bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorporating the risk of knowledge loss in supply chain risk management
Authors: Daghfous Abdelkader , Qazi Abroon , Khan M. Sajid
Published: March 2021

Purpose

The literature on supply chain risk management (SCRM) has investigated a multitude of supply chain risks. This paper aims to make a case for the importance of managing the risk of knowledge loss in the supply chain management (SCM) function and incorporating knowledge loss as a critical risk within the SCRM process.

Design/methodology/approach

This paper adopts a knowledge-based view of the SCRM process and attempts to bring to light insights based on a synthesis of the relevant literature. The authors conducted a systematic literature review of peer-reviewed articles published between 1998 and 2019. Further, a case study was conducted to illustrate the significance of the risk of knowledge loss in the SCM function in terms of how it operates and why it has such a significant impact on performance.

Findings

Knowledge loss is a relatively neglected type of supply chain risk that can be added to the existing typologies. This paper argues that knowledge loss in the SCM function has the propensity to significantly impact the performance of the focal firm, exacerbate other types of supply chain risk and impede risk mitigation efforts. We put forth several strategies that supply chain managers can adopt to mitigate the risk of knowledge loss in their function.

Research limitations/implications

This paper generates an exploratory opening that could pave the way for a systematic theory of knowledge loss as a supply chain risk and future empirical research. The study culminates in a number of important insights and initiatives for supply chain managers to recognize and manage the risk of knowledge loss.

Originality/value

This paper argues for the importance of incorporating the risk of knowledge loss in SCRM research and practice. It also provides an examination of some promising angles for future research in SCRM from a knowledge-based perspective.
Technical efficiency, intellectual capital efficiency and bank performance in emerging markets: the case of India
Authors: Maji Santi Gopal , Hussain Farah
Published: March 2021

Purpose

This paper examines the impacts of technical efficiency and intellectual capital efficiency (ICE) on bank performance in India after controlling other bank-, industry-specific and macroeconomic variables.

Design/methodology/approach

The authors use secondary data on listed Indian commercial banks for the period 2005–2018. The authors use data envelopment analysis (DEA) technique-based Malmquist index (MI) to obtain technical efficiency and value-added intellectual coefficient (VAIC) model for computing ICE. System generalized method of moments (GMM) (SGMM) model in a dynamic framework is used to estimate the parameters, which takes into consideration issues of endogeneity, heterogeneity and persistence of bank performance. Further, the authors use quantile regression model to examine whether the impacts of covariates are homogeneous at different locations of the conditional distribution of bank performance.

Findings

The authors find positive impact of technical efficiency and negative influence of market concentration on bank performance. The results of the study support the efficient structure (ES) hypothesis (ESH). The authors observe positive influence of intellectual capital (IC) on bank performance, which indicates the relevance of intellectual resources in enhancing banks' value. Further, the results of quantile regression indicate that the impacts of technical efficiency and ICE are more pronounced at higher quantiles of the conditional distribution of bank performance.

Originality/value

This paper in the Indian context examines the influences of technical efficiency and ICE after controlling bank-, industry-specific and macroeconomic factors.
A coordination mechanism through cost sharing of corporate social responsibility and government subsidy in a two-echelon supply chain
Authors: Liu Yong , Ren Wenwen , Xu Qian , Liu Zhiyang
Published: March 2021

Purpose

This paper aims to deal with the coordination problem of the supply chain through cost sharing of corporate social responsibility (CSR) and government subsidy.

Design/methodology/approach

With respect to the coordination problem of the supply chain with CSR, this paper constructs a three-stage game model consisting of a dominant retailer, n suppliers and government. From the perspective of cost sharing and government subsidies, this paper discussed the decentralized and centralized decision-making, respectively. On this basis, this paper designed a coordination mechanism considering both cost sharing and government subsidies and explore the impact of cost sharing rate and government subsidy rate on CSR efforts, members’ profits and social welfare.

Findings

CSR can improve the profits of supply chain members and the overall performance of the supply chain. Then the profits of supply chain nodal enterprises will be affected by the fulfillment level of CSR of their partners. Furthermore, excessive CSR will erode the supply chain profits and cause resource waste. High CSR costs often make retailers low CSR effort level, while a high CSR cost sharing rate can reduce the profits of suppliers and the supply chain. In addition, excessive government subsidies will lead to the decline of social welfare. Excessive government subsidies will cause the dependence of enterprises and affect their operating efficiency.

Practical implications

The proposed coordination mechanism can effectively do with the coordination problem of the supply chain.

Originality/value

The proposed coordination mechanism considering cost sharing and government subsidies simultaneously can effectively deal with conflict problems and guarantee the supply chain members and the supply chain to maximize their profits and social welfare.
Collections, local interactions, conservation and tourism aspects of monastic heritage sites in the Lake Tana region of Ethiopia: the case of Mandeba Medahinealem Monastery
Authors: Genet Abraham , Kebede Marshet
Published: March 2021

Purpose

Along with the varied values of heritages which are rationale for their safeguarding, sustainable conservation and tourism development have become central agendas in the field of heritage management in contemporary world. This study attempts to elaborate such interconnected issues at Mandeba Monastery, emphasizing not only cultural heritages but also mutually reflecting on natural features which are integral part of the monastery.

