bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing tourism productivity changes with complex configurations
Authors: Dong Hai , Liang Qi Bin , Peypoch Nicolas
Published: February 2024

This paper explores the use of fsQCA in order to explain the productivity changes in two-stage analysis. In this way, the idea from Corne and Peypoch (2020) in the efficiency analysis framework is extended to the case of productivity indexes and indicators. An empirical illustration to the case of Chinese provinces emphasizes the complex configurations explaining tourism productivity and opens avenues for future research.
Effect of franchising on the reliability of financial analysts’ earnings forecasts: Evidence from publicly traded US restaurant firms
Authors: Gim Jaehee , Shin Seunghun , Shin Hyejo Hailey
Published: February 2024

Unlike institutional investors, who have expertise in collecting and analyzing firm information to predict firms’ future performance, individual investors have a limited ability to conduct this task. Therefore, individual investors are known to commonly rely on financial analysts’ earnings forecasts, which are freely available to them. However, as demonstrated by numerous studies, financial analysts’ forecasts are not always accurate and free from bias. Drawing on screening theory and the innate financial and structural differences between highly franchised restaurants and their less franchised peers, the current study showed that analysts provide more accurate and less optimistically biased forecasts for the former than the latter. However, the positive impact of an additional number of analysts on the accuracy of forecasts was weaker for the former than the latter. The current study can help individual investors in the restaurant industry improve their understanding of financial analysts’ earnings forecasts and make better-informed investment decisions.
A qualitative study exploring the epistemology of suffering within a Malaysian Indigenous tribe
Authors: Thong Justine Jian-Ai , Ting Rachel Sing-Kiat , Takeuchi Tomomi , Jobson Laura , Phipps Maude Elvira
Published: February 2024

Despite the universal nature of suffering, few studies have examined how Indigenous ethnic minorities in non-western regions understand and respond to adversity. This study explored the epistemology of suffering among the Temiar ethnic group of Peninsular Malaysia using participant observation and semi-structured interviews. Interview transcripts of 43 participants were coded through inductive thematic analysis and a consensual qualitative approach. Three-tier themes were defined and named after subsequent analysis of core ideas and domains in the data. Major adversities reported included a lack of basic needs, lack of land-rights and unjust treatment from authorities, destruction of the forest environment and livelihood, and lack of accessibility and facilities, which were attributed to authorities’ negligence of responsibilities, increasing human–animal conflict, environmental threats and imposed lifestyle changes. Faced with adversity, the Temiar endeavoured to survive by working crops and gathering forest resources. They utilized resources from family, fellow villagers, external agencies and spiritual–religious traditions. Theoretical mapping of attribution styles into the Ecological Rationality Framework revealed predominantly external-focused and concrete–perceptual rationalities privileged by strong-ties societies. These findings pointed to the resilience of a strong-ties community while adapting to the systemic suffering and risk factors stemming from a rationality mismatch with modernization and globalization trends. To conclude, we advocate for culture-sensitive mental health and psychiatric practices, as well as sustainable development for the well-being of Indigenous communities locally and globally.
How to grow a transnational field: A network analysis of the global fact-checking movement
Authors: Lauer Laurens , Graves Lucas
Published: February 2024

The worldwide fact-checking movement has grown rapidly over the last decade and achieved remarkable prominence. This study investigates that global movement as a case of deliberate institution-building to consolidate a new transnational field. We use a comprehensive network analysis of the first eight years of the annual Global Fact conference to ask how fact-checkers grew their young field, examining the roles of leading practitioners as well as “meta-level” organizations like the International Fact-Checking Network (IFCN). We identify an elite tier shaping the development of the field, whose membership aligns with other markers of leadership. We show how these organizations play either internally or externally directed brokerage roles, reflecting the characteristic tension in emerging fields between maintaining community bonds and cultivating external stakeholders. And we highlight the pivotal role of the IFCN—while showing that certain fact-checking groups act like meta-level organizations, with resources dedicated to field-building and governance.
In Vivo Porcine Model of Acute Iliocaval Deep Vein Thrombosis
Authors: Roberts Sophia H. , Zaghloul Mohamed S. , Ismail Usama , Rowe Roger A. , Engel Connor , Meade Rodrigo , Elizondo-Benedetto Santiago , Genin Guy M. , Zayed Mohamed A.
Published: February 2024

Acute deep vein thrombosis (DVT) is a potentially life-threatening condition in which blood clots form in the venous system. Recently, a number of endovascular thrombectomy devices have been introduced to treat acute DVT. Given their varied efficacy and safety profiles, a clear need exists for further device innovation and enhancement. However, a major limitation in the testing, verification, and validation of new thrombectomy devices is a clinically representative large animal model of acute DVT. Unfortunately, existing approaches to creating DVT in porcine models are time-consuming, technically challenging, and yield inconsistent results. We therefore developed a rapid, technically straightforward, and reproducible protocol for induction of large-volume iliocaval DVTs in a living porcine host. This approach involves sequestering the iliocaval venous segment with standard balloon occlusion catheters, and a controlled limited infusion of a 25% ethanol solution within the sequestered static segment. We observed that this method was safe, technically straightforward, and reproducible in producing large-volume acute DVTs. We believe that this technique can be utilized as a standardized DVT model in the testing of future endovascular venous thrombectomy devices.

