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Purpose - The purpose of this article is to investigate the influences of green product innovation and product process innovation on two constructs of green innovation casual chain: green product competitive advantage and green new product success. The impacts of green product competitive advantage as a partial mediator in the link between green product/process innovations and green new product success are also examined. Design/methodology/approach - A model with four constructs is presented and tested on a sample of 203 R&D project leaders of electronics firms operating in China using quantitative methods. Findings - It is found that green product and process innovations are positively associated with green product competitive advantage and green new product success, and green product competitive advantage partially mediates the relationships between green product/process innovations and green new product success. It is also found that green product innovation exerts a stronger influence on the consequential constructs than green process innovation. Practical implications - The positive causalities among the constructs suggest that green innovation is more than a branding support. It pays to pursue green innovation. Green product innovation is demonstrated to have a positively stronger influence on both green product competitive advantage and green new product success than green process innovation. The difference in impact signals that when operating under limited resources, green product innovation should be pursued first. Originality/value - The article addresses the gap in green innovation theory concerning the associations among the key constructs of green innovation causal chain. It is the first green innovation research ever conducted in the e-industry in China. The causalities identified can be leveraged to improve Chinese e-industry players' innovative and competitive capabilities and to encourage them to stay proactive in addressing challenges arising from environmental issues.

Background Postoperative pain control can be challenging in patients undergoing hepatectomy. A previous retrospective study on hepatobiliary/ pancreatic surgeries showed better postoperative pain control in patients who received propofol TIVA. The aim of this study was to determine the analgesic effect of propofol TIVA for hepatectomy. This clinical study has been registered at ClinicalTrials.gov (NCT03597997). Methods A prospective randomized controlled trial was performed to compare the analgesic effect of propofol TIVA versus inhalational anaesthesia. Patients aged between 18 and 80 years old with an American Society of Anesthesiologist (ASA) physical status of I-III scheduled for elective hepatectomy were recruited. Ninety patients were randomly allocated to receive either propofol TIVA (TIVA group) or inhalational anaesthesia with sevoflurane (SEVO group). Perioperative anaesthetic/analgesic management was the same for both groups. Numerical rating scale (NRS) pain scores, postoperative morphine consumption, quality of recovery, patient satisfaction and adverse effects were evaluated during the acute postoperative period and at 3 and 6 months after surgery. Results No significant differences were found for acute postoperative pain scores (both at rest and during coughing) and postoperative morphine consumption between TIVA and SEVO groups. Patients given TIVA had lower pain scores with coughing at 3 months after surgery ( p  = 0.014, and FDR < 0.1). TIVA group was associated with better quality of recovery on postoperative day (POD) 3 ( p  = 0.038, and FDR < 0.1), less nausea ( p  = 0.011, and FDR < 0.1 on POD 2; p  = 0.013, and FDR < 0.1 on POD 3) and constipation ( p  = 0.013, and FDR < 0.1 on POD 3). Conclusion Propofol TIVA did not improve acute postoperative pain control compared to inhalational anaesthesia in patients who underwent hepatectomy. Our results do not support the use of propofol TIVA for reducing acute postoperative pain after hepatectomy.

Low back pain (LBP) is a common and important clinical problem. In addition to pain, patients are also affected by personal, social, and economic burdens. Intervertebral disc (IVD) degeneration is a common cause of LBP, further increasing the patient’s morbidity and medical costs. The limitations of current treatment strategies for long-term pain relief mean that increasing attention has been paid to regenerative medicine. We carried out a narrative review to explore the roles of four types of regenerative medicine for treating LBP: marrow-derived stem cells, growth factors, platelet-rich plasma, and prolotherapy. Marrow-derived stem cells are regarded as an ideal cell source for IVD regeneration. Growth factors may stimulate the synthesis of extracellular matrix and attenuate or reverse the degenerative process in IVD, while platelet-rich plasma, which contains multiple growth factors, is thought to be a promising alternative therapy for IVD degeneration. Prolotherapy can initiate the body’s inflammatory healing response to repair injured joints and connective tissues. This review summarizes the mechanisms, in vitro and in vivo studies, and clinical applications of these four types of regenerative medicine in patients with LBP.