Design/methodology/approach

Interviewing and systematic observation alongside secondary sources were used to generate data which were analyzed thematically.

Findings

Being a site for incredible collections, Mandeba maintained a tradition of not only heritage conservation and benevolent communal interaction but also of ecological sustainability. The rich collections together with its spectacular location on the shore of Lake Tana enable Mandeba to have highly noticeable tourism potentials. However, Mandeba encounters such challenges as inadequate museum, safety and security problems, lack of sufficient budget, professional, parasitic animal damages, weak promotion and lack of tourist facilities which hamper both conservation and tourism development on the site, which need to be tackled for the overall improvement of the monastery.

Originality/value

This research is original, presenting the ground knowledge and practice regarding the relationship between heritage conservation on the one hand, and local livelihood, environmental management and tourism sustainability on the other hand, with regard to the immovable cultural/religious heritage site of Mandeba Medahinealem Monastery.
Understanding the complexity of system-level leadership in the English schooling landscape
Authors: Constantinides Michalis
Published: March 2021

Purpose

The purpose of this paper is to explore the role and leadership practices of executive leaders in English multi-academy trusts (MATs) considering the meaning of system-level leadership and its perceived impact on schools' improvement processes, conditions and culture.

Design/methodology/approach

This paper was guided by an ecological systems approach emphasizing the interactions between the micro-, meso-, macro-, exo- and chronosystems, and was used to develop context-sensitive accounts of leadership across groups of schools. It involves interview-based multi-perspective case studies using a sample of five MATs and collecting data from 31 interviews with various school and MAT leaders.

Findings

The primacy of leadership at the executive level was central to efforts for school and MAT transformation and that was evident throughout the findings of the study. System leadership was multifaceted and was understood through the multiple layers of the organizational structure of MATs. Four major domains of practice highlight the efforts of these leaders to address complex and systemic challenges. These are setting strategic directions, developing people and organizational capacity, establishing organizational infrastructure to support schools' improvement efforts and providing instructional guidance.

Originality/value

Findings reveal new empirical data about the role of executive leaders in English MATs and highlight the ways in which they seek to establish, manage and sustain school and MAT-wide improvement providing the research with a holistic idea of system leadership.
Influence of middle management on dynamic capabilities
Authors: Cruz Marina de Almeida , Corrêa Victor Silva , Diniz Daniela Martins , Borini Felipe Mendes
Published: March 2021

Purpose

The dynamic capabilities (DC) literature focuses primarily on top managers. Although recent studies have drawn attention to middle management's (MM) relevance, these professionals have not been the focus of much attention in the DC literature. The purpose of this paper is to investigate whether and how MM influences DC dimensions.

Design/methodology/approach

Through a qualitative strategy and case-study method, 13 MM professionals from four Brazilian companies embedded in competitive and dynamic contexts were investigated. The “micro-practices” approach was used to operationalize the DC construct.

Findings

The evidence shows that MM influences DC dimensions. This influence appears to emanate from 19 identified and named micro-practices.

Practical implications

By examining how micro-practices (micro-level) influence macro-level DC dimensions, this article raises the significance of including the micro-practices identified herein in management-training programs.

Originality/value

The first relates to the identification of micro-practices within the MM scope. The second relates to the association of micro-practices with management functions. The third relates to the association of micro-practices with DC dimensions. Thereby, this article highlights how DC work in organizations' daily activities. The fourth is the construction of a framework that demonstrates how to integrate the DC micro (micro-practices), meso (managerial functions) and macro (DC dimensions) scopes. Fifth, this paper affirms the emerging research stream that stresses MM's relevance for DC generation.
Use of social media information sources: a systematic literature review
Authors: Khatri Deepti
Published: March 2021

Purpose

This paper aimed to investigate reading format preference of undergraduate students with regard to various categories of information sources and use of social media information sources for academic and non-academic activities.

Design/methodology/approach

An exhaustive literature review was carried out in a very well organised way using total 56 publications which include 48 research papers, four conference papers, two books and two reports, which were selected for analysis on the basis of prescribed data schema and adopting the inclusion and exclusion criteria matching with the research objectives of the study.

Findings

Undergraduate students preferred text books in print format for passing the exams, and use of search engines and Internet sites were rated as the most crucial source for the academic information. In particular, Wikipedia, YouTube and Blogs were the most frequently used social media information sources by undergraduate students for their academic activities. However, Facebook and Twitter were most prominently used for social interaction.

Research limitations/implications

The population of the study was restricted to the homogenous group of users, i.e. undergraduate students to examine their choices and preferences for their academic and non-academic activities. Further research studies may be conducted covering the more diverse and heterogeneous user group of postgraduate students and research scholars of different disciplines.

