bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leadership for a healthy work environment – a question about who, what and how
Authors: Vidman Åsa , Strömberg Annika 
Published: December 2020

Purpose
Recruiting and retaining staff to work with elderly people in social care is a global issue. The quality of leadership is considered important because it influences employees’ job satisfaction, job turnover and health. This paper aims to identify leadership that employees in residential elderly care facilities in Sweden consider as contributing towards a healthy work environment.

Design/methodology/approach
The authors interviewed 14 persons employed in facilities organized in different ways. The data from these interviews was analysed using qualitative content analysis..

Findings
The results showed that the employees felt that their health partly depended on the attributes that leaders possessed, what leaders do and how leaders do it. This study confirms that leadership influences the perception of a healthy workplace. It also shows that questions about leadership are complex.

Originality/value
Research about factors that increase health risks is wide-ranging; however, research that examines factors that promote health, especially how leadership influences employees’ well-being, is not as comprehensive.
Covid-19 “tourism in flight mode”: a lost opportunity to rethink tourism – towards a more sustainable and inclusive society
Authors: Pardo Carmen , Ladeiras Ana 
Published: December 2020

Purpose
This paper aims to report on a post-confinement reflection (not post-COVID-19) resulting from a series of online forums that took place during the peak moments of the pandemic, with the intention of raising awareness and mobilising tourism agents for the development of tourism planning and tourism intelligence, taking advantage of the period of stagnation of the tourism industry. The project was named “Tourism in flight mode: Thinking together the post COVID-19 tourism”.

Design/methodology/approach
The project was based on the sharing of information and experiences in virtual forums where participants from all over the world had the opportunity to explain how the pandemic was influencing their work/business, the regional or national tourism activity, GDP and jobs and how they and their regions were preparing for the recovery of tourism. On a biweekly basis, virtual forums were organised, with participants from three continents and 12 countries. The results were contextualised by carrying out a review of the most recent literature and authors’ tourism know-how in the field.

Findings
The results of the discussions allowed for an identification of new potential successful tourism products and new proposals for the design of basic pillars for destinations planning.

Practical implications
This paper offers practical recommendations for public administration and others on dealing with unexpected crises in the tourism sector and how to respond through the development of new and adapted products and approaches to tourism.

Originality/value
This paper creates awareness in public administration and other agencies about the opportunities and the needs for this “new era”.
Covid-19 crisis: a new model of tourism governance for a new time
Authors: Vargas Alfonso 
Published: December 2020

Purpose
The COVID-19 crisis has had a dramatic impact on the tourism industry, with new challenges that calls for a combination of short- and medium-/long-term perspectives. At the destination level, a factor that has a critical incidence in the recovery path is the type of tourism governance. With the spotlight on this factor, the purpose of this paper is to reflect on the need to accommodate the model of tourism governance to the requirements of this new time.

Design/methodology/approach
The discussion that already existed in the literature about the roles of destination marketing organizations (DMOs) has been brought into the new context of the coronavirus crisis to propose three fundamental changes in them, together with the centrality of host communities in a model based on public–private–people partnerships.

Findings
Under the principle that the M in DMOs has to stand for management, an evolution of these organizations toward the performance of three different roles is proposed, namely, as the orchestrator of the various players in the destination, the facilitator of opportunities for its members and the intelligence promoter and their strategic mind.

Practical implications
The practical implications of this proposal are numerous, as it represents a move beyond the usual public–private partnerships of the old normal and goes further than the traditional roles of marketer, intermediary in the value chain and brand promoter.

Originality/value
To the best of the author’s knowledge, this is the first work dealing with the topic of tourism governance in the context of the pandemic.
Possible roles of CXCL13/CXCR5 axis in the development of bullous pemphigoid
Authors: Ohuchi Kentaro , Fujimura Taku , Lyu Chunbing , Amagai Ryo , Muto Yusuke , Aiba Setsuya 
Published: December 2020

