bluuebunny/crossref_metadata_2025 huggingface dataset:
Provocative products, the boomerang effect, the shooting star crisis and the panacea of workforce diversity
Authors: Nizamidou Christina
Published: May 2022

Purpose

The present article focuses on crises that arise from provocative advertisement images and products and introduces the shooting star crisis. Moreover, it aims to shed some light on the interconnection between the boomerang effect, crisis, crisis management and workforce diversity.

Design/methodology/approach

By examining the cases of two leading organizations of the fashion industry that found themselves involved in crises and how they confronted them, it seeks to explore whether investments in workforce diversity is a solution for these problems.

Findings

Sometimes provocative products and images that intend to spark customers' imagination can backfire and initiate a crisis. Based on the findings, organizations that admit their wrongdoing and react promptly to their stakeholders' demands tend to overcome a crisis relatively faster than organizations with passive behavior. By understanding the need for a proactive approach, fashion organizations can evade future crises and avoid creating products or images that can be perceived as racist and invoke public outrage. Additionally, the study revealed that workforce diversity initiatives can mitigate a crisis and its aftermath.

Originality/value

Its novelty is that it deals with the interrelationship between boomerang effect, crisis, crisis management and workforce diversity. Moreover, it introduces a new type of crisis, the shooting star crisis, in order to capture new crises that emerge in modern era, as a result of the extensive power of modern social media.
E-leadership and virtual communication adoption by educators: an UTAUT3 model perspective
Authors: Gupta Saurabh , Mathur Nidhi , Narang Daviender
Published: May 2022

Purpose

The purpose of the study is to explore the various determinants of virtual communication technology (VCT) adoption among higher educational leaders by applying Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model. Further, this study ascertains the relationship among the various determinants and measure the effects of these determinants in adoption of VCT by educational leaders.

Design/methodology/approach

The study was conducted by using online survey method for data collection from 380 educational leaders of India through a convenience sampling procedure. The structural equation modelling technique was adopted to assess the dimensions of VCT adoption and test the proposed model and hypotheses.

Findings

The findings revealed that performance expectancy (PE), effort expectancy (EE), social influence (SI), facilitating conditions (FC) and personal innovativeness (PI) have positive and significant effects on intention to use VCT (ITUVCT) and actual use of VCT (AUVCT), i.e. e-leadership communication adoption. Besides this, there is also a significant and positive effect of ITUVCT on actual usage of VCT by the educational leaders.

Research limitations/implications

This study makes its contribution to the literature related to technology adoption recommended in previous research for expanding the contexts through new studies and generalizing the UTAUT3 model, specifically in the teaching–learning and administrative perspectives. The results of the study will be further helpful for the researchers and practitioners to better understand the factors that influence higher educational leaders to adopt VCT.

Originality/value

The authors applied the UTAUT3 model and explored the factors determining the adoption intention of VCT among educational leaders. This study is the first study that adopts UTAUT3 model in Indian educational leaders’ context.
Assessing the impact of technological progress on trade in COMESA: a PVECM approach
Authors: Fauzel Sheereen
Published: May 2022

Purpose

The present study investigates the extent to which technological progress influences trade in the Common Market for Eastern and Southern Africa (COMESA) region over the period 1990–2017.

Design/methodology/approach

Methodologically, this study uses a rigorous dynamic analysis namely a dynamic vector error correction model (PVECM) to carry out the proposed investigation. Such a procedure ensures that the dynamic behaviour under consideration is properly captured, while simultaneously catering for causality issues.

Findings

The results show that technological progress has had a positive and significant effect on trade for the sample of countries in the COMESA region over the years of studies. Also, the long-run results show that local investment and economic growth have a positive impact on international trade. Furthermore, the short-run estimates allowed us to make further analysis of the results. For instance, it is observed that trade as well results in technological progress as per the study. Hence, there is reverse causation or bi-directional causality between trade and technological progress.

Originality/value

Very few research studies have been conducted on the link between technological progress and trade in a macroeconomy. The analysis thus is believed to supplement the dwarf literature on the technological progress and trade nexus by bringing additional evidence from COMESA.
The impact of the Compact with Africa initiative on foreign direct investments and environmental pollution
Authors: Duodu Emmanuel , Oteng-Abayie Eric Fosu , Frimpong Prince Boakye , Takyi Paul Owusu
Published: May 2022

Purpose

This study is motivated by the Compact with Africa (CWA) initiative to promote foreign direct investment (FDI) in Africa. However, FDI is argued to be one of the primary causes of environmental pollution (CO2 emissions). In that regard, this study estimates the impact of the CWA initiative on FDI and environmental pollution.

Design/methodology/approach

The study utilized the difference-in-difference (DID) and triple difference (DDD) estimation strategies to examine the causal impact of the CWA initiative on FDI and environmental pollution from 2005 to 2019. The study selected nine CWA countries and nine non-CWA countries as treatment and control samples.

Findings

The authors found that the CWA initiative positively promotes FDI in the participant countries compared to non-participant countries. The CWA initiative also promoted environmental pollution in the CWA countries compared to non-CWA countries. Furthermore, the DDD estimates show that the effect of the CWA initiative on environmental pollution is through FDI.

Practical implications

The authors recommend policies to attract environmentally friendly FDI for both Compact and non-Compact economies.

