bluuebunny/crossref_metadata_2025 huggingface dataset:
Industry Analysis
Authors: Henry Anthony E.
Published: September 2023

This chapter assesses the impact of the competitive environment and shows how an organization might achieve competitive advantage. It explains that the external environment facing an organization consists of its macro-environment and competitive environment, noting that any changes that occur in the macro-environment have the potential to impact an organization's competitive environment. It also highlights the importance for organizations to scan and monitor their macro-environment to discern weak signals that may be able to affect or fundamentally change the industry within which they compete. The chapter looks at some of the tools of analysis available to evaluate industries and discusses Michael Porter's approach to competitive strategy, focusing on his structural analysis of industries: the five forces framework. It outlines strategy formulations or generic strategies that emanate from Porter's framework.
Corporate Governance And Corporate Social Responsibility
Authors: Henry Anthony E.
Published: September 2023

This chapter focuses on corporate governance, which is inextricably bound up with views on the purpose of corporations and how to define a corporation or business. It begins the discussion on corporate governance with a review of the origins of corporate governance and the corporate form. It also explains the reasons for the growth of modern corporations, which in turn has led to an increase in the separation of ownership and control. The chapter examines the different perspectives that exist on the role of corporations, noting the divide that exists between those who advocate a shareholder approach to corporate governance and those who adopt a stakeholder approach. It investigates corporate collapses and regulatory codes to determine if lessons can be learned to avoid further failures.
The Societal Dimension
Authors: Antoniou Christos , Gajewska-De Mattos Hanna
Published: September 2023

This chapter discusses the impact and importance of the societal dimension for global factory managers. It presents the main theoretical underpinnings for contextualizing and understanding culture and cultural variation across countries and regions. It also examines the main cultural frameworks that have been developed and the cultural dimensions on which they are based. The chapter explores intercultural interaction and its outcomes, in the form of convergence or divergence between different cultures and societies. It highlights specific regions, the historic background to the culture of the interaction, and its contemporary manifestations, including the managerial implications arising from the existence and awareness of stereotypes.
Financial Management Strategies
Authors: Jones Chris , Temouri Yama , Read Robert
Published: September 2023

This chapter explains how a global factory operates within a multi-currency environment and that managers need to understand the implications of exchange rate exposure and currency risk. It discusses the nature of and key players in the foreign exchange market and explores theories of foreign exchange rate determination and forecasting. It also examines the implications for global factory operations and techniques for currency risk hedging. The chapter considers financial management techniques available to the global factory manager and concludes with a discussion of transfer pricing and the use of tax havens within the global factory.
Conclusions
Authors: Buckley Peter J. , Enderwick Peter
Published: September 2023

This chapter considers theories of the firm and strategic behaviour in relation to the contemporary global factory. Drawing on developments in internalization thinking, the chapter examines the competitive advantages of the global factory and the challenges it faces in relation to coordination, innovation, and adaptation. The chapter draw on a range of frameworks to discuss these challenges and stresses the importance of economic principles when considering under-researched aspects of the global factory.
The governance interface
Authors: Winch Graham , Maytorena-Sanchez Eunice , Sergeeva Natalya
Published: September 2023

This chapter considers the governance interface between the owner organization and the temporary delivery organization. It explains that the governance interface is about how the owner ensures that what they get at the end of the project as output is as close as feasible to what they expected from the project mission. Moreover, governing the interface is essential because the owner and its stakeholders must be assured that the investment project is on track for delivery. The chapter looks into the structure of contemporary project governance, which involves the stage-gate process for governing delivery through the life cycle and the portfolio management process. The chapter notes how the project management office operates as the controller, supporter, and developer of project governance.
Being a project leader in SPO
Authors: Winch Graham , Maytorena-Sanchez Eunice , Sergeeva Natalya
Published: September 2023

This chapter looks into being a project leader in strategic project organizing (SPO). It discusses the required social competencies for SPO and associated career development, which are symbiotic with the technical competencies. In many organizations, successful project leaders focus on the strategic and relational factors rather than the technical factors of their projects, and the complexity of the project coincides with how important social competencies are. Thus, the profession of the project leader is not for everyone since it demands stamina and high levels of authenticity. The chapter explains the important consideration of ethics for project professionals, especially for issues involving relationships, optimization, and transparency.
Patterns of Buyer Behaviour
Authors: Szmigin Isabelle , Piacentini Maria
Published: September 2023

This chapter addresses patterns of buyer behaviour. It begins by analysing the concept of repeat buying and discussing the implications for brand loyalty and market share. The chapter also identifies what patterns of purchasing from consumer panel data can reveal about the state of a brand. Understanding how consumers actually purchase over repeated occasions allows one to consider what brand loyalty really means. The chapter then explores the concept of double jeopardy and the importance of market penetration. It also looks at market segmentation and differentiation and shows how marketers use empirical buyer behaviour principles in everyday business decisions.
Sustainability and the Consumer
Authors: TyreeHageman Jennifer , Moraes Caroline
Published: September 2023