AbstractCXCL13 recruits CXCR5+ follicular helper T (Tfh) cells in inflammatory lesions to develop secondary lymphoid organs. Tfh cells activate B cells to produce antibodies during humoral immune responses. Indeed, as previous reports suggested, CXCR5+ cell numbers were increased in the peripheral blood of bullous pemphigoid (BP) patients when compared with healthy donors, and the ratio of CXCR5+ cells was positively correlated with the anti‐BP180‐NC16A titers. From the above findings, in this report, we hypothesized that a chemokine related to CXCR5+ cells, namely CXCL13, may play a role in the development of BP. We performed immunohistochemical staining of CXCR5, CXCL13, LL37, CXCL10 and CCL20 for 10 cases of BP and 10 cases of pemphigus vulgaris (PV), and quantitatively analyzed the staining by digital microscopy. Moreover, we investigated the CXCL10 and CXCL13 production in BP and PV patients by enzyme‐linked immunosorbent assay. The immunomodulatory effects of LL37 on the production of T‐helper 17‐related chemokines were evaluated using monocyte‐derived M2 macrophages. Immunohistochemical staining and digital microscopic analysis showed that the ratios of CXCR5+, CXCL13+ and LL37+ cells in the dermis were significantly higher in BP patients than in PV patients. Notably, the ratio of CXCL13+ cells was positively correlated with the anti‐BP180‐NC16A titers. Moreover, the serum levels of CXCL13 were positively correlated with the anti‐BP180‐NC16A titers. Furthermore, CD163+ M2 macrophages stimulated by LL37 in vitro produced CXCL10 and CCL20. In the lesional skin of BP, CD163+ macrophages CXCL10 and CCL20 were produced. The serum levels of CXCL10 were negatively correlated with the anti‐BP180‐NC16A titers. The present study results indicate that the mechanism of the development of BP may involve the CXCL13/CXCR5‐mediated migration of Tfh cells.
Recombination proteins differently control the acquisition of homeologous DNA during Bacillus subtilis natural chromosomal transformation
Authors: Serrano Ester , Ramos Cristina , Alonso Juan C. , Ayora Silvia 
Published: December 2020

SummaryNatural chromosomal transformation (CT) plays a major role in prokaryote evolution, yet factors that govern the integration of DNA from related species remain poorly understood. We show that in naturally competent Bacillus subtilis cells the acquisition of homeologous sequences is governed by sequence divergence (SD). Integration initiates in a minimal efficient processing segment via homology‐directed CT, and its frequency decreases log‐linearly with increased SD up to 15%. Beyond this and up to 23% SD the interspecies boundaries prevail, the CT frequency marginally decreases, and short (<10‐nucleotides) segments are integrated via homology‐facilitated micro‐homologous integration. Both mechanisms are RecA dependent. We identify the other recombination proteins required for the acquisition of homeologous DNA. The absence of AddAB, RecF, RecO, RuvAB or RecU, crucial for repair‐by‐recombination, did not affect CT. However, dprA, radA, recJ, recX or recD2 inactivation strongly decreased intraspecies and interspecies CT. Interspecies CT was not detected beyond ~8% SD in ΔdprA, ~10% in ΔrecJ, ΔradA, ΔrecX and ~14% in ΔrecD2 cells. We propose that DprA, RecX, RadA/Sms, RecJ and RecD2 accessory proteins are important for the generation of genetic diversity. Together with RecA, they facilitate gene acquisition from bacteria of related species.
Is it necessary to always resect elastofibroma dorsi?
Authors: Sahin Mutlu , Gul Vahit O. 
Published: December 2020

AbstractBackgroundElastofibroma dorsi (ED) is a benign soft tissue tumour of the subscapular region of the chest wall. It is a frequent lesion, especially seen in females and in the elderly. It remains unclear whether the size or symptomatology of the tumour is important to make a resection decision. Our aim in this study is to reveal the results between asymptomatic or symptomatic ED cases, and to reveal which factors are important for making a resection decision.MethodsPatients operated between January 2010 and December 2019 were included in the study, and divided into two groups as patients who were asymptomatic or with various symptoms. Patients were evaluated in terms of demographic and operational factors.ResultsThe study included 57 patients with the average age of 56.1 ± 11.5 years. Whilst 31 (54.4%) of these patients were asymptomatic, 26 (45.6%) were symptomatic. There was a statistical significance between groups in terms of occupation (P < 0.001), comorbidity (P = 0.042) and the duration of complaints (P = 0.001). A statistically significant difference was analysed between comorbidity versus early and late complications (P = 0.011 and P = 0.002, respectively).ConclusionED probably occurs as a result of repeated trauma in the subcapular region in people who use their arms extensively. Regardless of the size of the lesion, surgery should be avoided as much as possible, especially in asymptomatic patients. However, in patients who are symptomatic, a precise surgical procedure can give satisfactory results. In these patients, who are generally elderly, early and late complications can be seen more, if they have comorbidity.
Process lessons from evaluating a combined continuity of carer and home birth scheme
Authors: Symon Andrew , Shinwell Shona , Craig Justine 
Published: December 2020