Originality/value

The study is the first to provide empirical evidence on the CWA initiative on FDI and environmental pollution in Africa. The study used a quasi-experimental method on the relationship between FDI and environmental pollution in Africa.
Commitment Systems in Cross‐boundary Work
Authors: van Rossenberg Yvonne G. T. , Swart Juani A. , Yalabik Zeynep Y. , Cross David , Kinnie Nicholas
Published: May 2022

Work increasingly takes place across organizational boundaries. This has implications for workers’ commitments to a plethora of targets, including the organization and the client, as well as for the conflicting nature of the interrelation between these commitments. In this paper, we draw on commitment system theory (CST), which views commitment as a malleable and interconnected system. Using a pragmatic abductive and quantitative discovery approach, we distinguish and develop commitment systems to consist of strength, including the multiple targets and types of commitment, as well as interaction between commitments, including coupling and nature. In particular, we develop a theoretical understanding of the nature dimension by identifying two target‐neutral types of conflict and one context‐ and target‐specific type of conflict. Three commitment systems are identified: ‘balanced system’, ‘conflicting system’, and ‘detached system’. Furthermore, we provide insights into how job demands resources and contextual job aspects influence membership of these commitment systems. This paper is the first to empirically explore commitment as a system, and it advances the theoretical understanding of commitment systems in a cross‐boundary space. Our study discusses the theoretical, methodological and practical implications for cross‐boundary organizations that compete with their clients for the commitment of their employees.
Princes, Armies, Sanctuaries
Authors: Meller Harald
Published: May 2022

The Circum-Harz group of the Central German Únětice Culture (2200-1600 BC) was a highly stratified society, which arose from the merging of the Corded Ware and Bell Beaker Cultures. This process was advanced by princes who established their legitimacy as rulers on symbolic references to both cultures as well as on newly created traditions and historical references. Their power was based on armed troops, which appear to have been accommodated in large houses or longhouses. The hierarchical structure of the troops can be determined by both their distinctive weapons and the colours thereof. The prince of the Dieskau territory commanded the largest army and occupied a dominant position, expressed through the large Bornhöck burial mound and by the gold find of Dieskau, which itself most likely originated in the Bornhöck barrow. The article concludes with a discussion whether the Dieskau ruler was an actual head of a genuine state, according to the criteria put forth by Max Weber and Stefan Breuer. There is some indication that these criteria of statehood were fulfilled by the period associated with the Nebra Sky Disk at the latest, since this disk allowed the prince to act as ‘a representative of the gods before the community’ (Breuer 1998, 39).
Re-Thinking Two Mid-Byzantine Castles on Kephallénia
Authors: Hodges Richard
Published: May 2022

In the early to mid-1990s in a pre-GIS era, Klavs Randsborg with a team from the University of Copenhagen directed a wide-ranging survey of the Ionian (Greek) island of Kephallénia. Randsborg punctiliously published the multi-period sites he discovered, and analysed the results, paying special attention to the island’s archaic Greek sites but also later medieval afterlife of certain of these sites, including the castles re-occupying Paleókastro (Sami) and Pronnoi (2002). Since the Kephallénia survey was made, new research in the early 2000s on castles and Byzantine urbanism in the western Balkans has significantly expanded the base of knowledge. With this new evidence, it is now possible to provide new interpretations of the Paleókastro, Sami and Paleókastro, Pronnoi castles that in turn shed new light on the management of Kephallénia in the Mid-Byzantine period.
Towards an Understanding of Spatiotemporal Dynamics at Great Zimbabwe
Authors: Sinclair Paul J.J.
Published: May 2022

In 1987 archaeologists from nine African countries and colleagues from Sweden began a co-operation programme to study urbanism in eastern and southern Africa under the auspices of The Urban Origins programme. The programme involved 22 parallel field projects throughout the West Indian Ocean region and the southern Africa interior. The article presents a compilation of diverse material on Great Zimbabwe that has been scattered in different fora. The research was directed by an overall approach that investigations in urban archaeology in Africa must be at the same scale that people lived in the past. The results briefly presented here show the potential of multivariate assessments of the spatial distributions of large-scale urban sites in Africa.
Farmers, Herders or Tradesmen?
Authors: Niknami Kamal Aldin , Mirghaderi Mohammad Amin
Published: May 2022

The highland plains of western Iran have been investigated with varying intensity. The Sarfirouzabad Plain located in the south of Kermanshah province, although visited perfunctorily, has not previously been studied systematically, despite attractive ecological and environmental conditions. In 2009, a team from Tehran University conducted a systematic and intensive field survey in the region to identify Bronze Age settlements and to assess their location in relation to ecological, environmental and cultural factors that may have impacted their distribution on the plain. The surveyed area was walked in transects at 20-metre intervals and resulted in the identification of 332 archaeological sites from different cultural periods, which added much to the limited knowledge about the history of this region. Twenty-four of these settlement sites belong to the Middle and Late Bronze Age horizons. This study uses GIS to map the distribution of archaeological materials and construct spatial models to determine the significance of the distribution patterns of the Bronze Age sites.
The double‐edged sword effect of high‐performance work systems: investigating when and why high‐performance work systems promote versus inhibit employee organizational citizenship behaviors
Authors: Zhang Guanglei , Peng Kun , Chen Silu
Published: May 2022

