bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual Dysfunctions Induced by Pregabalin
Authors: Hamed Sherifa Ahmed
Published: July 2018

Objectives

Pregabalin (PGB) is a gabapentinoid (ie, GABA analog), which has been Food and Drug Administration–approved for treatment of partial epilepsy in adults and neuropathic pain. It also has off-label uses for the treatment of generalized anxiety disorders, fibromyalgia, and tension headache and prevention of migraine. Few cases were reported with sexual dysfunctions (SDs) as adverse effects of PGB and gabapentin, and the majority were dose related (≥900 mg/d for gabapentin). This study aimed to determine the frequency and types of SDs induced by PGB and the temporal relation to its use.

Methods

We presented case series of patients (n = 75) treated with PGB for different indications (sciatica, atypical facial pain, chronic tension headache, transformed migraine, fibromyalgia, and generalized anxiety disorder and developed different aspects of SDs).

Results and Conclusions

In this case series, SDs were noticed with PGB in 41.33% (n = 31) (men, 13 [50%]; women, 18 [36.73%]), which included erectile dysfunction (n = 16, 51.61%), anorgasmia (n = 10, 32.26%), and loss of libido (n = 11, 35.48%). Sexual dysfunctions occurred within weeks after the use of PGB and were not dose related. They occurred with low therapeutic PGB doses (50–100 mg/d). Discontinuation of PGB resulted in improvement of SDs within weeks. To conclude, SDs are not infrequent adverse effects of PGB therapy. Pregabalin can induce erectile dysfunction, loss of libido, and anorgasmia. Sexual dysfunctions induced by PGB are not dose related. It is important for the clinician to acknowledge and encourage discussion regarding sexual function with patients and inquire about the impact of PGB on sexual function.
Interocular Symmetry and Repeatability of Foveal Outer Nuclear Layer Thickness in Congenital Achromatopsia
Authors: Mastey Rebecca R. , Litts Katie M. , Langlo Christopher S. , Patterson Emily J. , Strampe Margaret R. , Carroll Joseph
Published: July 2018

Purpose

To examine the intraobserver repeatability of foveal outer nuclear layer (ONL) thickness measurements and evaluate interocular symmetry for patients with achromatopsia (ACHM) and controls.

Design

Cross-sectional study.

Subjects

Sixty-four patients withCNGA3- orCNGB3-associated ACHM and 38 patients with normal vision were recruited for analysis.

Methods

Horizontal line scans through the fovea of each eye were acquired using optical coherence tomography. Three foveal ONL thickness measurements were made by a single observer using custom software to analyze repeatability. Interocular symmetry was assessed using the average of the three measurements for each eye.

Main Outcome Measures

The main parameter being measured is foveal ONL thickness.

Results

Mean (± SD) foveal ONL thickness for ACHM patients was 74.86 ± 17.82μm (OD) and 75.30 ± 15.68μm (OS) compared to 110.60 ± 15.67μm (OD) and 110.53 ± 13.91μm (OS) for controls. Foveal ONL thickness did not differ between eyes for ACHM (p = 0.821) or control patients (p = 0.961). Intraobserver repeatability was high for foveal ONL measurements in ACHM patients (ICC = 0.939, OD and 0.915, OS) and controls (ICC = 0.991, OD and 0.984, OS).

Conclusions

Foveal ONL thickness can be measured with excellent repeatability. While foveal ONL thickness is reduced in ACHM compared to controls, the high interocular symmetry indicates that contralateral ONL measurements could be used as a negative control in early-phase monocular treatment trials.
Hydrogen sulfide promotes nodulation and nitrogen fixation in soybean-rhizobia symbiotic system
Authors: Zou Hang , Zhang Ni-Na , Pan Qing , Zhang Jian-Hua , Chen Juan , Wei Ge-Hong
Published: July 2018

The rhizobium-legume symbiotic system is crucial for nitrogen cycle balance in agriculture. Hydrogen sulfide (H2S), a gaseous signaling molecule, may regulate various physiological processes in plants. However, whether H2S has regulatory effect in this symbiotic system remains unknown. Herein, we investigated the possible role of H2S in the symbiosis between soybean (Glycine max) and rhizobium (Sinorhizobium fredii). Our results demonstrated that exogenous H2S donor (sodium hydrosulfide, NaHS) treatment promoted soybean growth, nodulation and nitrogenase (Nase) activity. Western blotting analysis revealed that the abundance of nitrogenase component nifH was increased by NaHS treatment in nodules. Quantitative real-time PCR data showed that NaHS treatment up-regulated the expressions of symbiosis-related genesnodCandnodDofS. fredii. Besides, expression of soybean nodulation marker genes including early nodulin 40 (GmENOD40), ERF required for nodulation (GmERN), nodulation signaling pathway2b (GmNSP2b) and nodulation inception genes (GmNIN1a, GmNIN2aandGmNIN2b) were up-regulated. Moreover, the expressions of glutamate synthase (GmGS), nitrite reductase (GmNiR), ammonia transporter (GmSAT1), andnifHinvolved in nitrogen metabolism were up-regulated in NaHS-treated soybean roots and nodules. Together, our results suggested that H2S may act as a positive signaling molecule in soybean-rhizobia symbiotic system and enhance their nitrogen fixation ability.