Originality/value

Generally, many previous research studies depicted users' preference for print and electronic media format without paying special attention on the usage of a variety of information sources by user groups. However, the present study is a value addition to the existing literature which emphasised the use of various categories of information sources, particularly by undergraduate students in print and digital format for different purposes in the digital environment. A major shift from the use of print media to digital media to social media information sources by undergraduate students for their academic and non-academic activities.
Validation of a lateral flow immunochromatographic assay for tinea unguium diagnosis
Authors: Tsuboi Ryoji , Mochizuki Takashi , Ito Haruo , Kawano Shiomi , Suzuki Yosuke , Naka Wataru , Hata Yasuki , Hamaguchi Taizo , Maruyama Ryuji
Published: March 2021

Tinea unguium is a common nail disease caused by dermatophytes. Although direct potassium hydroxide (KOH) microscopy and fungal culture are considered the gold standard for diagnosing this disease, their accuracy is insufficient. A lateral flow immunochromatographic assay (LFIA) kit, using a monoclonal antibody against Trichophyton rubrum, was developed and its sensitivity was recently improved 50% in vitro relative to its earlier version. The present study aimed to validate the clinical utility of this improved LFIA kit for diagnosing tinea unguium in comparison with direct KOH microscopy. A similar trial was simultaneously performed using scale samples from patients with tinea pedis to determine the assay’s diagnostic potential. Nail samples, approximately 2 mg in weight, were collected from 112 non‐treated tinea unguium patients and 56 non‐tinea unguium patients. Samples from 25 tinea pedis patients and 20 non‐tinea pedis patients were also collected. The sensitivity and specificity of the LFIA kit for tinea unguium was 84.8% (95/112) (95% confidence interval [CI], 76.8–90.9) and 83.9% (47/56) (95% CI, 71.7–92.4), respectively. The inconsistency rate was 15.5% (26/168) (95% CI, 10.4–21.9). The sensitivity and specificity of the LFIA kit for tinea pedis was 84.0% (21/25) and 100.0% (20/20), respectively. These results suggest that for diagnosing tinea unguium, the LFIA kit is a useful supplement to, but not a replacement for, direct KOH microscopy. For definitive diagnosis of suspected cases, appropriate sampling, repeated examinations, and a combination of diagnostic techniques are essential.
The resilience of coastal ecosystems: A functional trait‐based perspective
Authors: De Battisti Davide
Published: March 2021

Coastal ecosystems provide important services to human population, such as nurseries for fish, carbon storage and coastal protection. However, the pressure faced by these systems due to global changes will strongly challenge the capacity of coastal ecosystems to persist. Therefore, it is crucial to understand the resilience of coastal ecosystems.

Here, I propose that combining a resilience framework based on ecosystem properties with the functional trait response–effect framework would allow researchers and managers to quantify the resilience of coastal ecosystems. I place emphasis on salt marsh and sand dunes because of the higher availability of studies for these systems.

First, I introduce the resilience framework based on ecosystem properties and, second, I show how adopting a functional trait perspective in this framework would allow researchers to link how environmental changes influence ecosystem properties. In turn, measuring the changes in ecosystem properties would allow researchers to measure the resilience of the system.

Synthesis. I reviewed several types of disturbances (e.g. storms and sea‐level rise) that are threatening the persistence of coastal ecosystems, with an emphasis on salt marshes and sand dunes. Applying this resilience framework reveals, for instance, that the same suite of traits (e.g. plant density and stiffness) increase marsh resistance to multiple threats (e.g. storms and sea‐level rise); yet, these traits vary along environmental gradients (e.g. along estuaries) and, therefore, the resilience of marshes vary accordingly. Overall, this framework would allow researchers to gather crucial insights on the resilience of coastal ecosystems and to set reference marks for measuring their resilience under environmental changes.
Tree recruitment failure in old‐growth forest patches across human‐modified rainforests
Authors: Arasa‐Gisbert Ricard , Arroyo‐Rodríguez Víctor , Galán‐Acedo Carmen , Meave Jorge A. , Martínez‐Ramos Miguel
Published: March 2021

Land‐use change threatens biodiversity in tropical landscapes, but its impact on rainforest regeneration remains poorly known. In fact, the landscape‐scale patterns driving the diversity of regenerating plants within forest fragments have been rarely explored, and we are uncertain whether such drivers vary across regions with different land‐use change patterns.

We assessed the effect of landscape composition (forest cover and matrix openness) and configuration (forest patch density) on species diversity of sapling assemblages (trees ≥30 cm height and <1 cm diameter) in old‐growth forest fragments from three Mexican rainforest regions with different disturbance levels (n = 20 landscapes per region). We separately assessed old‐growth forest specialists (OGS) and forest generalist (FG) species to test the hypotheses that: (a) OGS species show recruitment limitation (‘loser’ species), and can therefore be negatively impacted by landscape changes, especially by forest loss and matrix openness in more deforested regions; and (b) FG species can regenerate and even proliferate in more disturbed landscapes (‘winner’ species).

