Sustainable procurement: comparing in-house and outsourcing implementation modes

Sustainable supply chain management practices can be particularly difficult to implement when the responsibility for sustainable procurement (SP) rests with buyers employed by a contractor, rather than an in-house procurement team. Yet there is no extant research that investigates the effect of outsourcing on SP. To address this research gap, this paper uses multi-case study data to explore the impact of outsourcing versus in-house implementation modes in the pursuit of SP. The findings suggest that each implementation mode has distinctive challenges and facilitators. However, by considering Transaction Cost Economics, results reveal that the advantage of outsourcing to professionals, with well-established SP expertise, brings information asymmetries in developing initial outsourcing contracts, which can lead to poorer sustainability performance than initially expected. Furthermore, when applying Principal Agency Theory, results suggest that sustainable performance can be improved in the long term through the effective design of well-constructed contractual relationships as SP maturity increases

Tooth wear: the view of the anthropologist

Anthropologists have for many years considered human tooth wear a normal physiological phenomenon where teeth, although worn, remain functional throughout life. Wear was considered pathological only if pulpal exposure or premature tooth loss occurred. In addition, adaptive changes to the stomatognathic system in response to wear have been reported including continual eruption, the widening of the masticatory cycle, remodelling of the temporomandibular joint and the shortening of the dental arches from tooth migration. Comparative studies of many different species have also documented these physiological processes supporting the idea of perpetual change over time. In particular, differential wear between enamel and dentine was considered a physiological process relating to the evolution of the form and function of teeth. Although evidence of attrition and abrasion has been known to exist among hunter-gatherer populations for many thousands of years, the prevalence of erosion in such early populations seems insignificant. In particular, non-carious cervical lesions to date have not been observed within these populations and therefore should be viewed as ‘modern-day’ pathology. Extrapolating this anthropological perspective to the clinical setting has merits, particularly in the prevention of pre-mature unnecessary treatment

Overturning Pathways Control AMOC Weakening in CMIP6 Models

This is the final version. Available on open access from Wiley via the DOI in this recordData Availability Statement: The CMIP6 data used in this study is available from ESGF (https://esgf-index1.ceda.ac.uk/search/cmip6-ceda/) with references listed in Supporting Information S1 (Table S1). MOC estimates from ECCOv4, a robust diagnostic simulation and an inverse model were taken from Cessi (2019), Lee et al. (2019), and Lumpkin and Speer (2007) respectively. MOC estimates from GloRanV14 (funded by the E.U. Copernicus Marine Service) are available through Zenodo: https://doi.org/10.5281/zenodo.7649266 (Baker & Renshaw, 2023).Future projections indicate the Atlantic Meridional Overturning Circulation (AMOC) will weaken and shoal in response to global warming, but models disagree widely over the amount of weakening. We analyze projected AMOC weakening in 27 CMIP6 climate models, in terms of changes in three return pathways of the AMOC. The branch of the AMOC that returns through diffusive upwelling in the Indo-Pacific, but does not later upwell in the Southern Ocean (SO), is particularly sensitive to warming, in part, because shallowing of the deep flow prevents it from entering the Indo-Pacific via the SO. The present-day strength of this Indo-Pacific pathway provides a strong constraint on the projected AMOC weakening. However, estimates of this pathway using four observationally based methods imply a wide range of AMOC weakening under the SSP5-8.5 scenario of 29%–61% by 2100. Our results suggest that improved observational constraints on this pathway would substantially reduce uncertainty in 21st century AMOC decline.European Union Horizon 2020Met Office Hadley Centre Climate Programm

Ursodeoxycholic acid to reduce adverse perinatal outcomes for intrahepatic cholestasis of pregnancy: the PITCHES RCT