Highlight

We demonstrated for the first time that H2S as a signaling molecule may promote the establishment of symbiotic relationship and nitrogen fixation ability in the soybean-rhizobia symbiotic system.
Basal forebrain and brainstem cholinergic neurons differentially impact amygdala circuits and learning-related behavior
Authors: Aitta-aho Teemu , Hay Y Audrey , Phillips Benjamin U. , Saksida Lisa M. , Bussey Tim J. , Paulsen Ole , Apergis-Schoute John
Published: July 2018

The central cholinergic system and the amygdala are important for motivation and mnemonic processes. Different cholinergic populations innervate the amygdala but it is unclear how these projections impact amygdala processes. Using optogenetic circuit-mapping strategies in ChAT-cre mice we demonstrate that amygdala-projecting basal forebrain and brainstem ChAT-containing neurons can differentially affect amygdala circuits and behavior. Photo-activating ChAT terminalsin vitrorevealed the underlying synaptic impact of brainstem inputs to the central lateral division to be excitatory, mediated via the synergistic glutamatergic activation of AMPA and NMDA receptors. In contrast, stimulating basal forebrain inputs to the basal nucleus resulted in endogenous ACh release resulting in biphasic inhibition-excitation responses onto principal neurons. Such response profiles are physiological hallmarks of neural oscillations and could thus form the basis of acetylcholine-mediated rhythmicity in amygdala networks. Consistent with this,in vivoNBm activation strengthened amygdala basal nucleus theta and gamma frequency rhythmicity, both of which continued for seconds after stimulation and were dependent on local muscarinic or nicotinic receptor activation, respectively. Activation of brainstem ChAT-containing neurons however resulted in a transient increase in central lateral amygdala activity that was independent of cholinergic receptors. In addition, driving these respective inputs in behaving animals induced opposing appetitive and defensive learning-related behavioral changes. Since learning and memory is supported by both cellular and network-level processes in central cholinergic and amygdala networks, these results provide a route by which distinct cholinergic inputs can convey salient information to the amygdala and promote associative biophysical changes that underlie emotional memories.
Three-component reaction between isatoic anhydride, amine and methyl-substituted furylacrylaldehydes: crystal structures of 3-benzyl-2-[(E)-2-(5-methylfuran-2-yl)vinyl]-2,3-dihydroquinazolin-4(1H)-one, 3-benzyl-2-[(E)-2-(furan-2-yl)-1-methylvinyl]-2,3-dihydroquinazolin-4(1H)-one and 3-(furan-2-ylmethyl)-2-[(E)-2-(furan-2-yl)-1-methylvinyl]-2,3-dihydroquinazolin-4(1H)-one
Authors: Zaytsev Vladimir P. , Sorokina Elena A. , Kvyatkovskaya Elisaveta A. , Toze Flavien A. A. , Mhaldar Shashank N. , Dorovatovskii Pavel V. , Khrustalev Victor N.
Published: July 2018

Compounds (I), C22H20N2O2, (II), C22H20N2O2 and (III), C20H18N2O3 are the products of three-component reactions between isatoic anhydride, the corresponding amine and 3-(5-methylfuran-2-yl)- or (furan-2-yl)-2-methylacrylaldehyde. Compound (I) crystallizes in the monoclinic space group P21/n, while compounds (II) and (III) are isostructural and crystallize in the orthorhombic space group Pbca. The tetrahydropyrimidine ring in (I)–(III) adopts a sofa conformation. The NH nitrogen atom has a trigonal–pyramidal geometry, whereas the N(R) nitrogen atom is flattened. The furyl-vinyl substituents in (I)–(III) are practically planar and have an E configuration at the C=C double bond. In (I), this bulky fragment occupies the axial position at the quaternary carbon atom of the tetrahydropyrimidine ring, whereas in (II) and (III) it is equatorially disposed. In the crystal of (I), molecules form hydrogen-bonded chains propagating along [001] by strong intermolecular N—H...O hydrogen bonds. The chains are packed in stacks along the a-axis direction. In the crystals of (II) and (III), molecules also form hydrogen-bonded chains propagating along [100] by strong intermolecular N—H...O hydrogen bonds. However, despite the fact that compounds (II) and (III) are isostructural, steric differences between the phenyl and furyl substituents result in chains with different geometries. Thus in the crystal of (II) the chains have a zigzag-like structure, whereas in the crystal of (III), they are almost linear. In both (II) and (III), the hydrogen-bonded chains are further packed in stacks along the b-axis direction.
Big data academic and learning analytics
Authors: Chaurasia Sushil S. , Kodwani Devendra , Lachhwani Hitendra , Ketkar Manisha Avadhut
Published: July 2018

Purpose

Although big data analytics (BDA) have great benefits for higher education institutions (HEIs), due to lack of sufficient evidence on how BDA investment can pay off, it is tough for HEIs practitioners to realize value from such adoption. The purpose of this paper is to propose a big data academic and learning analytics enabled business value model to explain BDA potential benefits and business value which can be obtained by developing such analytics capabilities in HEIs.