There is growing interest in using cannabinoids for chronic pain. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain. PubMed, EMBASE, Web of Science, Cochrane CENTRAL and clinicaltrials.gov were searched up to December 2018. Information on the type, dosage, route of administration, pain conditions, pain scores, and adverse events were extracted for qualitative analysis. Meta-analysis of analgesic efficacy was performed. Meta-regression was performed to compare the analgesic efficacy for different pain conditions (neuropathic versus non-neuropathic pain). Risk of bias was assessed by The Cochrane Risk of Bias tool, and the strength of the evidence was assessed using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Forty-three randomized controlled trials were included. Meta-analysis was performed for 33 studies that compared cannabinoids to placebo, and showed a mean pain score (scale 0–10) reduction of −0.70 ( p  < 0.001, random effect). Meta-regression showed that analgesic efficacy was similar for neuropathic and non-neuropathic pain (Difference = −0.14, p  = 0.262). Inhaled, oral, and oromucosal administration all provided statistically significant, but small reduction in mean pain score (−0.97, −0.85, −0.45, all p  < 0.001). Incidence of serious adverse events was rare, and non-serious adverse events were usually mild to moderate. Heterogeneity was moderate. The GRADE level of evidence was low to moderate. Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption, but effect sizes were small. Efficacy for neuropathic and non-neuropathic pain was similar.

Purpose – What leads to new product success (NPS) is a very complex issue. Although prior research widely demonstrates that entrepreneurial orientation (EO) is a determinant for NPS and environmental turbulence is a form of unpredictability which impacts on the success of a product, little research has been conducted to examine if and to what extent environmental turbulence induces the EO behaviors of a firm and how these behaviors contribute to NPS. The paper aims to discuss these issues. Design/methodology/approach – This study, which used data collected from 244 China-based electronics manufacturers, proposed and tested the theoretical relationships among the three constructs in the context of the electronics industry in China. Findings – Results revealed that the three dimensions of EO (innovativeness, proactiveness and risk-taking) drive NPS. Environmental turbulence strongly influenced all three dimensions of EO, though its influence on NPS was mixed as there existed a strong negative but insignificant direct association between the two constructs. Innovativeness, which was found to be most effective in driving NPS in the EO and NPS relationship, was relatively less responsive to environmental turbulence than proactiveness. The study confirmed the postulated role of environmental turbulence in inducing the EO behaviors of a firm, signaling environmental turbulence, if tactfully leveraged, can play a positive role in new product development (NPD). Research limitations/implications – The study is quantitative using data emanating from the electronics manufacturing industry in China, further empirical study would be useful to verify and complement the results in other industries and other countries. Originality/value – This study contributes to the scholarly inquiry of EO and NPD by exploring the influences of environmental turbulence and EO on NPS. As environmental turbulence induces EO and EO mediates the relationship between environmental turbulence and NPS, simultaneous consideration of these two constructs can lend useful insight into their joint impacts on NPD. Theoretical and managerial implications were examined and policy implications, especially the practicality of the findings to policymakers in China, were discussed.

In Western countries, chronic pain patients with neuropathic characteristics have more intense pain, greater negative impact in quality of life and worse psychological well-being. The aim of this study was to compare the outcomes, impact, and health seeking behaviours in Chinese chronic pain patients with and without neuropathic characteristics in Hong Kong. Random telephone survey was conducted on the general Hong Kong population, and based on the Nuprin Pain Report. Specific questions on chronic and neuropathic pain were included. Respondents with pain lasting three months or more were asked to indicate their two most painful sites. Chi-square and Mann-Whitney U-test were used to investigate differences between variables in patients with and without neuropathic characteristics. P<0.05 was regarded as significant. The response rate was 32.3%. Chronic pain patients with neuropathic characteristics reported higher pain scores and longer duration of pain (p = 0.0001). They reported greater negative impact on work and effect on daily life (p = 0.0131); were significantly more likely to consult pain specialists (p = 0.0006), Chinese medicine practitioners (p = 0.0203), and psychiatrists (p = 0.0212); and were significantly less likely to be prescribed oral analgesics (p = 0.0226), to feel 'very satisfied' (p = 0.0263) with prescribed treatment and to find oral analgesics 'very useful' (p = 0.0215). There was no difference in oral analgesic medications taken. Chinese individuals having chronic pain with neuropathic characteristics had worse pain related outcomes. Differences in help-seeking behaviour were observed. Lack of appropriate analgesic prescription suggests that identification and management of chronic neuropathic pain in Hong Kong needs to be improved.