This chapter opens with a definition of sustainability and how sustainability ideas have translated into consumer behaviour. Competing moral perspectives around sustainable consumption are then explored in relation to relevant theoretical persectives. The chapter goes on to review interdisciplinary principles and techniques for behaviour change and gives a range of examples of sustainable consumption issues in the food and textile industries. The chapter considers the idea of conspicuous conservation, the use of incentives, and how brands can communicate sustainability messages to drive active brand engagement.
Getting Started: Reviewing the Literature
Authors: Bell Emma , Bryman Alan , Harley Bill
Published: September 2023

This chapter details how to write a literature review after a researcher has established their research questions. It explains how a literature review provides the basis for an empirical study involving primary or secondary data collection using quantitative or qualitative methods. While the systematic review is designed as a more reliable method of presenting literature searching and review, the narrative review is an alternative approach with the advantage of flexibility. Referencing, which refers to providing publication details of the research, is a key part of all literature reviewing. The chapter also highlights the importance of understanding what constitutes plagiarism and its associated penalties.
Self-Completion Questionnaires
Authors: Bell Emma , Bryman Alan , Harley Bill
Published: September 2023

This chapter tackles the concept of the self-completion questionnaires. It explains how self-completion questionnaires constitute one of the main instruments for gathering data using a social survey design, along with the structured interview. Previously mail or postal questionnaires were the most common form of a questionnaire,but online surveys have recently grown in popularity. The chapter discusses how questionnaires should be designed in order to make answering easier for respondents and less prone to error. It then considers diaries as a traditional form of self-completion questionnaire relative to quantitative research when a researcher needs to achieve precise estimates of different kinds of behaviour.
Secondary Analysis and Official Statistics
Authors: Bell Emma , Bryman Alan , Harley Bill
Published: September 2023

This chapter considers secondary analysis and official statistics, which analyse data collected by others. Secondary analysis of data can be collected by other researchers or other organizations in the course of business and this puts the comparative element into the research design. Moreover, secondary analysis of existing data offers the prospect of exploring research questions of interest to the researcher without having to personally go through the process of collecting the data. The chapter then considers the analysis of official statistics, which involves unease about the reliability and validity of certain types of official data. It notes the notion that official statistics and big data are forms of unobtrusive methods.
Visual Qualitative Research
Authors: Bell Emma , Bryman Alan , Harley Bill
Published: September 2023

This chapter focuses on the notion of visual qualitative research, which involves the use of photographs, video recordings, digital images, and visual arts-based methods. The visual turn in social science and business research acknowledges the meaning-making role of the visual. Visual methods can also be used in quantitative research, such as when photographs are sometimes used as prompts in structured interviewing. The chapter notes the use of visual methods in inductive, constructionist, and interpretive research, while also considering grounded visual pattern analysis (GVPA), semiotic and multimodal analysis to refer to its systematic methods on the communication and construction of visual meaning. Meanwhile, visual ethnography refers to ethnographic research where visual materials feature prominently in the setting and the researchers' analysis.
Mixed Methods Research: Combining Quantitative and Qualitative Research
Authors: Bell Emma , Bryman Alan , Harley Bill
Published: September 2023

This chapter covers how to conduct mixed methods research by combining quantitative and qualitative research. It acknowledges the arguments surrounding mixed methods research, such as the notion that research methods carry their respective epistemological commitments and separate paradigms. Moreover, objections to mixed methods research tend to be the result of a view that there are epistemological and ontological impediments to the combination of quantitative and qualitative research. The chapter then considers that the approaches to mixed method research include the notion of triangulation wherein qualitative research facilitate quantitative research and vice versa. It cites that outcomes of combining quantitative and qualitative research can be planned or unplanned.
Developing human resources
Authors: Gilmore Sarah
Published: September 2023

This chapter studies the approaches to human resource management (HRM) in the context of heightened competition and fluctuating economic conditions. It investigates the changing nature of skills and government responses to organizational and national requirements for competent employees. It then focuses on government interventions in the training and skills arena. andIt also explores the means by which training and development needs, design, delivery, and evaluation are undertaken in organizations via an explanation and evaluation of the systematic training cycle (STC). Next, tThe chapter also exploresdiscusses the approaches to training and development which emphasize the centrality of learning,. especially It mentionsthe ways by which employees, groups, and organizations as a whole can learn from engaging in work, and how organizations are trying to capture and share learning outcomes internationally. It concludes with an evaluation of the developments outlined in the chapter.
Opportunity Analysis and Selection of Markets
Authors: Lee Kiefer , Carter Steve
Published: September 2023