Design/methodology/approach

The study examined 47 case descriptions from 26 HEIs to investigate the causal association between the BDA current and potential benefits and business value creation path for big data academic and learning analytics success in HEIs.

Findings

The pressure of compliance with all legal and regulatory requirements and competition had pushed HEIs hard to adopt BDA tools. However, the study found out that application of risk and security and predictive analytics to higher education fields is still in its infancy. Using this theoretical model, the results provide new insights to higher education administrators on ways to create BDA capabilities for HEIs transformation and suggest an empirical foundation that can lead to more thorough analysis of BDA implementation.

Originality/value

A distinctive theoretical contribution of this study is its conceptualization of understanding business value from BDA in the typical setting of higher education. The study provides HEIs with an all-inclusive understanding of BDA and gives insights on how it helps to transform HEIs. The new perspectives associated with the big data academic and learning analytics enabled business value model will contribute to future research in this area.
Determinants of bank loan spread in project finance
Authors: Thierie Wouter , De Moor Lieven
Published: July 2018

Purpose

The purpose of this paper is to develop a better understanding of the pricing decisions of banks for project finance (PF) loans and the main drivers affecting the cost of debt in infrastructure deals. As infrastructure projects are typically highly leveraged, the cost of bank lending is an important driver of the overall funding costs for the project.

Design/methodology/approach

First, the paper provides a general review of the drivers of the cost of funds in PF. Second, the paper develops a regression analysis of the loan’s spread on four categories: project, loan, bank characteristics and the economic environment. By using a new data set of InfraDeals containing data on bank spreads of more than 700 infrastructure projects worldwide from 2006 to 2016.

Findings

The results show that the cost of debt is predominantly affected by the market and the business cycle, rather than the structuring of the project. This implicates that the timing when the deal is closed weighs more heavily than the specificities of the project itself.

Practical implications

The results have important policy implications. As PF deals are often paid for by taxpayers, this paper could help policymakers to use public funds for infrastructure in the most efficient way.

Originality/value

One weakness of existing studies in PF loan pricing is that they undervalue the role of the economic environment in the cost of debt. Few studies in the literature include macroeconomic control variables in their model and the others do not seem to find significant results. This paper reveals new insights on the pricing decisions of banks for PF loans.
Organizational cloud security and control: a proactive approach
Authors: Spanaki Konstantina , Gürgüç Zeynep , Mulligan Catherine , Lupu Emil
Published: July 2018

Purpose

The purpose of this paper is to unfold the perceptions around additional security in cloud environments by highlighting the importance of controlling mechanisms as an approach to the ethical use of the systems. The study focuses on the effects of the controlling mechanisms in maintaining an overall secure position for the cloud and the mediating role of the ethical behavior in this relationship.

Design/methodology/approach

A case study was conducted, examining the adoption of managed cloud security services as a means of control, as well as a large-scale survey with the views of IT decision makers about the effects of such adoption to the overall cloud security.

Findings

The findings indicate that there is indeed a positive relationship between the adoption of controlling mechanisms and the maintenance of overall cloud security, which increases when the users follow an ethical behavior in the use of the cloud. A framework based on the findings is built suggesting a research agenda for the future and a conceptualization of the field.

Research limitations/implications

One of the major limitations of the study is the fact that the data collection was based on the perceptions of IT decision makers from a cross-section of industries; however the proposed framework should also be examined in industry-specific context. Although the firm size was indicated as a high influencing factor, it was not considered for this study, as the data collection targeted a range of organizations from various sizes.

Originality/value

This study extends the research of IS security behavior based on the notion that individuals (clients and providers of cloud infrastructure) are protecting something separate from themselves, in a cloud-based environment, sharing responsibility and trust with their peers. The organization in this context is focusing on managed security solutions as a proactive measurement to preserve cloud security in cloud environments.
Pacing international acquisitions: emerging markets as the new success stories
Authors: Du Kui , Jaw Yuan-May
Published: July 2018

Purpose

The purpose of this paper is to investigate how to manage the pace of international expansion through acquisitions based on a case study of a Chinese conglomerate, Wanda Group.

Design/methodology/approach

The paper is a qualitative study based on the analyses of the series of international acquisitions made by Wanda Group in the global cinema and film studio markets from 2012 through the middle 2017. Comprehensive qualitative data have been collected from public sources, including company press releases, media reports and interviews, for each and every major acquisition made by Wanda during this period. The collected materials are then analyzed to reveal the patterns of Wanda’s serial acquisitions.

Findings

When expanding globally through acquisitions, firms need to carefully pace their different types of acquisitions; managing the speed of post-acquisition integration can be critical; and managing public relations and communications in host countries is also important.

Research limitations/implications

The research is limited to one single case, so the generalizability of its findings needs further validation. The research contributes to cross-border acquisition studies by discussing the pacing of acquisitions and their affiliated activities.

Practical implications

The research offers an example of how firms pace their series of international acquisitions, whose lessons are potentially transferrable to other global acquirers.