Background: Meperidine, a synthetic opioid, has a rapid onset and short duration of action. Mounting evidence has challenged meperidine’s analgesic benefits, and concerns have been raised about its safety profile. Despite recommendations to restrict the prescription of meperidine, the drug remains frequently used. Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety of meperidine for acute postoperative and labor pain. Study Design: This was a narrative review of the analgesic efficacy and side effects of meperidine compared to other analgesic drugs for acute postoperative and labor pain in adults. Setting: Randomized controlled trials that compared the analgesic efficacy and side effect profile of meperidine versus another analgesic drug in adult patients were evaluated. Methods: A systemized search of randomized controlled trials studying meperidine for acute postoperative or labor pain in the adult patient population from PubMed, Medline, and EMBASE was performed. Included studies reported on different routes of meperidine administration including intramuscular, intravenous, and patient-controlled analgesia in various surgical procedures such as abdominal surgery, Cesarean section, gynecological surgery, orthopedic surgery, cardiothoracic surgery, as well as for labor analgesia. Meperidine’s analgesic efficacy and safety profile were compared to other opioids (morphine, tramadol, fentanyl, buprenorphine, nalbuphine, and pentazocine), nonsteroidal anti-inflammatory drugs (ketorolac, diclofenac, and indomethacin), dipyrone, ketamine, and bupivacaine. Results: A total of 62 randomized controlled trials published between 1972 and 2018 were reviewed. Meperidine had a similar or inferior analgesic efficacy compared to other analgesics for acute postoperative or labor pain. Meperidine was associated with more sedation and respiratory depression. Limitations: The sample sizes of many clinical studies were small, and therefore probably insufficiently powered to detect differences in uncommon side effects, such as central nervous system toxicity. In addition, some of the included clinical studies were old. Conclusion: Considering the availability of other effective analgesics with potentially fewer side effects, the use of meperidine for acute postoperative or labor pain should not be recommended. Key words: Acute postoperative pain, adverse effects, labor analgesia, meperidine, pethidine

Purpose - This research seeks to investigate key determinants of new product success (NPS) from the perspective of new product development (NPD) team leaders in the electronics industry in China. A model is proposed investigating the interplay among elements of market orientation and the moderating effects of customer and competitor orientations on the relationship between R&D-Marketing cooperation and NPS.Design methodology approach - Data were collected from 217 respondents to an online questionnaire that had been sent to 3,000 potential participants randomly selected from electronics firms across China. Regression analysis was used to analyse the data.Findings - Results from the research support the hypotheses that NPS is driven by R&D-Marketing cooperation, customer and competitor orientations. Also, the association between R&D-Marketing cooperation and NPS is moderated by customer and competitor orientations.Practical implications - This research confirms the positive role that R&D-Marketing cooperation plays in NPS and the moderating effects of customer and competitor orientations on the association between R&D-Marketing cooperation and NPS. The findings are of relevance to management practitioners as developing successful new products has become an ever more pressing issue in the wake of rising labour cost and increasing market competition.Originality value - Previous NPD literature has focused primarily on NPD activities in Western and developed countries. This research fills the research gap by identifying the empirical links between R&D-Marketing cooperation and NPS. It is the first to examine the moderating effects of customer and competitor orientations in the relationship between R&D-Marketing cooperation and NPS of electronics firms in China.

Unlike the commonly used method of blue-white screening for gene insertion, a fluorescent protein-based screening method offers a gain-of-function screening process without using any co-factors and a gene fusion product with a fluorescent protein reporter that is further useful in cell imaging studies. However, complications related to protein-folding efficiencies of the gene insert in fusion with fluorescent protein reporters prevent effective on-plate bacterial colony selection leading to its limited use. Here, we present three methods to tackle this problem. Our first method promotes the folding of the gene insert by using an N-terminal protein such as calmodulin that is well folded and expressed. Under this method, fluorescence was increased more than 30x over control allowing for enhanced screening. Our second method creates a fluorescent protein that is N-terminal to the gene upon insertion, thereby reducing the dependency of the fluorescent protein reporter on the folding of the gene insert. Our third method eliminates any dependence of the fluorescent protein reporter on the folding of the gene insert by using a stop and start sequence for protein translation. The three methods together will expand the usefulness of fluorescence on-plate screening and offer a powerful alternative to blue-white screening.