AbstractIntroductionContinuity of midwifery carer improves outcomes, but there is significant variation in how such schemes are implemented and evaluated cross‐culturally. The Angus home birth scheme in Scotland incorporates continuity of carer throughout pregnancy, labor, birth, and the postnatal period.MethodsManual maternity case note review to evaluate the 80% continuity of carer and 3% planned home birth rate targets.ResultsOf 1466 women booking for maternity care, 69 joined the scheme. Forty‐four had a planned home birth (3% overall), of whom seven were originally deemed ineligible. Of the 44, eight (18%) also achieved 80% continuity of carer with the primary midwife; by including a home birth team colleague, the continuity rate rose to 73%. Women whose care achieved home birth and continuity targets had lower deprivation scores. Eligibility issues, women's changing circumstances, and data recording lapses were complicating issues.ConclusionsTargets must be both feasible and meaningful and should be complemented by assessing a broad range of outcomes while viewing the scheme holistically. By expanding eligibility criteria, the home birth rate target was met; including input from a home birth team colleague in the calculation meant the continuity target was nearly met. With dedicated and competent staff, adequate resource and political support, and when considered in the round, the scheme's viability within local services was confirmed. Other generalizable learning points included the need to standardize definitions and data recording methods. Comparability across schemes helps grow the evidence base so that the links between processes and outcomes can be identified.
Developments allergy in 2019 through the eyes of clinical and experimental allergy, part I mechanisms
Authors: Roberts Graham , Almqvist C. , Boyle R. , Crane J. , Hogan S. P. , Marsland B. , Saglani S. , Woodfolk J. A. 
Published: December 2020

AbstractIn the first of two linked articles, we describe the development in the mechanisms underlying allergy as described by Clinical & Experimental Allergy and other journals in 2019. Experimental models of allergic disease, basic mechanisms, clinical mechanisms and allergens are all covered.
On‐ and off‐licensed premises drinking behaviour among adults in the city of Tshwane, South Africa: An analysis of data from the International Alcohol Control study
Authors: Londani Mukhethwa , Morojele Neo K. , Egbe Catherine O. , Nel Elmarie , Petersen Williams Petal , Harker Nadine , Parry Charles D. H. 
Published: December 2020

AbstractIntroduction and AimsAlcohol use is among the leading risk factors for premature death and morbidity in South Africa. This study sought to identify factors associated with drinking behaviour in on‐ and off‐licensed premises (typical occasion quantity and frequency) among adults in the City of Tshwane, South Africa.Design and MethodsA household survey was conducted in 2014, using a multi‐stage stratified cluster random sampling design. Participants comprised 982 adults (65% males) aged 18–65 years. Factors explored included socio‐demographic variables and situational variables at on‐ and off‐licensed premises. Multiple logistic regression analysis was performed to predict drinking behaviour at on‐ and off‐licensed premises.ResultsThe majority of the participants consumed alcohol in off‐licensed premises (64% vs. 36%). However, participants who consumed alcohol at on‐licensed premises were more likely to drink more alcohol and more frequently (weekly). Additionally, participants who consumed alcohol in above‐average sized containers were more likely to consume six or more drinks and drink weekly. Being of high socio‐economic status was associated with drinking weekly at off‐licensed premises, while being less educated was associated with a significantly higher frequency of drinking at on‐licensed premises.Discussion and ConclusionsInterventions to reduce alcohol use should target specific drinking behaviour at on‐ and off‐licensed premises, for example, regulating the availability of alcohol in big‐sized containers and the need for cutting down on quantity of alcohol and frequency of drinking for South African males who drink at on‐ and off‐licensed premises.
Treatment persistence in patients with type 2 diabetes treated with glucagon‐like peptide‐1 receptor agonists in clinical practice in Sweden
Authors: Svensson Ann‐Marie , Toll Anders , Lebrec Jeremie , Miftaraj Mervete , Franzén Stefan , Eliasson Björn 
Published: December 2020

