs that had significant associations with calcium ion concentrations and identified GATA2 from Bos taurus chromosome (BTA)22 as having the highest significance. Among the genes with significant results, we speculate that TMEM123 might be related to calcium channel proteins according to the functions of the TMEM family.
The role of fibrinogen and fibrinogen concentrate in cardiac surgery: an international consensus statement from the Haemostasis and Transfusion Scientific Subcommittee of the European Association of Cardiothoracic Anaesthesiology
Authors: Erdoes G. , Koster A. , Meesters M. I. , Ortmann E. , Bolliger D. , Baryshnikova E. , Ahmed A. , Lance M. D. , Ravn H. B. , Ranucci M. , von Heymann C. , Agarwal S.
Published: September 2019

To date, data regarding the efficacy and safety of administering fibrinogen concentrate in cardiac surgery are limited. Studies are limited by their low sample size and large heterogeneity with regard to the patient population, by the timing of fibrinogen concentrate administration, and by the definition of transfusion trigger and target levels. Assessment of fibrinogen activity using viscoelastic point‐of‐care testing shortly before or after weaning from cardiopulmonary bypass in patients and procedures with a high risk of bleeding appears to be a rational strategy. In contrast, the use of Clauss fibrinogen test for determination of plasma fibrinogen level can no longer be recommended without restrictions due to its long turnaround time, high inter‐assay variability and interference with high heparin levels and fibrin degradation products. Administration of fibrinogen concentrate for maintaining physiological fibrinogen activity in the case of microvascular post‐cardiopulmonary bypass bleeding appears to be indicated. The available evidence does not suggest aiming for supranormal levels, however. Use of cryoprecipitate as an alternative to fibrinogen concentrate might be considered to increase plasma fibrinogen levels. Although conclusive evidence is lacking, fibrinogen concentrate does not seem to increase adverse outcomes (i.e., thromboembolic events). Large prospective multi‐centre studies are needed to better define the optimal perioperative monitoring tool, transfusion trigger and target levels for fibrinogen replacement in cardiac surgery.
Gastric cancer during pregnancy: A report on 13 cases and review of the literature with focus on chemotherapy during pregnancy
Authors: Maggen Charlotte , Lok Christianne A. , Cardonick Elyce , van Gerwen Mathilde , Ottevanger Petronella B. , Boere Ingrid A. , Koskas Martin , Halaska Michael J. , Fruscio Robert , Gziri Mina M. , Witteveen Petronella O. , Van Calsteren Kristel , Amant Frédéric ,   for the International Network on Cancer, Infertility and Pregnancy (INCIP)
Published: September 2019

Introduction

Gastric cancer during pregnancy is extremely rare and data on optimal treatment and possible chemotherapeutic regimens are scarce. The aim of this study is to describe the obstetric and maternal outcome of women with gastric cancer during pregnancy and review the literature on antenatal chemotherapy for gastric cancer.

Material and methods

Treatment and outcome of patients registered in the International Network on Cancer, Infertility and Pregnancy database with gastric cancer diagnosed during pregnancy were analyzed.

Results

In total, 13 women with gastric cancer during pregnancy were registered between 2002 and 2018. Median gestational age at diagnosis was 22 weeks (range 6‐30 weeks). Twelve women were diagnosed with advanced disease and died within 2 years after pregnancy, most within 6 months. In total, eight out of 10 live births ended in a preterm delivery because of preeclampsia, maternal deterioration, or therapy planning. Two out of six women who initiated chemotherapy during pregnancy delivered at term. Two neonates prenatally exposed to chemotherapy were growth restricted and one of them developed a systemic infection with brain abscess after preterm delivery for preeclampsia 2 weeks after chemotherapy. No malformations were reported.

Conclusions

The prognosis of gastric cancer during pregnancy is poor, mainly due to advanced disease at diagnosis, emphasizing the need for early diagnosis. Antenatal chemotherapy can be considered to reach fetal maturity, taking possible complications such as growth restriction, preterm delivery, and hematopoietic suppression at birth into account.
Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross‐sectional analysis of the 2009‐2010 National Health and Nutrition Examination Survey
Authors: Ballou Sarah , Singh Prashant , Rangan Vikram , Iturrino Johanna , Nee Judy , Lembo Anthony
Published: September 2019

Background

Obesity is associated with increased risk for various gastrointestinal and liver diseases. However, the relationship between obesity and abnormal bowel habits is poorly understood.

Aim

To investigate the relationship between body mass index (BMI) and bowel habit, controlling for clinical, demographic and dietary factors, in a representative sample of the United States adult population

Methods

Data were extracted from the 2009‐2010 National Health and Nutrition Examination Survey. Survey responses were included in this study if respondents completed the bowel health questionnaire (BHQ), were ≥20 years of age, and did not report history of IBD, celiac disease or colon cancer. BMI was divided into the following categories: underweight, normal weight, overweight, obese and severely obese. Stepwise logistic regression provided risk ratios of constipation and diarrhoea controlling for confounding factors (dietary, life‐style, psychological and medical).