We recorded ~24,000 plants from 415 species. Landscape composition showed stronger effects than landscape configuration. The diversity of OGS species generally decreased in more deforested landscapes dominated by open matrices, and FG species followed the opposite response, especially in the regions with high‐to‐intermediate degree of disturbance. Overall, forest fragmentation (patch density) showed weak or no effects on species diversity, especially after controlling for forest cover effects (i.e. fragmentation per se). In contrast to the fragmentation threshold hypothesis, the effect of fragmentation was independent of the regional context. Moreover, FG species were affected by landscape attributes operating at larger scales than OGS species.

Synthesis. Our findings support our hypotheses, and suggest that forest loss and matrix openness, not fragmentation per se, can cause the recruitment failure of tree assemblages in highly deforested rainforests. This can be related to source and dispersal limitation in more deforested landscapes with treeless matrices. Therefore, to promote the regenerative potential (resilience) of forest patches in human‐modified tropical landscapes, conservation programs should focus on preventing forest loss (even the smallest forest patches) and improving matrix quality with treed elements, particularly in highly deforested tropical regions.
Return to work and cancer: Perspectives of occupational therapists
Authors: Hatton Rebecca , Wallis Amy , Chew Angela , Stanley Mandy , Smith Andrew
Published: March 2021

Introduction

Progress in the early detection, diagnosis, and treatment of cancer has translated into more people in Australia living with and beyond cancer. Therefore, there is a larger number of people returning to work following cancer treatment while managing ongoing symptoms of cancer, and side effects of treatment. The purpose of this study was to explore the facilitators and barriers for return to work for someone with cancer, from the perspective of occupational therapists.

Method

This study used a qualitative descriptive design. Participants were recruited via key contacts within the industry and relevant interest groups, and included eight occupational therapists with experience supporting someone with cancer to return to work. Data were collected in semi‐structured in‐depth Interviews which were audio recorded, transcribed verbatim, and analysed thematically.

Findings

Two main themes were developed; expectations of the cancer experience versus reality, and vulnerability during return to work. Occupational therapists perceived that the person with cancer, employers, family members, co‐workers, and society underestimate the impact of ongoing cancer symptoms on return to work. Return to work was challenging as survivors face unexpected challenges due to ongoing fatigue, cognitive difficulties, or psychological factors. Fear of relapse, concerns regarding disclosure affecting how people with cancer are perceived at work, and worries of leaving the high levels of professional support during treatment, also affected return to work.

Conclusion

Findings from this study may contribute to occupational therapists and people with cancer setting realistic expectations for the return to work experience. Furthermore, it may provide support for occupational therapists to work more effectively with their clients to facilitate a smoother transition back to work as a cancer survivor.
Population pharmacokinetic analysis of ropivacaine extended‐release from a temperature‐responsive hydrogel in rats
Authors: Bang Ji‐Yeon , Nam Sugeun , Hwang Chang‐Soon , Lee Eun‐Kyung , Choi Byung‐Moon
Published: March 2021

Therapeutic agents with a short half‐life need to be administered frequently to achieve sustained and effective concentrations. This could be accomplished using sustained drug delivery technology. PF‐72 (TGel Bio, Inc., Seoul, Korea) is a drug delivery system based on a powder obtained from lyophilisation of a reverse thermal hydrogel, which could assist in achieving prolonged pain relief if mixed with an anaesthetic and injected into the incision site following surgery. The pharmacokinetic parameters related to the absorption of the local anaesthetic ropivacaine delivered using this hydrogel were quantified. Ten rats were divided into two groups (n = 5 each), and equal doses (4 mg/kg) of different formulations were subcutaneously injected into the abdomen. The experimental group received PF‐72 mixed with 0.75% ropivacaine, and the control group received 0.75% ropivacaine. Blood was collected at specific times to measure the plasma concentration of ropivacaine. Population pharmacokinetic analysis was performed using NONMEM VII level 4 (ICON Development Solutions, Dublin, Ireland). The one‐compartment absorption model, which combines zero‐order absorption and first‐order absorption, was used to describe the change in ropivacaine plasma concentration over time. The type of formulation was a significant covariate for zero‐order absorption duration (experimental group, 92.9 min; control group, 60.5 min). The addition of PF‐72 to 0.75% ropivacaine increased the duration of absorption into the blood, suggesting a longer lasting effect of the analgesic injected into the surgical wound.
The Gender Wars, Academic Freedom and Education
Authors: Suissa Judith , Sullivan Alice
Published: March 2021