Originality/value

The research takes a rarely used angle by studying serial acquisitions as a whole and focuses on the pacing of them. It is one of the very few in the acquisition literature to highlight the temporal patterns among serial acquisition moves.
Lean Office contributions for organizational learning
Authors: Freitas Rodrigo de Castro , Freitas Maria do Carmo Duarte , Gomes de Menezes Glauco , Odorczyk Ricardo Siebenrok
Published: July 2018

Purpose

In organizational contexts, learning fosters the creation of knowledge at the individual and collective levels. In Lean Office, processes are customer oriented through continuous improvement and elimination of waste. In addition, Lean Office can promote changes in the corporate environment and drive organizational learning. Thus, the purpose of this paper is to identify and analyze the Lean Office factors that contribute to the organizational learning.

Design/methodology/approach

The method consists in a qualitative analysis of researches on Lean Office carried out in Brazil, based on the theoretical framework for analyzing organizational learning proposed by Argote and Miron-Spektor (2011). This framework defends the relevance of context and experience in knowledge conversion processes in organizations.

Findings

The study shows that Lean Office provides benefits for the learning process through Work Cells, Value Stream Mapping and Continuous Improvement. The effects of Lean Office are present in the organizational context, culture and behaviors, attitudes and skills of individuals.

Practical implications

This study brings for academics a discussion on Lean Office from the standpoint of elements pertaining to the organizational learning process. In this aspect, the study proposes treating the topic at a strategy level, striving to break out of the research boundaries that limit their scope to their operational results. For practitioners, the study introduces Lean Office factors that add positive results to the organizational learning process.

Originality/value

The paper presents a reflection of Lean Office in the field of organizational learning. In addition to the elimination of waste, the study investigates other functions in which Lean initiatives play a role, such as providing solutions for organizational problems and creating favorable learning contexts.
Two-sided form, differentiation and second-order observation in Escher’s artworks and Calvino’s stories
Authors: Appignanesi Laura
Published: July 2018

Purpose

The purpose of this paper is to find a leading idea of the mid-twentieth century, demonstrating the pervasive nature of some concepts belonging to second-order systems theory. To achieve this objective, the paper looks at the art and literature of this era, to identify the principles developed by Luhmann in his late works. In particular, Escher’s drawings, Calvino’s stories and Luhmann’s concepts seem to express, in different ways, the same functioning mechanism of the complex social system.

Design/methodology/approach

With reference to theoretical approach and methodology, this paper carries out an interdisciplinary demonstration by alternative modes of logos and mythos. Some of the pillars of general systems theory are examined through the logical articulation of concepts developed by Spencer-Brown, von Foerster, and first of all through the late works of Luhmann, as well as through the analysis of Escher’s artworks and Calvino’s literary works. This paper interprets these artistic and literary works using cybernetic principles and systemic concepts, in particular, “two-sided forms,” “system–environment differentiation” and “second-order observation.”

Findings

In general, the main finding is the similarity of fascination with paradoxes and forms, with post-ontological reasoning, in twentieth century. The result of the cross-reading of Escher, Calvino and Luhmann reveals the presence of what Simmel called the “hidden king”: a philosophical paradigm of an era. In mid-1900s, this leading idea seems to express itself in the discoveries of biology and cybernetics, such as in Luhmann’s theory, art and literature. Escher’s drawings, Calvino’s stories and the concepts of Luhmann are projections of second-order system theory, in its constructivist value.

Originality/value

The originality of this paper lies mainly in the demonstration of theoretical concepts through the alternative modes of logos and mythos. These reflections can provide a new perspective to investigate social sciences from a cultural angle. This particular approach allows a deep awareness of the theory. The concrete value is to provide a better understanding to manage complexity.
Development of performance management system incorporating dual perspectives of enterprise and customers’
Authors: Yadav Neetu , Sushil Sushil , Bititci Umit Sezer
Published: July 2018

Purpose

Performance measurement and management (PMM) literature is highly abundant with numerous PMM frameworks encapsulating various aspects of enterprise performance that are largely driven by enterprise viewpoint. Considering dynamic nature of Indian telecom industry where customers hold high bargaining power in the industry, flexible strategy game-card has been adopted as a theoretical basis. The purpose of this study is to capture an “outside-in view” of enterprise performance by incorporating performance measurement from customers’ perspective and highlight dual perspectives of performance, i.e. enterprise and customers’.

Design/methodology/approach

Rigorous empirical data analysis tools have been used on the data collated through opinion survey to develop strategic performance management model for Indian telecom service providers where mediation effects of customers’-based strategic factors have also been captured.

Findings

The findings emphasize the fact that financial performance indicators are outcome variables that are driven by the external environment, internal organizational structure and business processes. An effective performance management system (PMS) should consist enabling performance indicators (customers’ perspective) in addition to leading and lagging performance indicators that are widely discussed in the literature.

Research limitations/implications

The set of performance indicators identified is in the context of Indian telecom service operators, which should be used in another context with full caution. The generalization of the empirically validated strategic performance management model in other country context is limited. However, the process of development of PMS could be taken as an example to replicate in any other context.

