bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflections over the past and present research and higher education on tourism in Czechoslovakia and Slovakia
Authors: Kučerová Jana , Gúčik Marián
Published: February 2022

In Slovakia (and former Czechoslovakia), tourism was the subject of a systematic research of more research institutions between 1960 and 1990. These were institutions managed by government departments. Tourism research in Czechoslovakia started in the academic institutions in 1964, when the Department of Tourism and Hospitality was established at Bratislava School of Economics in Slovakia. This department moved to Banská Bystrica in 1973 and became the keystone of the newly established Faculty of Economics of Services and Tourism of the Bratislava School of Economics. After 1990, tourism research in Slovakia was concentrated in the academic institutions, and the number of higher education institutions offering studies in tourism and hotel management increased to seven. Research institutions changed their character, or disappeared in the privatization process. This paper outlines the specialization of tourism research in particular decades from the 1960s in the former Czechoslovakia, and after the splitting of the country into two separate states; it characterizes tourism research and education in Slovakia. Many results have been achieved thanks to the personal commitment and enthusiasm of scientists and teachers, as well as due to the conditions created for scientific research and tourism development by the state. Current tourism research is compared with the past fragmented and uncoordinated situation, which led to the wasting of human and financial resources.
The influence of tourism experience self-congruity on the use of virtual social networks
Authors: Cortés Gonzalo
Published: February 2022

Based on previous research in the literature of symbolic consumption and social media, the present study analyses the relationship between tourism experience self-congruity, perceived social value and tourists’ use of virtual social networks. The study presents a series of hypotheses and an empirical model, which establishes the relationship between these constructs. In order to contrast the hypotheses, a quantitative research was carried out in the city of Valencia (Spain), using a structured survey and personal interviews. During the analysis of the results, the reliability and the validity of the scales used to measure the constructs were verified by confirmatory factor analysis (CFA). Subsequently, the methodology of the structural equation models (SEM) was used to estimate the relation between the constructs.The results show that tourists perceive higher social value when they live a tourism experience that is congruent with their self-concepts and, when tourists perceive higher social value, the revisit intention increases. When it comes to virtual social networks, experience self-congruity and perceived social value influence their use. Finally, the use of social networks also increases the perceived social value of the experience.
Does income from tourism sources have an equalising effect on inequality among the poor? The case of Langkawi island, Malaysia
Authors: Roslan A. , Noor Mohd
Published: February 2022

The question posed in this paper is this: is income from tourism sources an equalising or a disequalising factor in the distribution of income among the poor? The examination of this question is imperative since recent literature has suggested that tourism development should be linked with poverty reduction. Unfortunately, this is usually ignored in the formulation of tourism policies and strategies. This paper, therefore, argues that as well as encouraging the poor to participate in the tourism industry, the question of inequality among the poor resulting from their participation in the tourism industry should be considered. In other words, the potential of tourism as a vehicle for scaling up income of the poor should not lead to the widening of inequality among the poor, which could lead to social and political instability. This paper explores this issue by examining the case of the poor households in Langkawi Island, one of the major tourist destinations in Malaysia.
Antecedents and outcomes of a City’s Global Image: the impact of a tourist staple
Authors: Bairrada Cristela , Vieira Maria , Costa João
Published: February 2022

It is paramount to understand the impact of distinctive features in a city’s global image. This research was based on a questionnaire to tourists who visited Coimbra, Portugal (n=255), a city best known for its 727-year-old University. Results showed that the affective image and the personality of the University of Coimbra brand has a direct influence on the city’s global image as a tourist destination. Results also showed that the global destination image has a positive impact on satisfaction. Overall, there are impacts of memorable experience in affective image and of satisfaction in brand evangelism. A distinctive feature is forcedly an anchor for the city’s brand development; separate and unrelated brand strategies for a tourist staple and the city can be conflicting.
Examining the effects of personal factors and travel characteristics on tourists’ perceived crowding
Authors: Rasoolimanesh S. , Jaafar Mastura , Marzuki Azizan , Abdullah Shardy
Published: February 2022

This paper investigates the effects of personal factors and travel characteristics on tourists’ perceived crowding of Kilim Geopark, Langkawi Island, Malaysia. There are paucity of studies in the literature to investigate the influencing factors on perceived crowding, including personal factors and travel characteristics. Moreover, we justify, propose and assess both influencing factors and perceived crowding as formative (composite) factors, which has not been a common practice in previous studies. Data for this study was collected during March 2014. To analyze the proposed relationships, this study uses partial least squares–structural equation modeling (PLS-SEM). The results show a significant effect for age, education, and income level on perceived crowding. In addition, the findings support the effects of motivation and travel characteristics on perceived crowding. However, the results of this study do not support the effects of nationality, gender, or destination familiarity on perceived crowding. This study has a number of theoretical and methodological contributions. Moreover, the results can assist Langkawi Island’s local authorities to understand the perceptions of tourists, and increase their satisfaction.
The first chatbot of a tourism/hospitality journal: Editor’s impressions
Authors: Ivanov Stanislav
Published: February 2022