Philosophical arguments regarding academic freedom can sometimes appear removed from the real conflicts playing out in contemporary universities. This paper focusses on a set of issues at the front line of these conflicts, namely, questions regarding sex, gender and gender identity. We document the ways in which the work of academics has been affected by political activism around these questions and, drawing on our respective disciplinary expertise as a sociologist and a philosopher, elucidate the costs of curtailing discussion on fundamental demographic and conceptual categories. We discuss some philosophical work that addresses the conceptual distinction between academic freedom and free speech and explore how these notions are intertwined in significant ways in universities. Our discussion elucidates and emphasises the educational costs of curtailing academic freedom.
Combatting Corruption and Collusion in UK Public Procurement: Proposals for Post‐Brexit Reform
Authors: Jones Alison
Published: March 2021

Every year the UK government spends billions of pounds purchasing goods, works and services that are vital to growth, development, health and social welfare. Performed well, public procurement helps a government to nurture competition, save money, and provide better public services. These benefits will not be reaped, however, if the system is not protected adequately from distortion by corruption and/or supplier collusion. This paper concludes that additional measures are required to protect the integrity of procurement processes in England & Wales through improving the distinct public procurement, anti‐corruption and competition regimes and uniting them around a cohesive strategy. It advocates policy coordination and enhancements designed to yield major benefits to public procurement as the UK seeks to develop its own policies post‐Brexit and to grapple with the demands that the Covid‐19 pandemic has placed on public purchasing and the public purse.
Public support for social security in 66 countries: Prosperity, inequality, and household income as interactive causes
Authors: Andersen Robert , Curtis Joshua , Brym Robert
Published: March 2021

It is widely accepted that support for government intervention is highest among people in lower socioeconomic positions, during economic recessions and in less prosperous countries. However, the relationship between income inequality and attitudes toward government intervention is less clear. We contribute new insights to both questions by exploring how subjective household income, economic prosperity, and income inequality interact to influence attitudes. Using mixed‐effects and country fixed‐effects models fitted to data from 66 countries, we demonstrate that income inequality has a strong positive impact on attitudes toward government intervention in rich countries but no discernable effect in poor countries. Concomitantly, the impact of economic prosperity differs by level of inequality. It has little effect when income inequality is relatively low, a weakening effect as inequality rises, and no apparent effect when inequality is high. Consistent with these findings, the effect of subjective household income on attitudes toward government intervention is strongest in countries that are simultaneously very prosperous and highly unequal. Taken together, these findings suggest that if inequality continues to rise, especially in rich countries, public demand for social spending will eventually increase as well.
Age‐stage, two‐sex life tables of the maple poison moth (Lymantria nebulosa Wileman) at different ambient temperatures
Authors: Lei Ling , Huang Hui Jing , Yi Jin Yu , Qiu Lin , Ding Wen Bin , He Hua Liang , Yi Tu Yong , Li You Zhi , Xue Jin
Published: March 2021

The maple poison moth (MPM), Lymantria nebulosa (Wileman), is a Lepidopteran defoliator and one of the most important pests of Liquidambar formosana Hance. The objective of this study was to determine the effects of temperature on the population growth and reproduction of this species. MPM were raised in artificial climate chambers in a laboratory at 21 ± 1°C, 24 ± 1°C, 27 ± 1°C, 30 ± 1°C, 33 ± 1°C and 36 ± 1°C, under a relative humidity (RH) of 70% ± 10% and a 14 L:10D photoperiod, and age‐stage, two‐sex life tables complied for insects at each temperature. The developmental duration, adult preoviposition period and overall preoviposition period decreased with temperature in a time‐dependent manner. The growth curves of the different temperature groups overlapped considerably. The highest larval survival rate (80%) was recorded at 30 ± 1°C. At 36°C only a few eggs hatched and the first instar could not complete the first molt. We consequently regard 36°C as the lethal temperature threshold for this species. Life expectancy decreased with age under all six temperatures. The endogenous growth rate was significantly lower at 21 ± 1°C than at the other temperatures, and was highest in 30 ± 1°C group. The net growth rate of the 30 ± 1°C group was also significantly higher than others. Reproductive parameters were highest at 27 ± 1°C and 30 ± 1°C. Although environmental factors absent from the laboratory environment may limit the generality of our results, they nonetheless provide a theoretical basis for developing integrated control methods for MPM in the wild.
HRM and the COVID‐19 pandemic: How can we stop making a bad situation worse?
Authors: Butterick Mark , Charlwood Andy
Published: March 2021

This provocation argues that the COVID‐19 pandemic has exposed deep labour market inequalities. Partially underpinning these inequalities are human resource management (HRM) theories and practices which encourage and legitimise the commodification of labour. Workers whose jobs have been commodified have suffered disproportionately during the pandemic. While HRM is not wholly responsible for this suffering it is important for those of us involved in researching, teaching and practicing HRM to reflect on the ways in which what we do has made a bad situation worse so that we can do better in the future.
Prevalence and risk factors for falls in patients with spondyloarthritis: A systematic review
Authors: Lim Grace Rui Si , Ng Caitlin Hsuen , Kwan Yu Heng , Fong Warren
Published: March 2021

Objective

Patients with spondyloarthritis (SpA) may have a greater risk of falling due to poor postural balance and decreased mobility. To our best knowledge, there are no published reviews that study falls in patients with SpA. Therefore, we aim to systematically review the literature and identify the prevalence and risk factors of falls in patients with SpA.