Originality/value

Measuring an enterprise performance from customers’ perspective is the major contribution of this study. With the diverse set of performance indicators, effective PMS can be developed and deployed where tangible measures act as lagging indicators, namely, situational and operational, strategic measures act as leading indicators, and subscribers’ crucial assessment measures act as enabling indicators.
International terrorism as a threat to student mobility
Authors: Dostál Jakub , Chalupová Martina , Černá Martina , Prokop Martin
Published: July 2018

Purpose

International terrorism affects various areas of society. This paper aims to determine whether fear of terrorism is a barrier to international student mobility based on the opinions of representatives from four universities of the European International Business Week network.

Design/methodology/approach

Data were obtained through interviews with representatives of four universities. Two universities are located in relatively “safe” countries (Czech Republic and Finland), whereas the other two are located in countries recently hit by terrorist attacks (Brussels and Paris). The interviews were conducted between December 2016 and April 2017.

Findings

Terrorist attacks affected international student mobility in the two universities recently hit by terrorist attacks.

Research limitations/implications

The research findings are relatively significant because they show how terrorist attacks can influence international student mobility. However, data are still limited. Data from other universities are necessary to verify causality.

Practical implications

The internationalisation of higher education is a strategic goal for many higher education institutions (HEIs). However, international terrorism may affect this goal. Understanding the impact of terrorism can be valuable in preparing policies for promoting the internationalisation of HEI.

Social implications

International terrorism is increasingly an issue for many people and organisations, including HEI. Understanding how terrorism affects economies and societies can be crucial for policymakers and for citizens living in or visiting areas endangered by terrorism.

Originality/value

The paper describes the immediate impact of two terrorist attacks on international student mobility. The paper presents the fear of terrorist attacks and the shock caused by terrorism as major barriers to international student mobility.
Graduates in/for a multicultural and globalising world
Authors: Killick David
Published: July 2018

Purpose

This paper aims to question the terminology, modelling and vagueness surrounding the notion of “global citizen” and argues for the more holistic construct of global selfhood as a legitimate goal for graduates who must make their way in a multicultural and globalising world.

Design/methodology/approach

This paper draws upon established education and global citizenship theories to present a model of global graduate attributes. Using this theoretical model, practice implications for learning and teaching in higher education are presented.

Findings

This paper proposes some radical transformations to current practice.

Practical implications

Proposals within the paper offer academics and academic developers tools for reflection on and transformation of practice.

Originality/value

This paper takes forward the often reductive construct of “global citizen” and demonstrates how a more holistic notion of global self can be applied to higher education and graduate outcomes.
Hearing narrative voices of Filipino social enterprise employees
Authors: Caringal-Go Jaimee Felice , Canoy Nico A.
Published: July 2018

Purpose

The purpose of this paper is to explore the personal and contextual factors that shape the work experiences of Filipino social enterprise employees by listening to voices within their narratives.

Design/methodology/approach

In total, 11 social enterprise employees were interviewed about their work experiences. Using the Listening Guide as a method of analysis, common themes and the multiple voices within the narratives were identified.

Findings

Upon analysis, four stories were identified: stories of serving others, stories of providing for family, stories of managing relationships and stories of personal learning. Results show that the experiences and multiple identities of employees evoke the duality and hybridity that characterizes social enterprise organizations. The importance of relationships in collectivist cultures, and the salience of the indigenous concept of kapwa are also discussed.

Research limitations/implications

The use of narratives, and particularly, of voices within narratives as a critical tool to study work experiences is highlighted. Generalizability of results may be limited by contextual factors, such as organization type and country culture.

Originality/value

In this study, the narratives of social enterprise workers from different positions were explored. The voices within their narratives were analyzed and used as a means to understand how they viewed the self, others, and their work in social enterprises embedded in collectivist and developing country contexts.
Main dimensions that impact knowledge management and university-business-government collaboration in the Brazilian scenario
Authors: Ribeiro Suzana Xavier , Nagano Marcelo Seido
Published: July 2018

Purpose

The purpose of this paper is to investigate how certain characteristics of the university–industry–government collaboration facilitate knowledge creation and management, hence innovation focusing on particularities of the Brazilian scenario.

Design/methodology/approach

As a conceptual basis, there are correlations between theories of knowledge management and the Triple Helix, a model referenced to university–industry–government cooperation. The research was conducted through a multiple case study at two National Institutes of Science and Technology (INCTs in Portuguese).

Findings

The main results show the importance of participation in the INCT program, as it enables the creation of an organizational structure with the coordinator’s leadership, who directs the flow of knowledge among organizations and stimulates innovation.

Originality/value

The choice of the topic is justified by the lack of studies on the identification and analyses of the main aspects of this type of collaboration in an integrated way.
European Union tourism policy: an institutional theory critical discourse analysis
Authors: Estol Judith , Camilleri Mark Anthony , Font Xavier
Published: July 2018

Purpose

This research uses the institutional theory perspective to better understand the social dynamics of the European Union (EU) tourism policy and its directions. The purpose of this paper is to critically evaluate the processes, content and outcomes of EU tourism policy.

Design/methodology/approach

A thorough literature review involving a critical discourse analysis on the regulative, normative and cultural elements of institutionalisation improves our understanding of the EU policy, in terms of its processes, content and outcomes. Therefore, this paper explores how the European institutions have incrementally legitimised tourism policy among Member States.