Drawing from self‐regulation theory and self‐identity orientation theory, this study examines the effects of experiencing different high‐performance work systems (HPWS) on the organisational citizenship behaviours of employees. Using a sample of 271 employees in China, we found that firstly, emotional exhaustion mediated the relationship between performance‐oriented/maintenance‐oriented human resource (HR) systems and helping/voice. Secondly, both relational identity and collective identity moderated the relationship between performance‐oriented HR systems and emotional exhaustion. Thirdly, both relational identity and collective identity moderated the indirect effect of performance‐oriented HR systems on helping through emotional exhaustion. Fourthly, both relational identity and collective identity moderated the indirect effect of performance‐oriented HR systems on voice through emotional exhaustion. Fifthly, individual identity moderated the relationship between emotional exhaustion and helping/voice. Finally, individual identity moderated the indirect effect of performance‐oriented HR systems on helping/voice through emotional exhaustion, as well as the indirect effect of maintenance‐oriented HR systems on helping/voice through emotional exhaustion. Our findings provide a balanced view of the effects of HPWS on employees’ outcomes and reveal the underlying mechanisms driving these relationships.
Perceptions of adequacy of fruit and vegetable intake as a barrier to increasing consumption
Authors: Wellard‐Cole Lyndal , Watson Wendy L. , Hughes Clare , Tan Nina , Dibbs Jane , Edge Rhiannon , Dessaix Anita
Published: May 2022

Aim

To investigate New South Wales adults' perceived adequacy of their fruit and vegetable consumption and to identify the barriers to consumption.

Method

An online cross‐sectional survey of a sample of adults in New South Wales (n = 1603) in February 2019 measured self‐reported fruit and vegetable intakes, perception of consumption adequacy and barriers to consumption. Proportions of participants whose reported consumption met the daily recommended serves of fruit and vegetables per day were calculated. Chi‐square and Fisher's exact tests were used to explore differences between demographic characteristics and meeting fruit and vegetable recommendations. For those not meeting recommendations, Chi‐square and Fisher's exact tests were used to explore perceived adequacy of intake as a potential barrier to consumption.

Results

The sample included 52.7% women, 40.0% aged under 40 years and 28.6% over 59 years, 68.2% lived in a major city, and 32.6% were university educated. Overall, 64.8% of participants reported consuming adequate fruit and 12.4% reported consuming adequate vegetables. Of those consuming less than the guidelines, 21.3% perceived that they were eating enough fruit and 53.7% perceived they were eating enough vegetables. The most common barriers to eating more fruit were preference for other foods (29.6%), fruit spoiling too quickly (28.3%), and habit (27.0%). The most common barriers to eating more vegetables were the perception that they eat enough (26.8%), preference for other foods (21.9%), and habit (19.7%).

Conclusions

Greater efforts are needed to support the public to eat adequate fruit and vegetables, consistent with dietary guidelines. Public education campaigns specifically targeting increasing vegetable consumption are required to address knowledge gaps, given a large proportion of our study population consumed inadequate levels of vegetables yet perceived their intake to be adequate.
New weapons to fight malaria transmission: A historical view
Authors: Huang Wei , Cha Sung‐Jae , Jacobs‐Lorena Marcelo
Published: May 2022

The stagnation of our fight against malaria in recent years, mainly due to the development of mosquito insecticide resistance, argues for the urgent development of new weapons. The dramatic evolution of molecular tools in the last few decades led to a better understanding of parasite–mosquito interactions and coalesced in the development of novel tools namely, mosquito transgenesis and paratransgenesis. Here we provide a historical view of the development of these new tools and point to some remaining challenges for their implementation in the field.
Role of suppressing GLT‐1 and xCT in ceftriaxone‐induced attenuation of relapse‐like alcohol drinking in alcohol‐preferring rats
Authors: Das Sujan C. , Althobaiti Yusuf S. , Hammad Alaa M. , Alasmari Fawaz , Sari Youssef
Published: May 2022

Alcohol dependence results in long‐lasting neuroadaptive changes in meso‐corticolimbic system, especially in the nucleus accumbens (NAc), which drives relapse‐like ethanol drinking upon abstinence or withdrawal. Within NAc, altered glutamate homeostasis is one of the neuroadaptive changes caused by alcohol dependence. Accumbal glutamate homeostasis is tightly maintained through glutamate transporter 1 (GLT‐1) and cystine‐glutamate antiporter (xCT). But the role of GLT‐1 and xCT in relapse‐like ethanol drinking is poorly understood. Here, we used alcohol‐preferring (P) rats in relapse‐like ethanol drinking paradigm to (a) determine the effect of relapse‐like ethanol drinking on gene and protein expression of GLT‐1 and xCT in NAc, measured by quantitative polymerase chain reaction (qPCR) and Western blot, respectively; (b) examine if glutamate uptake is affected by relapse‐like ethanol drinking in NAc, measured by radioactive glutamate uptake assay; (c) elucidate if upregulation of either/both GLT‐1 or/and xCT through ceftriaxone is/are required to attenuate relapse‐like ethanol drinking. The GLT‐1 or xCT protein expression was suppressed during ceftriaxone treatments through microinjection of GLT‐1/xCT anti‐sense vivo‐morpholinos. We found that relapse‐like ethanol drinking did not affect the gene and protein expression of GLT‐1 and xCT in NAc. The glutamate uptake was also unaltered. Ceftriaxone (200 mg/kg body weight, i.p.) treatments during the last 5 days of abstinence attenuated relapse‐like ethanol drinking. The suppression of GLT‐1 or xCT expression prevented the ceftriaxone‐induced attenuation of relapse‐like ethanol drinking. These findings confirm that upregulation of both GLT‐1 and xCT within NAc is crucial for ceftriaxone‐mediated attenuation of relapse‐like ethanol drinking.
Growing alcohol use preceding death by suicide among women compared with men: age‐specific temporal trends, 2003–18
Authors: Lange Shannon , Kaplan Mark S. , Tran Alexander , Rehm Jürgen
Published: May 2022

Background and aims

In the United States, until 2018 both the prevalence of heavy alcohol use and the suicide mortality rate increased among men and women; however, women had experienced a notably higher increase in both. As heavy alcohol use may have contributed to the observed sex disparity in the suicide mortality rate increase, the aim of the current study was to estimate the temporal trend of the sex‐ and age‐group‐specific proportion of suicides that were alcohol‐involved in the United States.

