bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leader’s behaviours for promoting innovation in a multidisciplinary musculoskeletal service
Authors: Nalajala Narender , Craig Rachel 
Published: May 2021

Purpose
Financial constraints, an increase in the demand for health-care from an ageing population, multiple comorbidities in both mental and physical health and delivering care closer to the community, are amongst the factors creating a need for innovation in the NHS. The purpose of this paper is to explore leader behaviours that promote innovation in a multidisciplinary musculoskeletal (MSK) service.

Design/methodology/approach
Qualitative semi-structured interviews were conducted to explore the experience and views of the multidisciplinary team (MDT) members on leadership and innovation. A total of 13 MDT members participated in the study.

Findings
Inter-professional collaboration and the absence of hierarchical behaviours are associated with a positive experience. Traditionally established hierarchy and inter-professional barriers for interaction were associated with challenging experience in MDT. There was an expression of fear of and vulnerability to being “taken over” or “eaten up” by other professions. Supportiveness, consulting behaviour, provision of time, vision and inspiring and risk-taking behaviours are associated with innovation. Target drove and monitoring behaviours or hierarchical expression of authority, directive or supervisory behaviours are negatively associated with innovation.

Practical implications
Day to day leader’s behaviours and interactions influences the work environment for innovation. Knowledge gained through Informal interaction, understanding each other’s professional strengths and weaknesses are implicit strengths of an MDT but when a member perceives their skills as less valuable to that of another member, they hold less power and influence. Therefore, a flat hierarchy provides a more effective structure for knowledge translation and maximising MDT productivity.

Originality/value
MSK services are complex adaptive systems with several pathways and interactions flowing between various specialities. For improving innovation and effective functioning of the MSK MDT, it is important to provide informal training for team leads on self-awareness of the behaviours associated with innovation.
Determinant analysis of employee attitudes toward pro-environmental behavior in textile firms of Pakistan: a serial mediation approach
Authors: Nisar Sundas , Khan Naveed R. , Khan Mustafa Rehman 
Published: May 2021

PurposeThe purpose of this study was to determine how environmentally specific transformational leadership (ETFL), green training (GT) and psychological green climate (PGC) affect environmental passion (EP) of employees which leads to pro-environmental behaviors (PEBs).Design/methodology/approachThe context of the study was set in textile industry of Pakistan which holds a promising future in the international markets as an emerging export-based industry. Using purposive sampling technique, cross-sectional self-report data were collected from the employees of textile exporting firms (n = 239) of Pakistan. Hypotheses were tested using PLS-SEM.FindingsThe findings revealed that ETFL and PGC act as important predictors of EP, whereas GT plays no role in influencing EP. EP predicts green behavioral intention (GBI) of employees, in turn, GBI predicts employees' PEBs. Further, mediation analyses revealed that EP and GBI sequentially mediated the link between PGC and PEBs.Research limitations/implicationsThe present study is not free from its limitations. First, the study adopted cross-sectional design that prevents the causal inferences which the researcher can make from the population. Second, the present study adopted purposive sampling technique which is a non-probability sampling technique. Third, the constructs of this study were assessed with self-report measures which are associated with social desirability bias (Podsakoff and Organ, 1986) or common-method variance (Podsakoff et al., 2003). Hence, this research suggests on the future direction of research based on these limitations.Practical implicationsAs per the results of this study, it is also suggested that managers may focus more on the overall organizational and psychological climate rather than on leadership styles alone. While conducting training, the leaders must pay close attention to training objectives to ensure that they do not lead to counterproductive behaviors.Originality/valueThis research adds to the literature in the area of PEBs at micro-level by focusing on how and why employees engage in PEBs.
The analysis of debt levels in public firms: an international evidence
Authors: Pathak Rajesh , Das Gupta Ranjan , Jalali Abhinav 
Published: May 2021

PurposeThis study investigates if the widely held predictors of corporate leverage exhibit predictive consistency through times and across countries amidst country heterogeneities such as legal principles, state of economic development and protection of investors’ rights.Design/methodology/approachWe employ financial data for 3,197 unique firms from eight emerging and ten developed countries during the years 2001–2017 and use Tobit regression models, a two-step Fama−MacBeth(1973) regression and panel data regression techniques in order to ensure the robustness of estimates.FindingsWe find that firms in the civil French law system exhibit the highest average of a debt (around 27%), whereas firms based in high investors’ protection environment and in developed nations borrow significantly less than their counterparts. Furthermore, among predictors, including a firm's payout ratio, it returns on equity and the cash ratio except the P/B ratio have varying predictability for a corporate debt when firms are classified based on law systems, investors’ rights and the economic scenarios. The crisis period significantly affects the relationship of debt levels with legal systems, investors’ rights and economic development scenario. The author’s estimates are robust to alternate analysis.Originality/valueThis study is unique in its methodological approach and involves a considerably large number of countries and a longer study period for the results to be more generalizable compared to other existing studies.
Integrating genetics, physiology and morphology to study desert adaptation in a lizard species
Authors: Araya‐Donoso Raúl , San Juan Esteban , Tamburrino Ítalo , Lamborot Madeleine , Veloso Claudio , Véliz David 
Published: May 2021