Methods

We conducted a systematic review using 5 electronic databases: PubMed, EMBASE, Scopus, Web of Science and Google Scholar using controlled vocabulary terms (eg MeSH terms) in the search strategy for the concepts: falls, fall risk, SpA and its subtypes.

Results

We identified 7279 articles, of which 3 studies with a total of 441 patients were included. Prevalence of falls ranged from 13% to 25%. We identified 16 main factors across 5 categories. Under socio‐demographic factors, functional limitation, decreased quality of life, advanced age and job loss were associated with an increased risk of falls. Poor balance and mobility and fear of falling were associated with increased risk of falls. Active disease and symptoms of SpA were medical factors that were associated with increased risk of falls. Medication factors including polypharmacy, myorelaxants and antidepressants were not associated with increased fall risk.

Conclusion

We identified potentially modifiable risk factors associated with increased risk of falls in patients with SpA, including functional limitation, poor balance and mobility, fear of falling and active disease. Clinicians should recognize these factors and address them in the holistic management of patients with SpA, thereby reducing falls and their complications.
Mutation profile and immunoscore signature in thymic carcinomas: An exploratory study and review of the literature
Authors: Asselta Rosanna , Di Tommaso Luca , Perrino Matteo , Destro Annarita , Giordano Laura , Cardamone Giulia , Rubino Luca , Santoro Armando , Duga Stefano , Zucali Paolo Andrea
Published: March 2021

Background

Significant efforts have been made to investigate the molecular pathways involved in thymic carcinogenesis. However, genetic findings have still not impacted clinical practice. The aim of this exploratory trial was to evaluate the immunoscore and molecular profile of a series of thymic carcinomas (TCs), correlating this data with clinical outcome.

Methods

Formalin‐fixed, paraffin‐embedded (FFPE) TC tissues were retrieved from our center archive. The immunoscore was evaluated according to Angell and Gallon. DNA was extracted from FFPE tumor samples and, when available, from adjacent histologically normal tissues. Next‐generation sequencing (NGS) was performed targeting hotspot regions of 50 oncogenes and tumor suppressor genes.

Results

A series of 15 TCs were analyzed. After a median follow‐up of 82.4 months, the median overall survival was 104.7 months. The immunoscore was >2 in 5/15 patients (33%). Among the investigated genes, absence of mutations was observed in 5/15 patients (33%), whereas three variants in 1/15 (6%) patient, two variants in 4/15 (26%) patients, and one variant in 5/15 patients (33%) were found. The most recurrently mutated genes were FGFR3 (five mutations) and CDKN2A (three mutations, two of which were nonsense). Patients with CDKN2A loss showed a statistically significantly worse survival (P = 0.0013), whereas patients with FGFR3 mutations showed a statistically significantly better survival (P = 0.048).

Conclusions

This study adds data to the few existing reports on the mutational landscape of TCs, providing the first comprehensive analysis to date. Here, we confirm the low rate of mutations in TCs and suggest FGFR3 and CDKN2A mutations as intriguing potential therapeutic targets.
Effectively inferring overall spatial distribution pattern of species in a map when exact coordinate information is missing
Authors: Chen Youhua , Wu Yongbin , Zhou Jin , Zhang Wenyan , Lin Hong‐Da , Liu Xinke , Pan Kaiwen , Shen Tsung‐Jen , Pan Zhifen
Published: March 2021

Mapping and comparing biodiversity in space is a routine task in ecological research. However, accurate biodiversity mapping requires exact distributional information as inputs. When exact geographical coordinate information is missing or when only coarse distribution of species is available at the quadrat or plot level, how can we effectively infer and compare spatial distributional patterns of species with reasonable accuracy while controlling the confounding impacts of scale dependency?

A crossing‐scale coefficient of variation (CCV) is calculated for three simple diversity indices, the Shannon, Gini–Simpson and reciprocal‐Simpson evenness indices, from the quadrat‐based biodiversity data over varying sampling grain sizes for subtly measuring overall spatial distributional pattern of species in a survey map.

Extensive numerical simulations showed that, when the overall distribution of organisms was regular, CCV tended to be very small, for all the three evenness indices. By contrast, when the distribution was highly aggregate, CCV tended to be large. Finally, an intermediate CCV was observed when organism distribution was random. To this end, all the three evenness indices can detect the subtle change on aggregate or regular distribution. Among the indices, the Gini–Simpson evenness index is the most insensitive to both the change of population size of species and the number of sampling grain sizes used. Compared to available spatial statistic metrics that requires exact geographical coordinates as inputs, CCV is a useful metric for assessing the overall spatial distribution pattern of a species across sampling plots in which exact spatial coordinates of each individual are unavailable. Empirical applications of the CCV metric showed that plants in habitat patches extensively managed by humans can present very aggregate distributional pattern, being counterintuitive to the usual expectation that plants in cultivated or planted land should present regular distributional pattern.