Design

Using restricted‐access data from the National Violent Death Reporting System, we performed joinpoint regression analyses to investigate temporal trends in the sex‐ and age‐group (young adults = 18–34 years; middle‐aged adults = 35–64 years; and older adults = 65+ years)‐specific proportion of suicides that were alcohol‐involved.

Setting

United States.

Participants

A total of 115 202 suicide decedents 18+ years of age from 2003 to 2018.

Measurements

The sex‐ and age‐group‐specific proportion of suicides that were alcohol‐involved, among all suicide decedent, for which the decedent had a blood alcohol concentration (BAC) (a) ≥ 0.04 g/dl and (b) ≥ 0.08 g/dl.

Findings

For 2003–18, the proportion of suicides that were alcohol‐involved wherein the decedent had a BAC ≥ 0.08 g/day significantly increased on average annually for women of all age groups [young women: 2.80%, 95% confidence interval (CI) = 1.86%, 3.75%; middle‐aged women: 2.20%, 95% CI = 1.20%, 3.21%; older women: 10.48%, 95% CI = 1.17%, 20.65%], while only middle‐aged men experienced a significant average annual percentage increase (0.81%, 95% CI = 0.003%, 1.62%).

Conclusion

In the United States between 2003 and 2018, alcohol use preceding death by suicide increased among women compared with men.
Does recreational cannabis legalization change cannabis use patterns? Evidence from secondary school students in Uruguay
Authors: Rivera‐Aguirre Ariadne , Castillo‐Carniglia Alvaro , Laqueur Hannah S. , Rudolph Kara E. , Martins Silva S. , Ramírez Jessica , Queirolo Rosario , Cerdá Magdalena
Published: May 2022

Background and Aims

In 2013, Uruguay became the first country to legalize and regulate the production and distribution of cannabis for recreational use. We measured whether Uruguay's non‐commercial model of recreational cannabis legalization was associated with changes in the prevalence of risky and frequent cannabis use among secondary school students.

Design

We used data from repeated cross‐sectional surveys of secondary students in Uruguay and Chile (2007–2018). Using a difference‐in‐difference approach, we evaluated changes in the prevalence of past‐year, past‐month, any risky and frequent cannabis use following enactment (2014) and implementation (2016) of cannabis legalization among the full sample of secondary students and among students who reported past‐year/month use. We examined changes separately for students ages 12 to 17, and students for whom cannabis became legally accessible, ages 18 to 21.

Setting

Uruguay and Chile (2007–2018).

Participants

Secondary school students in 8th, 10th and 12th grade (n = 204 730).

Measurements

Past‐year and past‐month cannabis use; any risky cannabis use measured with the Cannabis Abuse Screening Test (CAST); and frequent cannabis use (10+ days in the past‐month).

Findings

We found a decrease in past‐year and past‐month use following enactment or implementation. Among students ages 18 to 21, post‐enactment, we observed a transitory increase in 2014 that decreased thereafter for: any risky use among those who reported past‐year use (prevalence difference [PD] = 13.5%; 95% CI: 2.0, 24.9), frequent use in the full sample (PD = 4.5%; 95% CI: 1.0, 8.1), and frequent use among those who reported past‐month use (PD = 16.8%; 95% CI: 1.9, 31.8).

Conclusion

The legalization of recreational cannabis in Uruguay was not associated with overall increases in either past‐year/past‐month cannabis use or with multi‐year changes in any risky and frequent cannabis use among young people.
Assessing the impacts of alcohol outlets on crime as a natural experiment: agglomeration, churning and spatial effects
Authors: Gruenewald Paul J. , Sumetsky Natalie , Gaidus Andrew , Ponicki William , Lee Juliet P. , Mair Christina
Published: May 2022

Background and aims

Retail alcohol outlets appear to open in neighborhoods with low land and structure rents near sources of demand; they may ‘agglomerate’, open near to one another or ‘churn’, replace one another, over time. We used the turnover in numbers of outlets over time to measure agglomeration and churning and the impacts of openings and closings of outlets on neighborhood crime.

Design

Interrupted quasi‐experiments using spatial panel population data from 3768 synthetic block areas over 6 years.

Setting

City of Oakland, CA, USA.

Participants

City population.

Measurements

Census‐based socio‐demographic estimates and counts of openings and closings of bars/pubs, restaurants and off‐premises outlets related to assault, burglary and robbery crime incidents across synthetic Census blocks. Bayesian space–time models were used to assess agglomeration and churning and measure impacts of openings/closings on crime.