This chapter discusses opportunity analysis and the selection of markets. It looks at the global market selection and marketing information system (MKIS). The chapter discusses the process of international marketing research which plays a vital role in the establishment and population of the MKIS. It includes the global market segmentation which is based on geographic, transnational, and hierarchical country/consumer segmentation. Moreover, the chapter explores how to select markets for targeting to evaluate the attractiveness of each segment and select specific segments. It highlights that analysing global market opportunities and subsequent market selection are key global strategic decisions.
Global Services Marketing
Authors: Lee Kiefer , Carter Steve
Published: September 2023

This chapter looks into global services marketing. It highlights the importance of services in the global economy. The chapter lists the drivers for growth in cross-border services such as deregulation and liberalization of trade in services. It defines cross-border services and places them in the context of the degree of intangibility, consumer-producer interaction, and multi-variant classification systems. Moreover, the chapter argues that intangibility, heterogeneity, inseparability, and perishability are the challenges of marketing services internationally. The chapter discusses strategic considerations for marketing services globally, such as knowledge. This is the fundamental source for competitive advantage and managing the process of service delivery. The chapter also looks at the role of technology in aiding service.
Global Pricing and Terms of Access
Authors: Lee Kiefer , Carter Steve
Published: September 2023

This chapter focuses on global pricing and terms of access. It lists the factors impacting global pricing decisions. The chapter then discusses pricing strategies such as competitive pricing, geographical pricing, promotional pricing, and product mix pricing. It highlights the concept behind price changes. Additionally, the chapter notes special issues related to global price setting such as price escalation, currency fluctuations, inflation, and leasing. It explores the export order process as well. The chapter considers tariffs and non-tariff barriers as terms of access. It cites incoterms and looks at special trade terms in exporting. Moreover, export payments and export financing are examples of export documentation.
Business and Sustainability
Authors: Blowfield Michael
Published: September 2023

Business and Sustainability has three main sections. Section One looks at the global context of business and sustainability. It starts off with an overview of the topic. It looks at the sustainability challenges confronting business. Section Two is about managing sustainability. This section includes examinations of leadership, entrepreneurship, and change; strategy and execution; innovation, planning, and design; financing sustainability; cooperation, collaboration, and partnership; and next generation competencies. The final section turns towards the external environment and considers governance, sustainable consumption and production, and the future.
Sustainable consumption and production
Authors: Blowfield Michael
Published: September 2023

This chapter explains the background to the rising interest in sustainable consumption and production and identifies the major trends. Striking a balance between production, consumption, and resource efficiency is a trichotomy that affects multiple facets of the business–sustainability relationship. The chapter then reviews sustainable production: its meaning, its drivers, the types of approach being adopted, and the challenges for further progress. Then it explores sustainable consumption: the main areas of consumer behaviour, the principles for effective action, the strengths and weaknesses of behavioural economics, and lessons from initiatives to date. The chapter concludes with a discussion of different types of consumption, and how this links to alternative definitions of well-being.
Human Resource Management
Authors: Combe Colin
Published: September 2023

This chapter looks at human resource management (HRM). It begins with a definition of HRM in organisations and identifies the core activities of attraction, recruitment, and retention. It goes on to explain key HRM strategies in the context of the recruitment and retention of staff and the implementation of reward systems. It then introduces the concept of equality and fairness in human resource management and the challenges of managing diversity in the modern global economy. The chapter also includes an assessment of human resource processes featuring policy, recruitment, performance, and feedback evaluations. It concludes with an overview of how management can develop workers as key assets and manage effective employee relations.
Motivation and Communications
Authors: Combe Colin
Published: September 2023

This chapter considers motivation and communications. It begins with a discussion of the job characteristics model and considers the role of job design and redesign as a means of improving job satisfaction and motivation. Then, it evaluates the theoretical perspectives relating to motivation, which include the instrumental approach, Maslow’s hierarchy of needs, and McGregor’s theory X/theory Y among others. The chapter discusses the development and implementation of reward systems as a means of motivating workers in different organisational settings. Moreover, it analyses the effect that empowering employees has on motivating workers in the modern business environment. It highlights the link between motivation and effective communications. Finally, the chapter includes an analysis of information richness in communications and an overview of some of the barriers to effective communication.
Strategic Management
Authors: Combe Colin
Published: September 2023

This chapter studies the application of strategic management. It begins with an overview of the strategic process and the different levels of strategy. Then, it discusses the development of strategic management thinking in the 1950s, when it first emerged as a distinct area of study. This is followed by a formal approach to understanding how strategic managers can analyse the external and internal environments by the application of theoretical models. The chapter illustrates how managers can make effective strategic choices given the resources and capabilities of the organisation. It concludes with a discussion of the importance of globalisation by highlighting the methods by which strategic managers can exploit opportunities in the international environment.
Sampling
Authors: Bradley Nigel
Published: September 2023

