bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tourism planning: impacts as benchmarks for sustainable development plans
Authors: Salazar Ana , Cardoso Carla 
Published: November 2019

Purpose
The purpose of this paper is to provide a comprehensive list of indicators to be used in the tourism sector, in support of the development of sustainable strategic plans. Specific objectives include making a comprehensive assessment and categorization of those indicators and facilitating an easier to use system that guarantees the use of those benchmarks as a base for objectives definition and performance standards monitorization.

Design/methodology/approach
This research adopted a descriptive design using secondary data. The data was analysed using content analysis and a posteriori categorization system, resulting in 87 indicators divided into positive and negative within six categories.

Findings
The results showed that there are six key factors that may have a significant impact on tourism development suggesting they could be used for setting objectives and performance indicators when developing a strategic plan, and therefore, ensuring the sustainability of a destination and its stakeholders.

Practical implications
The framework adopted in this study offers a practical tool to be used by destination and organizations planners to improve sustainable tourism performance in relation to economic, socio-cultural, psychological, political/administrative, tourism/commercial and environmental/physical measurement standards. This guidance may help decision-makers to design, manage and control sustainable strategic plans in a more effective way.

Originality/value
This paper links the academic debate on the impacts of tourism with the designing and implementation of sustainable tourism policies and strategies.
Sustainable destination management: a commitment for the future of world tourism
Authors: Guerreiro Marta 
Published: November 2019

Purpose
This paper aims to highlight the importance of implementing practices that enable sustainable economic, social, cultural and environmental development to tourism worldwide. In particular, reference is made to the Portuguese archipelago of the Azores, highlighting its certification process as an ongoing sustainable destination.

Design/methodology/approach
It contains an analysis of supply and demand statistics in the Azores and a characterization of policies and strategic positioning plans as an active destination and an explanation of the various steps of the certification process.

Findings
Through statistical analysis of the various planning instruments in the Azores, it is possible to understand the strategies of regional government in streamlining the economy without neglecting concerns about safeguarding the environmental heritage and the quality of life of inhabitants.

Originality/value
Through a local approach to a global issue, this paper presents the Azores as a destination and its path toward becoming one of the most sustainable regions in the world.
Mass ratio effects underlie ecosystem responses to environmental change
Authors: Smith Melinda D. , Koerner Sally E. , Knapp Alan K. , Avolio Meghan L. , Chaves Francis A. , Denton Elsie M. , Dietrich John , Gibson David J. , Gray Jesse , Hoffman Ava M. , Hoover David L. , Komatsu Kimberly J. , Silletti Andrea , Wilcox Kevin R. , Yu Qiang , Blair John M. 
Published: November 2019

Abstract

Random species loss has been shown experimentally to reduce ecosystem function, sometimes more than other anthropogenic environmental changes. Yet, controversy surrounds the importance of this finding for natural systems where species loss is non‐random.

We compiled data from 16 multi‐year experiments located at a single native tallgrass prairie site. These experiments included responses to 11 anthropogenic environmental changes, as well as non‐random biodiversity loss either the removal of uncommon/rare plant species or the most common (dominant) species.

As predicted by the mass ratio hypothesis, loss of a dominant species had large impacts on productivity that were comparable to other anthropogenic drivers. In contrast, the loss of uncommon/rare species had small effects on productivity despite having the largest effects on species richness.

The anthropogenic drivers that had the largest effects on productivity nitrogen, irrigation, and fire experienced not only loss of species but also significant changes in the abundance and identity of dominant species.