Findings

Churning was substantial; openings followed closings for all outlets [bars/pubs, relative risk (RR) = 50.9, 95% credible interval (CI) = 3.0–449.9; restaurants, RR = 3.1, CI = 1.5–6.1; off‐premises, RR = 23.5, CI = 2.0–129.8]. Bars/pub and restaurant openings agglomerated with other outlets (e.g., RR = 1.02, CI = 1.00–1.03 and RR = 1.01, CI = 1.00–1.01), but off‐premises outlets did not. Covarying out effects related to outlet densities, bar/pub openings were related to a 3.5% increase in assaults (RR = 1.04, CI = 1.01–1.06) and 6.9% increase in robberies (RR = 1.07, CI = 1.03–1.11). Restaurant openings were related to a 5.3% increase in burglaries (RR = 1.05, CI = 1.04–1.06). Openings and closings of off‐premises outlets were unrelated to all three crime types.

Conclusions

Retail alcohol outlets appear to follow a pattern of opening near to one another and replacing each other over time. Bar, pub and restaurant openings appear to be related to increases in neighborhood crime.
EPO synthesis induced by HIF‐PHD inhibition is dependent on myofibroblast transdifferentiation and colocalizes with non‐injured nephron segments in murine kidney fibrosis
Authors: Kobayashi Hanako , Davidoff Olena , Pujari‐Palmer Shiuli , Drevin Malin , Haase Volker H.
Published: May 2022

Aim

Erythropoietin (EPO) is regulated by hypoxia‐inducible factor (HIF)‐2. In the kidney, it is produced by cortico‐medullary perivascular interstitial cells, which transdifferentiate into collagen‐producing myofibroblasts in response to injury. Inhibitors of prolyl hydroxylase domain (PHD) dioxygenases (HIF‐PHIs) activate HIF‐2 and stimulate kidney and liver EPO synthesis in patients with anemia of chronic kidney disease (CKD). We examined whether HIF‐PHIs can reactivate EPO synthesis in interstitial cells that have undergone myofibroblast transdifferentiation in established kidney fibrosis.

Methods

We investigated Epo transcription in myofibroblasts and characterized the histological distribution of kidney Epo transcripts by RNA in situ hybridization combined with immunofluorescence in mice with adenine nephropathy (AN) treated with HIF‐PHI molidustat.  Lectin absorption chromatography was used to assess liver‐derived EPO.  In addition, we examined kidney Epo transcription in Phd2 knockout mice with obstructive nephropathy.

Results

In AN, molidustat‐induced Epo transcripts were not found in areas of fibrosis and did not colocalize with interstitial cells that expressed α‐smooth muscle actin, a marker of myofibroblast transdifferentiation. Epo transcription was associated with megalin‐expressing, kidney injury molecule 1‐negative nephron segments and contingent on residual renal function. Liver‐derived EPO did not contribute to serum EPO in molidustat‐treated mice. Epo transcription was not associated with myofibroblasts in Phd2 knockout mice with obstructive nephropathy.

Conclusions

Our studies suggest that HIF‐PHIs do not reactivate Epo transcription in interstitial myofibroblasts and that their efficacy in inducing kidney EPO in CKD is dependent on the degree of myofibroblast formation, the preservation of renal parenchyma and the level of residual renal function.
Patients' perceptions of quality of care delivery by urology residents: A nationwide study
Authors: Mantica Guglielmo , Chierigo Francesco , Gallo Fabio , Cocci Andrea , Esperto Francesco , Patruno Giulio , Diminutto Alberto , Cerasuolo Mattia , Campi Riccardo , Barale Maurizio , Ragonese Mauro , Bettin Laura , Zanetti Stefano , Bianchi Lorenzo , Principi Emanuele , Puliatti Stefano , Cancrini Fabiana , Parnanzini Daniele , Bianchi Grazia , Grande Pietro , Primiceri Giulia , Cavacece Fernando , Schiralli Pasquale , Amparore Daniele , Farullo Giuseppe , Di Mauro Marina , Durante Jacopo , Baldesi Ramona , Carobbio Francesca , Russo Giorgio I , Luperto Elia , La Rocca Roberto , Cacciamani Giovanni E. ,   the Italian Residents Association of the Italian Urology Association Study Group
Published: May 2022

Objective

To present the results of a nationwide survey among urological patients to evaluate their perception of the quality of care provided by residents.

Methods

An anonymous survey was distributed to patients who were referred to 22 Italian academic institutions. The survey aimed to investigate the professional figure of the urology resident as perceived by the patient.

Results

A total of 2587 patients were enrolled in this study. In all, 51.6% of patients were able to correctly identify a urology resident; however, almost 40% of respondents discriminated residents from fully trained urologists based exclusively on their young age. Overall, 98.2% patients rated the service provided by the resident as at least sufficient. Urology trainees were considered by more than 50% of the patients interviewed to have good communication skills, expertise and willingness. Overall, patients showed an excellent willingness to be managed by urology residents. The percentage of patients not available for this purpose showed an increasing trend that directly correlated with the difficulty of the procedure. Approximately 5–10% of patients were not willing to be managed by residents for simple procedures such as clinical visits, cystoscopy or sonography, and up to a third of patients were not prepared to undergo any surgical procedure performed by residents during steps in major surgery, even if the residents were adequately tutored.