Results

A total of 5126 respondents completed the BHQ, had BMI data available, and met eligibility criteria. Of these, 70 (1.40%) were underweight, 1350 (26.34%) were normal weight, 1731 (33.77%) were overweight, 1097 (21.40%) were obese and 878 (17.13%) were severely obese. Up to 8.5% of obese and 11.5% of severely obese individuals had chronic diarrhoea, compared to 4.5% of normal weight individuals. Stepwise regression revealed that severe obesity was independently associated with increased risk of diarrhoea.

Conclusion

Obesity is positively associated with chronic diarrhoea in a nationally representative US adult population after adjusting for several known confounding factors.
Two emergency cases of spontaneous esophageal perforation treated using a minimally invasive abdominal and left thoracic approach
Authors: Sekiya Sho , Ebihara Yuma , Yamamura Yoshiyuki , Tanaka Kimitaka , Nakanishi Yoshitsugu , Asano Toshimichi , Noji Takehiro , Kurashima Yo , Murakami Soichi , Nakamura Toru , Tsuchikawa Takahiro , Okamura Keisuke , Shichinohe Toshiaki , Hirano Satoshi
Published: September 2019

Boerhaave's syndrome is a rare life‐threatening disease that requires prompt intervention. Thoracotomy has traditionally been considered the gold standard approach for treatment, but other minimally invasive approaches have recently been reported. Our institute reported the efficacy of minimally invasive abdominal and left thoracic approach in the treatment of patients with esophagogastric junction cancer and introduced it for the treatment of two patients with Boerhaave's syndrome. We intraoperatively sutured the rupture sites and irrigated the pleural cavity using thoracoscopy. Then, after confirming the absence of intraabdominal contamination, we performed jejunostomy or gastrostomy using laparoscopy. Patients' vital signs remained stable intraoperatively, and their postoperative periods were uneventful with no leakage or stricture. The minimally invasive abdominal and left thoracic approach for Boerhaave's syndrome is convenient and useful as it provides excellent visualization of the thoracic and abdominal cavities with the possibility of quickly switching between views.
Damage to artificial seedlings across a disturbed Afromontane forest landscape
Authors: Ssali Fredrick , Moe Stein R. , Sheil Douglas
Published: September 2019

Seedling mortality is an important demographic bottleneck for forest regeneration, yet the factors influencing recruitment are often poorly characterized across space and time. In African highlands, where extensive patches of previously disturbed forests remain in persistent shrub‐dominated states, patterns of damage to seedlings have not been examined in detail. We used artificial seedlings to determine how (non‐herbivory‐related) damage varies across a fragmented forest landscape in the Bwindi Impenetrable National Park, Uganda. A total of 848 artificial seedlings were established in 106 plots, each with 8 seedlings, across a gradient of environmental factors, including habitat type, topographic position, distance to water, and distance to human activity. We divided damage into that due to vertebrates, plant debris, and unknown agents. From our 16,960 monthly stem assessments, 1,289 damage events were recorded. The mean “seedling” damage per year (± 1 SE) was 59.5 ± 2.3%. Damage was significantly more frequent in sites dominated by short herbs (66.1 ± 3.0) than in sites dominated by shrubs (60.1 ± 2.6) and ferns (47.9 ± 2.7). The mean percentage of damage by each class of agents was 45.8 ± 2.1% for vertebrates, 21.4 ± 2.1% for plant debris, and 3.8 ± 0.6% for unknown agents. These rates surpass those reported in other montane forests, likely reflecting the density of large vertebrates in our site. Our results indicate that most damage to artificial seedlings arises from larger vertebrates but that most spatial variation in this damage reflects the impacts of falling plant debris. These damage processes appear sufficient to constrain the regeneration of tree species in areas where forest cover is patchy and fragmented.
Prevalence of polycystic ovary syndrome in women with severe obesity – Effects of a structured weight loss programme
Authors: Kataoka Josefin , Larsson Ingrid , Björkman Sofia , Eliasson Björn , Schmidt Johanna , Stener‐Victorin Elisabet
Published: September 2019

Objective

Existing data are contradictory on the prevalence of polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS) in women with severe obesity (body mass index [BMI] ≥ 35 kg/m2), and there are few studies investigating the effect of weight reduction in women with severe obesity and PCOS. The aim was to study the prevalence of PCOS and MetS among women with severe obesity and to evaluate the effect of a 12‐months weight loss programme on the prevalence of PCOS and MetS.

Design/Participants

In total, 298 women with severe obesity were enrolled whereof 246 women had complete screening data for PCOS and MetS before commencing treatment. Weight loss intervention included very low energy diet. At 12‐months follow‐up, 72 women with complete data remained and were re‐examined with baseline parameters.

Results

At baseline, the prevalence of PCOS was 25.6% and in this group, the prevalence of MetS was 43.4% in PCOS vs 43.3% in controls (ns). At 12‐months follow‐up, weight loss in women with PCOS was 12.3 ± 10.7 kg (P < .001) and in non‐PCOS 13.9 ± 13.4 kg (P < .001) with no between group difference. Women without PCOS decreased in total bone mass.