The first chatbot of an academic journal in the field of tourism and hospitality was launched in 2017. This editorial presents the structure of the chatbot of the European Journal of Tourism Research, reflects on Editor’s experience in developing and using the chatbot, and provides practical recommendations to editors and publishers who may wish to adopt chatbots for social media communications.
Do ambient scents in hotel guest rooms affect customers’ emotions?
Authors: Anguera-Torrell Oriol , León Ivan , Cappai Alessandra , Glòria Sanmartín Antolín Glòria Sanmartín Antolín
Published: February 2022

The introduction of ambient scents in different business facilities might be an effective strategy to influence customers’ emotions and, ultimately, their experience. Yet, there is scant evidence on the effects of introducing ambient scents in hotels and, particularly, in hotels’ private areas such as the guest rooms. Accordingly, this study aims to analyse the impact on customers’ positive emotions when a pleasant ambient scent is introduced in a hotel guest room. To this end, a randomized control trial was conducted in a real four-star hotel in Barcelona in which two experimental groups (N=99) were invited to enter and experience a scented guest room and an identical but unscented room, respectively. The happiness level and the emotional valence of the experiment’s participants were measured using a facial recognition technique. This methodological strategy represents one of the significant contributions of the study. The results show that, on average, individuals who entered the scented room were happier and had a better emotional state than individuals who entered the unscented room. These results suggest an important managerial implication for hoteliers who can improve the guests’ experience by implementing a non- expensive action and opens an avenue for future studies on scent marketing in hotels.
Exploring the images of hospitality line-level employment: Hotel employees’ perceptions vs. the general public's perceptions
Authors: Fuchs Galia , Reichel Arie , Poria Yaniv
Published: February 2022

The study explores, compares, and contrasts the image of line-level hotel employment and its underlying dimensions as held by the general public and by hotel employees. Additionally, this study clarifies the images of six specific line-level occupations. A quantitative research approach was adopted. The analysis included 302 hospitality employees and 273 participants representing the general public. The findings revealed that the image of line-level employment is a multifaceted concept, represented by eight factors that were further utilized for the identification of the employment image profiles of the combined two samples. Furthermore, the study found differences in images of six line-level occupations, indicating higher rankings provided by current hospitality employees. Managerial implications and suggestions for future research are presented.
The adoption of self-service kiosks in quick-service restaurants
Authors: Rastegar Nazi , Flaherty Joan , Liang Lena , Choi Hwan-suk
Published: February 2022

This study investigates factors influencing the customers’ decision to use self-service kiosks in quick service restaurants. A model incorporating Technology Acceptance Model and Satisfaction Model was developed to examine the relationships among trust, self-efficacy, perceived ease of use, perceived usefulness, perceived enjoyment, perceived value, satisfaction and behavioural intention toward using these kiosks. The moderating impact of age, gender and past self-service kiosks experience was also examined. An online survey that measured customer perceptions and evaluations of self-service kiosks in McDonald’s garnered 415 responses. Data were analysed using structural equation modelling and multiple regression analyses. Recommendations address the importance of clear, accessible information about kiosk operation; visible security measures; and enhanced features such as menu item nutrient profiles and promotions. These findings and recommendations can be used to promote self-service kiosk usage, thereby addressing the COVID-19 induced prohibitions against direct service in restaurants.
The symmetric and asymmetric impacts of cognitive attitude components on overall mass tourism destination image: gender comparison
Authors: Ceylan Demet , Cizel Beykan , Hatice Hatice
Published: February 2022

Mass tourism has become the preferred travel type for millions of people. All-inclusive (AI) initially emerged as an accommodation type for mass tourism destinations but has evolved to become its own form of tourism. Factors motivating tourists towards a mass-tourism destination offering all-inclusive products may vary according to market segments and demographic attributes. Research shows that cognitive factors that affect a destination’s image, which is one factor that attracts tourists, are not symmetrical in all cases. This study examines the effect of cognitive attitude components on the general destination image perception of tourists by using Asymmetric Impact-Performance Analysis (AIPA) to assess Antalya, a prominent AI mass-tourism destination. Regression analysis results provide important insights for destination management organisations (DMO) by classifying the asymmetric effects of each destination’s cognitive attitude component on overall destination image perception, according to gender.
Investigating the satisfaction of active event sport tourists
Authors: Perić Marko , Tanković Ana
Published: February 2022

Active event sport tourists (AESTs) are those tourists who are taking part in organised events as competitors. Each event is held in a particular destination and, as a part of a highly competitive industry, both events and destinations offer an ever-widening range of services, striving to make their visitors satisfied. In order to better understand, conceptualize and manage the AESTs’ satisfaction, the primary research based on a questionnaire survey was conducted on 16 small-scale sports events, collecting 502 responses. Results indicate that six satisfaction categories emerged: four event-related dimensions (staff and communication, event reputation, safety, and facilities and key processes) and two destination-related dimensions (destination offering and destination attributes). Understanding the role of the satisfaction of AESTs in a small-scale sport event creates both scientific and practical contributions, where sport event management and marketing need to consider each of these satisfaction categories in order to design and deliver the best active sport tourism experience.
Luxury tourism – a review of the literature
Authors: Iloranta Riina
Published: February 2022