This chapter reviews the purposes and procedures of sampling. Sampling means taking one or more examples from which to learn something new. The sources of the sample are discussed, with a detailed examination of techniques for telephone, face-to-face, and self-completion research. The chapter illustrates the differences between probability and non-probability methods. Quota sampling is of great importance to market research, so this area is emphasised. How sample sizes can be determined, both for qualitative and quantitative research is also explained.
Qualitative research
Authors: Bradley Nigel
Published: September 2023

This chapter looks at qualitative research, one of the two main branches of inquiry. It explores some of the different methods of qualitative research to uncover the key motivation behind behaviour. Focus groups and depth interviews are of extreme importance to qualitative market researchers, so these two techniques are emphasised. The Delphi method, ethnography, semiotics, and grounded theory are also discussed. The chapter also provides a detailed examination of both the spoken word and body language, which are essential in interpreting group dynamics.
Analysis
Authors: Bradley Nigel
Published: September 2023

This chapter tackles the meaning and techniques of analysis and the identification of meaningful patterns in data. It distinguishes between qualitative and quantitative data analysis. Transcripts and computer software are features of qualitative analysis; on the other hand, quantitative processes imply preparation, checking, editing, and coding. The coding of open-ended questions is examined in some detail. The chapter covers measures of dispersion, averages, and significance testing. Univariate, bivariate, and multivariate analyses are explained, as are procedures for tabulation weighting and grossing.
An approach to remove the numerical dispersion in elastic wave modeling using R-Cycle-GAN networks
Authors: Zheng Wanqiu , Wang Jian , Meng Xiaohong
Published: September 2023

The finite difference forward modeling has been widely used in geophysics exploration and petroleum fields. Because of its high efficiency and easy application for graphical processing units, it has been widely concerned by industry and academia. However, owing to many factors, the problem of numerical dispersion has been an important factor hindering this method. To overcome the numerical dispersion, this paper proposes a method for removing numerical dispersion using deep learning. Unlike the conventional optimized algorithms target to optimize the finite difference coefficients, our strategy is based on big data training to eliminate the dispersion data after seismic data modeling. We design a neural network architecture based on cycle-consistent generative adversarial networks (Cycle-GANs) and residual learning for elastic wave propagation. Under the premise of not significantly increasing the calculation time, we can obtain higher calculation accuracy. Compared with the high-order finite difference algorithm, the calculation time is the advantage of our proposed deep learning method. Tests prove the efficiency and stability of our proposed algorithm.
Powers Correlation Analysis of Returns with a Non-stationary Zero-Process
Authors: Patilea Valentin , Raïssi Hamdi
Published: September 2023

The higher order dynamics of individual stocks is investigated. We show that classical powers correlation analysis can lead to a spurious assessment of the volatility persistence or long memory volatility effects, if the zero return probability is non-constant over time. In other words, classical tools are not able to distinguish between long-run volatility effects, such as IGARCH, and the case where the zero returns are not evenly distributed over time. As a remedy, new diagnostic tools are proposed that are robust to changes in the zero return probability. Since a time-varying zero return probability could potentially be accompanied by a non-constant unconditional variance, we also develop powers correlation analysis that is robust in such a case. In addition, the diagnostic tools we propose offer a rigorous analysis of the short-run volatility effects, while the use of the classical powers correlations lead to doubtful conclusions. Monte Carlo experiments, and the study of the absolute value correlation of daily returns taken from the Chilean financial market and the 1-min returns of Facebook stocks, suggest that the volatility effects are only short-run in many cases.
Multiscale influences on Elk (Cervus canadensis) calving site selection across a fragmented Appalachian landscape
Authors: Hooven Nathan D , Williams Kathleen E , Hast John T , McDermott Joseph R , Crank R Daniel , Springer Matthew T , Cox John J
Published: September 2023

Due to the vulnerability of neonatal ungulates, selection of a birth site can have important implications for offspring survival and thus fitness of the mother. We studied parturition site selection in cow Elk in southeastern Kentucky, United States, using a use–availability framework to evaluate the effects of landscape variables sampled at multiple spatial grains on the relative probability of use of parturition sites. We identified 81 Elk parturition sites during May–Aug 2020–2022 and fit several candidate resource selection function models using a sample of 24,314 random locations to characterize habitat availability. Using an information-theoretic approach to rank candidate models, we identified two top-performing models (cumulative ωi = 0.97), which indicated that at fine spatial grains (~10- and 30-m pixels) parturient cow Elk selected for intermediate canopy cover and lower terrain ruggedness compared to available locations. At coarse grains (250–1,000-m buffers/neighborhoods), Elk selected against vegetation greenness/biomass, for higher topographic positions, for closer proximity to major roads, and with higher solar radiation potential. We also found evidence that Elk responded positively to forest/open edge densities at coarse grains, demonstrating that calving habitat throughout the Kentucky Elk Restoration Zone is associated with heterogeneous landscapes resulting from surface mine reclamation. As a result, habitat management actions should aim to increase patchy, early successional shrub cover on gentle topography.
Education and Formation in an Interwar Hasidic Yeshiva: The Case of Tomkhe Temimim Warsaw
Authors: Tworek Wojciech
Published: September 2023