Synthesis. These results suggest that mass ratio effects, rather than species loss per se, are an important determinant of ecosystem function with environmental change.
The Impact of Lean Management Practices and Sustainably‐Oriented Innovation on Sustainability Performance of Small and Medium‐Sized Enterprises: Empirical Evidence from the UK
Authors: Dey Prasanta Kumar , Malesios Chrisovalantis , De Debashree , Chowdhury Soumyadeb , Abdelaziz Fouad Ben 
Published: November 2019

AbstractWhile lean management practices (LMP) help small and medium‐sized enterprises (SMEs) to be efficient, sustainability‐oriented innovation (SOI) facilitates adopting environmental and social practices. Although prior research looks into the effect of LMP on the economic performance (EP) of SMEs, less is known about the effect of LMP on sustainability (economic, environmental and social) performance. Studies on the effect of SOI on sustainability and economic performance are also scant. Additionally, examining the mediating effect of corporate social responsibility (CSR) practices (environmental and social practices) on both LMP and SOI achieving sustainability performance (SP) is rare. This research bridges these knowledge gaps by answering the question of how LMP, SOI, CSR practices, sustainability and economic performance are correlated. Through hypothesis testing using structural equation modelling, this study reveals the impact of LMP, SOI, CSR (environmental and social) practices on sustainability and economic performance. The study uses data from 119 SMEs within manufacturing industries in the Midlands, UK. The analysis reveals that LMP and SOI facilitate achieving both sustainability and economic performance, and SOI mediates LMP to achieve sustainability performance. Additionally, although CSR practices mediate LMP to achieve sustainability performance, they only borderline mediate SOI to achieve sustainability performance.
Frequent intoxication and alcohol tolerance in adolescence: associations with psychiatric disorders in young adulthood
Authors: Sarala Marian , Miettunen Jouko , Koskela Jari , Mustonen Antti , Rose Richard J. , Hurtig Tuula , Veijola Juha , Niemelä Solja 
Published: November 2019

AbstractAimsTo assess the associations of intoxication frequency and number of drinks needed to become intoxicated in mid‐adolescence with onset of psychiatric disorders in early adulthood.Design, Setting and ParticipantsProspective cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986 who self‐reported adolescent alcohol use: 6548 subjects (69.4% of the original sample). Data on alcohol use were collected using questionnaires at ages 15–16 years.MeasurementsOutcomes were any non‐organic psychosis, mood disorder, anxiety disorder, any substance use disorder (SUD) and all the studied psychiatric disorders in early adulthood gathered from nation‐wide health care, pension and insurance registers. Number of drinks needed to become intoxicated was categorized into three classes: (1) no alcohol use or intoxication, and (2) low and (3) high alcohol tolerance (more than seven/nine drinks for females/males) groups. Similarly, intoxication frequency was divided into three classes: (1) never, (2) one to two times and (3) three or more times during the past 30 days. Information regarding gender, family type, other drug use, psychopathology using Youth Self‐Report (YSR) total score and parental psychiatric disorders were used as covariates.FindingsIn the multivariable analyses, both low [odds ratio (OR) = 3.0, 95% confidence interval (CI) = 1.3–6.7, P‐value = 0.009] and high (OR = 4.4, 95% CI = 1.8–11.1, P‐value = 0.001) alcohol tolerance were associated with increased risk of SUD. More frequent intoxication was associated with increased frequency of SUD (OR = 3.9, 95% CI = 2.0–7.3, P‐value < 0.001) and mood disorder (OR = 1.6, 95% CI = 1.1–2.3, P‐value = 0.008). The latter was attenuated after adjusting with concurrent psychopathology (YSR) and other drug use.ConclusionsBoth higher alcohol tolerance and frequent intoxication in adolescence appear to be associated with increased risk of future substance use disorder.
Association study of the single‐nucleotide polymorphisms −3971G/A and +276G/T in the adiponectin gene with type 2 diabetes in a North Indian Punjabi population
Authors: Bains Veena , Kaur Harjit , Badaruddoza  
Published: November 2019

AbstractObjectiveTo investigate the role of ADIPOQ gene variants (−3971G/A rs822396 and +276G/T rs1501299) with type 2 diabetes risk in a North Indian Punjabi population.MethodsAdiponectin is one of the most abundant circulating adipocytokines in the human body that plays an important role in the metabolic processes and positively regulates energy homeostasis and insulin secretion. Several studies have provided the evidence of adiponectin gene polymorphisms association with type 2 diabetes mellitus (T2DM) in different ethnic populations. A total of 616 subjects including 316 T2DM patients and 300 normal healthy controls from Punjab were genotyped for ADIPOQ polymorphisms (rs822396 and rs1501299) by using a polymerase chain reaction–based restriction fragment length polymorphism (PCR‐RFLP) technique. Anthropometric, physiometric, and biochemical measurements were taken from each participant.ResultsGenotypic frequencies were significantly different in T2DM subjects and healthy controls for both polymorphisms (rs822396 and rs1501299). The risk genotype GG of −3971A/G and TT of +276G/T conferred an approximately twofold risk towards the development of T2DM and were found to be significantly higher in T2DM cases than control subjects (p = 0.006 and p = 0.019, respectively, after the Bonferroni correction). The recessive model of the ADIPOQ polymorphism rs822396 was significantly shown to confer a 3.63‐fold risk towards type 2 diabetes after adjusting for confounding factors and Bonferroni correction [odds ratio (OR): 3.63 (1.20–10.96), p = 0.022]. rs1501299 gave a 3.82‐fold risk towards development of T2DM but was not statistically significant after Bonferroni correction [OR: 3.82 (1.16–12.55), p = 0.027]. Meta‐analysis also illustrated the overall effect of the minor allele of rs822396 (−3971A/G) polymorphism, providing a greater risk for the T2DM development.ConclusionThus, we concluded on the basis of observed results that the ADIPOQ gene polymorphisms rs822396 and rs1501299 plays an important role in the development of type 2 diabetes in North Indian Punjabi population.
Muslim mothers mainly saw circumcision in terms of religion or tradition but wanted it to be carried out medical professionals
Authors: Altunkol Adem , Abat Deniz , Topuz Ayşe Nur , Alma Ergün , Gürbüz Zafer Gökhan , Verit Ayhan 
Published: November 2019

AbstractAimThis study assessed the relationship between the education level of Muslim Turkish mothers whose sons had been circumcised and their views on circumcision.MethodsInterviews based on 20 close‐ended questions were carried out in the Çukurova region of southern Turkey between June 2015 and September 2016. The participants were 1497 Muslim Turkish mothers whose sons had been circumcised and who were recruited using convenience sampling in schools, hospitals and public spaces.ResultsMost (82%) of the mothers saw circumcision as a religious and traditional requirement, 64% mentioned the health benefits and 48% mentioned cosmetic appearance. The majority (80%) were performed by health organisations, with two‐thirds (66%) expressing this preference. Most circumcisions were at school age (38%), which was about 6 years of age plus at the time of the study, and there were no complications in 79% of cases. Higher education levels were associated with views that circumcision was an important surgical procedure, it decreased the risk of urinary tract infections, it should be performed in hospitals and the foreskin did not prevent sexual intercourse.ConclusionCircumcision was mainly seen as a religious and traditional ritual, and more highly educated Turkish Muslim mothers were better informed about the health aspects.
In silico screening and surface plasma resonance‐based verification of programmed death 1‐targeted peptides
Authors: Zhang Pengli , Li Chengping , Ji Xiaoyue , Gao Mingjie , Lyu Sifan , Dai Xiaojun , Du Jiangfeng 
Published: November 2019

AbstractProgrammed death 1 (PD‐1) is a key immune checkpoint molecule. When it binds to programmed death‐ligand 1 (PD‐L1), it can negatively regulate the immune response. Therefore, blockade of the PD‐1/PD‐L1 interaction could unleash the power of immune system. Though successes achieved by anti‐PD‐1/PD‐L1 antibody drugs in clinical for various cancers, many intrinsic limitations of the high molecular weight drugs require alternatives such as peptide drugs and chemical compounds. In this study, we described a novel in silico approach which was used to screen peptides from PDB database and aimed to identify peptides that have potential to bind the PD‐L1 binding area of PD‐1 molecule. Based on the docking poses, eight peptides were synthesized and measured for their binding abilities by surface plasma resonance technique. The KD values of the synthesized peptides ranged from 10.0 to 133.0 μM. Furthermore, the binding mechanism between PD‐1 and the peptides was studied. In conclusion, we established a fast and reliable screening method for peptide discovery, which could be applied for identifying peptide inhibitors of various targets. The synthesized peptides could be served as starting points for designing PD‐1 drug for cancer immunotherapy.
Relationship between changes in motor capacity and objectively measured motor performance in ambulatory children with spastic cerebral palsy
Authors: Halma Elisabeth , Bussmann Johannes Bernardus Josephus , van den Berg‐Emons Hendrika Johanna Gerarda , Sneekes Emanuel Maria , Pangalila Robert , Schasfoort Fabienne Carmen ,   On behalf of the SPACE BOP study group
Published: November 2019

AbstractBackgroundDifferent interventions are offered to children with cerebral palsy (CP) to improve the activity domain of the international classification of functioning (ICF). In therapy settings, the focus is mostly on motor capacity, but the ultimate goal is to improve motor performance. We therefore examined if changes in motor capacity outcomes are accompanied by changes in objectively measured motor performance after a 3‐month intensive treatment period in ambulatory children with CP.MethodsA secondary analysis on prospective clinical trial data was performed using multivariate linear regression. Sixty‐five children (37 boys and 28 girls) with spastic CP, mean age 7 years and 3 months, Gross Motor Function Classification System (GMFCS) levels I–III were involved in a distinct 3‐month intensive treatment period. Motor capacity (Gross Motor Function Measure [GMFM], functional muscle strength [FMS], and walking speed [WS]) and motor performance (using three Actigraph‐GT3X+‐derived outcome measures) were measured at baseline, 12 and 24 weeks.ResultsNo significant associations were found for any of the change scores (∆12) between motor capacity and motor performance after a 12‐week intensive treatment period. After 24 weeks, ∆24FMS (p = .042) and ∆24WS (p = .036) were significantly associated with changes in motor performance outcome measure percentage of time spent sedentary (∆24%sedentary). In this model, 16% of variance of ∆24%sedentary was explained by changes in motor capacity (p = .030).ConclusionsChanges in motor capacity are mostly not accompanied by changes in objectively measured motor performance after an intensive treatment period for ambulatory children with CP. These findings should be taken into account during goal setting and are important to manage expectations of both short‐ and longer term effects of treatment programmes.
Our experience of a paediatrician‐led clinic for the medical management of children with obstructive sleep‐disordered breathing
Authors: Kubba Haytham , Rowe Katherine , Pinczower Gideon , Sloane Robert , Waterham Michelle , Weiss Emma , Harwood Rachel 
Published: November 2019

AbstractBackgroundObstructive sleep‐disordered breathing (OSDB) is very common in children. Adenotonsillectomy is usually curative, but there is emerging evidence that topical nasal steroids can also be effective for some children and may avoid the need for surgery. The number of children referred for assessment of OSDB is increasing and in some departments, waiting times are long. We established a paediatrician‐led clinic for assessment and initial medical management of OSDB and in this study we report the proportion of children who avoided the need for surgery.MethodReferral letters to the otolaryngology department were screened and those with suspected OSDB and no significant co‐morbidities were diverted to the paediatrician‐led clinic. We recorded data for a consecutive series of children seen in this clinic with suspected OSDB over a 3‐month period. Parents completed a 5‐item subset of questions from the OSA‐11 questionnaire before and after treatment with 6 weeks of topical nasal steroids.ResultsIn the 3‐month study period, 103 children were seen, with a mean age of 6 (range 1‐16). Six (5.8%) had improved spontaneously before clinic attendance. Of the 97 children who were still symptomatic, 17 (17.5%) were referred directly for surgery on the basis of the severity of their symptoms, or because of other coexisting conditions that required surgical treatment (such as recurrent tonsillitis or otitis media). Three declined intranasal steroids. Seventy‐seven had a trial of intranasal steroids, of whom 34 (35%) reported enough improvement to avoid surgery, and 29 (28%) failed to improve and were referred for surgery. Fourteen (14%) failed to attend after the trial of steroids: of these, 5 (5%) were contactable by phone and confirmed improvement after topical steroids. OSA‐5 scores were significantly improved following intranasal steroids.DiscussionA paediatrician‐led clinic can be an effective way to ease the workload of an over‐stretched otolaryngology service, and judicious use of topical nasal steroids can help around 40% of children with OSDB avoid surgery.
Plaque stage folliculotropic mycosis fungoides: histopathologic features and prognostic factors in a series of 40 patients
Authors: van Santen Suzanne , Jansen Patty M. , Quint Koen D. , Vermeer Maarten H. , Willemze Rein 
Published: November 2019

AbstractBackgroundFolliculotropic mycosis fungoides (FMF) is a distinct variant of mycosis fungoides. Recent studies recognized indolent and aggressive subgroups of FMF, but there is controversy how patients presenting with plaques should be classified. The present study describes the histopathologic features of 40 FMF plaques. The aim of the study was to identify risk factors for disease progression and poor outcome in this group.MethodsClinical, histopathological, and immunophenotypical data from 40 patients with plaque stage FMF were reviewed and analysed for risk factors for disease progression and survival.ResultsAfter a median follow‐up of 80 months, disease progression occurred in 20 of 40 patients. Percentage of atypical cells, cell size, percentage of Ki‐67+ cells, and co‐existent interfollicular epidermotropism, but not the extent of perifollicular infiltrates, were associated with disease progression and reduced survival, while extensive follicular mucinosis was associated with increased survival.ConclusionsThis study underlines that FMF patients presenting with plaques represent a heterogeneous group and that a subgroup of these patients may have an indolent clinical course. It further shows that histological examination is a valuable tool to differentiate between indolent and aggressive disease.
Localization value of subclinical seizures on scalp video‐EEG in epilepsy presurgical evaluation
Authors: Wang Shan , Wang Z. Irene , Tang Yingying , Alexopoulos Andreas V. , Chen Cong , Katagiri Masaya , Aung Thandar , Najm Imad M. , Ding Meiping , Wang Shuang , Chauvel Patrick 
Published: November 2019

AbstractObjectiveTo evaluate the localization value and prognostic significance of subclinical seizures (SCSs) on scalp video‐electroencephalography monitoring (VEEG) in comparison to clinical seizures (CSs) in patients who had epilepsy surgery.MethodsWe included 123 consecutive patients who had SCSs and CSs during scalp‐VEEG evaluation. All patients had subsequent epilepsy surgery and at least 1‐year follow‐up. Concordance between SCSs and CSs was summarized into five categories: complete, partial, overlapping, no concordance, or indeterminate. Using the same scheme, we analyzed the relationship between resection and SCS/CS localizations. The concordance measures, along with demographic, electroclinical, and other presurgical evaluation data, were evaluated for their associations with postoperative seizure outcome.ResultsSixty‐nine patients (56.1%) had seizure‐free outcome at 1‐year follow‐up. In 68 patients (55.3%), the localizations of SCSs and CSs were completely concordant. Multivariate logistic analysis showed that complete SCS/CS concordance was independently associated with seizure‐free outcome at 1‐year (P = .020) and 2‐year follow‐up (P = .040). In the temporal lobe epilepsy (TLE) seizure‐free group, SCS localization was completely contained within the resection in 44.4% and CS localization was completely contained within the resection in 41.7%; in the extratemporal lobe epilepsy (ETLE) seizure‐free group, SCS localization was completely contained within the resection in 54.5% and CS localization was completely contained within the resection in 57.6%.SignificanceComplete concordance between CS and SCS localization is a positive prognostic factor for 1‐year and 2‐year postoperative seizure‐free outcome. Localization value of SCSs on scalp VEEG is similar to that of CSs for TLE and ETLE. Although SCSs cannot replace CSs, localization information from SCSs should not be ignored.