Conclusions

Polycystic ovary syndrome occurs in one out of four women with severe obesity. The prevalence of MetS does not differ between women with or without PCOS with severe obesity. There was a significant weight loss in both groups but no difference between groups regarding change in metabolic parameters.
Clostridioides difficile colonization and infection in patients admitted for a first autologous transplantation: Incidence, risk factors, and patient outcomes
Authors: Ford Clyde D. , Lopansri Bert K. , Coombs Jana , Webb Brandon J. , Nguyen Andy , Asch Julie , Hoda Daanish
Published: September 2019

Background

More data are needed regarding the incidence, risk factors, and outcomes for Clostridioides difficile infection (CDI) and colonization in patients undergoing an autologous hematopoietic stem cell transplantation (AHSCT).

Methods

We studied 472 consecutive patients admitted for a first AHSCT and conducted a prospective C difficile stool surveillance and ribotyping analysis in a subset of 94 patients.

Results

Clostridioides difficile infection was diagnosed in 7% of patients for an incidence of 3.4 CDI/1000 inpatient days, recurrent/reinfection CDI was rare. CDI was increased in patients who were colonized on admission, had required a recent pre‐admission inpatient stay for fever and/or serious infection, or received empiric therapy with a carbapenem or extended‐spectrum penicillin. CDI was associated with a longer length of stay and higher hospital costs. Twelve of 94 patients (13%) were found to have colonization on admission; CDI was diagnosed in 27% of these vs 1% in those with initial negative stools. Colonization in the hospital for those negative on admission was infrequent. C difficile ribotyping showed a predominance of 014/020.

Conclusions

Clostridioides difficile infection is a significant infection in patients receiving a first AHSCT. The risk factors identified may be useful in designing preventive interventions.
Stepping up early treatment for help‐seeking youth with at‐risk mental states: Feasibility and acceptability of a real‐world exercise program
Authors: Lederman Oscar , Ward Philip B. , Rosenbaum Simon , Maloney Chris , Watkins Andrew , Teasdale Scott , Morell Rachel , Curtis Jackie
Published: September 2019

Introduction

Youth with at‐risk mental states (ARMS) have low levels of physical activity (PA), reduced fitness levels and experience poor sleep quality. These lifestyle factors exacerbate mental health symptoms and increase cardiometabolic disease risk. PA interventions can help prevent this decline in physical health whilst reducing mental health symptom severity. Whether PA interventions are feasible and acceptable amongst youth with ARMS is unclear.

Methods

This study evaluated the feasibility and acceptability of headspace Active, a pragmatic PA program offered to 14 to 25 year olds with ARMS. The 12‐week exercise physiologist‐led intervention was conducted in adjunct to usual care. Feasibility was determined by number of referrals, attendance, engagement in exercise sessions and dropout from the intervention. Acceptability was assessed by a 10‐item questionnaire. Secondary outcomes included anthropometry, cardiorespiratory fitness and strength. Subjective PA levels, symptoms of depression and anxiety, sleep, motivation and quality of life were also assessed.

Results

Within 12 months, 77% of referrals completed the 12‐week intervention (n = 20), with six dropouts. Of the 20 “completers”, 95% attended at least five sessions over the 12‐week intervention. Participants found the program highly acceptable (mean = 41.2/50 on the 10‐item acceptability questionnaire) and experienced significant improvements in PA, strength, motivation, depressive symptoms and sleep quality post‐intervention. No changes in anthropometry were observed.

Conclusion

Results suggest headspace Active was feasible and acceptable and was associated with improvements in physical and mental health outcomes among ARMS youth. Given the potential scalability of this real‐world PA program to other youth mental health settings, these data have implications for best practice implementation of PA interventions for individuals with emerging mental illness.
Dialogue and Dominance in Couple Therapy for Depression: Exploring Therapists’ Responses in Creating Collaborative Moments
Authors: Artigas Miralles Lourdes , Vilaregut Puigdesens Anna , Feixas Viaplana Guillem , Mateu Martínez Clara , Seikkula Jaakko , Vall Castelló Berta
Published: September 2019

Previous investigations have found specific communication patterns in couples dealing with depression, specifically when depression concurs with conjugal conflicts. The presence of these patterns can reflect couples’ difficulties in engaging in collaborative communication during their sessions, posing a real challenge for therapists. This exploratory study uses a dialogical approach to examine issues of dominance and type of dialogue in two couples who differed in terms of their levels of dyadic adjustment. The therapists’ reactions were explored in order to detect the kinds of responses that were most effective at engendering a collaborative attitude in therapy sessions. The method used to analyze the dialogue was Dialogical Investigations of Happenings of Change (DIHC). Results on dominance indicated that the degree of quantitative and semantic dominance displayed by a different member of the couple in each case was illustrative of their relational dynamics, while in both cases interactional dominance was exercised by the therapists. Results on dialogue revealed that dialogic dialogue might help to coconstruct new shared meanings of depression. The findings indicated that certain responses by therapists as part of the dialogue could be useful in bringing about a reduction in hostility between the members of a couple, provided that the responses are maintained over the course of the session. Some research and clinical implications that emerge from the results are discussed.