Findings

Over the years, the EU’s policies were intended to enhance the European single market whilst supporting the growth of the industrial competitiveness, sustainable innovation and entrepreneurship. This has inevitably led to the development of new policies in the realms of tourism.

Originality/value

This contribution has identified a gap in academic research, as it reports about the evolution of EU tourism policy and on the conditions of how it has been planned, organised and implemented. It also exposes the challenges of institutionalising tourism policy in intergovernmental institutions.
Patients admitted via the emergency department to the intensive care unit: An observational cohort study
Authors: Crilly Julia , Sweeny Amy , O'Dwyer John , Richards Brent , Green David , Marshall Andrea P
Published: July 2018

Objective

Timely and appropriate assessment and management within the ED impacts patient outcomes including in‐hospital mortality and length of stay (LOS). Within the ED, several processes facilitate timely recognition of the need for intensive care unit (ICU) admission. This study describes characteristics and outcomes for patient presentations admitted to ICU from ED, categorised by Australasian Triage Score (ATS), ICU admission time and ICU admission source.

Methods

A retrospective observational cohort study with linked health data of adult ICU admissions during 2012. Outcomes measured included: ED, ICU and hospital LOS, time to see ED clinician, ICU readmission and ICU and hospital mortality rates.

Results

In total, 423 ICU admissions occurred within 24 h of ED arrival; 395 were admitted directly to ICU; 28 were admitted to the ward before ICU admission. ATS 3/4/5 patients comprised 26.7% of ICU admissions and experienced longer waits to be seen, longer total ED LOS, shorter ICU LOS and a lower mortality rate than those triaged ATS 1/2. Compared to ICU admissions during business hours, admissions outside hours did not differ significantly for any outcome measured. Patients admitted to the ward before ICU experienced longer waits to be seen and longer ED LOS.

Conclusion

Most patients are appropriately identified in ED as requiring ICU admission, although around one in four were triaged ATS 3/4. Patients admitted to the ward first tended to have poorer outcomes than those directly admitted to ICU. Factors predicting the need for ICU admission should be identified to support clinical decision‐making.
Editorial: post‐operative complications in elderly onset inflammatory bowel disease—what is surgery, what is disease, and what is delay of surgery?
Authors: Myrelid P.
Published: July 2018

Linked Content

This article is linked to Sacleux et al and Savoye et al papers. To view these articles visit https://doi.org/10.1111/apt.14790 and https://doi.org/10.1111/apt.14854.
Exosome‐mediated regulation of tumor immunology
Authors: Seo Naohiro , Akiyoshi Kazunari , Shiku Hiroshi
Published: July 2018

Exosomes are representative extracellular vesicles (EV) derived from multivesicular endosomes (MVE) and have been described as new particles in the communication of neighborhood and/or distant cells by serving as vehicles for transfer between cells of membrane and cytosolic proteins, lipids, and nucleotides including micro (mi) RNAs. Exosomes from immune cells and tumor cells act in part as a regulator in tumor immunology. CD8+ T cells that show potent cytotoxic activity against tumor cells reside as an inactive naïve form in the T‐cell zone of secondary lymphoid organs. Once receiving tumor‐specific antigenic stimulation by dendritic cells (DC), CD8+ T cells are activated and differentiated into effector CTL. Subsequently, CTL circulate systemically, infiltrate into tumor lesions through the stromal neovasculature where mesenchymal stromal cells, for example, mesenchymal stem cells (MSC) and cancer‐associated fibroblasts (CAF), abundantly exist, destroy mesenchymal tumor stroma in an exosome‐mediated way, go into tumor parenchyma, and attack tumor cells by specific interaction. DC‐derived and regulatory T (Treg) cell‐derived exosomes, respectively, promote and inhibit CTL generation in this setting. In this review, we describe the roles of exosomes from immune cells and tumor cells on the regulation of tumor progression.
Individuals with obesity but no other metabolic risk factors are not at significantly elevated all‐cause mortality risk in men and women
Authors: Kuk J. L. , Rotondi M. , Sui X. , Blair S. N. , Ardern C. I.
Published: July 2018

Studies have examined mortality risk for metabolically healthy obesity, defined as zero or one metabolic risk factors but not as zero risk factors. Thus, we sought to determine the independent mortality risk associated with obesity or elevated glucose, blood pressure or lipids in isolation or clustered together. The sample included 54 089 men and women from five cohort studies (follow‐up = 12.8 ± 7.2 years and 4864 [9.0%] deaths). Individuals were categorized as having obesity or elevated glucose, blood pressure or lipids alone or clustered with obesity or another metabolic factor. In our study sample, 6% of individuals presented with obesity but no other metabolic abnormalities. General obesity (hazard ratios [HR], 95% CI = 1.10, 0.8–1.6) and abdominal obesity (HR = 1.24, 0.9–1.7) in the absence of metabolic risk factors were not associated with mortality risk compared to lean individuals. Conversely, diabetes, hypertension and dyslipidaemia in isolation were significantly associated with mortality risk (HR range = 1.17–1.94, P < 0.05). However, when using traditional approaches, obesity (HR = 1.12, 1.02–1.23) is independently associated with mortality risk after statistical adjustment for the other metabolic risk factors. Similarly, metabolically healthy obesity, when defined as zero or one risk factor, is also associated with increased mortality risk (HR = 1.15, 1.01–1.32) as compared to lean healthy individuals. Obesity in the absence of metabolic abnormalities may not be associated with higher risk for all‐cause mortality compared to lean healthy individuals. Conversely, elevation of even a single metabolic risk factor is associated with increased mortality risk.
Position paper: Telemedicine in occupational dermatology – current status and perspectives
Authors: Elsner Peter , Bauer Andrea , Diepgen Thomas Ludwig , Drexler Hans , Fartasch Manigé , John Swen Malte , Schliemann Sibylle , Wehrmann Wolfgang , Tittelbach Jörg
Published: July 2018