Background: Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and raised serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment, but without an adequate evidence base. / Objective: We aimed to evaluate whether or not ursodeoxycholic acid reduces adverse perinatal outcomes in affected women. / Design: Multicentre, masked, randomised, placebo-controlled, two-arm, parallel-group trial. / Setting: Thirty-three UK maternity units. / Participants: Women with intrahepatic cholestasis of pregnancy aged ≥ 18 years, between 20+0 and 40+6 weeks’ gestation with a singleton or twin pregnancy and no known lethal fetal anomaly. / Interventions: Women were randomly assigned (1 : 1 allocation ratio) to take ursodeoxycholic acid tablets or matched placebo tablets, at an equivalent dose of 1000 mg daily, titrated as needed. / Main outcome measures: The primary outcome was a composite of perinatal death (in utero fetal death after randomisation or known neonatal death up to 7 days) or preterm delivery (< 37 weeks’ gestation) or neonatal unit admission for at least 4 hours (from birth until hospital discharge). Each infant was counted once within this composite. Analyses were by intention to treat. / Results: Between 23 December 2015 and 7 August 2018, 605 women were randomised, with 305 women allocated to the ursodeoxycholic acid arm and 300 women to the placebo arm. There was no evidence of a significant difference in the incidence of the primary outcome between the groups: 23.0% (74 out of 322 infants) in the ursodeoxycholic acid group compared with 26.7% (85 out of 318 infants) in the placebo group; adjusted risk ratio 0.85 (95% confidence interval 0.62 to 1.15). There was no evidence of a significant difference in total costs (maternal, infant and the cost of ursodeoxycholic acid) between the two trial groups. There were two serious adverse events in the ursodeoxycholic acid group and six in the placebo group. / Limitations: Limitations include a primary outcome event rate in the control group that was lower than that estimated for the sample size calculation, but the lack of evidence of effect in all analyses suggests that it is unlikely that the trial had insufficient power. / Conclusions: In this clinical trial of ursodeoxycholic acid in women with intrahepatic cholestasis of pregnancy, there is no evidence that it is effective in reducing a composite of adverse perinatal outcomes. / Future work: Future research should aim to elucidate the aetiology and pathophysiology of adverse perinatal outcomes, particularly stillbirth, in women with intrahepatic cholestasis of pregnancy to assist the development of an effective preventative treatment. Further exploratory analyses may identify groups of women who might respond to ursodeoxycholic acid treatment. / Trial registration: Current Controlled Trials ISRCTN91918806. / Funding: This project was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 7, No. 9. See the NIHR Journals Library website for further project information

Segregation discovery in a social network of companies

We introduce a framework for a data-driven analysis of segregation of minority groups in social networks, and challenge it on a complex scenario. The framework builds on quantitative measures of segregation, called segregation indexes, proposed in the social science literature. The segregation discovery problem consists of searching sub-graphs and sub-groups for which a reference segregation index is above a minimum threshold. A search algorithm is devised that solves the segregation problem. The framework is challenged on the analysis of segregation of social groups in the boards of directors of the real and large network of Italian companies connected through shared directors

Straight from the source's mouth: Controls on field‐constrained sediment export across the entire active Corinth Rift, central Greece

The volume and grain‐size of sediment supplied from catchments fundamentally control basin stratigraphy. Despite their importance, few studies have constrained sediment budgets and grain‐size exported into an active rift at the basin scale. Here, we used the Corinth Rift as a natural laboratory to quantify the controls on sediment export within an active rift. In the field, we measured the hydraulic geometries, surface grain‐sizes of channel bars and full‐weighted grain‐size distributions of river sediment at the mouths of 47 catchments draining the rift (constituting 83% of the areal extent). Results show that the sediment grain‐size increases westward along the southern coast of the Gulf of Corinth, with the coarse‐fraction grain‐sizes (84th percentile of weighted grain‐size distribution) ranging from approximately 19 to 91 mm. We find that the median and coarse‐fraction of the sieved grain‐size distribution are primarily controlled by bedrock lithology, with late Quaternary uplift rates exerting a secondary control. Our results indicate that grain‐size export is primarily controlled by the input grain‐size within the catchment and subsequent abrasion during fluvial transport, both quantities that are sensitive to catchment lithology. We also demonstrate that the median and coarse‐fraction of the grain‐size distribution are predominantly transported in bedload; however, typical sand‐grade particles are transported as suspended load at bankfull conditions, suggesting disparate source‐to‐sink transit timescales for sand and gravel. Finally, we derive both a full Holocene sediment budget and a grain‐size‐specific bedload discharged into the Gulf of Corinth using the grain‐size measurements and previously published estimates of sediment fluxes and volumes. Results show that the bedload sediment budget is primarily comprised (~79%) of pebble to cobble grade (0.475–16 cm). Our results suggest that the grain‐size of sediment export at the rift scale is particularly sensitive to catchment lithology and fluvial mophodynamics, which complicates our ability to make direct inferences of tectonic and palaeoenvironmental forcing from local stratigraphic characteristics