Clinical Impact

The study establishes a rapid, technically straightforward, and reproducible porcine large animal model for acute iliocaval deep vein thrombosis (DVT). The procedure can be performed with basic endovascular skillsets. With its procedural efficiency and consistency, the platform is promising for comparative in vivo testing of venous thrombectomy devices in a living host, and for future verification and validation studies to determine efficacy of novel thrombectomy devices relative to predicates.
Is LigaSure Alone Sufficient for the Closure of the Appendix Stump?
Authors: Tazeoglu Deniz , Cem Esmer Ahmet
Published: February 2024

Purposes

Closure of the appendix stump is necessary for laparoscopic appendectomy. Problems that occur during the appendix stump closure can cause severe morbidity. Several methods of stump closure have been described. This study aimed to investigate the adequacy of LigaSure alone in closing the appendix stump.

Methods

Patients who were operated on with the diagnosis of acute appendicitis between October 2021 and January 2022 were evaluated retrospectively. The patients were divided into two groups according to the closure technique of the appendix stump hemoclip(group I) and LigaSure only(group II). In addition, demographic data (age, gender), body mass index (BMI), presence of comorbid disease, perioperative appendicitis classification, operation time, postoperative hospital stay, radiological and pathological appendix size of the patients included in the study were recorded. Clavien Dindo was used for postoperative complication assessment.

Result

The study included 77 patients. 48(62.3%) of the patients were in group I, and 29(37.7%) were in group II. There was no statistical difference between the groups regarding age, gender distribution, BMI, presence of comorbid disease ( P > .05). The operation time of group I was longer than group II ( P < .001). There was no difference between the groups in terms of both radiological and pathological appendix size. There was no statistical difference between the groups regarding postoperative complications and severity of complications ( P = .76, P = .99, respectively).

Conclusion

Appendiceal stump closure can be performed with Ligasure, but it should be noted that this procedure can be performed on selected patients, as in the study group, not on all patients.
Navigating Pandemic Education in Smallville: Challenges of Socioeconomic Disparities, Leadership Dynamics, and Racial Tensions in a Rural School District
Authors: Heisel Stan
Published: February 2024

The Smallville Independent School District case study highlights the challenges of a school district facing the COVID-19 pandemic in a rural–urban divide. The district’s socioeconomic status, with a high population of economically disadvantaged families, limited resources, and dependence on grants and local charity, further complicates matters. The district’s new superintendent was hired, expecting her experience to help address the district’s challenges. Teacher retention and technology integration were critical areas of focus. However, resistance from some board members added to the already-existing racial tensions in the town, making it a challenging environment to implement change during a pandemic.
How to perform Baxter’s nerve blockage easily by ultrasound in chronic heel pain: Four simple steps
Authors: Yildizgoren Mustafa Turgut , Ekici Burak , Bagcier Fatih
Published: February 2024

Baxter’s neuropathy is one of the overlooked causes of chronic heel pain. Diagnosing neuropathy in Baxter’s can be challenging due to its potential occurrence as a secondary condition to other common syndromes that cause heel pain, such as plantar fasciitis, calcaneal spur, hypertrophic muscle, tenosynovitis, space-occupying lesions or trauma. Ultrasound is a reliable and easily accessible device that guides injections for the treatment of Baxter’s neuropathy. We have written this letter as a guide, especially for beginner and professional pain specialists.
Ectopic cervical thymus: Recognising the characteristic ‘embroidery yarn’ appearance on ultrasound
Authors: Krishnan Venkatram , Ram Adhitya , Rana Abhilasha , Jaganathan Sriram , Jayappa Sateesh , Glasier Charles , Vattoth Surjith , Ramakrishnaiah Raghu
Published: February 2024

Introduction:

The thymus normally forms in the neck from the third pharyngeal pouch and descends to its normal position in the mediastinum. Arrest of descent or sequestration of thymic tissue can occur at any point along its path leading to an ectopic thymus which can present as a neck mass, usually in the paediatric age group.

Purpose and Case Report:

Ultrasound is generally performed in the presence of a neck mass in children. Although a characteristic ‘starry sky’ appearance of the thymus has been described on ultrasound, it is not considered sufficiently specific and cross-sectional imaging with magnetic resonance imaging is usually performed. On magnetic resonance imaging, the ectopic thymus appears as a homogeneous T1 isointense and T2 hyperintense mass and may actually appear ominous due to the tendency of ectopic thymus to sometimes show diffusion restriction unlike the normal thymus. Subsequent invasive biopsy or surgical removal is usually necessary to rule out a neoplastic lesion. In our observation, the ultrasound appearance of thymus is sufficiently distinctive to be confidently diagnosed as ectopic thymic tissue. This appearance is similar to the high-resolution appearance of an embroidery yarn. The reason most radiologists are not aware of the same is because the normal mediastinal thymus is not usually imaged by ultrasound.

Conclusion:

An accurate diagnosis on ultrasound would mean avoidance of expensive cross-sectional imaging and invasive biopsy or surgical excision in favour of regular non-invasive follow-up ultrasound scans until the lesion involutes in late childhood.
Evaluating the Role of Ultrasound in Prostate Cancer trial – phase 1: Early experience of micro-ultrasound in the United Kingdom
Authors: Parker Pamela , Twiddy Maureen , Rigby Alan , Whybrow Paul , Simms Matthew
Published: February 2024

Purpose:

The purpose of this study was to evaluate if the use of micro-ultrasound can detect clinically significant prostate pathology when compared to histology obtained during a transperineal prostate biopsy.