Conclusions

Our data showed that patients have a good willingness to be managed by residents during their training, especially for medium‐ to low‐difficulty procedures. Furthermore, the majority of patients interviewed rated the residents' care delivery as sufficient. Urology trainees were considered to have good communication skills, expertise and willingness.
Separation of powers in the UK social care system: A 50‐year perspective
Authors: Dowson Steve
Published: May 2022

UK social care policy has “traditionally” sought to minimise organisational and sector boundaries through cooperation and partnership. This discussion paper argues that there is a case for a social care system based openly on separation of powers to address the conflicts of interest that inevitably exist between the actors—notably local authorities and service providers. Such systems, with “guardrails” to separate the actors, and “checks and balances” to keep them stable, have been developed over centuries in other spheres. Furthermore, if disabled people are to be considered as participants with rights, rather than mere recipients, they should be recognised as the third main actor in the system, also with powers that are protected and constrained. This paper takes a 50‐year retrospective view of these issues in terms of policy affecting people with learning disabilities, focusing on three policy episodes in the UK. First, the 1970s, with a system unbalanced by powerful medical professions, and an absence of self‐advocacy. Second, care management in the 1990s, which ducked the spirit of Sir Roy Griffiths' vision of a lively provider market. Third, the adoption and degradation of Personal Budgets. The learning from UK and international individualised funding programmes is too complex to be certain which ingredients are the keys to success. However, there are strong arguments, and substantial evidence, to suggest that Personal Budgets will not truly succeed until they are built on a structure that determines not only what councils and providers can and should do but also where they must not interfere.
Combination therapy with exenatide decreases the dapagliflozin‐induced changes in brain responses to anticipation and consumption of palatable food in patients with type 2 diabetes: A randomized controlled trial
Authors: van Ruiten Charlotte C. , Veltman Dick J. , Wijdeveld Madelief , ten Kulve Jennifer S , Kramer Mark H. H. , Nieuwdorp Max , IJzerman Richard G.
Published: May 2022

Aims

Sodium‐glucose cotransporter‐2 inhibitors induce less weight loss than expected. This may be explained by sodium‐glucose cotransporter‐2 inhibitor‐induced alterations in central reward‐ and satiety circuits, leading to increased appetite and food intake. Glucagon‐like peptide‐1 receptor agonists reduce appetite and body weight because of direct and indirect effects on the brain. We investigated the separate and combined effects of dapagliflozin and exenatide on the brain in response to the anticipation and consumption of food in people with obesity and type 2 diabetes.

Materials and Methods

As part of a larger study, this was a 16 week, double‐blind, randomized, placebo‐controlled trial. Subjects with obesity and type 2 diabetes were randomized (1:1:1:1) to dapagliflozin 10 mg with exenatide‐matched placebo, exenatide twice‐daily 10 μg with dapagliflozin‐matched placebo, dapagliflozin plus exenatide, or double placebo. Using functional magnetic resonance imaging, the effects of treatments on brain responses to the anticipation of food and food receipt were assessed after 10 days and 16 weeks.

Results

After 10 days, dapagliflozin increased activation in right amygdala and right caudate nucleus in response to the anticipation of food, and tended to decrease activation in right amygdala in response to actual food receipt. After 16 weeks, no changes in brain activation were observed with dapagliflozin. Dapagliflozin plus exenatide reduced activation in right caudate nucleus and amygdala to the anticipation of food, and decreased activation in the right amygdala in response to food receipt after 16 weeks.

Conclusions

The dapagliflozin‐induced changes in brain activation may contribute to the discrepancy between observed and expected weight loss with dapagliflozin. Exenatide blunted the dapagliflozin‐induced changes in brain activation, which may contribute to the additional weight loss with combined treatment.
Real‐world outcomes of addition of insulin glargine 300 U/mL (Gla‐300) to glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) therapy in people with type 2 diabetes: The DELIVER‐G study
Authors: Bailey Timothy S. , Gill Jasvinder , Jones S. Merwyn , Shenoy Laxmi , Nicholls Charlie , Westerbacka Jukka
Published: May 2022

Aims

To provide real‐world data on the addition of basal insulin (BI) in people with type 2 diabetes mellitus (PWD2) suboptimally controlled with glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) therapy. However, real‐world data on the addition of BI to GLP‐1RA therapy are limited.

Materials and Methods

We used a US electronic medical record data source (IBM® Explorys®) that includes approximately 4 million PWD2 to assess the real‐world impact of adding the second‐generation BI analogue insulin glargine 300 U/mL (Gla‐300) to GLP‐1RA therapy. Insulin‐naïve PWD2 receiving GLP‐1RAs who also received Gla‐300 between March 1, 2015 and September 30, 2019 were identified; participants were required to have data for ≥12 months before, and ≥6 months after, addition of Gla‐300.

Results

The mean (standard deviation [SD]) age of participants (N = 271) was 57.9 (10.8) years. Baseline glycated haemoglobin (HbA1c) was 9.16% and was significantly reduced (−0.97 [SD 1.60]%; P < 0.0001) after addition of Gla‐300; a significant increase in the proportion of PWD2 achieving HbA1c control was observed after addition of Gla‐300 (HbA1c <7.0%: 4.80% vs. 22.14%, P < 0.0001; HbA1c <8.0%: 19.56% vs. 51.29%, P < 0.0001). The incidence of overall (8.49% vs. 9.59%; P = 0.513) and inpatient/emergency department (ED)‐associated hypoglycaemia (0.37% vs. 0.74%; P = 1.000), as well as overall (0.33 vs. 0.46 per person per year [PPPY]; P = 0.170) and inpatient/ED‐associated hypoglycaemia events (0.01 vs. 0.04 PPPY; P = 0.466) were similar before and after addition of Gla‐300.

Conclusions

In US real‐world clinical practice, adding Gla‐300 to GLP‐1RA significantly improved glycaemic control without significantly increasing hypoglycaemia in PWD2. Further research into the effect of adding Gla‐300 to GLP‐1RA therapy is warranted.
Comparative cardiovascular effectiveness of glucagon‐like peptide‐1 receptor agonists versus sodium‐glucose cotransporter‐2 inhibitors in patients with type 2 diabetes: A population‐based cohort study
Authors: Dong Yaa‐Hui , Chang Chia‐Hsuin , Lin Jou‐Wei , Yang Wei‐Shun , Wu Li‐Chiu , Toh Sengwee
Published: May 2022

Aims

To examine the comparative effectiveness of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and sodium‐glucose cotransporter‐2 (SGLT2) inhibitors for select cardiovascular outcomes and to examine whether the relative risks varied across different patient subgroups in patients with type 2 diabetes.

Materials and Methods

We conducted a nationwide cohort study of patients with type 2 diabetes who initiated GLP‐1RAs or SGLT2 inhibitors between 2012 and 2018 in Taiwan. The study outcomes included myocardial infarction and total stroke, further classified into ischaemic or haemorrhagic stroke. We estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for each outcome, comparing GLP‐1RAs with SGLT2 inhibitors using Cox proportional hazards models after 1:1 propensity‐score (PS) matching. We also examined if there was effect modification by age, underlying chronic kidney disease, or coexisting cardiovascular disease in prespecified subgroup analyses.

Results

Among 26 032 PS‐matched patients, GLP‐1RA initiators and SGLT2 inhibitor initiators showed similar risks of myocardial infarction (HR 0.99, 95% CI 0.65‐1.52), total stroke (HR 0.90, 95% CI 0.69‐1.17), ischaemic stroke (HR 0.86, 95% CI 0.65‐1.14) and haemorrhagic stroke (HR 0.88, 95% CI 0.63‐1.25). However, GLP‐1RA treatment was associated with an increased risk of total stroke (HR 1.76, 95% CI 1.06‐2.94) and ischaemic stroke (HR 1.88, 95% CI 1.09‐3.23) among patients with chronic kidney disease, but not among patients without chronic kidney disease. GLP‐1RA therapy seemed to have a lower risk of haemorrhagic stroke among patients with cardiovascular disease (HR 0.64, 95% CI 0.43‐0.97), but not in patients without cardiovascular disease.

Conclusions

Glucagon‐like peptide‐1 receptor agonists and SGLT2 inhibitors appeared to have comparable effectiveness with regard to several cardiovascular outcomes overall, but their comparative effectiveness may vary in certain patient subgroups.
Q&A with Bryan Boyer
Authors: Boyer Bryan
Published: May 2022

Urban places present unique design challenges, and they require a unique set of skills and talents to tackle them successfully.
Embedding Equity in Civic Design to Transform Customer Experience
Authors: Hodge Lashanda , Stienstra Aaron
Published: May 2022

Every interaction between the government and the American public is an opportunity to deliver the services our people expect and deserve.

Bringing a design mindset and focus on equity to the complexity of the U.S. federal government helps create customer experiences that can work for everyone.
Working from within Government to Support the Design Industry in Jalisco, Mexico
Authors: Vera Kassim , Delsordo Sofía
Published: May 2022

…introducing design and working from/within government in Mexico has been an interesting endeavor due to its initial maturity level and by how we approach design at our local government level…

Civic designers are putting their unique stamp on public projects that not only enhance the State but are also expanding the role of design throughout Mexico.
Recalibration of existing pedotransfer functions to estimate soil bulk density at a regional scale
Authors: Khodaverdiloo Habib , Bahrami Amir , Rahmati Mehdi , Vereecken Harry , Miryaghoubzadeh Mirhassan , Thompson Sally
Published: May 2022

Soil bulk density (ρb) is an important indicator of soil quality, productivity, compaction and porosity. Despite its importance, ρb is often omitted from global datasets due to the costs of making many direct ρb measurements and the difficulty of direct measurement on rocky, sandy, very dry, or very wet soils. Pedotransfer functions (PTFs) are deployed to address these limitations. Using readily available soil properties, PTFs employ estimator equations to fit existing datasets to estimate properties like ρb. However, PTF performance often declines when applied to soils outside those in the training dataset. Potentially, recalibrating existing PTFs using new observations would leverage the power of large datasets used in the original PTF derivation, while updating information based on new soil observations. Here, we evaluate such a recalibration approach for ρb estimation, benchmarking its performance against two alternatives: the original, uncalibrated PTFs, and novel, local PTFs derived solely from new soil observations. Using a ρb dataset of N = 360 total observations obtained in West Azerbaijan, Iran, we varied the local dataset size (with N = 15, 30, 60, and 360) and recalibrated four existing PTFs with these data. Local PTFs were generated based on stepwise multiple linear regression for the same datasets. The same PTFs (original, recalibrated, and local) were also applied to the study area, and the resulting ρb estimates were compared with the global SoilGrids dataset. Recalibration of PTFs reduced errors relative to the original uncalibrated PTFs; for instance, the NSE increased from −22.07 to 0.30 (uncalibrated) to 0.20–0.41 (recalibrated), and RMSE decreased from 0.12 to 0.60 Mg m−3 (uncalibrated) to 0.10–0.13 Mg m−3 (recalibrated). The recalibrated PTFs performance was comparable to or better than local PTFs applied to the same data. Recalibration of existing PTFs with local/regional uses provides a viable alternative to the use of global datasets or the development of local PTFs in data‐scarce regions.

Highlights

Existing global PTFs were calibrated and tested using a small dataset for local utilisation.

Several new local PTFs were also developed using the same datasets.

Recalibration of existing global PTFs is comparable to or more accurate than developing new PTFs.
Reduction in hemodialysis catheter‐related bloodstream infections after implementation of a novel care program
Authors: Lee Kai‐Ni , Chen Chien‐An , Wu Chia‐Hui , Yang Li‐Yu
Published: May 2022

Background

Catheter‐related bloodstream infection (CRBSI) due to dialysis is the major factor causing morbidity and mortality factor for patients undergoing hemodialysis and is associated with additional costs for these patients. This study investigated the effect of a novel care program in terms of reducing CRBSIs for hemodialysis patients with nontunneled (temporary) catheters inserted in their femoral veins.

Methods

This study included dialysis patients (inpatients and outpatients) from July 2018 to September 2019, covering two periods, pre‐intervention (baseline period) and intervention with a novel care program (novel care period). The novel care program was initiated on December 1, 2018. The CRBSI rates (/1000 catheter‐days) for the baseline and novel care periods were compared, and the characteristics of the pathogens were determined.

Findings

Of a total of 72 patients, 33 were from the baseline period and 39 were from the novel care period. Patients in the baseline and novel care periods had the catheter inserted in their femoral veins for a median of 20 and 29 days, respectively. The CRBSI rate decreased by 82.63%, from 8.52/1000 catheter‐days in the baseline period to 1.48/1000 catheter‐days in the novel care period (p = 0.036). The most common organisms involved in CRBSIs were coagulase‐negative staphylococcus and Burkholderia cepacia (26% for both).

Discussion

The novel care program reduced the incidence of CRBSIs in patients with temporary catheters inserted in their femoral veins.
Subsegmental pulmonary embolism and anticoagulant therapy: the impact of clinical context
Authors: Dahan Ariel , Farina Sergio , Holmes Natasha E. , Kachel Stefan , McDonald Christine F. , Lewis Jane E. , Marhoon Nada , Yanase Fumitaka , Yang Natalie , Bellomo Rinaldo
Published: May 2022

Background

Anticoagulation for subsegmental pulmonary embolism (SSPE) is controversial.

Aim

To assess the impact of clinical context on anticoagulation and outcomes of SSPE.

Methods

We electronically searched computed tomography pulmonary angiogram reports to identify SSPE. We extracted demographic, risk factor, investigations and outcome data from the electronic medical record. We stratified patients according to anticoagulation and no anticoagulation.

Results

From 1 January 2017 to 31 December 2019, we identified 166 patients with SSPE in 5827 pulmonary angiogram reports. Of these, 123 (74%) received anticoagulation. Compared with non‐anticoagulated patients, such patients had a different clinical context: higher rates of previous venous thromboembolism (11% vs 0%; P = 0.019), more recent surgery (26% vs 9%; P = 0.015), more elevated serum D‐dimer (22% vs 5%; P = 0.004), more lung parenchymal abnormalities (76% vs 61%; P = 0.037) and were almost twice as likely to require inpatient care (76% vs 42%; P < 0.001). Such patients also had twice the all‐cause mortality at 1 year (32% vs 16%).

Conclusions

SSPE is diagnosed in almost 3% of pulmonary angiograms and is associated with high mortality, regardless of anticoagulation, due to coexistent disease processes rather than SSPE. Anticoagulation appears dominant but markedly affected by the clinical context of risk factors, alternative indications and illness severity. Thus, the controversy is partly artificial because anticoagulation after SSPE is clinically contextual with SSPE as only one of several factors.
Associations between fruit consumption and home blood pressure in a randomly selected sample of the general Swedish population
Authors: Ström Edvin , Östgren Carl Johan , Nystrom Fredrik H. , Wijkman Magnus O.
Published: May 2022

Frequent fruit consumption has been associated with lower office blood pressure. Less is known about associations between fruit consumption and home blood pressure. Our aim was to study the correlation between consumption of specific fruits and home blood pressure in a large randomly selected study population. The main outcome was systolic home blood pressure. Home blood pressure measurements were performed with calibrated oscillometric meters during seven consecutive days. Means for all available measurements were used. Validated food frequency questionnaires were used for estimating frequency of fruit consumption. The specified fruits were bananas, apples/pears and oranges/citrus fruit. Complete case analysis regarding fruit consumption, office‐ and home blood pressure measurements and other relevant variables was performed in 2283 study participants out of 2603 available. Multivariable linear regression analysis was performed. There were statistically significant associations between consumption of all fruit types and lower systolic home blood pressure unadjusted (p for trend; bananas, apples/pears and oranges/citrus fruit p < .001). The numerical differences between most and least frequent consumption of fruit were for bananas ‐2.7 mm Hg, apples/pears ‐3.9 mm Hg and for oranges/citrus fruit ‐3.4 mm Hg. When adjusted for covariates, both consumption of apples/pears and oranges/citrus fruit had an independent statistically significant association with lower blood pressure (p = .048 resp. p = .009). Future controlled interventional studies are needed to evaluate the effect of specific fruit on home blood pressure.