The present study recommends one effective tool, the combination of CCV and evenness indices, for exploring the overall spatial distributional pattern of a single species under the quadrat‐sampling scheme. The proposed method is particularly suitable to handle ecological data for which the finest‐scale distributional coordinate information of each individual of species is missing.
Potential and pitfalls of citizen science with children: Reflections on Pollinators in the Playground project
Authors: Prendergast Kit , Vanderstock Amelie , Neilly Heather , Ross Catherine , Pirotta Vanessa , Tegart Patrick
Published: March 2021

Engaging school‐age children in activities involving ‘real‐world’ science and interacting with scientific researchers can promote an interest in appreciating and understanding the natural world and the scientific method. Here, we describe a project involving five female early‐career and PhD researchers who facilitated a citizen science project with school‐age children. Under the guidance of the researchers, across five schools, children created artificial flowers and installed them on school ovals. Over repeated 10‐min observations, students recorded how colour (yellow vs. blue) and configuration (isolated, clumped adjacent, clumped mixed colour and clumped single colour) influenced how many and what taxa of insects visited. Here, we reflect on what we were able to achieve including creating a simple, fun, cost‐effective project; anecdotal student interest in insects, and positive female STEM role models. We also acknowledge constraints and shortcomings, including set curricula resulting in suboptimal season for pollinator studies; confounding of results due to children’s observations; and being unable to verify the data. We offer recommendations for more robust projects in future, which include collecting specimens to verify results, and measuring learning outcomes. If these recommendations are met, researcher–student projects can engage children in conducting scientific experiments with applications for home and school garden management.
Prevalence and experience of fatigue in survivors of critical illness: a mixed‐methods systematic review
Authors: Bench S. , Stayt L. , Shah A. , Dhiman P. , Czuber‐Dochan W.
Published: March 2021

We conducted a mixed methods systematic review to investigate the prevalence, experience and management of fatigue in survivors of critical illness. We identified 76 studies investigating fatigue or vitality in adults discharged from an intensive care unit and split the extracted data into three datasets: vitality scores from the Short Form Health Survey‐36 (n = 54); other quantitative data (n = 19); and qualitative data (n = 9). We assessed methodological quality using critical appraisal skills programme tools. We adopted a segregated approach to mixed‐methods synthesis. In a final step, we attributed combined results to one of four qualitative themes: prevalence and severity; contributing factors; impacts on quality of life; and assessment and management. Prevalence of fatigue ranged from 13.8 to 80.9%. Short Form Health Survey‐36 vitality scores were commonly used as a marker of fatigue. Vitality scores reached a nadir approximately one month following ICU discharge (mean (SD) 56.44 (32.30); 95%CI 52.92–59.97). They improved over time but seldom reached reference population scores. Associated biological, disease‐related and psychological factors included age, poor pre‐morbid status, sleep and psychological disturbance. Qualitative data highlight the profound negative impact of fatigue on survivors’ quality of life. Survivors seldom had any information provided on the potential impact of fatigue. No fatigue assessment tools specific to critical illness or evidence‐based interventions were reported. Fatigue is highly prevalent in survivors of critical illness, and negatively impacts recovery. Further research on developing fatigue assessment tools specifically for critically ill patients and evaluating the impact of pharmacological and non‐pharmacology interventions is needed.
Bariatric surgery has positive effects on patients’ and their partners’ sexual function: A prospective study
Authors: Gokalp Fatih , Koras Omer , Ugur Mustafa , Yildirak Ekrem , Sigva Hakan , Porgali Sefa B. , Tamkac Nezih , Gorur Sadik
Published: March 2021

Background

Obesity has been associated with severe conditions and sexual dysfunction. Bariatric surgery has effects positively patients’ sexual function.

Objectives

To assess the effect of bariatric surgery on sexual functions of couples.

Materials and Methods

The study included 57 obese patients and their sexually active partners. Male participations were assessed with the International Index of Erectile Function (IIEF) and Male Sexual Health Questionaries (MSHQ‐4), and female participations were assessed with the Female Sexual Function Index (FSFI).

Results

There were 31 (54.4%) male patients and 26 (45.6%) female patients in the study. The median IIEF score of the male patients statistically increased postoperatively (p < 0.001). The IIEF subgroup areas were found to have increased after surgery. The median FSFI score of the female patients statistically increased postoperatively (p < 0.001). The median FSFI of male patients’ partners significantly increased postoperatively (p < 0.001). All FSFI domains were statistically significantly increased (p < 0.001, all areas). The median IIEF value of the postoperative partners of the female patients also increased statistically significant (p < 0.001). In addition, the increases in the IIEF’s subdomains in terms of sexual desire (p < 0.001), intercourse satisfaction (p < 0.001), and general satisfaction (p < 0.001) were statistically significant.