Methods:

Patients suspected of having prostate cancer, who had a pre-biopsy magnetic resonance imaging and could tolerate a transrectal examination, were prospectively recruited. All patients had a micro-ultrasound scan prior to their biopsy. The findings of magnetic resonance imaging, micro-ultrasound and histology were risk stratified in accordance with local pathways. Comparison of assigned risk scores was made using histology as the reference standard.

Results:

Data from 101 patients were evaluated. Histology showed that clinically significant prostate cancer was detected in 48.5% ( n = 49/101) of patients. Moderate inter-rater agreement was found in both magnetic resonance imaging and micro-ultrasound with К of 0.31 in both modalities. High-risk findings were identified in 81% ( n = 82/101) patients at magnetic resonance imaging and in 66% ( n = 67/101) patients at micro-ultrasound. Sensitivity and specificity of magnetic resonance imaging were found to be 87% and 34.6% and for micro-ultrasound 73.3% and 53.8%, respectively.

Conclusion:

A limitation of this study was that the biopsy was not performed with micro-ultrasound which may have resulted in unidentified cancers and lowered the apparent accuracy of the technique. However, we conclude that while micro-ultrasound was diagnostic, magnetic resonance imaging demonstrated higher sensitivity in our local population and remains the pre-biopsy imaging modality of choice. However, the higher specificity of micro-ultrasound identified does indicate that it may be of value when magnetic resonance imaging is contraindicated. The role of micro-ultrasound, within an active surveillance pathway for prostate cancer, warrants further investigation.
The diagnostic journey of pulmonary arterial hypertension patients: results from a multinational real-world survey
Authors: Small Mark , Perchenet Loïc , Bennett Alex , Linder Jörg
Published: February 2024

Background:

Pulmonary arterial hypertension (PAH) is a life-threatening, progressive disease often diagnosed late in its course.

Objectives:

To present patient-reported data that were captured within a large, multinational, point-in-time survey of PAH-treating physicians and their patients to better understand the diagnostic journey.

Design:

Cross-sectional survey conducted in five European countries (EU5), Japan and the USA.

Methods:

PAH-treating pulmonologists, cardiologists, rheumatologists or internists (USA only) completed a patient record form (PRF) for the next four consecutive adult PAH patients they saw; these patients filled in a patient self-completion (PSC) form on an anonymous, voluntary basis. Our report focuses on patient data; data are from PSC forms unless stated otherwise.

Results:

Physician-reported PRFs and self-completed PSC forms were obtained for 1152 and 572 patients, respectively. Patients’ mean (SD) age was 59.1 (14.0) years, 55.6% were female, and 57.3% had idiopathic PAH. Patient-reported data showed an average delay of 17.0 months between symptom onset and PAH diagnosis. This is longer than physicians estimated (13.8 months): this disparity may be partly due to the time taken by patients to consult a physician about their symptoms [9.6 months overall, longest in the USA (15.3 months)]. Most patients (71.6%) initially consulted primary care physicians about their symptoms and 76.4% of patients were referred to a specialist. Misdiagnoses occurred in 40.9% of patients [most frequent in the USA (51.3%), least common in Japan (27.6%)] and they saw an average of 2.9 physicians overall (3.5 in EU5 versus 2.0 in Japan/USA) before being diagnosed. Diagnosis was most often made by cardiologists (50.4%) or pulmonologists (49.3%).

Conclusion:

Our data suggest that diagnostic delay in PAH results from patient- and physician-related factors, which differ across regions and include lack of awareness of PAH on both sides. Development of better screening strategies may help address this barrier to timely PAH diagnosis.
ChatGPT: It’s Here, Whether We Want It or Not!
Authors: Wayne Litvin Stephen , Pei-Sze Tan Karen
Published: February 2024

This Managerial Perspective considers the use of ChatGPT by hotels as a tool for replying to their property’s online consumer-generated media postings. As readers would certainly know, ChatGPT is a free artificial intelligence software program designed to assist users with tasks requiring intelligence to perform. In this brief study, test participants were provided actual posted online TripAdvisor review comments along with the responses to these that had been posted by hotel management as well as a second response created by ChatGPT, with the request that the participant indicate which response was real and which was produced by the computer. A second request asked the participant to indicate which they felt was “better.” The results suggest that ChatGPT does a relatively effective job of mimicking authentic responses. These findings, and the discussion of relevant theory, will be useful for hospitality industry managers and academics as they consider the future use of artificial intelligence software for performing this important albeit often tedious task.
The path from participatory culture to participatory politics: A critical investigation—An interview with Henry Jenkins
Authors: Jenkins Henry , Jie You
Published: February 2024

In this interview, Henry Jenkins critically reviews his theorization of the logical and practical connection between participatory culture and participatory politics, which is enabled and facilitated by the civic imagination of various social groups strategically and affectively deploying popular culture resources for different political purposes. Henry Jenkins emphatically discusses the democratic potential of participatory culture in autocratic societies and the mechanisms to promote the progressiveness of participatory politics, and carefully yet enthusiastically defends the significance of fandom’s affective and appropriative practices for bridging participatory culture and participatory politics. In the end of this interview, Henry Jenkins also reflects on the genealogical relations of his thinking on participatory democracy with John Fiske’s political understanding of popular culture and evaluates his own theoretical contributions to the political philosophy of participatory democracy.
A Preliminary Investigation of the Relationship Between Gamification and Organizational Socialization Outcomes: Does Gamification Live Up to Its Expectations?
Authors: Pečiūra Žigimantas , Žukauskaitė Irena
Published: February 2024