Teledermatology is the use of telecommunication technologies to exchange medical information for diagnosis, consultation, treatment and teaching in dermatology. While its use has been evaluated in a wide range of dermatological diagnoses, only few studies exist on its validity, diagnostic precision, feasibility, and cost‐effectiveness in occupational dermatology. However, these studies show a considerable potential for diagnosis, prevention, treatment support and follow‐up of patients with occupational skin diseases. Asynchronous (store and forward; SAF) or synchronous dermatology teleconsults could assist occupational medicine specialists not only in occupational preventive care, but also in the context of skin cancer screening in outdoor workers. Thus, teledermatology might contribute to earlier prevention and notification of occupational skin diseases. Modern smartphone apps with artificial intelligence technologies may also facilitate self‐monitoring in employees working in high‐risk jobs.
Spatial modelling with Euclidean distance fields and machine learning
Authors: Behrens T. , Schmidt K. , Viscarra Rossel R. A. , Gries P. , Scholten T. , MacMillan R. A.
Published: July 2018

This study introduces a hybrid spatial modelling framework, which accounts for spatial non‐stationarity, spatial autocorrelation and environmental correlation. A set of geographic spatially autocorrelated Euclidean distance fields (EDF) was used to provide additional spatially relevant predictors to the environmental covariates commonly used for mapping. The approach was used in combination with machine‐learning methods, so we called the method Euclidean distance fields in machine‐learning (EDM). This method provides advantages over other prediction methods that integrate spatial dependence and state factor models, for example, regression kriging (RK) and geographically weighted regression (GWR). We used seven generic (EDFs) and several commonly used predictors with different regression algorithms in two digital soil mapping (DSM) case studies and compared the results to those achieved with ordinary kriging (OK), RK and GWR as well as the multiscale methods ConMap, ConStat and contextual spatial modelling (CSM). The algorithms tested in EDM were a linear model, bagged multivariate adaptive regression splines (MARS), radial basis function support vector machines (SVM), Cubist, random forest (RF) and a neural network (NN) ensemble. The study demonstrated that DSM with EDM provided results comparable to RK and to the contextual multiscale methods. Best results were obtained with Cubist, RF and bagged MARS. Because the tree‐based approaches produce discontinuous response surfaces, the resulting maps can show visible artefacts when only the EDFs are used as predictors (i.e. no additional environmental covariates). Artefacts were not obvious for SVM and NN and to a lesser extent bagged MARS. An advantage of EDM is that it accounts for spatial non‐stationarity and spatial autocorrelation when using a small set of additional predictors. The EDM is a new method that provides a practical alternative to more conventional spatial modelling and thus it enhances the DSM toolbox.

Highlights

We present a hybrid mapping approach that accounts for spatial dependence and environmental correlation.

The approach is based on a set of generic Euclidean distance fields (EDF).

Our Euclidean distance fields in machine learning (EDM) can model non‐stationarity and spatial autocorrelation.

The EDM approach eliminates the need for kriging of residuals and produces accurate digital soil maps.
Disentangling seasonal and interannual legacies from inferred patterns of forest water and carbon cycling using tree‐ring stable isotopes
Authors: Szejner Paul , Wright William E. , Belmecheri Soumaya , Meko David , Leavitt Steven W. , Ehleringer James R. , Monson Russell K.
Published: July 2018

Tree‐ring carbon and oxygen isotope ratios have been used to understand past dynamics in forest carbon and water cycling. Recently, this has been possible for different parts of single growing seasons by isolating anatomical sections within individual annual rings. Uncertainties in this approach are associated with correlated climate legacies that can occur at a higher frequency, such as across successive seasons, or a lower frequency, such as across years. The objective of this study was to gain insight into how legacies affect cross‐correlation in the δ13C and δ18O isotope ratios in the earlywood (EW) and latewood (LW) fractions of Pinus ponderosa trees at thirteen sites across a latitudinal gradient influenced by the North American Monsoon (NAM) climate system. We observed that δ13C from EW and LW has significant positive cross‐correlations at most sites, whereas EW and LW δ18O values were cross‐correlated at about half the sites. Using combined statistical and mechanistic models, we show that cross‐correlations in both δ13C and δ18O can be largely explained by a low‐frequency (multiple‐year) mode that may be associated with long‐term climate change. We isolated, and statistically removed, the low‐frequency correlation, which resulted in greater geographical differentiation of the EW and LW isotope signals. The remaining higher‐frequency (seasonal) cross‐correlations between EW and LW isotope ratios were explored using a mechanistic isotope fractionation–climate model. This showed that lower atmospheric vapor pressure deficits associated with monsoon rain increase the EW‐LW differentiation for both δ13C and δ18O at southern sites, compared to northern sites. Our results support the hypothesis that dominantly unimodal precipitation regimes, such as near the northern boundary of the NAM, are more likely to foster cross‐correlations in the isotope signals of EW and LW, potentially due to greater sharing of common carbohydrate and soil water resource pools, compared to southerly sites with bimodal precipitation regimes.
Densification kinetics of boron carbide with medium entropy alloy as a sintering aid during spark plasma sintering
Authors: Zhang Mei , Feng Xiao , Yuan Tiechui , Li Ruidi
Published: July 2018