Abstract

Integration of multiple approaches is key to understand the evolutionary processes of local adaptation and speciation. Reptiles have successfully colonized desert environments, that is, extreme and arid conditions that constitute a strong selective pressure on organisms. Here, we studied genomic, physiological and morphological variations of the lizard Liolaemus fuscus to detect adaptations to the Atacama Desert.

By comparing populations of L. fuscus inhabiting the Atacama Desert with populations from the Mediterranean forests from central Chile, we aimed at characterizing features related to desert adaptation.

We combined ddRAD sequencing with physiological (evaporative water loss, metabolic rate and selected temperature) and morphological (linear and geometric morphometrics) measurements. We integrated the genomic and phenotypic data using redundancy analyses.

Results showed strong genetic divergence, along with a high number of fixed loci between desert and forest populations. Analyses detected 110 fixed and 30 outlier loci located within genes, from which 43 were in coding regions, and 12 presented non‐synonymous mutations. The candidate genes were associated with cellular membrane and development. Desert lizards presented lower evaporative water loss than those from the forest. Morphological data showed that desert lizards had smaller body size, different allometry, larger eyeballs and more dorsoventrally compressed heads.

Our results suggest incipient speciation between desert and forest populations. The adaptive signal must be cautiously interpreted since genetic drift could also contribute to the divergence pattern. Nonetheless, we propose water and resource availability, and changes in habitat structure, as the most relevant challenges for desert reptiles. This study provides insights of the mechanisms that allow speciation as well as desert adaptation in reptiles at multiple levels, and highlights the benefit of integrating independent evidence.
Association between serum estradiol levels prior to progesterone administration in artificial frozen–thawed blastocyst transfer cycles and live birth rate: a retrospective study
Authors: Zhou R , Zhang X , Huang L , Zhu X , Dong M , Liu W , Wang S , Liu F 
Published: May 2021

ObjectiveTo study whether serum estradiol (E2) levels prior to progesterone administration in the artificial endometrial preparation (AEP) of frozen–thawed blastocyst transfer affect the live birth rate.DesignRetrospective cohort study.SettingTertiary‐care academic medical centre.PopulationA total of 3857 frozen–thawed blastocyst transfer cycles were divided into three groups: <200 pg/ml (n = 1676); 200–399 pg/ml (n = 1296); and ≥400 pg/ml (n = 885), based on the 25th (182.3 pg/ml) and 75th percentile (390.2 pg/ml) of serum E2 level prior to progesterone administration.MethodsUnivariable and multivariable logistic regression analysis was performed.Main outcome measuresThe primary outcome of the study was the live birth rate and the secondary outcomes included clinical pregnancy rate, pregnancy loss rate, neonatal birthweight, Z‐score, and small for gestational age (SGA).ResultsCompared with the reference group, accounting for major covariates, the live birth rate significantly decreased in the ‘≥400 pg/ml’ group (adjusted OR 0.71, 95% CI 0.59–0.85). Compared with the reference group, there was an association between the E2 level in the ‘≥400 pg/ml’ group and a decrease in the clinical pregnancy rate (adjusted OR 0.74, 95% CI 0.61–0.89). Compared with the reference group, the pregnancy loss rate significantly increased in the ‘≥400 pg/ml’ group (adjusted OR 1.45, 95% CI 1.08–1.93). The E2 levels did not affect neonatal birthweight, Z‐score, and SGA among singletons.ConclusionsHigh serum E2 levels prior to progesterone administration in AEP are associated with a decreased live birth rate after frozen–thawed blastocyst transfer.Tweetable abstractHigh serum E2 levels prior to progesterone administration in artificial FET are associated with a decreased live birth rate after frozen–thawed blastocyst transfer.
Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise
Authors: Scrivin Rachel , Costa Ricardo JS , Pelly Fiona , Lis Dana , Slater Gary 
Published: May 2021