AbstractAimTo compare treatment persistence in patients with type 2 diabetes initiating the glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) dulaglutide, exenatide once‐weekly (QW), liraglutide or lixisenatide in routine clinical practice in Sweden and assess clinical outcomes.Materials and MethodsWe performed a retrospective study using data from several nationwide Swedish health registries, including the National Diabetes Register and other mandatory and population‐based registries. Individual level data were collected from 17 361 patients who initiated GLP‐1 RA treatment from 23 May 2015 to 15 October 2017, up to 2.5 years postindex (treatment start date). Treatment persistence and modification, predictors of discontinuation, HbA1c and body weight were recorded. Non‐persistence was defined as a treatment gap of more than 45 days. Treatment modification included switching and augmentation. Confounding was addressed through the use of propensity scores.ResultsTreatment persistence was higher and treatment modifications were lower in patients initiating dulaglutide compared with those on exenatide QW, liraglutide and lixisenatide. Patients who remained on the same treatment for 1‐year postindex experienced greater HbA1c reductions and a steadier decrease in body weight.ConclusionsOur study suggests that in clinical practice in Sweden there is a greater persistence of treatment among patients initiating dulaglutide compared with those on exenatide QW, liraglutide and lixisenatide. Persistence with the index GLP‐1 RA was closely correlated with positive clinical outcomes and thus should be considered a critical factor of patient‐centric treatment in Sweden.
Sex differences in survival: viability selection in nymphal tree crickets from a conopid fly parasitoid
Authors: Etzler Erik A. , Gwynne Darryl T. 
Published: December 2020

1. Variation in mortality due to parasitoids is expected to be affected by host sex and size.2. We use selection analyses to examine the effects of Stylogaster neglecta (Diptera: Conopidae), a recently discovered parasitoid of nymphal Oecanthus nigricornis (Orthoptera: Gryllidae), on sex and size viability in the host crickets.3. O. nigricornis nymphs were sampled across Ontario and New York State and dissected to determine whether they were parasitised. Logistic regression was used to examine parasitism by host body size and sex.4. There was strong evidence for an effect of sex and body size on parasitism, with males and smaller crickets being more likely to be parasitised and containing more parasitoids in them. There was also weaker evidence of an interaction effect between sex and body size, with body size being a significant predictor of parasitism only in males. Using a selection analysis, we found evidence of positive and disruptive selection on male body size.5. Causes of these viability differences may include sex differences in larval cricket immune function, riskier behaviour of male nymphs as they acquire resources necessary for adult trait development, as well as the effects of S. neglecta flies targeting hosts that maximise fitness.
Spawning strategy of Japanese anchovy Engraulis japonicus in the coastal Yellow Sea: Choice and dynamics
Authors: Zhang Wenchao , Yu Haiqing , Ye Zhenjiang , Tian Yongjun , Liu Yang , Li Jianchao , Xing Qinwang , Jiang Yiqian 
Published: December 2020

AbstractUnderstanding the relationships between hydrodynamics and the spawning activities of small pelagic fishes is crucial for understanding their recruitment dynamics and for fisheries management. Here, we clarify the effects of marine environmental factors and the associated hydrodynamic processes on the spawning activities of the Japanese anchovy Engraulis japonicus in the coastal Yellow Sea using data from in situ ichthyoplankton surveys (7 recent years), a hydrodynamic model and satellite remote sensing. We confirmed the peak spawning period (May and June) and primary spawning location (Haizhou Bay). We defined the ‘spawning temperature optima’ hypothesis to identify the optimal spawning temperature (13.0–18.0°C) for the Japanese anchovy based on egg occurrence and abundance. We detected fortnightly variation in spawning behaviour, which peaked after the spring tide. Anchovy eggs showed evident aggregation in the nearshore upwelling area during May and June, while strong upwelling in July may cause a negative spawning‐site choice in upwelling zone. These findings clarify the effects of hydrodynamics on the spawning behaviour of the Japanese anchovy in the coastal Yellow Sea.
Further evaluation of the world health organization international reference reagent for Haemoglobin A2 measurement
Authors: Wild Barbara J. , Chohan Duljeet K. , Harteveld Cornelis L. , De la Salle Barbara 
Published: December 2020