Hasidic yeshivas rose to prominence in Eastern Europe in the interwar period (1918–1939), as a way of keeping orthodox youth in the fold and of shaping the new generations of Hasidim, enabling them to withstand the allures of non-Orthodox cultures. Using the Chabad–Lubavitch yeshiva Tomkhe Temimim as a case study, this article focuses on the educational and formative strategies employed in interwar Hasidic yeshivas. It examines previously unused internal yeshiva sources, such as student lists or teachers’ reports, to show the pedagogical practices of the yeshiva staff and faculty. Effectively, the article provides an egalitarian and down-to-earth perspective on the Hasidic transformation in the interwar years. This perspective goes beyond the theoretical Hasidic concepts preached by the leaders to show how, in practical terms, these concepts were understood by the movement’s secondary intelligentsia and passed on to the next generation in the movement’s formative institutions.
Goreisan as a successful adjuvant therapy of heart failure with preserved ejection fraction and advanced chronic kidney disease: a case report
Authors: Sugihara Ryuta , Hashimura Tatsuro , Sakata Yasushi
Published: September 2023

Atrial functional mitral and tricuspid regurgitation due to atrial fibrillation (AF) are common causes of heart failure with preserved ejection fraction, but standard treatment with conventional diuretics can often lead to renal dysfunction. Kampo Goreisan, a traditional Eastern-Asian herbal medicine that regulates body water balance via the aquaporin-incorporated water reabsorption system can be used as an alternative therapy without causing renal burden. In this report, we describe a case of successful treatment with Goreisan of heart failure with preserved ejection fraction (HFpEF) due to atrial functional mitral and tricuspid regurgitation (AFMR/TR) receiving guideline-directed medical-therapy. Goreisan could afford amelioration of regurgitation and improvement bilateral systolic ventricular function without renal dysfunction. Thus, Goreisan may be a promising therapeutic option for patients refractory to conventional diuretics.
Comparative analysis of nascent RNA sequencing methods and their applications in studies of cotranscriptional splicing dynamics
Authors: Liu Min , Zhu Jiafu , Huang Huijuan , Chen Yan , Dong Zhicheng
Published: September 2023

High-throughput detection of nascent RNA is critical for studies of transcription and much more challenging than that of mRNA. Recently, several massively parallel nascent RNA sequencing methods were established in eukaryotic cells. Here, we systematically compared 3 classes of methods on the same pure or crude nuclei preparations: GRO-seq for sequence nuclear run-on RNAs, pNET-seq for sequence RNA polymerase II-associated RNAs, and CB RNA-seq for sequence chromatin-bound (CB) RNAs in Arabidopsis (Arabidopsis thaliana). To improve the resolution of CB RNAs, 3′CB RNA-seq was established to sequence the 3′ ends of CB RNAs. In addition, we modified pNET-seq to establish the Chromatin Native Elongation Transcript sequencing (ChrNET) method using chromatin as the starting material for RNA immunoprecipitation. Reproducibility, sensitivity and accuracy in detecting nascent transcripts, experimental procedures, and costs were analyzed, which revealed the strengths and weaknesses of each method. We found that pNET and GRO methods best detected active RNA polymerase II. CB RNA-seq is a simple and cost-effective alternative for nascent RNA studies, due to its high correlation with pNET-seq and GRO-seq. Compared with pNET, ChrNET has higher specificity for nascent RNA capture and lower sequencing cost. 3′CB is sensitive to transcription-coupled splicing. Using these methods, we identified 1,404 unknown transcripts, 4,482 unannotated splicing events, and 60 potential recursive splicing events. This comprehensive comparison of different nascent/chromatin RNA sequencing methods highlights the strengths of each method and serves as a guide for researchers aiming to select a method that best meets their study goals.
The right inferior frontal gyrus as pivotal node and effective regulator of the basal ganglia-thalamocortical response inhibition circuit
Authors: Zhuang Qian , Qiao Lei , Xu Lei , Yao Shuxia , Chen Shuaiyu , Zheng Xiaoxiao , Li Jialin , Fu Meina , Li Keshuang , Vatansever Deniz , Ferraro Stefania , Kendrick Keith M , Becker Benjamin
Published: September 2023

Background

The involvement of specific basal ganglia-thalamocortical circuits in response inhibition has been extensively mapped in animal models. However, the pivotal nodes and directed causal regulation within this inhibitory circuit in humans remains controversial.