This study aims to provide a holistic and comprehensive picture of the current state of luxury tourism research. In order to do so, 119 articles published between 2004-2019 were analysed by content analysis and a systematic literature review. Based on the analysis of the systematic literature review, the study synthesised the theoretical research streams on luxury tourism research. The studies approached the context via ten different key features. The findings suggest that current luxury tourism research concentrates on quantitative studies, conducted mainly in contexts that present traditional luxury tourism products. The synthesis of the theoretical streams identifies that research is based on marketing literature, and this is discussed with four different approaches (1) consumer consumption, (2) brand management, (3) service marketing, and (4) consumer behaviour-oriented perspective. Luxury tourism is a multidimensional and broad concept that requires attention in academic research. The study also gives suggestions for future research opportunities.
Book review of Koc, E. (2020). Cross-Cultural Aspects of Tourism and Hospitality. ISBN 978-0-367-862893, Routledge: New York & London, 370 pp.
Authors: Tuncdogan Aybars
Published: February 2022

Abstract

This book review essay discusses “Cross-Cultural Aspects of Tourism and Hospitality” (Routledge, 4 September 2020, in English, ISBN: 9780367862893, Hardback: £128.00; Paperback: £26.39; E-book: £26.39) by Erdogan Koc, which provides a summary of culture research with a focus on tourism and hospitality. The book is written in a concise and to-the-point manner (13 chapters, 370 pages), and considers the issue both from the perspective of the consumer marketing and service management. Chapters include several elements (e.g., activities and brief case studies) that facilitate learning and class discussion. Overall, it represents a text that is useful for university students, researchers and practitioners in the areas of tourism and hospitality, marketing and management.
The relationships between institutionalization and dual commitment: A study on hotel kitchen employees
Authors: Evren Emine , Cakici A. Celil
Published: February 2022

Long-termed continuance of employees in hotel enterprises, especially in kitchen department where standard production is of utmost importance, is critical for organizational success. At this point, how institutionalization, a phenomenon that is usually associated with standardization, effects the organizational commitment (OC) is an important question. Another important question is how commitment to an impressive supervisor such as the chef mediates the relationship between institutionalization and OC in institutionalized hotels where standards become important instead of personal approaches. In this context, the relationship between institutionalization, OC, and commitment to the supervisor (CS), which has not been studied before, has been examined within the framework of hotel businesses. The data were collected with an online survey. The sample consisted of the kitchen staff of a national hotel chain in Turkey. The findings demonstrated that the effects of institutionalization on OC and CS were significant. CS partially mediates the relationship between institutionalization and OC. When considered within the scope of the dimensions, the CS has a partial mediating effect on the relationship between cultural power and all three dimensions of OC (affective, continuance, normative). The effect of formalization and professionalization on affective and normative commitment is partially mediated by CS.
European tourist destinations on the internet search engines
Authors: Díaz Estrella , Blázquez Juan , Martín-Consuegra David
Published: February 2022

This paper examines the accessibility and visibility of tourist destinations in a search engine as anopportunity to influence destination competitiveness. The study employed a research design thatsimulates a traveller’s use of four search engines for travel planning by using the concept “tourism”and a set of pre-defined keywords in combination with European tourist destination names. Theresults of this research reveal that search engines index a great number of websites related totourism, although the visibility of tourist destinations is extremely low.
Time allocation in a museum: an empirical investigation
Authors: Brida Juan , Meleddu Marta , Pulina Manuela , Statzu Vania
Published: February 2022

This paper examines the determinants that influence the time spent by visitors in a cultural site. This empirical investigation is based on survey data collected at the South Tyrol's Museum of Archaeology in Bolzano (Italy) between June and August 2010. Descriptive statistics show that, on average, visitors spend almost two hours, much longer than the length of stay in other museums as found in former empirical studies. Empirically, a zero-truncated Negative Binomial model has proved to achieve the best results. The analysis reveals that gender, age, income, group type, time spent at the destination, importance attributed to the museum and weather conditions have an impact on length of stay at this cultural site. These findings provide a useful tool to implement management directions about the museum.
Guests’ perceptions of hotels’ (un)fair treatment of staff: their impact on service recovery
Authors: Zoghbi-Manrique-de-Lara Pablo , Suárez-Acosta Miguel , Arias-Febles José
Published: February 2022

Limited previous research has examined the impact that third-party guests’ observations of (in)justice for others can have on a hotel. This study deals with this issue by testing whether the way guests who raised a complaint perceive management treatment towards hotel staff influence their satisfaction with service recovery (SSR), when controlling for perceptions of justice for the self: distributive, procedural, and interactional. The paper first verifies the distinctiveness of all the justice variables included in this study. Data were collected from 288 guests who had experienced a service failure in seven sampled hotels in the Canary Islands (Spain). Structural equation modeling (SEM) results indicated that guests who raised a complaint and were unhappy on the management treatment towards hotel staff, showed significantly lower satisfaction with service recovery (SSR). These findings suggest that, like justice for the self, justice toward staff also predicts satisfaction with service recovery (SSR), thus earning a place in the service recovery literature. Suggestions for future research and practical implications are also presented.
Quality assessment in the Italian mountain huts
Authors: Duglio Stefano , Beltramo Riccardo
Published: February 2022

Because of its intangibility, the evaluation of the quality in the lodging services is extremely complicated. In the last 30 years several studies have focused on the measurement of the quality in the tourist organisations, in order to define a methodology able to evaluate their performances. The paper contribution to the debate is focused on the quality of service in a specific kind of accommodation, the mountain hut, which operates in a fragile habitat. The study presents the results of an empirical analysis on the perception of quality in the mountain huts conducted by interviewing 372 guests in the Piedmont Region in the north-western Italian Alps. The analysis highlights the importance, on the one hand, of a correct communication of the activities conducted by managers of the mountain huts and, on the other hand, the substance of avoiding a short-contact experience between guest and structure. Finally, the paper underlines how this experience was also useful in order to reason about the definition of a quality label specifically thought for mountain huts.
Developing a new typology for a behavioural classification of stakeholders using the case of tourism public policy planning in the snow sports industry
Authors: Tomsett Paula , Shaw Michael
Published: February 2022

Stakeholders have been broadly described as those people or groups with an interest in the outcomes of the actions taken by others, which includes actions by commercial businesses, not-for-profit organizations, and those of all levels of government as well as their delegated representatives. In considering their role the types and classification of stakeholders has become increasingly important to the efficient management of the public policy planning process, particularly in the tourism industry with its very diverse stakeholder population. In recent decades research on stakeholders in public policy making has been described in detail (through studies of attributes, interests, and influences) and has sought to categorize stakeholders (especially in identifying who should be a stakeholder and who is a genuine stakeholder) to better manage the consultative process involved. Using the process of constructing a strategic plan for the government controlled ski resorts in the State of Victoria (Australia) which involved substantial involvement from the public, businesses, property lessees and skiing enthusiasts, this paper reviews the utility of currently used stakeholder classification schema from both a theoretical and practical viewpoint and posits that a better approach to understanding differences would consider the behavioural variations between the stakeholder groups as they participate in the consultative phases of the process. It concludes that public policy managers can improve their understanding of potential stakeholder responses and proactively engage these people and groups in the public policy planning process by understanding the impact of the outcomes and nurturing their different levels of involvement and on-going support. This can be expected to improve acceptance and support of final policy decisions that are made, especially when difficult compromises between alternatives are required.
Editorial
Authors: Chávez Espinoza Raúl Arturo
Published: February 2022

La expresión por escrito de las ideas ha dejado en nuestra cultura una huella profunda y constituye una práctica llevada a cabo por las civilizaciones más sobresalientes. Este proceso condujo al nacimiento del libro, que viene a ser uno de los mejores formatos para preservar ideas de todas clases que otrora y en su momento fueron escritas en pergamino o más atrás en tablillas de barro.

DOI: https://doi.org/10.54167/tecnociencia.v1i1.25
Enfermedades ocupacionales y accidentes de trabajo en Chihuahua: Una aproximación a la oculta realidad
Authors: Idrovo-Velandia Alvaro Javier , Guevara-Godinez Dra. Rosa María
Published: February 2022

En Chihuahua la ocurrencia de enfermedades ocupacionales y accidentes de trabajo es desconocida. Este dato es fundamental para determinar las acciones de prevención requeridas para proteger la salud de los trabajadores. En este estudio se estima la incidencia anual de enfermedades ocupacionales y accidentes de trabajo (general, discapacitantes y fatales). Las enfermedades ocupacionales fueron estimadas usando el método empleado en el estudio de “Carga Global de la Enfermedad”, y los accidentes extrapolando los datos nacionales presentados por el Instituto Mexicano del Seguro Social. Adicionalmente se realizaron 50000 simulaciones Monte Carlo para mejorar las estimaciones deterministas iniciales. Los resultados indican que deben ocurrir aproximadamente 7574 casos de enfermedades ocupacionales/año (equivalentes a 5,83/1000 trabajadores- año), siendo las más frecuentes las alteraciones musculoesqueléticas (1,84/1000 trabajadores-año), las enfermedades respiratorias crónicas (1,44/1000 trabajadores-año) y las dermatosis (1,06/1000 trabajadores-año). Deben ocurrir aproximadamente 29868 accidentes/año (22,99/1000 trabajadores-año). De estos, 1299 pueden ser discapacitantes (1,00/1000 trabajadores- año) y 117 fatales (0,09/1000 trabajadores-año). Estas cifras sirven como estimación inicial de la problemática sanitaria en las empresas chihuahuenses, y de punto de partida para futuras intervenciones preventivas y proyectos de investigación.

DOI: https://doi.org/10.54167/tecnociencia.v1i3.58
Formación de partículas de polietilenglicol en presencia de calcitonina como nuevos biomateriales
Authors: Monreal-Romero Humberto Alejandro , Villegas-Ham Julio , Guzmán Medrano Rebeca , Duarte-Rico Raquel , Loya-Loya Marta , Pajaro-Hernández Ramón , Pinedo-Hernández Janeth Sarahí , García-Torres Evelyn
Published: February 2022

En este estudio, la formación de partículas de polietilenglicol en presencia de calcitonina de varios tamaños, es presentado. El presente trabajo tiene como objetivo mostrar una fácil ruta para la formación de nuevos biomateriales usando sistemas biológicos. La muestra de polietilenglicol fue preparada con Calcitonina; subsecuentemente, las muestras fueron sujetas a tratamiento térmico a 28° C. Las características estructurales y morfológicas fueron determinadas usando Difracción de Rayos–X, Microscopia Electrónico de Barrido, Análisis de Energía Dispersiva de Rayos-X y Microscopia Electrónico de Transmisión. Los resultados mostraron la formación de partículas con tamaños de 1 a 3 μm de diámetro. La presencia de fase cristalina no pudo ser detectada mediante difracción de rayos-X. Se observaron además, partículas de 5 nm en la estructura del compuesto. Este resultado, es importante en medicina, porque partículas de Polietilenglicol/Calcitonina pueden ser aplicadas como vehículos farmacéuticos.

DOI: https://doi.org/10.54167/tecnociencia.v1i3.59
Evaluating the Promotion Requirements for the Appointment of Office-Based Educators in the Department of Basic Education in South Africa
Authors: Mbokazi Msawenkosi Sandile , Mkhasibe Rachel Gugu , Ajani Oluwatoyin Ayodele
Published: February 2022

Various promotion requirements are adopted in the appointment of classroom or subject educators as office-based educators or subject advisors (education specialists) in the Department of Basic Education. This qualitative adopted interpretive paradigm study sought to explore educators' lived experiences on the promotion requirements espoused by the Department for the appointment of qualified educators as office-based educators. Ten educator-participants were purposively selected for a semi-structured, face-to-face interview to collect in-depth data for the study. Collected data were thematically analysed to generate themes for the presentation and discussion of findings. The promotion requirements for office-based educators are inadequately utilised in the selection of suitable candidates for the posts. The study established an unfair promotion process in the appointment of office-based educators, and thus, many qualified educators are disadvantaged. The study recommends that promotion requirements should be adhered to in the selection process, to ensure fairness and social justice for all qualified candidates.
Identifying Competencies for Leisure and Hospitality Curriculum in a Rural Region
Authors: Dixon Raymond A. , Jovanovska Emilija
Published: February 2022

This case study describes how competencies that are common across entities that operate in the leisure and hospitality industry in North Central Idaho were identified. The leisure and hospitality industry is crucial to the economy of many rural regions with scenic surroundings. Tourists’ satisfaction, however, depends on their experiences with frontline staff in the industry and service encounters are among the significant factors for customer satisfaction. Developing curriculum that leads to the proper training of frontline customer service representatives is important. A groupware process using workers in the leisure and hospitality sector was used to identify duties, tasks, general knowledge, skills, and attitudes for a guest relations agent. Issues and future trends were also identified. Results show half of the duties referenced essential interaction with customers, such as communicating to support customers and team, providing customer service, providing product/service/organization information, and providing customer assistance for local and regional activities. Trends and issues also point to the need to be prepared for factors such as outbreak of disease that may affect the operations in the sector.
Evaluation of Google Image Translate in Rendering Arabic Signage into English
Authors: Almahasees Zakaryia , Mahmoud Sameh
Published: February 2022

When people travel to another country for work or leisure, they regularly need a medium to help them understand the written messages in other languages. Google Translate offers a new service: translating the content of images (texts) instantly and freely into 100 languages powered by the Neural Machine Translation approach (NMT). In this vein, the current research paper attempts to evaluate the accuracy of Google Image Translate service in rendering the texts printed on Arabic signage: banners and road and shop signs from Arabic into English. Besides, it aims to identify the capacity of Google Translate in rendering Arabic signage into English effectively without the help of human translators. The paper adopts the Linguistic Error Analysis Framework of Costa et al. (2015) in analyzing the output of Google image service in terms of orthography, grammar, lexis, and semantics. The paper shows that Google Translate made the following errors while rendering the content of images into English: mistranslation, omission, additions, wrong choice, misordering, subject-verb disagreement, and semantic errors. In conclusion, the Google Image Translate service helps the users configure the gist of the image. However, a human translator is still needed since MT may not provide an adequate and effective translation as humans do.
Between the Homeland and Diaspora: Identity Dilemma in Indian Literature
Authors: Borgohain Indrani Atul , Ammari Deema
Published: February 2022

The article aims to analytically and comparatively examine how the negotiation of identity is represented in Indian literature, both in the homeland and abroad, in a situation where cultures meet, collide, and merge. The focus of the article will be on four books: Aravind Adiga’s The White Tiger (2008), Bapsi Sidwa’s Water (2006), Kiran Desai’s The Inheritance of Loss (2006), and Bharathi Mukherjee’s Jasmine (1989). All the authors write about identity from a particular cultural context: the Bengali community in the USA, Brahmins in the Indian caste system, the privileged and less-privileged status of Indian individuals, and the hegemonic aspirations of the middle class that have taken the form of politics and produce socio-cultural inequalities. Because of the complex social structure dominated by the Indian caste system, one aspect of migrant experiences is the limitations placed by society on their identity, which can also be a critical determinant of their economic well-being and thus affect identity formation. Accordingly, the presumption is that the utility of the protagonists, both the immigrants and the locals in their homeland, encompasses economic well-being and cultural identity. Despite their sense of alienation, displacement, and rootlessness, the protagonists in all the novels that I have mentioned above manage to carve out a space of belonging for themselves, be it in their homeland or abroad, despite social, political, and cultural obstacles.
5-Year Revision Rates After Elective Multilevel Lumbar/Thoracolumbar Instrumented Fusions in Older Patients: An Analysis of State Databases
Authors: Cummins Daniel D. , Callahan Matthew , Scheffler Aaron , Theologis Alekos A.
Published: February 2022

Objective:

The purpose of this study wasto evaluate cause-specific 5-year revision rates and risk factors for revision after elective multilevel lumbar instrumented fusion in older patients.

Methods:

Older patients (>60 years) who underwent elective multilevel (3+) lumbar instrumented fusions were identified in Healthcare Cost and Utilization Project state inpatient databases and followed for 5 years for revision operations because of mechanical failure, degenerative disease (DD), infection, postlaminectomy syndrome, and stenosis. Cox proportional hazards multivariate analyses were conducted to determine risk factors associated with revision for each diagnostic cause.

Results:

The cohort included 5,636 patients (female-3,285; average age-71.6 years). Most of the operations were 3 to 7 levels (97.4%), and the mean length of stay was 5.4 days. The overall 5-year revision rate was 16.5% with predominant etiologies of DD (50.7%), mechanical failure (32.2%), and stenosis (8.0%). The revision procedure at the index operation was associated with an increased revision risk for DD (hazards ratio [HR] = 1.59, 95% confidence interval [CI], 1.29 to 1.98, P < 0.001) and mechanical failure (HR = 1.56, 95% CI, 1.19 to 2.04, P = 0.020). Male sex was associated with a significantly reduced revision risk for DD (HR = 0.75, 95% CI, 0.62 to 0.91, P = 0.04). Age, race, and number of comorbidities had no notable effect on the overall or cause-specific risk of revision.

Discussion:

In this large database analysis, DD and mechanical failure were the most common etiologies comprising a 5-year revision rate of 16.5% after elective multilevel lumbar instrumented fusion in older patients. Revision operations and female patients carried the strongest risks for revision.
Comparison of Extramedullary and Intramedullary Implants for Stable Intertrochanteric Fractures: Have We Swung the Pendulum Too Far the Other Way?
Authors: Darbandi Aria Darius , Saadat Ghulam H. , Siddiqi Ahmed , Butler Bennet A.
Published: February 2022

Introduction:

Although intramedullary implants are commonly used to treat stable intertrochanteric (IT) fractures, there is a lack of evidence to demonstrate their superiority over extramedullary implants in treating these fractures. The purpose of this study was to compare short-term outcomes (<30 days) between intramedullary and extramedullary implants in patients with closed nondisplaced stable IT fractures.

Methods:

Patients with closed nondisplaced stable IT fractures were identified from the American College of Surgeons National Surgical Quality Improvement Program database between 2016 and 2019. Patients who either underwent extramedullary implant or intramedullary implant fixation were selected for this analysis. Postoperative outcomes included transfusion, surgical complications (stroke, myocardial infarction, venous thromboembolism, pneumonia, renal failure/insufficiency, surgical site infection, urinary tract infections, and sepsis), weight-bearing on postoperative day 1, discharge destination, place of residence at 30 days after the operation, days from operation to discharge, readmission related to the index procedure, any readmission, revision surgery, and mortality.

Results:

Of the 3,244 cases identified for the study, 2,521 (77.7%) underwent intramedullary nailing (IMN). Based on adjusted multivariable analysis, surgical complications between the two intervention groups were not statistically significantly (odds ratio [OR] 1.142; confidence interval [CI], 0.838 to 1.558; P = 0.4). However, patients who underwent IMN were associated with higher rates of blood transfusions (OR, 1.35, CI, 1.042 to 1.748, P = 0.023), more likely discharged to a place other than home (OR, 1.372, CI, 1.106 to 1.700, P = 0.004), and more likely to get readmitted (OR, 1.783, CI, 1.157 to 2.75, P = 0.009). Patients treated with IMN were associated with lower postoperative length of stay (OR 0.982, CI 0.967 to 0.998, P = 0.030).

Discussion:

Our study found that extramedullary implants were associated with lower transfusions rates, lower readmissions, and better patient disposition. We recommend surgeons to consider extramedullary implants when treating stable IT fractures, especially if the patient is anemic or at high risk for hospital readmission.

Level of Evidence:

Level III. Retrospective cohort study
The Utility of Machine Learning Algorithms for the Prediction of Early Revision Surgery After Primary Total Hip Arthroplasty
Authors: Klemt Christian , Laurencin Samuel , Alpaugh Kyle , Tirumala Venkatsaiakhil , Barghi Ameen , Yeo Ingwon , Subih Murad Abdullah , Kwon Young-Min
Published: February 2022

Background:

Revision total hip arthroplasty (THA) is associated with increased morbidity, mortality, and healthcare costs due to a technically more demanding surgical procedure when compared with primary THA. Therefore, a better understanding of risk factors for early revision THA is essential to develop strategies for mitigating the risk of patients undergoing early revision. This study aimed to develop and validate novel machine learning (ML) models for the prediction of early revision after primary THA.

Methods:

A total of 7,397 consecutive patients who underwent primary THA were evaluated, including 566 patients (6.6%) with confirmed early revision THA (<2 years from index THA). Electronic patient records were manually reviewed to identify patient demographics, implant characteristics, and surgical variables that may be associated with early revision THA. Six ML algorithms were developed to predict early revision THA, and these models were assessed by discrimination, calibration, and decision curve analysis.

Results:

The strongest predictors for early revision after primary THA were Charlson Comorbidity Index, body mass index >35 kg/m2, and depression. The six ML models all achieved excellent performance across discrimination (area under the curve >0.80), calibration, and decision curve analysis.

Conclusion:

This study developed ML models for the prediction of early revision surgery for patients after primary THA. The study findings show excellent performance on discrimination, calibration, and decision curve analysis for all six candidate models, highlighting the potential of these models to assist in clinical practice patient-specific preoperative quantification of increased risk of early revision THA.
Management of severe diarrhea in an AIDS patient with inflammatory bowel disease with Short Bowel Syndrome
Authors: Bisotto Jóyce da Rosa , Gorini Albert Pinto Coelho , Claudino Luana Dias , Zatt João Vitor Dal Ponte , Boer Daniel Trahtman de , Kern Gustavo Matas , Abdalla Yasser Abrahão , Fontana Vanessa Cardoso , Schneider Geórgia Savicki , Coelho Jaqueline Costa
Published: February 2022

Introduction: The human immunodeficiency virus (HIV) can lead to a loss of lymphoid tissue through the intestinal mucosa, making the intestine susceptible to infections and inflammation. As a result, the patient may present with Crohn's Disease (CD), a chronic inflammatory bowel disease (IBD). Short Bowel Syndrome (SBS) results from loss of bowel absorption capacity after extensive bowel resection and is associated with several complications. Objective: To report the case of a patient presenting with acute chronic diarrhea, of probable multifactorial etiology, secondary to HIV, CD, and SBS. Methods: The information contained in this report was obtained through a review of the medical record and a review of the literature. Case Report: This is the report of E. F. C, male, 49 years old, who was admitted to the ICU of Hospital Ernesto Dornelles, in Porto Alegre, from 12/04/2020 to 01/07/2021, with HIV, CD, and SBS. The patient was admitted complaining of diarrhea that had started 15 days ago, which had worsened in the last 7 days, with loss of appetite, vomiting episodes, and mental confusion. Using empirical Lamivudine, Zidovudine, Tenofovir, Ciprofloxacin and Metronidazole, Methotrexate and Prednisone. On physical examination, he was sleepy, afebrile, with a normotensive abdomen, severe dehydration, and edema 3+/4+. From anthropometry, the measured weight of 50 kg, reported height of 1.70 m, and BMI of 17 kg/m2. On laboratory tests, he had severe pancytopenia and electrolyte disturbances. Although the cause of diarrhea was not clarified, bowel rest and the use of glutamine and enteral symbiotic were chosen, while treating HIV and CD, to improve enterocyte nutrition and reduce bacterial translocation capable of causing septic conditions. Despite this, diarrhea was untreatable, mean greater than 1,000 ml/day, with indication, but without the possibility of total parenteral nutrition, due to thrombocytopenia. On 12/06, E. F. C was in poor general condition, anasarca, tachycardic, hypotensive, treating septicemia caused by Candida tropicalis. On 12/07, he presented no spontaneous breathing, absence of central pulses and pupillary reflexes, opted not to institute invasive measures, and died. Final Considerations: The report highlights the need to cover IBD and opportunistic infections in the differential diagnosis of diarrhea in AIDS patients with CD and SBS. It also demonstrates the challenge of nurturing the patient who does not have conditions for enteral and/or parenteral nutrition, with a high risk of malnutrition due to the catabolism of such pathologies.
Use of ivermectin in the treatment of COVID-19: a review
Authors: Zanoti Eduardo Bertollini , Porto Rodrigo Magalhães , Scriboni Andreia Borges
Published: February 2022