Conclusion

The sexual functions of both males and females and also their’ partners were improved after bariatric surgery. Patients with preoperative poor sexual function achieve significant benefits over patients without sexual dysfunction.
Intestinal SGLT1 as a therapeutic target in COVID‐19‐related diabetes: A “two‐edged sword” hypothesis
Authors: Koufakis Theocharis , Metallidis Symeon , Zebekakis Pantelis , Kotsa Kalliopi
Published: March 2021

Emerging data are linking coronavirus disease 2019 (COVID‐19) with an increased risk of developing new‐onset diabetes. The gut has been so far out of the frame of the discussion on the pathophysiology of COVID‐19‐induced diabetes, with the pancreas, liver, and adipose tissue being under the spotlight of medical research. Sodium‐glucose co‐transporters (SGLT) 1 represent important regulators of glucose absorption, expressed in the small intestine where they mediate almost all sodium‐dependent glucose uptake. Similar to what happens in diabetes and other viral infections, SGLT1 upregulation could result in increased intestinal glucose absorption and subsequently promote the development of hyperglycaemia in COVID‐19. Considering the above, the question whether dual SGLT (1 and 2) inhibition could contribute to improved outcomes in such cases sounds challenging, deserving further evaluation. Future studies need to clarify whether putative benefits of dual SGLT inhibition in COVID‐19 outweigh potential risks, particularly with respect to drug‐induced euglycaemic diabetic ketoacidosis, gastrointestinal side effects, and compromised host response to pathogens.
Achievements and challenges of the Sakigake designation system in Japan
Authors: Tanaka Mototsugu , Idei Mayumi , Sakaguchi Hiroshi , Kato Ryosuke , Sato Daisuke , Sawanobori Kenji , Kawarasaki Shuichi , Hata Toshiyuki , Yoshizaki Asako , Nakamura Miki , Ikuma Mutsuhiro
Published: March 2021

The Sakigake designation system (Sakigake) has been launched to encourage the pioneered development of innovative new medical products for the effective treatment of severe illness in Japan, which allows leveraging the several advantages in prioritized consultation, rapid review, premium drug pricing and extended data‐protection period. We retrospectively analysed the Sakigake products including drugs and regenerative medical products to clarify the achievements and the future issues in this system. From April 2015 to August 2020 (the first 5‐year trial period of Sakigake), 37 products were designated, and 10 of those were approved in Japan in which 7 new active substances achieved the first‐in‐world approvals. Oncology, neurology and cardiovascular disease were the major therapeutic areas, and those 3 accounted for 75.7% of all products. Sakigake achieved some first‐in‐world approvals by the Pharmaceuticals and Medical Devices Agency/the Ministry of Health, Labor and Welfare of innovative new medical products, although in some therapeutic areas, there remains room in stimulating drug development.
Protocol for the UK cohort study to investigate the prevention of parastomal hernia (the CIPHER study)
Authors: Tabusa Hana , Blazeby Jane M. , Blencowe Natalie , Callaway Mark , Daniels Ian R. , Gunning Amanda , Hollingworth William , McNair Augus G. , Murkin Charlotte , Pinkney Thomas D. , Rogers Chris A. , Smart Neil J. , Reeves Barnaby C.
Published: March 2021

Aim

Abdominal surgery sometimes necessitates the creation of a stoma, which can cause future complications including parastomal hernia (PSH), an incisional hernia adjacent to and related to the stoma. PSH affects approximately 40% of patients within 2 years of stoma formation. Complications of PSH reduce a patient’s quality of life and can be severe (e.g. bowel obstruction). PSHs are difficult to manage and can recur after surgical repair. Therefore, it is very important to prevent a PSH. Surgeons create stomas in different ways and both patient and surgical factors are believed to influence the development of PSH. The aim of the CIPHER study is to investigate the influence of different surgical techniques on the development of PSH.

Method

The UK cohort study to investigate the prevention of parastomal hernia (the CIPHER study) aims to recruit 4000 patients undergoing elective or expedited surgery with the intention of forming an ileostomy or colostomy, irrespective of the primary indication for the planned surgery. For each patient, surgeons will describe their methods of trephine formation, mesh reinforcement of the stoma trephine, use of the stoma as a specimen extraction site and wound closure. The primary outcome will be incident PSH during follow‐up, defined as symptoms of PSH (custom‐designed questionnaire) and anatomical PSH, ascertained by independent reading of usual care CT scans. Secondary outcomes will include surgical site infection, the Comprehensive Complication Index, quality of life (EQ‐5D‐5L and SF‐12), PSH repair and use of NHS resources.

Results

Results of the study will be submitted for publication in peer‐reviewed journals. All publications relating to the results of CIPHER will use a corporate authorship, ‘The CIPHER Study Investigators’ with named writing committee members.

Conclusion

The CIPHER study will be the first to investigate detailed surgical methods of stoma formation in a large, representative cohort of patients with a range of primary indications, both cancer and noncancer.