Objective

The main aim of the present study was to determine the causal information flow and critical nodes in the basal ganglia-thalamocortical inhibitory circuits and also to examine whether these are modulated by biological factors (i.e. sex) and behavioral performance.

Methods

Here, we capitalize on the recent progress in robust and biologically plausible directed causal modeling (DCM-PEB) and a large response inhibition dataset (n = 250) acquired with concomitant functional magnetic resonance imaging to determine key nodes, their causal regulation and modulation via biological variables (sex) and inhibitory performance in the inhibitory circuit encompassing the right inferior frontal gyrus (rIFG), caudate nucleus (rCau), globus pallidum (rGP), and thalamus (rThal).

Results

The entire neural circuit exhibited high intrinsic connectivity and response inhibition critically increased causal projections from the rIFG to both rCau and rThal. Direct comparison further demonstrated that response inhibition induced an increasing rIFG inflow and increased the causal regulation of this region over the rCau and rThal. In addition, sex and performance influenced the functional architecture of the regulatory circuits such that women displayed increased rThal self-inhibition and decreased rThal to GP modulation, while better inhibitory performance was associated with stronger rThal to rIFG communication. Furthermore, control analyses did not reveal a similar key communication in a left lateralized model.

Conclusions

Together, these findings indicate a pivotal role of the rIFG as input and causal regulator of subcortical response inhibition nodes.
The Effect of Political Frictions on the Pricing and Supply of Insurance
Authors: Liu Jessica , Liu Weiling
Published: September 2023

Political frictions significantly affect both pricing and supply in the long-term care insurance (LTCI) market. Comparing the same insurer’s requests submitted for the same policy at the same time to different state regulators, we find that they are 13% more likely to be approved and receive 4% more of the requested amount after an election year. Over time, regulatory pushback on premium increase requests leads to persistently lower cash reserves and increases the probability of company dropout. An insurer who receives one-standard-deviation less of their requested increase is 20% more likely to leave the market next year.
Delta-8-tetrahydrocannabinol: a phytocannabinoid on the rise
Authors: Ledvina Kaitlin R , Suelzer Elizabeth , El-Alfy Abir T
Published: September 2023

Objective

Delta-8-tetrahydrocannabinol (THC) is a minor psychoactive phytocannabinoid, similar to delta-9-tetrahydrocannabinol. Recent statements released by the Food and Drug Administration and Center for Disease Control reported around 660 delta-8-THC exposure cases. With the rise in commercially available products, it is crucial to understand the pharmacological and toxicological properties of this compound. The objective of this review is to summarize current literature regarding the pharmacokinetic and pharmacologic properties of delta-8-THC.

Methodology

Searches were performed in MEDLINE (Ovid), Scopus, Web of Science Core Collection and Cochrane Central Register of Controlled Trials (CENTRAL). The searches used database-specific advanced search techniques.

Key findings

A total of 772 references were retrieved, with 517 references identified after the removal of duplicate articles. The references were imported into Rayyan (Rayyan.ai), and the retrieved articles (100) were reviewed and summarized. The scoping review is divided into sections focussing on the pharmacokinetic (12) and pharmacologic (88) properties of delta-8-THC. The majority of pharmacological studies examined the central nervous system effects of delta-8-THC. The findings suggest that it exhibits distinct pharmacological effects, and while its psychoactive profile may be milder compared to delta-9-THC, caution should still be exercised when considering its use. Pharmacologic effects often express a dose-dependent relationship with the potential for tolerance development.

Conclusions

In conclusion, this review provides a comprehensive examination of the current state of knowledge of delta-8-THC. Moreover, the review highlights several gaps in the existing literature, emphasizing the need for further research to fully elucidate the mechanisms of action, long-term effects and potential interactions with other drugs.
Antenatal Corticosteroids at 21–23 Weeks of Gestation
Authors: Battarbee Ashley N.
Published: September 2023

Neonates born at the cusp of viability are at particularly high risk of severe morbidity and mortality. With advances in medicine and technology, the ability to resuscitate smaller, more premature neonates has become possible, and survival as early as 21 weeks of gestation has been reported. Although administration of antenatal corticosteroids has been shown to reduce the risk of morbidity and mortality at later gestational ages, neonates born before 24 weeks of gestation have not been included in randomized clinical trials. Changing clinical practices surrounding neonatal resuscitation with intervention offered after birth at earlier gestational ages has prompted re-evaluation of the use of antenatal corticosteroids at these very early gestational ages. Recent observational data demonstrate that antenatal corticosteroids administered before deliveries at or after 22 weeks of gestation are associated with lower risks of neonatal mortality, although survival with severe morbidity remains high. Future research is needed to determine the efficacy of antenatal corticosteroids for deliveries before 22 weeks of gestation and should evaluate the timing of corticosteroid administration. Furthermore, efforts should be made to include diverse populations and clinically meaningful long-term outcomes. At this time, the decision surrounding antenatal corticosteroids for threatened periviable deliveries should incorporate multidisciplinary counseling with the goal of achieving concordant prenatal and postnatal management aligned with the patient’s desires.
Bruton’s Tyrosine Kinase in Ankylosing Spondylitis
Authors: Liao Hsien-Tzung , Chen Chun-Hsiung
Published: September 2023

Study Design.