Organizations are increasingly incorporating gamification elements into their activities, but research regarding how this affects newcomers is limited. Successful integration of new employees contributes to optimal functioning in the workplace. However, gamification can be associated with mixed work-related impact. The present cross-sectional study evaluates the relationship between gamification and organizational socialization outcomes. The results of this study show that gamification plays a minimal role in the socialization process. Nevertheless, there are some weak relationships between gamification elements and socialization outcomes. Role clarity, social integration, task mastery, and organizational commitment were positively related to employees’ interactions with gamification elements. However, no tendencies were observed concerning job motivation, turnover intentions, or perceived organizational insider status. Challenges were the most related to socialization outcomes. It has also been observed that competition can have a relatively negative impact on organizational commitment. The study suggests practical value for managers regarding gamification usage.
The Effect of AI Chatbots on Pro-environment Attitude and Willingness to Pay for Environment Protection
Authors: Chi Nguyen Thi Khanh
Published: February 2024

Since AI Chatbots are increasingly adopted in different industries, the purpose of this paper is to examine the influence of AI Chatbots on pro-environment attitudes and willingness to pay for environmental protection. By employing quantitative methodology, multivariate data analysis was conducted to test the effects of AI Chatbot in terms of its interaction, anonymity, customization, and problem-solving on pro-environmental attitudes and individual willingness to pay for environment protection. This study reveals the critical role of Chatbots in encouraging people to protect the environment. Problem-solving is found to be the highest influence on both pro-environmental attitudes and individual willingness to pay. Meanwhile, interaction, anonymity, and customization were revealed to affect WTP indirectly through pro-environmental attitudes. Therefore, digitalization by exploring new technology like AI Chatbots becomes an important concern to reduce the negative actions of humans on the environment and Carbon emissions and develop agricultural tourism activities toward green production.
A delay in flap coverage of open midshaft tibia fractures increases complications: A retrospective study
Authors: Mahmoud Ahmed , Younger Jarrod , Morris Emily , Hope Matthew
Published: February 2024

Background: This retrospective study aimed to assess whether delaying flap coverage in open midshaft tibia fractures leads to higher infection rates. Methods: Patients were recruited retrospectively from a tertiary trauma database between 2012 and 2020. Patients included were over 18-years old and had an open tibia fracture that required flap coverage with at least 6 months follow-up. The collected complications were deep infections, aseptic non-union, flap failure and revision surgery. Results: Group-A ( n = 18) and Group-B ( n = 37) were analysed. Deep infections rate was 6% in Group-A and 38% in Group-B which was significantly different, χ2(1, N = 55) = 6.4, p = 0.01. The rate of revision surgery was 17% in Group-A and 54% in Group-B and was significant, χ2(1, N = 55) = 7, p = 0.008. Binary logistic regression showed that Group-B were 10 times more likely to develop a deep infection (95% confidence interval 1.2–83, p = 0.034). Conclusion: Delaying soft tissue coverage of open tibia fractures for over a week increases the risk of deep infection and revision surgery.
Hearing Aid Amplification Improves Postural Control for Older Adults With Hearing Loss When Other Sensory Cues Are Impoverished
Authors: Behtani L. , Paromov D. , Moïn-Darbari K. , Houde MS , Bacon BA , Maheu M. , Leroux T. , Champoux F.
Published: February 2024

Recent studies suggest that sound amplification via hearing aids can improve postural control in adults with hearing impairments. Unfortunately, only a few studies used well-defined posturography measures to assess balance in adults with hearing loss with and without their hearing aids. Of these, only two examined postural control specifically in the elderly with hearing loss. The present study examined the impact of hearing aid use on postural control during various sensory perturbations in older adults with age-related hearing loss. Thirty individuals with age-related hearing impairments and using hearing aids bilaterally were tested. Participants were asked to perform a modified clinical sensory integration in balance test on a force platform with and without hearing aids. The experiment was conducted in the presence of a broadband noise ranging from 0.1 to 4 kHz presented through a loudspeaker. As expected, hearing aid use had a beneficial impact on postural control, but only when visual and somatosensory inputs were both reduced. Data also suggest that hearing aid use decreases the dependence on somatosensory input for maintaining postural control. This finding can be of particular importance in older adults considering the reduction of tactile and proprioceptive sensitivity and acuity often associated with aging. These results provide an additional argument for encouraging early hearing aid fitting for people with hearing loss.
Is It Any Better? A Comparison of PhD Students’ Experiences and Degree Completion Plans Between the Summers of 2020 and 2021
Authors: Smith Rachel A. , Gowen Garrett H. , Perez Rosemary J. , Tipton Jennifer A. , Ogilvie Craig A. , Brooks Thomas R.
Published: February 2024

PhD students’ experiences in graduate school and associated outcomes vary by field of study, learning environment conditions, and support structures. In the context of the COVID-19 pandemic specifically, PhD students’ individual educational trajectories were potentially rendered more uncertain, as disruptive conditions for learning and research have continued over the past several years. We compared the reports of 422 PhD students at 12 U.S. institutions in terms of their experiences of support or marginalization and educational plans from the summer of 2020 with follow-up data gathered during the summer of 2021. We then examined factors related to PhD students’ changes in their estimated times to degree. We found lower, but still on average moderate, levels of depression symptoms compared to the previous year and continued experiences of emotional, financial, educational, and career stressors. Findings point to the importance of institutional material and psychological structural supports over time.
Evaluation of a Novel Equity-Focused Curriculum for Early-Stage Medical Students
Authors: Roper Karen L. , South Anna-Maria , Palmer Skyler , Johnson Julia , Sims Lillian , Hustedde Carol , Mangino Anthony A.
Published: February 2024

OBJECTIVES

Medical school curricula have increasingly incorporated topics and content related to health equity and affiliated social determinants of health. However, there is limited literature to guide how programs might measure the success of these initiatives. Previous studies assessed medical student attitudes and perceived knowledge, preparedness, and skills. Based on self-reported measures of these attributes, we compared within-group and between-group differences at the onset of a novel equity-focused curriculum implementation.

METHODS

A multi-component approach to “thread” lectures, panel discussions, and other content dedicated to health equity concepts was assessed using adapted versions of two validated survey instruments of the measured constructs. Baseline data were collected prior to coursework and at follow-up early in students’ second year assessed change attributable to the equity-focused curriculum thread, with additional comparison to a cohort of second-year students who had no exposure to the curriculum. Data were collected at the beginning of academic years 2021–2022 and 2022–2023.

RESULTS

The multivariate analysis of variance indicated significant change over time (p < 0.001) with the analyses of variance identifying students’ perceived current skills and topic knowledge increasing over time. No significant differences were found between two separate groups of M2 students.

CONCLUSIONS

Students’ perceived skills at working with diverse patient populations and knowledge of topics focused on health equity increased across the study, despite a much smaller response rate for the same student cohort at follow-up. Students’ perception that they are prepared to care for patients of diverse backgrounds was unaffected. Attitudinal assessment revealed a ceiling effect at baseline, which should be explored further with longitudinal assessment. For the ongoing effort to evaluate the success of equity-focused curricula and programs, this study contributes evidence of change on some but not all outcomes, and can help guide other programs in determining which outcomes best reflect areas of programmatic need and impact.
Drug classes affecting intracranial aneurysm risk: Genetic correlation and Mendelian randomization
Authors: Ruigrok Ynte M , Veldink Jan H , Bakker Mark K
Published: February 2024

Introduction:

There is no non-invasive treatment to prevent aneurysmal subarachnoid hemorrhage (ASAH) caused by intracranial aneurysm (IA) rupture. We aimed to identify drug classes that may affect liability to IA using a genetic approach.

Patients and methods:

Using genome-wide association summary statistics we calculated genetic correlation between unruptured IA ( N = 2140 cases), ASAH ( N = 5140) or the combined group, and liability to drug usage from 23 drug classes ( N up to 320,000) independent of the risk factor high blood pressure. Next, we evaluated the causality and therapeutic potential of correlated drug classes using three different Mendelian randomization frameworks.

Results:

Correlations with IA were found for antidepressants, paracetamol, acetylsalicylic acid, opioids, beta-blockers, and peptic ulcer and gastro-esophageal reflux disease drugs. MR showed no evidence that genetically predicted usage of these drug classes caused IA. Genetically predicted high responders to antidepressant drugs were at higher risk of IA (odds ratio [OR] = 1.61, 95% confidence interval (CI) = 1.09–2.39, p = 0.018) and ASAH (OR = 1.68, 95% CI = 1.07–2.65, p = 0.024) if they used antidepressant drugs. This effect was absent in non-users. For beta-blockers, additional analyses showed that this effect was not independent of blood pressure after all. A complex and likely pleiotropic relationship was found between genetic liability to chronic multisite pain, pain medication usage (paracetamol, acetylsalicylic acid, and opioids), and IA.

Conclusions:

We did not find drugs decreasing liability to IA and ASAH but found that antidepressant drugs may increase liability. We observed pleiotropic relationships between IA and other drug classes and indications. Our results improve understanding of pathogenic mechanisms underlying IA.
The influence of voice quality, voice content, and managers’ mood on their evaluations of voice: An experimental investigation
Authors: Stumpf Robin
Published: February 2024

Whether organizations can benefit from employee voice depends on the receiving managers’ evaluations, as proposals can be implemented, dismissed, or forwarded to superiors for consideration. Despite its important role in identifying valuable suggestions, research on managers’ evaluations of employees’ proposals is scarce. Grounded in the literature on employee voice, innovation management, social hierarchy, the Elaboration Likelihood Model, and the Hedonic Contingency Model, the current study addresses this research gap by investigating the influence of voice quality, voice content, and managers’ mood on managers’ evaluations of voice. The findings from using a factorial, between-subjects experimental design with 384 German managers as participants demonstrate that managers’ evaluations tend to be higher when voice is of high quality and that managers evaluate promotive voice higher than they do prohibitive voice. No direct or indirect influence of managers’ mood was identified. The study concludes with implications for employees and organizations, limitations, and directions for future research.
Prioritizing Stakeholders in Collaborative Research and Innovation Projects Toward Sustainability
Authors: Santos José M. R. C. A. , Fernandes Gabriela
Published: February 2024

Stakeholder engagement in collaborative research and innovation projects poses significant challenges, particularly in complex, multistakeholder settings addressing sustainability concerns. This study proposes a novel method for stakeholder prioritization in such projects, combining the analytic network process (ANP) tool with the sustainability categories of the P5 standard for sustainability in project management. Its applicability and usefulness are demonstrated through a case study project, using the new stakeholder theory (NST) lens. The ANP-P5 method can assist project managers in effectively aligning stakeholder management with both sustainability and NST principles.
Tumor mutational load is prognostic for progression to therapy among high-count monoclonal B-cell lymphocytosis
Authors: Kleinstern Geffen , Boddicker Nicholas J. , O’Brien Daniel R. , Allmer Cristine , Rabe Kari G. , Norman Aaron D. , Griffin Rosalie , Yan Huihuang , Ma Tao , Call Timothy G. , Bruins Laura , Brown Sochilt , Bonolo de Campos Cecilia , Hanson Curtis A. , Leis Jose F. , Ding Wei , Vachon Celine M. , Kay Neil E. , Oakes Christopher C. , Parker Alexander S. , Brander Danielle M. , Weinberg J. Brice , Furman Richard R. , Shanafelt Tait D. , Cerhan James R. , Parikh Sameer A. , Braggio Esteban , Slager Susan L.
Published: February 2024

High-count monoclonal B-cell lymphocytosis (HCMBL) is a precursor condition to chronic lymphocytic leukemia (CLL). We have shown that among individuals with HCMBL, the CLL-International Prognostic Index (CLL-IPI) is prognostic for time-to-first therapy (TTFT). Little is known about the prognostic impact of somatically mutated genes among individuals with HCMBL. We sequenced DNA from 371 individuals with HCMBL using a targeted sequencing panel of 59 recurrently mutated genes in CLL to identify high-impact mutations. We compared the sequencing results with that of our treatment-naïve CLL cohort (N = 855) and used Cox regression to estimate hazard ratios and 95% confidence intervals (CIs) for associations with TTFT. The frequencies of any mutated genes were lower in HCMBL (52%) than CLL (70%). At 10 years, 37% of individuals with HCMBL with any mutated gene had progressed requiring treatment compared with 10% among individuals with HCMBL with no mutations; this led to 5.4-fold shorter TTFT (95% CI, 2.6-11.0) among HCMBL with any mutated gene vs none, independent of CLL-IPI. When considering individuals with low risk of progression according to CLL-IPI, those with HCMBL with any mutations had 4.3-fold shorter TTFT (95% CI, 1.6-11.8) vs those with none. Finally, when considering both CLL-IPI and any mutated gene status, we observed individuals with HCMBL who were high risk for both prognostic factors had worse prognosis than patients with low-risk CLL (ie, 5-year progression rate of 32% vs 21%, respectively). Among HCMBL, the frequency of somatically mutated genes at diagnosis is lower than that of CLL. Accounting for both the number of mutated genes and CLL-IPI can identify individuals with HCMBL with more aggressive clinical course.
Differences of ventilatory muscle recruitment and work of breathing in COPD and interstitial lung disease during exercise: a comprehensive evaluation
Authors: Ferreira Jeferson George , Iamonti Vinícius Carlos , Caleffi Pereira Mayra , Pletsch-Assunção Renata , Macchione Marcelo Ceneviva , Santana Pauliane Vieira , Cardenas Letícia Zumpano , Caruso Pedro , de Carvalho Carlos R.R. , de Albuquerque André L.P.
Published: February 2024

Introduction

COPD and interstitial lung disease (ILD) are significant chronic respiratory disorders, impacting quality of life. Respiratory muscle roles and differences remain not entirely clear. The objective of the present study was to evaluate the degree of recruitment of the respiratory muscles and the work of breathing in COPD and ILD during exercise.

Methods

We compared the sensory–mechanical relationships in COPD, ILD and healthy controls (n=20 each). They performed pulmonary function, noninvasive and invasive respiratory muscle strength, surface electromyography and work-of-breathing assessments.

Results

COPD and ILD did not show lower static muscle strength compared to controls, but did show poor performance in the exercise test with increased transdiaphragmatic pressure (Pdi). In ILD, there was a higher increase in oesophageal pressure and a lower gastric pressure (Pga) on inspiration; in COPD, there was a significant increase inPgaon inspiration. In ILD, there is greater recruitment of accessory inspiratory muscles, whereas in COPD, there is marked use of both inspiratory and expiratory muscles. The neuromechanical inefficiency (increased neural respiratory drive without the corresponding tidal volume) was found in both diseases. In COPD, there is a considerable increase in elastic work to overcome intrinsic positive end-expiratory pressure (PEEPi) and expiratory work of breathing, whereas in ILD, non-PEEPielastic work of breathing is the highest part of the total work of breathing.

Conclusions

Early and increased activity of the respiratory muscles and work-of-breathing components significantly contribute to dyspnoea, exercise intolerance and neuromechanical inefficiency of ventilation in COPD and ILD. The mechanisms ofPdigeneration were different between diseases.
Cardiac dysfunction during exercise in young adults with bronchopulmonary dysplasia
Authors: Steenhorst Jarno J. , Helbing Willem A. , van Genuchten Wouter J. , Bowen Daniel J. , van den Bosch Annemien , van der Velde Nikki , Kamphuis Lieke S. , Merkus Daphne , Reiss Irwin K.M. , Hirsch Alexander
Published: February 2024

Background

Worldwide, 1–2% of children are born premature and at risk for developing bronchopulmonary dysplasia (BPD). Preterm-born adults are at risk for early cardiovascular disease. The role of BPD is unclear. This study aims to examine cardiorespiratory function during submaximal exercise in young adult survivors of extreme prematurity, with or without BPD.

Methods

40 preterm-born young adults, 20 with BPD (median gestational age 27 weeks, interquartile range (IQR) 26–28 weeks) and 20 without BPD (median gestational age 28 weeks, IQR 27–29 weeks) were prospectively compared to age-matched at term-born adults (median gestational age 39 weeks, IQR 38–40 weeks). Participants underwent exercise testing and cardiovascular magnetic resonance with submaximal exercise.

Results

Resting heart rate in BPD subjects was higher than in at term-born subjects (69±10 mLversus61±7 mL, p=0.01). Peak oxygen uptake during maximal cardiopulmonary exercise testing was decreased in BPD subjects (91±18%versus106±17% of predicted, p=0.01). In BPD subjects, cardiac stroke volume change with exercise was impaired compared to at term-born subjects (11±13%versus25±10%; p<0.001). With exercise, left ventricular end-diastolic volume decreased more in preterm-born subjects withversuswithout BPD (−10±8%versus−3±8%; p=0.01) and compared to at term-born subjects (0±5%; p<0.001). Exploratory data analysis revealed that exercise stroke volume and end-diastolic volume change were inversely correlated with oxygen dependency in those born prematurely.

Conclusions

In preterm-born young adults, particularly those with BPD, resting cardiac function, exercise performance and cardiac response to exercise is impaired compared to controls. Exercise cardiovascular magnetic resonance may reveal an important predisposition for heart disease later in life.
Phase I dose-escalation study to assess the safety, tolerability, pharmacokinetics and pharmacodynamics of an inhaled recombinant human ACE2
Authors: Bauer Martin , Jorda Anselm , al-Jalali Valentin , Wölfl-Duchek Michael , Bergmann Felix , Nussbaumer-Pröll Alina , Steindl Ariane , Gugenberger Romana , Bischof Sarah , Wimmer Doris , Idzko Marco , Zeitlinger Markus
Published: February 2024

Background

APN01 is a soluble recombinant human angiotensin-converting enzyme 2 (rhACE2), a key player in the renin–aldosterone–angiotensin system (RAAS). In clinical studies, APN01 was administered intravenously only, so far. The aim of this study (ClinicalTrials.gov:NCT05065645) was to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of inhaled APN01.

Methods

This was a phase I, double-blind, placebo-controlled, dose-escalation study. Inhalation was conductedviaa nebuliser over 15 min in three single ascending dose (SAD) cohorts (n=24) and two multiple ascending dose (MAD) cohorts (n=16: every 12 h for 7 days). Doses in the SAD cohort were 1.25, 2.5 and 5 mg·mL−1; doses in the MAD cohort were 2.5 and 5 mg·mL−1. Safety (including adverse events (AEs), laboratory findings and lung function results), PK and PD data were assessed.

Results

In the SAD and MAD cohorts, treatment-related AEs were slightly more frequent in the active treatment group than in the placebo group. AEs were mild to moderate, with no dose-limiting toxicities. No clinically relevant changes in lung function and laboratory results were observed. The mean maximum observed plasma concentration (Cmax) values after single and multiple doses of 5 mg·mL−1APN01 were 1.88 and 6.61 ng·mL−1, respectively. Among the PD variables, significance was found for ACE2 and angiotensin 1–5.

Conclusions

The application of aerosolised APN01 is safe and well tolerated after single and multiple doses. By achieving a high local concentration in the lungs and low systemic bioavailability, inhaled rhACE2 may present a therapeutic option in ACE2-related diseases.
Single-centre prospective evaluation of the first 5 years of cystic fibrosis newborn screening in Germany
Authors: Gesenhues Florian , Michel Katarzyna , Greve Tobias , Röschinger Wulf , Gothe Florian , Nübling Jenna , Feilcke Maria , Kröner Carolin , Pawlita Ingo , Sattler Franziska , Seidl Elias , Griese Matthias , Kappler Matthias
Published: February 2024

Background

In 2016, nationwide cystic fibrosis newborn screening (CFNS) was newly implemented in Germany, using an immunoreactive trypsin/pancreatitis-associated protein/DNA screening algorithm that differs from most other nationwide screening programmes.

Methods

We analysed real-life feasibility of the confirmation process with respect to our pre-specified procedural objectives. These included overall accuracy through false-negative and false-positive results, effectiveness of the Bavarian tracking system, and accuracy of Macroduct and Nanoduct sweat conductivity compared with quantitative chloride determination. All consecutive CFNS-positive newborns assigned to our CF centre and born between 1 September 2016 and 31 August 2021 (n=162) were included.

Results

The German CFNS was feasible at our CF centre as all procedural objectives were met. The positive predictive value (PPV) of positive CFNS was low (0.23) and two initially negatively screened children were later diagnosed with CF. The tracking system was highly efficient with a 100% tracking rate. The Macroduct and Nanoduct systems had comparable success rates (93.2%versus95.9%). Importantly, conductivityviaMacroduct was more accurate thanviaNanoduct (zero and four false-positive newborns, respectively).

Conclusions

CF confirmation diagnostics of neonates in a certified regional CF centre was well managed in daily routine. The PPV of the German CFNS needs to be improved,e.g.by extending the DNA analysis within the screening algorithm and by increasing the number of variants tested. The Bavarian tracking system can serve as a successful model for other tracking systems. We preferred the Macroduct system because of its more accurate sweat conductivity readings.
The treatable traits of asthma in pregnancy: a clinical audit
Authors: Duszyk Katarzyna , McDonald Vanessa Marie , Thomas Dennis , Steel Kelly , Gibson Peter Gerard
Published: February 2024

Rationale

Poor asthma control in pregnancy is associated with adverse perinatal outcomes. Treatable traits improve patient outcomes but the pattern and prevalence of treatable traits in pregnant women with asthma is unknown. Whether treatable traits in pregnant women with asthma can be identifiedviaa virtual care consult is also unknown. The objective of the present study was to assess the prevalence of treatable traits in pregnant women with asthma using a virtual model of care.

Methods

Pregnant women with asthma (n=196) underwent an assessment by an asthma nurse educator and a respiratory physicianviatelehealth. In this clinical audit, 16 treatable traits were assessed including two traits in the pulmonary domain, five traits in the behavioural/risk factors domain and nine traits in the extrapulmonary domain.

Results

Pregnant women with asthma had a mean±sdof 7.5±2.0 treatable traits per person including 1.0±0.7 treatable traits per person in the pulmonary domain, 3.5±1.56 in the extrapulmonary domain and 2±0.9 in the risk factor/behavioural domain. Treatable traits in the behavioural/risk factor domain were most prevalent and these included limited asthma knowledge (96%), inadequate inhaler technique (84%) and no written asthma action plan (80%). On average 3.8±1.24 interventions per person were delivered for a mean±sdof 7.5±2.0 treatable traits per person.

Conclusion

Virtual antenatal asthma care is a feasible approach for assessing treatable traits in pregnant women with mild asthma.Pregnant women with asthma exhibit multiple management issues. Virtual models of care might increase asthma in pregnancy service uptake and acceptability.
Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients
Authors: Waeijen-Smit Kiki , Crutsen Mieke , Keene Spencer , Miravitlles Marc , Crisafulli Ernesto , Torres Antoni , Mueller Christian , Schuetz Philipp , Ringbæk Thomas J. , Fabbian Fabio , Mekov Evgeni , Harries Timothy H. , Lun Chung-tat , Ergan Begum , Esteban Cristóbal , Quintana Lopez Jose M. , López-Campos José Luis , Chang Catherina L. , Hancox Robert J. , Shafuddin Eskandarain , Ellis Hollie , Janson Christer , Suppli Ulrik Charlotte , Gudmundsson Gunnar , Epstein Danny , Dominguez José , Lacoma Alicia , Osadnik Christian , Alia Inmaculada , Spannella Francesco , Karakurt Zuhal , Mehravaran Hossein , Utens Cecile , de Kruif Martijn D. , Ko Fanny Wai San , Trethewey Samuel P. , Turner Alice M. , Bumbacea Dragos , Murphy Patrick B. , Vermeersch Kristina , Zilberman-Itskovich Shani , Steer John , Echevarria Carlos , Bourke Stephen C. , Lane Nicholas , de Batlle Jordi , Sprooten Roy T.M. , Russell Richard , Faverio Paola , Cross Jane L. , Prins Hendrik J. , Spruit Martijn A. , Simons Sami O. , Houben-Wilke Sarah , Franssen Frits M.E.
Published: February 2024

Background

Exacerbations of COPD (ECOPD) have a major impact on patients and healthcare systems across the world. Precise estimates of the global burden of ECOPD on mortality and hospital readmission are needed to inform policy makers and aid preventive strategies to mitigate this burden. The aims of the present study were to explore global in-hospital mortality, post-discharge mortality and hospital readmission rates after ECOPD-related hospitalisation using an individual patient data meta-analysis (IPDMA) design.

Methods

A systematic review was performed identifying studies that reported in-hospital mortality, post-discharge mortality and hospital readmission rates following ECOPD-related hospitalisation. Data analyses were conducted using a one-stage random-effects meta-analysis model. This study was conducted and reported in accordance with the PRISMA-IPD statement.

Results

Data of 65 945 individual patients with COPD were analysed. The pooled in-hospital mortality rate was 6.2%, pooled 30-, 90- and 365-day post-discharge mortality rates were 2.0%, 6.4% and 12.2%, respectively, and pooled 30-, 90- and 365-day hospital readmission rates were 11.8%, 26.5% and 38.2%, respectively, with noticeable variability between studies and countries. Strongest predictors of mortality and hospital readmission included noninvasive mechanical ventilation and a history of two or more ECOPD-related hospitalisations <12 months prior to the index event.

Conclusions

This IPDMA stresses the poor outcomes and high heterogeneity of ECOPD-related hospitalisation across the world. Whilst global standardisation of the management and follow-up of ECOPD-related hospitalisation should be at the heart of future implementation research, policy makers should focus on reimbursing evidence-based therapies that decrease (recurrent) ECOPD.