The high sintering temperature of pure B4C considerably limits its widespread application, thus searching an effective sintering aid is critical. In this work, B4C‐based ceramic with 1 vol.% nonequiatomic Fe50Mn30Co10Cr10 medium entropy alloy as a sintering aid were fabricated at 1900‐2000°C by spark plasma sintering (SPS) under applied pressure, and their mechanical properties were examined and compared with pure B4C ceramic sintered at same condition. The maximal flexural strength of 255.59 MPa, microhardness of 2297.6 Hv0.2 and fracture toughness of 3.62 MPa m1/2 could be obtained at optimized SPS pressure of 50 MPa, which were all higher than those of pure B4C ceramic. To better understand the densification kinetics mechanisms, the densification ratio as a function of SPS temperature and pressure was theoretically analyzed using steady creep model. It was found that densification controlled by grain‐boundary sliding at lower pressure transferred to power law creep regime at higher pressure, which were proved by the dislocation net shown in transmission electron microscopy image.
Silicon oxycarbide glasses and glass‐ceramics: “All‐Rounder” materials for advanced structural and functional applications
Authors: Stabler Christina , Ionescu Emanuel , Graczyk‐Zajac Magdalena , Gonzalo‐Juan Isabel , Riedel Ralf
Published: July 2018

Silicon oxycarbides can be considered as being carbon‐containing silicates consisting of glass networks in which oxygen and carbon share bonds with silicon. The carbon‐for‐oxygen substitution in silicate glass networks has been shown to induce significant changes in the network connectivity and consequently strong improvements in the properties of the silicate glass network. For instance, SiOC glasses exhibit Young's moduli, hardness values, glass transition, and crystallization temperatures which are superior to those of vitreous silica. Moreover, the silicon oxycarbide glass network exhibits unique structural features such as reduced mass fractal dimension and nano‐heterogeneity, which significantly affect and/or dictate its properties and behavior. In the present Review, a consideration of the current state of the art concerning the synthesis, processing, and various structural and functional properties of silicon‐oxycarbide‐based glasses and glass‐ceramics is done. Thus, the synthesis of silicon oxycarbides starting from macromolecular precursors such as polysiloxanes or alkoxysilanes‐based sol‐gel systems as well as current advances related to their processing will be critically reviewed. In addition, various structural and functional properties of silicon oxycarbides are presented. Specific emphasis will be put on the intimate correlation between the molecular architecture of the precursors and the structural features and properties of the resulting silicon oxycarbides.
ASK1 inhibitor treatment suppresses p38/JNK signalling with reduced kidney inflammation and fibrosis in rat crescentic glomerulonephritis
Authors: Amos Liv A. , Ma Frank Y. , Tesch Greg H. , Liles John T. , Breckenridge David G. , Nikolic‐Paterson David J. , Han Yingjie
Published: July 2018

Activation of p38 mitogen‐activated protein kinase (MAPK) and c‐Jun amino terminal kinase (JNK) is prominent in human crescentic glomerulonephritis. p38 and JNK inhibitors suppress crescentic disease in animal models; however, the upstream mechanisms inducing activation of these kinases in crescentic glomerulonephritis are unknown. We investigated the hypothesis that apoptosis signal‐regulating kinase 1 (ASK1/MAP3K5) promote p38/JNK activation and renal injury in models of nephrotoxic serum nephritis (NTN); acute glomerular injury in SD rats, and crescentic disease in WKY rats. Treatment with the selective ASK1 inhibitor, GS‐444217 or vehicle began 1 hour before nephrotoxic serum injection and continued until animals were killed on day 1 (SD rats) or 14 (WKY rats). NTN resulted in phosphorylation (activation) of p38 and c‐Jun in both models which was substantially reduced by ASK1 inhibitor treatment. In SD rats, GS‐444217 prevented proteinuria and glomerular thrombosis with suppression of macrophage activation on day 1 NTN. In WKY rats, GS‐444217 reduced crescent formation, prevented renal impairment and reduced proteinuria on day 14 NTN. Macrophage activation, T‐cell infiltration and renal fibrosis were also reduced by GS‐444217. In conclusion, GS‐444217 treatment inhibited p38/JNK activation and development of renal injury in rat NTN. ASK1 inhibitors may have therapeutic potential in rapidly progressive glomerulonephritis.