Prospective case-control study.

Objective.

To explore the role of Bruton’s tyrosine kinase (BTK) in ankylosing spondylitis (AS).

Summary of Background Data.

AS substantially affects patients, impairing range of motion in the whole spine and peripheral joints, as well as overall quality of life. However, surveillance for this condition is limited and biomarkers that can predict disease activity are not well documented.

Methods.

The expression of the BTK gene in peripheral blood mononuclear cells was measured using flow cytometry and real time quantitative polymerase chain reaction (qPCR) in 36 AS patients and 30 healthy controls. Demographic features, Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP based, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, HLA-B27, ESR, and CRP were evaluated to identify factors associated with BTK expression. Analyses were performed using Spearman’s rank correlation test for continuous data, the chi-test for categorical data, and that between continuous and dichotomous variables was measured using a point-biserial correlation test. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the performance of each candidate biomarker.

Results.

BTK gene expression was significantly higher in AS patients than in controls (P=0.042) according to qPCR results. BTKY223 was also high in CD19+ peripheral blood mononuclear cells (PBMCs) from AS patients, with CD19+BTKY223+high cells being significantly positive correlated to ESR, CRP, and ASDAS. A negative association was observed between BTK expression and the chest expansion distance. The AUC for CD19+BTKY223+ was larger than that for ESR, but CRP still had the largest area.

Conclusions.

BTK expression was higher in PBMCs from AS patients when compared to controls, and was associated with a higher disease activity index, inflammatory reactants, arthritis and extra-articular manifestations. These findings suggest that BTK expression may play a crucial role in the inflammatory process in individuals with AS.
MRI-guided Real-time Online Gated Stereotactic Body Radiation Therapy for Liver Tumors
Authors: Prasad Venkatesulu Bhanu , Ness Emily , Ross Dylan , Saripalli Anjali L. , Abood Gerard , Badami Ami , Cotler Scott , Dhanarajan Asha , Knab Lawrence M. , Lee Brian , Molvar Christopher , Sethi Anil , Small Jr William , Refaat Tamer
Published: September 2023

Background:

Liver tumors are commonly encountered in oncology. The study aimed to assess the impact of magnetic resonance imaging (MRI)-guided stereotactic body radiation therapy (SBRT) (MRgSBRT) on disease-related outcomes and the toxicity profile.

Methods:

Patients who received MRgSBRT from 2019 to 2021 for primary and metastatic liver tumors were included in this analysis. The protocol for treatment simulation included Gadoxetate disodium injection followed by a single-dimensional post-exhale MRI (0.35-T MRI linear accelerator) and computed tomography simulation. The patient demographics and treatment-related outcomes were assessed. The time-to-event curves were analyzed for freedom from local progression (FFLP) and overall survival (OS).

Results:

A total of 35 patients were eligible for analysis with a median age of 70 years (range 25 to 95). The median follow-up was 19.4 months (range 1 to 37 mo). The one-year OS was 77.7%, with an estimated 3 years of 47.9%. Patients with the locally controlled disease had a better median OS of 27.8 months (95% CI [23.8-31.6]) compared with 13.5 months (95% CI [5.6-21.3], P=0.007) in patients with local disease progression. The 1-year FFLP was 95.6%, and 3-year estimated FFLP was 87.1%. Patients who received a radiation dose of biologically equivalent dose≥100 Gy had FFLP of 30.9 months (95% CI [28.7-33.1]) compared with 13.3 months (95% CI [5.3-21.3], P=0.004) in patients who received <100 Gy biologically equivalent dose.

Conclusion:

MRI-guided SBRT provides optimal local control, associated with improved OS in a heavily morbid, pretreated older cohort of patients with reasonable safety profiles.
A Potential Outcomes Approach to Selection Bias
Authors: Kenah Eben
Published: September 2023