AbstractIntroductionThe accurate measurement of HbA2 is essential for the detection of β‐thalassaemia carriers and as no single calibrant is used by the various manufacturers of analysers, differences are seen in results obtained. The World Health Organization International Reference Reagent for HbA2 (WHO IRR 89/666) was made available to diagnostic laboratories in the 1980s and remains the only international reference material available. A previous study (2015) demonstrated that the WHO IRR remained suitable for use as an HbA2 standard as tested by 52 participants in the UK NEQAS Haematology Abnormal Haemoglobins Programme. This study was undertaken to include simultaneous analysis of three whole blood specimens over a range of HbA2 values with the WHO IRR and to include participants from laboratories outside of the UK.MethodThree whole blood specimens with HbA2 levels ranging from 2.4% to 5.7% and the WHO IRR were distributed to 56 laboratories located in 14 different countries. Participants were requested to test the specimens at defined intervals and return results accompanied by chromatograms or electropherograms produced.ResultsDifferences found in results from different analyser groups reflect the bias found in the 2015 study in that bias is seen according to the methodology used and also varies in relation to the level of analyte being measured.ConclusionResults of measurements from whole blood specimens and the lyophilized WHO IRR standard did not show any deterioration of the IRR, and it remains suitable for use. Linearity and calibration of analysers remain a problem.
Multicentric evaluation of the new HemosIL Acustar® chemiluminescence ADAMTS13 activity assay
Authors: Pascual Cristina , Nieto Jorge M. , Fidalgo Teresa , Seguí Inés Gómez , Díaz‐Ricart Maribel , Docampo Marta Fernández , del Rio Julio , Salinas Ramon 
Published: December 2020

AbstractIntroductionThrombotic thrombocytopenic purpura (TTP) is a rare life‐threatening thrombotic microangiopathy (TMA) characterized by the severe deficiency of ADAMTS13 activity (<10%). Rapid ADAMTS13 testing is crucial for early diagnosis and optimal management of TTP patients and other TMAs. The objective of this study was to retrospectively evaluate the performance of the recently commercialized HemosIL Acustar® ADAMTS13 activity chemiluminescent immunoassay (Instrumentation Laboratory, Bedford, Massachusetts, United States) in a multicentric study between Spain and Portugal.MethodsA comparison method was performed to compare HemosIL Acustar® with an in‐house FRETS‐VWF73 assay and two commercial ELISA assays: the TECHNOZYM® ADAMTS13 Activity (Technoclone GmbH, Vienna, Austria) and the DG‐EIA ADAMTS‐13 Activity (Diagnostic Grifols, SA, Barcelona, Spain). A set of 241 frozen plasma samples with known ADAMST13 levels was used. Agreement between methods was assessed with focus on two cut‐off ADAMTS13 activity values: <10% (the clinical accepted cut‐off value to confirm TTP diagnosis) and <5%.ResultsHemosIL AcuStar® showed high agreement with the other methods in correctly classify patients with ADAMTS13 values below 10% (Kappa = 0.89) and even below 5% (Kappa = 0.94) with no false negatives and few false positives (5.40%; 95% CI: 2.20 to 8.60%). However, it also tended to underestimate ADAMTS13 levels, especially for the high assay range values (>40%) (absolute mean bias of 8.40% (95% CI: 6.53 to 10.42%)) when compared to other assays.ConclusionsHemosIL AcuStar® is highly sensitive to detect ADAMTS13 values below 10% and 5%. A large prospective validation study is needed to corroborate its utility in clinical practice.