AbstractAimTo develop and validate a questionnaire investigating endurance athletes' carbohydrate beliefs, knowledge, information sources, and other dietary and non‐dietary practices related to exercise‐associated gastrointestinal symptoms.MethodsA questionnaire was developed by a review of relevant literature and sports‐related questionnaires, and input from five experienced sports dietitians. Item construct and format was adapted and modified from a previous questionnaire. The modified questionnaire sought information on demographics, nutrition knowledge, beliefs, intended practices, information sources and exercise‐associated gastrointestinal symptoms. A five‐phase validity process was conducted to determine content, face and construct validity, item difficulty and internal reliability of the questionnaire. The Delphi technique was applied with experts over three anonymous rounds. Items were reviewed to determine whether to keep, modify, or delete, rate the relevance of each item using a content validity index (CVI), and provide comments. A content analysis was conducted on all comments after each round. Online interviews were conducted with a pilot group of endurance athletes (n = 15) to assess item difficulty and feasibility. Nutrition knowledge was compared between pilot group of athletes and experts to determine construct validity and internal consistency. A test‐retest process was applied to a second pilot group (n = 8) to verify questionnaire reliability.ResultsHigh CVI (≥.83) and agreement scores were obtained through the Delphi technique. High reliability (r = .942) and acceptable internal consistency (α = .53‐.78) of the questionnaire were obtained.ConclusionsThe questionnaire was shown to be a valid and reliable tool that will be of use for clinicians and research purposes.
Clinical practice guideline on spinal stabilisation of adult trauma patients: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Authors: Yli‐Hankala Arvi , Chew Michelle S. , Olkkola Klaus T. , Rehn Marius , Sverrisson Kristinn Ö. , Møller Morten H. 
Published: May 2021

AbstractThe Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline New clinical guidelines on the spinal stabilisation of adult trauma patients—consensus and evidence based. The guideline can serve as a useful decision aid for clinicians caring for patients with traumatic spinal cord injury. However, it is important to acknowledge that the overall certainty of evidence supporting the guideline recommendations was low, implying that further research is likely to have an important impact on the confidence in the estimate of effect.
Alcohol‐induced aggression in Drosophila
Authors: Park Annie , Tran Tracy , Gutierrez Linda , Stojanik Christopher J. , Plyler Julian , Thompson Grace A. , Bohm Rudolf A. , Scheuerman Elizabeth A. , Smith Dean P. , Atkinson Nigel S. 
Published: May 2021

AbstractAlcohol‐induced aggression is a destructive and widespread phenomenon associated with violence and sexual assault. However, little is understood concerning its mechanistic origin. We have developed a Drosophila melanogaster model to genetically dissect and understand the phenomenon of sexually dimorphic alcohol‐induced aggression. Males with blood alcohol levels of 0.04‐mg/ml BAC were less aggressive than alcohol‐naive males, but when the BAC had dropped to ~0.015 mg/ml, the alcohol‐treated males showed an increase in aggression toward other males. This aggression‐promoting treatment is referred to as the post‐ethanol aggression (PEA) treatment. Females do not show increased aggression after the same treatment. PEA‐treated males also spend less time courting and attempt to copulate earlier than alcohol‐naive flies. PEA treatment induces expression of the FruM transcription factor (encoded by a male‐specific transcript from the fruitless gene), whereas sedating doses of alcohol reduce FruM expression and reduce male aggression. Transgenic suppression of FruM induction also prevents alcohol‐induced aggression. In male flies, alcohol‐induced aggression is dependent on the male isoform of the fruitless transcription factor (FruM). Low‐dose alcohol induces FruM expression and promotes aggression, whereas higher doses of alcohol suppress FruM and suppress aggression.
Modern agricultural value chains and the future of smallholder farming systems
Authors: Ma Meilin , Sexton Richard J. 
Published: May 2021

AbstractSmallholder farms continue to play a prominent role in many developing countries. A substantial debate has emerged regarding the future role of smallholder farms as a means to lift rural households out of poverty and contribute to food security as part of modern agricultural value chains. We build a conceptual model to compare household income and total food output under smallholder production versus a hypothetical setting wherein households cease engaging as farm owner‐operators, but supply land and labor to consolidated commercial farms. Based on the empirical literature, we calibrate the model to quantify the advantages in acquiring working capital and output marketing that can plausibly accrue to large‐scale farming operations and offset any labor efficiency decrement compared to smallholder farms. Results show that households can earn more from renting out land and labor into competitive factor markets for a wide range of plausible market conditions. The higher the price premium commanded by and less the loss in labor efficiency on large farms, and the tighter the credit constraints on smallholders, the greater is the income advantage from supplying inputs to large farms over operating small farms. An output advantage also accrues to large farms under similar conditions.
The role of scrotal ultrasonography from infancy to puberty
Authors: Spaziani Matteo , Lecis Claudio , Tarantino Chiara , Sbardella Emilia , Pozza Carlotta , Gianfrilli Daniele 
Published: May 2021

AbstractBackgroundScrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new‐generation ultrasound machines characterized by clearly improved image quality, low health cost, and higher patient safety, represents only some characteristics of ultrasound investigation. The usefulness of scrotal ultrasonography is particularly evident in the period of life from infancy to puberty, during which males undergo important morphofunctional changes, and several pathological conditions may occur.ObjectivesThis pictorial review primarily aimed to investigate the aspects of ultrasonography related to the normal physiological development of the gonads from mini‐puberty to pubertal onset. This study also aimed to provide an update on the use of ultrasonography in main andrological pathologies that may occur during this period. The conditions that are discussed in depth are: cryptorchidism, inguinoscrotal hernias, and hydrocele in the neonatal phase; acute scrotum, epididymo‐orchitis, and testicular cancers in childhood; and hypogonadism, varicoceles, testicular microlithiasis, and oncohematological pathology in puberty.DiscussionWe provided an ultrasound slant for all the above‐mentioned pathologies while purposely avoiding excessive deepening of the pathogenetic, clinical, and therapeutic aspects. Studying the ultrasound aspects of the gonads also facilitates differential diagnosis between various conditions and represents a good aid in evaluating therapeutic success (e.g., in hypogonadism or postsurgical evaluation of varicoceles and cryptorchidism).ConclusionScrotal ultrasonography is now globally recognized as the necessary completion of clinical–laboratory overview in gonads evaluation. This diagnostic procedure is even more indispensable in the infancy–childhood–puberty period for the evaluation of normal gonadal development as well as diagnosis of other possible diseases.
Dose–response association of acute‐phase quetiapine treatment with risk of new‐onset hypothyroidism in schizophrenia patients
Authors: Zhao Ying , Wen Shi Wu , Li Mengzhe , Sun Zhongyu , Yuan Xiang , Retnakaran Ravi , Zhang Ruiling , Zhai Desheng 
Published: May 2021

AimsTo assess association between quetiapine treatment and risk of new‐onset hypothyroidism in schizophrenia patients.MethodsWe conducted a retrospective cohort study in a tertiary hospital in China between January 2016 and December 2018. Schizophrenia patients with normal thyroid tests at admission were included. Hypothyroidism, which was defined as thyroid‐stimulating hormone >4.20 mU/L and free thyroxine <12.00 pmol/L, or on L‐thyroxine prescriptions, was the outcome measure, and quetiapine treatment between admission and subsequent thyroid test was the exposure measure of this study. Adjusted relative risks and 95% confidence intervals were used to assess the independent association of quetiapine treatment with risk of new‐onset hypothyroidism. The dose–response association was further analysed by 3 quetiapine doses: low (≤<=0.2 g/d), medium (0.2–0.6 g/d), and high (>0.6 g/d).ResultsA total of 2022 eligible patients were included in the final analysis. Sixty patients (15.0%) in the quetiapine group developed hypothyroidism, while 56 patients (3.5%) in the nonquetiapine group developed hypothyroidism. Relative risk (95% confidence interval) of developing hypothyroidism for quetiapine use was 4.01 (2.86–5.64) after adjusting for several potential confounding factors. A strong dose–response association between quetiapine use and risk of developing hypothyroidism was observed: adjusted relative risks (95% confidence intervals) were 1.00 (0.25–2.59), 4.22 (2.80–6.25) and 5.62 (3.66–8.38), respectively, for low‐, medium‐ and high‐dose quetiapine, as compared with no quetiapine.ConclusionAcute phase quetiapine treatment for schizophrenia patients was strongly associated with increased risk of developing new‐onset hypothyroidism, with a clear dose–response association.
Evaluation of artificial intelligence clinical applications: Detailed case analyses show value of healthcare ethics approach in identifying patient care issues
Authors: Rogers Wendy A. , Draper Heather , Carter Stacy M. 
Published: May 2021

AbstractThis paper is one of the first to analyse the ethical implications of specific healthcare artificial intelligence (AI) applications, and the first to provide a detailed analysis of AI‐based systems for clinical decision support. AI is increasingly being deployed across multiple domains. In response, a plethora of ethical guidelines and principles for general AI use have been published, with some convergence about which ethical concepts are relevant to this new technology. However, few of these frameworks are healthcare‐specific, and there has been limited examination of actual AI applications in healthcare. Our ethical evaluation identifies context‐ and case‐specific healthcare ethical issues for two applications, and investigates the extent to which the general ethical principles for AI‐assisted healthcare expressed in existing frameworks capture what is most ethically relevant from the perspective of healthcare ethics. We provide a detailed description and analysis of two AI‐based systems for clinical decision support (Painchek® and IDx‐DR). Our results identify ethical challenges associated with potentially deceptive promissory claims, lack of patient and public involvement in healthcare AI development and deployment, and lack of attention to the impact of AIs on healthcare relationships. Our analysis also highlights the close connection between evaluation and technical development and reporting. Critical appraisal frameworks for healthcare AIs should include explicit ethical evaluation with benchmarks. However, each application will require scrutiny across the AI life‐cycle to identify ethical issues specific to healthcare. This level of analysis requires more attention to detail than is suggested by current ethical guidance or frameworks.