We propose a novel definition of selection bias in analytic epidemiology using potential outcomes. This definition captures selection bias under both the structural approach (where conditioning on selection into the study opens a noncausal path from exposure to disease in a directed acyclic graph) and the traditional definition (where a given measure of association differs between the study sample and the population eligible for inclusion). This approach is nonparametric, and selection bias under the approach can be analyzed using single-world intervention graphs both under and away from the null hypothesis. It allows the simultaneous analysis of confounding and selection bias, it explicitly links the selection of study participants to the estimation of causal effects using study data, and it can be adapted to handle selection bias in descriptive epidemiology. Through examples, we show that this approach provides a novel perspective on the variety of mechanisms that can generate selection bias and simplifies the analysis of selection bias in matched studies and case–cohort studies.
Validation and optimization of AFP-based biomarker panels for early HCC detection in Latin America and Europe
Authors: Beudeker Boris J.B. , Fu Siyu , Balderramo Domingo , Mattos Angelo Z. , Carrera Enrique , Diaz Javier , Prieto Jhon , Banales Jesus , Vogel Arndt , Arrese Marco , Oliveira Jeffrey , Groothuismink Zwier M.A. , van Oord Gertine , Hansen Bettina E. , de Man Robert A. , Debes José D. , Boonstra Andre
Published: September 2023

Background:

HCC is a major cause of cancer death worldwide. Serum biomarkers such as alpha-fetoprotein (AFP), protein induced by vitamin K absence-II, and the Gender, Age, AFP-L3, AFP, Des-gamma-carboxy prothrombin (GALAD) score have been recommended for HCC surveillance. However, inconsistent recommendations in international guidelines limit their clinical utility.

Methods:

In this multicenter study, over 2000 patient samples were collected in 6 Latin American and 2 European countries. The performance of the GALAD score was validated in cirrhotic cases, and optimized versions were tested for early-stage HCC and prediagnostic HCC detection.

Results:

The GALAD score could distinguish between HCC and cirrhosis in Latin American patients with an AUC of 0.76, sensitivity of 70%, and specificity of 83% at the conventional cutoff value of −0.63. In a European cohort, GALAD had an AUC of 0.69, sensitivity of 66%, and specificity of 72%. Optimizing the score in the 2 large multicenter cohorts revealed that AFP-L3 contributed minimally to early-stage HCC detection. Thus, we developed a modified GALAD score without AFP-L3, the ASAP (age, sex, AFP, and protein induced by vitamin K absence-II), which showed promise for early-stage HCC detection upon validation. The ASAP score also identified patients with cirrhosis at high risk for advanced-stage HCC up to 15 months before diagnosis (p < 0.0001) and differentiated HCC from hemangiomas, with a specificity of 100% at 71% sensitivity.

Conclusion:

Our comprehensive analysis of large sample cohorts validates the GALAD score’s utility in Latin American, Spanish, and Dutch patients for early-stage HCC detection. The optimized GALAD without AFP-L3, the ASAP score, is a good alternative and shows greater promise for HCC prediction.
Aspirin is associated with a reduced incidence of liver disease in men
Authors: Vell Mara Sophie , Krishnan Arunkumar , Wangensteen Kirk , Serper Marina , Seeling Katharina Sophie , Hehl Leonida , Rendel Miriam Daphne , Zandvakili Inuk , Vujkovic Marijana , Scorletti Eleonora , Creasy Kate Townsend , Trautwein Christian , Rader Daniel James , Alqahtani Saleh , Schneider Kai Markus , Schneider Carolin Victoria
Published: September 2023

Background:

The hepatoprotective effects of aspirin have been observed in individuals with viral hepatitis; however, its impact on the general population remains uncertain. Understanding the association between aspirin use and the development of liver diseases is crucial for optimizing preventive strategies.

Methods:

We identified individuals with aspirin use in the UK Biobank and the Penn Medicine Biobank, as well as propensity-score-matched controls. Outcome measures included new liver disease development, diagnosed by MRI or “International Classification of Diseases and Related Health Problems” coding, and incidences of gastrointestinal bleeding and ulcers.

Results:

In the UK Biobank cohort, regular aspirin use was associated with an 11.2% reduction in the risk of developing new liver diseases during the average 11.84 ± 2.01-year follow-up period (HR=0.888, 95% CI = 0.819–0.963; p = 4.1 × 10-3). Notably, the risk of metabolic dysfunction-associated steatotic liver disease (ICD-10 K76.0) and MRI-diagnosed steatosis was significantly lower among aspirin users (HR = 0.882−0.911), whereas no increased risk of gastrointestinal bleeding or ulcers was observed. These findings were replicated in the Penn Medicine Biobank cohort, in which the protective effect of aspirin appeared to be dependent on the duration of intake. The greatest risk reduction for new liver disease development was observed after at least 1 year of aspirin use (HR = 0.569, 95% CI = 0.425−0.762; p = 1.6 × 10-4). Intriguingly, when considering general risk factors, only men exhibited a lower risk of MRI-confirmed or ICD-coded steatosis with aspirin use (HRs = 0.806−0.906), while no significant protective effect of aspirin was observed in females.

Conclusion:

This cohort study demonstrated that regular aspirin use was associated with a reduced risk of liver disease in men without an elevated risk of gastrointestinal bleeding or ulcers. Further investigation is warranted to elucidate potential sex-related differences in the effects of aspirin and to inform tailored preventive strategies for liver diseases.