Introduction: SARS-CoV-2 produces a respiratory syndrome that can range from a mild, self-limiting inflammatory condition to severe, progressive pneumonia. Prevention and treatment strategies have become a priority since the emergence of COVID-19. Noteworthy is the use of ivermectin, an anti-parasitic agent, which has been widely recommended by some health professionals for the prevention and treatment of COVID-19. Objective: To assess the evidence on the efficacy and safety of using ivermectin for the prevention and treatment of COVID-19, identifying its mode of action and the benefits and adverse reactions of using this drug. Methods: The search strategy for articles was based on a search in the electronic databases MEDLINE (NationalLibrary of Medicine, United States), LILACS (Latin American and Caribbean Literature in Health Sciences), Scielo, specialized libraries of Universities, PubMed, and Google Academic. The selected articles will be from 2015 to 2021. Results and Conclusion: Studies reveal that ivermectin is a broad-spectrum drug with high-fat solubility and has numerous effects on several parasites. In addition to having antiviral and antiparasitic effects, this drug also causes immunomodulation in the host. Ivermectin has already demonstrated its potent antiviral effects in vitro against several RNA viruses, such as influenza A, Zika virus, Newcastle disease virus, yellow fever virus, Chikungunya virus, dengue virus, among others. One way to delay viral transmission would be to stop the virus from replicating, thus reducing the viral load in infected individuals. Thus, studies have shown that ivermectin may have the potential for inhibiting and replicating SARS-CoV-2.
An Ever Distant Union: The Cross-Border Loss Relief Conundrum in EU Law
Authors: Ruiz Almendral Violeta
Published: February 2022

Cross-border loss relief may well be the last milestone, barring total tax consolidation, in the European Union (EU) market integration from a tax law perspective. As the Commission’s Communication on the Tax Treatment of Losses in Cross-Border Situations demonstrates, there is yet a lot of ground to be covered in harmonizing this aspect of corporate income taxes (CITs). While the Common Consolidated Corporate Tax Base (CCCTB) proposal seems to be stalled, a series of relatively recent European Court of Justice (ECJ) cases (among others, X Holding BV) may be tilting the balance in the interest of Member States, for the first time allowing the safeguard of revenues, or the ‘balanced allocation of taxing powers’ to be the deciding argument in allowing restrictions on the offsetting of losses. Losses cannot be analysed in isolation of the rules to determine the taxable base, as they are one more piece in the tax base puzzle. In this article, I focus on two issues: multinational groups and permanent establishments (PEs), as they comprise the main problems arising in cross-border loss relief. The different methods employed to grant loss relief are assessed, as well as the new Organisation for Economic Co-operation and Development (OECD) proposals on the taxation of PEs. My main argument is that restrictions of loss relief have an effect that go beyond discriminating or restricting – that is, beyond making it ‘less attractive‘ to move around the EU. Such restrictions touch the core of taxation of income. If no loss relief is provided, the tax is not reflecting the real ability to pay, thus not only is it not being neutral and inefficient, it is also creating a fictional tax debt.
The CCCTB Concept of Consolidation and the Rules on Entering a Group
Authors: van de Streek Jan
Published: February 2022

The consolidation element is at the heart of the proposed Directive on a harmonized Common Consolidated Corporate Tax Base (CCCTB). In this article, the author examines the scope of the consolidation concept. When a company enters a consolidated group, conflicts of interest arise between Member States. These arise as a consequence of the shift from 'separate accounting' to the apportionment formula regime. The author also discusses the measures provided for by the draft Directive to protect the financial interests of Member States.
Tax Havens and Tax Shelters: Volume 2  The Hidden Money
Authors: Ronfeldt Thomas
Published: February 2022

This article is the second in a series of articles on the issue of Tax Havens. In the first article, the cross-border transaction was discussed. In this second article, the focus will be on the hiding of money in tax shelters. Unlike the cross-border transactions, this article will show that the problem of the hidden money shelter is much worse. The hidden money shelter appears to be the key issue. Furthermore, the hidden money shelter appears to be the most difficult issue; hence, the governments around the world view the need of sharing information differently. This article will analyse the issue from a Danish perspective, but the conclusions drawn would be similar in most of the western part of the world - at least in Europe and the United States.
Taxation of Income in Foreign Trusts: Denmark Introduces a New Anti-avoidance Rule Targeting the Use of Foreign Trusts
Authors: Schmidt Peter Koerver
Published: February 2022

Denmark has introduced a new provision that states that Danish settlors of foreign trusts, under certain circumstances, must include the trust’s income in their own taxable income. The provision forms part of the Danish legislator’s recent attempts to prevent international tax evasion/ avoidance, and the underlying aim of the provision is to make the rules concerning foreign trusts easier to administrate and enforce by the Danish tax authorities. Based on an analysis of the provision’s area of application and legal effects, it is concluded that the new provision seems to be effective in mitigating the use of foreign (family) trusts for tax evasion/avoidance purposes. However, it is also concluded that there is reason to question whether the new provision is sufficiently precise and whether the aim could have been reached in a more expedient way.