Nutritional and environmental regulation of the synthesis of highly unsaturated fatty acids and of fatty-acid oxidation in Atlantic salmon (Salmo salar L.) enterocytes and hepatocytes

The aim was to determine if highly unsaturated fatty acid (HUFA) synthesis and fatty acid oxidation in Atlantic salmon (Salmo salar L.) intestine was under environmental and/or seasonal regulation. Triplicate groups of salmon were grown through a full two-year cycle on two diets containing either fish oil (FO), or a diet with 75% of the FO replaced by a vegetable oil (VO) blend containing rapeseed, palm and linseed oils. At key points in the life cycle, fatty acyl desaturation/elongation (HUFA synthesis) and oxidation activities were determined in enterocytes and hepatocytes using [1-14C]18:3n-3 as substrate. As observed previously, HUFA synthesis in hepatocytes showed peak activity at seawater transfer and declined thereafter, with activity consistently greater in fish fed the VO diet. In fish fed FO, HUFA synthesis in enterocytes in the freshwater stage was at a similar level to that in hepatocytes. However, HUFA synthesis in enterocytes increased rapidly after seawater transfer and remained high for some months after transfer before decreasing to levels that were again similar to those observed in hepatocytes. Generally, enterocyte HUFA synthesis was higher in fish fed the VO diet compared to the FO diet. Oxidation of [1-14C]18:3n-3 in hepatocytes from fish fed FO tended to decrease during the freshwater phase but then increased steeply, peaking just after transfer before decreasing during the remaining seawater phase. At the peak in oxidation activity around seawater transfer, activity was significantly lower in fish fed VO compared to fish fed FO. In enterocytes, oxidation of [1-14C]18:3 in fish fed FO showed a peak in activity just prior to seawater transfer. In fish fed VO, other than high activity at 9 months, the pattern was similar to that obtained in enterocytes from fish fed FO with a high activity around seawater transfer and declining activity in seawater. In conclusion, fatty acid metabolism in intestinal cells appeared to be under dual nutritional and environmental or seasonal regulation. The temporal patterns for fatty acid oxidation were generally similar in the two cell types, but HUFA synthesis in enterocytes peaked over the summer seawater phase rather than at transfer, as with hepatocytes, suggesting possibly different regulatory cues

Epistemic and Ontic Quantum Realities

Quantum theory has provoked intense discussions about its interpretation since its pioneer days. One of the few scientists who have been continuously engaged in this development from both physical and philosophical perspectives is Carl Friedrich von Weizsaecker. The questions he posed were and are inspiring for many, including the authors of this contribution. Weizsaecker developed Bohr's view of quantum theory as a theory of knowledge. We show that such an epistemic perspective can be consistently complemented by Einstein's ontically oriented position

The effects of socioeconomic status and indices of physical environment on reduced birth weight and preterm births in Eastern Massachusetts

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Air pollution and social characteristics have been shown to affect indicators of health. While use of spatial methods to estimate exposure to air pollution has increased the power to detect effects, questions have been raised about potential for confounding by social factors.Methods: A study of singleton births in Eastern Massachusetts was conducted between 1996 and 2002 to examine the association between indicators of traffic, land use, individual and area-based socioeconomic measures (SEM), and birth outcomes ( birth weight, small for gestational age and preterm births), in a two-level hierarchical model.Results: We found effects of both individual ( education, race, prenatal care index) and area-based ( median household income) SEM with all birth outcomes. The associations for traffic and land use variables were mainly seen with birth weight, with an exception for an effect of cumulative traffic density on small for gestational age. Race/ethnicity of mother was an important predictor of birth outcomes and a strong confounder for both area-based SEM and indices of physical environment. The effects of traffic and land use differed by level of education and median household income.Conclusion: Overall, the findings of the study suggested greater likelihood of reduced birth weight and preterm births among the more socially disadvantaged, and a greater risk of reduced birth weight associated with traffic exposures. Results revealed the importance of controlling simultaneously for SEM and environmental exposures as the way to better understand determinants of health.This work is supported by the Harvard Environmental Protection Agency (EPA) Center, Grants R827353 and R-832416, and National Institute for Environmental Health Science (NIEHS) ES-0002

Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi.

In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART). We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy