bluuebunny/crossref_metadata_2025 huggingface dataset:
Back to the table: how omnichannel social media marketing returns customers to restaurant locations
Authors: Suttikun Chompoonut , Mahasuweerachai Patcharaporn , Bicksler William Hamilton
Published: December 2024

Purpose

The purpose of this study was to understand how social media marketing activities (SMMA) influence consumers’ perceived value of online-to-offline food ordering experiences, subsequently affecting satisfaction and intentions to visit physical establishments.

Design/methodology/approach

Data from 845 participants was collected using a purposive sampling technique. Covariance-based structural equation modeling was then applied to assess the conceptual model and its hypotheses.

Findings

Analysis of the structural equation modeling showed support for all hypotheses. SMMA exhibited positive effects on trust, hedonic value and utilitarian value, while these in turn positively influenced the use of online-to-offline food delivery services (O2O-FDS). In addition, results indicated a positive effect of O2O-FDS use on omni-channel restaurant satisfaction which then led to increased intentions to dine in at physical restaurants.

Practical implications

Results suggest that engaging SMMA and O2O-FDS builds trust and encourages in-person visits.

Originality/value

Results from this study build upon the literature by shedding new light on the links between the effects of SMMA, trust, perceived value and consumers’ intentions to visit physical restaurants after using the O2O-FDS. In addition, consumers’ perceived trust, as well as hedonic and utilitarian values, mediate the effect of SMMA on O2O-FDS.
How ethnic discord impacts the relationship between health service delivery and state legitimacy: lessons from fragile Nepal
Authors: Bhandari Sudip
Published: December 2024

Purpose

Despite extensive research on the relationship between service delivery and state legitimacy in fragile settings, we know little about how this relationship is impacted by ethnic discord, particularly when essential health services are delivered to an oppressed ethnic minority by an ethnic majority. This study addresses the research gap in the fragile setting of Nepal, characterized by unresolved ethnic tensions. It examines how Nepal’s Madheshi ethnic minority engages with state health services delivered by the Pahadi ethnic majority. The objective is to analyze how Madhesis’ perceptions of these services shape their views on state legitimacy.

Design/methodology/approach

Semi-structured interviews were conducted with 18 Madhesi patients and five Pahadi frontline healthcare practitioners at Narayani sub-zonal hospital, a state-run facility in Madhesh, the southern region of Nepal. Additionally, a focus group discussion was held with 11 Madhesi recipients of government health services in Madhesh’s Pipra rural municipality.

Findings

Madhesis viewed health service delivery and the Pahadi providers favorably and supported state legitimacy by commending the state’s commitment to provide free and equitable health services. In contrast, the Pahadi healthcare providers expressed skepticism and discontentment, perceiving Madhesi patients as ill-behaved and distrustful of their medical decisions. These providers often felt their authority was challenged by the Madhesi patients and their families.

Originality/value

The discrepancies in perspectives are striking. Healthcare workers predominantly viewed clients through an ethnic lens, whereas clients focused more on the professional provider–patient relationship. These findings provide new insights into the nuanced interplay of ethnicity in service delivery in fragile settings characterized by ethnic discord, where governments seek to enhance state legitimacy.
Building bridges in uncertain times: supply relationships, lean supply chain management and performance
Authors: Garcia-Buendia Noelia , Moyano-Fuentes José , Maqueira Juan Manuel
Published: December 2024

Purpose

The purpose of this study is to examine how a focal firm’s supply relationships influence lean supply chain management (LSCM) implementation and its impact on operational performance.

Design/methodology/approach

An empirical study of 285 Spanish focal firms has explored the relationships between supply uncertainty, strategic supplier performance, LSCM implementation and operational performance. A structural equation model was used to test four hypotheses.

Findings

The results indicate that supply uncertainty and strategic supplier performance significantly impact the decision to implement LSCM. The findings highlight the importance of strategic supplier performance for driving LSCM adoption. However, this study also suggests that LSCM implementation should be carefully considered in situations characterized by high supply uncertainty.

Practical implications

This study suggests that enhancing LSCM implementation and improving performance from key suppliers are crucial factors in achieving favorable operational performance in focal firms. Practitioners receive guidance on aligning their supply relationships, considering contextual factors and leveraging strategic supplier performance to drive effective LSCM implementation.

Originality/value

This study offers novel insights by examining the antecedents to LSCM implementation from a contingency and relational perspective specifically focused on the context of supply relationships. This research contributes to the existing body of knowledge on supply chain management by shedding light on the interplay between supply uncertainty, strategic supplier performance, LSCM implementation and operational performance.
Suicide among prisoners: a bibliometric analysis
Authors: Datta Manjistha , Kar Sujita Kumar , Arafat S.M. Yasir
Published: December 2024

Purpose

Suicide in prisons accounts for about half of all prison deaths globally. A bibliometric analysis would indicate research output and potential contributors in the sector, which has not been conducted previously. The purpose of this paper was to conduct a bibliometric analysis to understand the patterns, trends and gaps in research on this issue.

Design/methodology/approach

The PubMed database was searched by using the terms: (suicide) AND ((Prison) OR (prisoner) OR (incarceration)). A bibliometric analysis was done with the help of Harvard Catalyst, PubMed PubReMiner and biblioshiny.

Findings

A total of 1,683 publications were identified in the PubMed database from 1949 to 2024, with an annual growth rate of 4.4% and a Hirsch index of 46. Journal articles were the top publications with the highest number in the journal Crisis. The USA published the highest number of articles, and countries with low income showed much less production.

Originality/value

Prison suicide is not well-researched worldwide. The majority of the studies are published in high-income countries. An interdisciplinary outlook and more intervention-based and longitudinal studies are required in this field. Importantly, more research in low- and middle-income countries is required to understand mental health issues and prevent suicide in prisons.
Blockchain technology as a driver for sustainability? A consumer purchase intention perspective
Authors: Huang Bo , Dai Jing , Lim Jia Jia
Published: December 2024

Purpose

Blockchain-based traceability labels is increasingly adopted in supply chain, yet there is little empirical research to examine effectiveness from consumer perspective. Can blockchain technology motivate consumers to purchase sustainable products? Drawing on signaling theory, this paper answers this question by comparing the effect of blockchain-based traceability labels with certification-based labels on consumer purchase intention of sustainable products. We further investigate consumers’ perception of sustainability level as a mediating variable and social enterprise as a boundary condition.

Design/methodology/approach

This study uses three online between-subject experiments with a total of 750 participants. The proposed hypotheses are tested using analysis of covariance (ANCOVA) as well as mediation analysis based on PROCESS macro.

Findings

The results suggest that (1) blockchain-based traceability labels lead to greater consumer purchase intention of sustainable products than certification-based labels; (2) such a positive effect of blockchain-based traceability labels occurs as consumers perceive a higher sustainability level; (3) however, the effect is attenuated when the company is a social enterprise.

Originality/value

This study contributes to the operations and supply chain management (OSCM) literature by studying the effectiveness of blockchain-based traceability labels from the overlooked yet emerging perspective of consumers. We provide a theoretical explanation and empirical evidence of how blockchain-based traceability labels influence consumer purchase intention during sustainable consumption compared with certification-based labels. We thus additionally contribute to the extant research on the intersection of blockchain and sustainability. Moreover, the incorporation of social enterprise as a moderator enriches the application of signaling theory on the context of sustainability signaling.
Institutional innovation in tourism: a systematic review approach
Authors: Peinado Osuna Nadia Ilenia , López-Chávez Beatriz Adriana , Kallmuenzer Andreas
Published: December 2024

Purpose

The objective of this research is to analyze the existing academic literature on institutional innovation in tourism to identify advances and knowledge gaps.

Design/methodology/approach

Through a systematic review methodology, 273 academic articles were identified in online databases such as Google Scholar, Taylor and Francis, Scopus and Web of Science; 31 articles met the inclusion criteria by presenting theoretical or empirical contributions in the field of institutional innovation in tourism. Subsequently, a qualitative content analysis was carried out based on its main contributions.

Findings

The results indicate that only few studies address this issue even though institutional innovation is the most complex of the tourism innovation typologies and necessary for improving adequate tourism development. The main contributions are synthesized into two central topics: territorial management and innovative behavior. The first includes studies with a broader perspective at the destination or region level, focusing on public policy, competitiveness and sustainability issues. The second focuses on innovation systems, innovation strategies and results such as social and environmental benefits. Future lines of research are identified to advance knowledge on this topic.

Originality/value

Institutional innovation is essential for destination and organizational management. However, this type of innovation remains the least explored in the tourism innovation literature. This paper aims to review the current knowledge on institutional innovation from both macro and micro perspectives. To achieve this, the discussion focuses on territorial management and innovative behavior, aligning with the principles of sociological institutionalism to understand how institutional innovation processes and outcomes emerge.
Case studies in business education: an investigation of a learner-friendly approach
Authors: Vítečková Klára , Cramer Tobias , Pilz Matthias , Tögel Janine , Albers Sascha , van den Oord Steven , Rachwał Tomasz
Published: December 2024

Purpose

Case studies are widely used in business education as an action-oriented teaching method to develop students’ problem-solving skills. While they are popular in the classroom, the authors know little about how best to design and use case studies and whether they improve students’ learning experience and outcomes. This paper aims to investigate whether pedagogically developed case studies lead to better student learning outcomes than do traditional case studies.

Design/methodology/approach

This large-scale, international quantitative research surveyed students (N = 159) at four major faculties of business and economics in Belgium, the Czech Republic, Germany and Poland to determine whether integrating pedagogical principles into the design phase of teaching cases and adhering to pedagogical principles in case study design affected students’ learning outcomes.

Findings

This study finds that pedagogically developed case studies have a more positive impact on student learning compared to traditional case studies. In addition, the authors found that students who have had previous experience with case-study work and who have positive perceptions of it had even better learning outcomes compared to students who have had no previous experience with case-study work and have negative perceptions of it.

Originality/value

Anecdotal accounts of using case studies in business education suggest that they have a positive impact on the teaching-learning process and learning outcomes, yet very few studies have surveyed students themselves to evaluate whether case-study teaching and learning does in fact lead to better learning outcomes. By empirically showing that teaching with pedagogically developed case studies leads to better learning outcomes, the study suggests that developing case studies using these methods can improve student learning. In addition, the study suggests that students with no prior experience with case studies or with negative prior experiences may need greater preparation and support to fully benefit from case-study work.
Developmental and instrumental leadership: interrelationship and individual profiles
Authors: Börjesson Marcus , Fors Brandebo Maria , Larsson Gerry
Published: December 2024

Purpose

The aim of this study was twofold, first to examine the relationship between developmental leadership (a Scandinavian culture adapted version of transformational leadership) and instrumental leadership, as well as the relationship between these leadership variables and indices of performance and job satisfaction. Second, to identify individual patterns regarding developmental and instrumental leadership.

Design/methodology/approach

Using a longitudinal design, questionnaire data were collected three times among Swedish conscripts and voluntarily employed soldiers during their basic military training (n = 667 at T1, n = 503 at T2 and n = 554 at T3).

Findings

The main findings were: (1) high observed correlations between the developmental and instrumental leadership scales on all measurement occasions; (2) a low to moderate amount of explained variance explained by these leadership scales in regression analyses with performance and job satisfaction as dependent variables, where developmental leadership was strongly associated with ratings of job satisfaction and instrumental leadership accounted for a higher proportion of the variance on ratings of performance and (3) the identification of three distinct profiles of response patterns on the leadership scales, which were fairly similar across time and indicate a temporal consistency of leadership styles.

Research limitations/implications

Methodological strengths include the longitudinal study design, the comparatively large sample size, the use of well-established measurement scales and the person-centered approach allowing for the identification of response patterns. Study weaknesses include too few background variables and the use of self-report ratings only. From a work and organizational perspective, the sample with low-level conscripts and soldiers could also be regarded as unusual.

Practical implications

Education of leaders should focus on the importance of both interpersonal and instrumental aspects. There is also a need for development of leadership training fostering leaders’ instrumental leadership skills.

Originality/value

The study responds to the call from leadership researchers to further research on instrumental leadership and its relationship to the FRLT across diverse organizational contexts. Longitudinal comparisons of developmental (transformational) and instrumental leadership resulted in more trustworthy results as both a variable-oriented and a person-oriented approach was used.
Splitting the rent: a strategy for managers to address instability in network organization governance
Authors: Shi Wenlei
Published: December 2024

Purpose

This study aims to develop an analytical model for generating relational rent within network organizations and to establish a comprehensive framework for the allocation of such rent.

Design/methodology/approach

The design stage involves the formulation of integrated computer-aided manufacturing definition (IDEF0) methodologies. The construction stage comprises the detailed elaboration of three distinct stages for rent allocation methods.

Findings

The “relational rent” perspective has illustrated that firms create value and distribute rent within network organizations by identifying partners with complementary resources, establishing high levels of robust informal trust, sharing knowledge and making customized investments tailored to their partners’ needs.

Practical implications

This innovative approach, for the first time, sheds light on the path for managers to secure the stability of network organizations by implementing multiple iterations of benefit distribution. However, it remains an area lacking standardized guidelines for decision-makers. Essentially, our paper pioneers the endeavor, marking the inaugural step toward ensuring network organization stability through profit distribution decisions. Additionally, it constitutes the initial attempt to bridge the gap between qualitative analysis and a quantitative profit distribution framework.

Originality/value

This rent allocation method unequivocally highlights the importance of efficient allocation within network organizations, emphasizing the streamlining of the allocation process and thus substantiating the rationality of the proposed method.
Citizenship behaviors against organizational interests: perceived follower support and supervisor competence uncertainty
Authors: Abdelmotaleb Moustafa , Mouri Nacef , Lahlouh Khaled , Saha Sudhir K.
Published: December 2024

Purpose

Adopting a followership perspective and drawing upon the literature on perceived support, we provide new theoretical insights into when and why supervisors engage in unethical behavior with the intention of benefiting a “favorite” follower, referred to as unethical favoritism behavior (UFB).

Design/methodology/approach

We conducted two studies: an experiment and a multi-rater field study. Data were collected and analyzed using AMOS and the Macro process for SPSS.

Findings

We found that a follower’s standing among his or her peers in terms of citizenship behaviors toward their supervisor (i.e. relative organizational citizenship behaviors toward supervisor or ROCBS) has a positive effect on the supervisor’s perception of the follower’s support. The results further reveal that the choice of the supervisor on whether to reciprocate or not the perceived support (triggered by ROCBS) with UFB depends on the supervisor’s competence uncertainty (i.e. the degree of supervisor uncertainty regarding his/her work competencies).

Originality/value

Our findings broaden the way the supervisor–follower relationship has traditionally been investigated in the organizational behavior literature by showing that under certain circumstances, followers’ good behaviors might become an antecedent to supervisors’ unethical acts.
Corporate performance: green supply chain management, digital transformation and carbon neutrality
Authors: Chen Yuhan , Guo Hailan
Published: December 2024

Purpose

This study examines the interdependent relationships between green supply chain management (GSCM), carbon neutrality capability (CNC), digital transformation (DT) and firm performance (FP) among enterprises listed on the Chinese stock market. The primary objective is to provide a scholarly examination that may help these organisations to enhance their GSCM practices significantly.

Design/methodology/approach

Drawing on data from mainland Chinese publicly listed firms over the period from 2014 to 2021, this study posits and methodically evaluates four hypotheses: (1) GSCM practices are positively associated with an increase in CNC; (2) GSCM practices have a beneficial impact on FP; (3) DT moderates the GSCM–FP relationship and (4) CNC mediates the effect of GSCM on FP.

Findings

Contrary to initial assumptions, the findings suggest that GSCM practices may initially have a negative impact on FP. However, a concerted focus on CNC has the potential to convert this negative trajectory into a positive influence on FP. The findings further identify that DT has a significant moderating effect on the GSCM–FP relationship.

Originality/value

The findings of this study enrich the academic discourse concerning the symbiotic effects of GSCM, CNC and DT on FP. By systematically analysing these dynamics, the study underscores the critical importance of CNC and DT in the successful application of GSCM practices, thus offering valuable contributions to the literature on sustainable corporate operations.
Anxiety, mental health, job insecurity and workplace challenges: exploring the well-being of women gig workers in the gig economy
Authors: Singh Ramya , Sharma Archana , Gupta Nimit , Mishra Manish , Kushwaha Rohit
Published: December 2024

Purpose

The rapid growth of the gig economy has reshaped the labor market and provided flexible work opportunities but also exposed gig workers to challenges such as job insecurity, anxiety and mental health concerns. For women gig workers, these challenges are often more pronounced due to the precarious nature of gig work and the lack of social protections.

Design/methodology/approach

A cross-sectional survey was conducted with 603 women gig workers across various sectors in India’s major metro cities. The survey used a combination of Likert scale and structured questionnaire to assess anxiety, mental health, job insecurity, workplace challenges and overall well-being, with reliability tests confirming internal consistency.

Findings

Descriptive statistics revealed moderate levels of anxiety, job insecurity and workplace challenges, with most respondents reporting relatively positive perceptions of well-being. Reliability analysis indicated satisfactory internal consistency across the survey constructs, with Cronbach’s alpha values ranging from 0.774 to 0.789. Hypothesis testing showed significant negative correlations between anxiety, job insecurity, workplace challenges and well-being, indicating that higher levels of these stressors are associated with lower well-being. The findings emphasize the need for targeted interventions and policy enhancements to improve the working conditions and support systems for women gig workers.

Research limitations/implications

The study highlights the need for tailored policies and interventions to address the unique challenges faced by women gig workers. Enhancing social protections, providing mental health support and ensuring safer working conditions could help improve their overall well-being.

Originality/value

This study adds to the limited literature on women gig workers in India by examining the specific factors influencing their well-being. It offers new insights into the intersection of gender and gig work, emphasizing the need for policy frameworks that better support this vulnerable workforce.
The effects of esports viewers’ customer experience on intention to purchase sponsoring brands: the mediating role of social identification
Authors: Navarro-Lucena Fernando , Anaya-Sánchez Rafael , Molinillo Sebastian
Published: December 2024

Purpose

The aim of this study is to understand how the dimensions of esports streaming viewers’ customer experience influence their intentions to buy brands produced by sponsors, both directly and through the mediating effect of their identification with players and teams.

Design/methodology/approach

Data were collected through an online survey of 396 regular esports viewers in Spain, using convenience sampling. The proposed conceptual model was evaluated using partial least squares structural equation modeling (PLS-SEM).

Findings

The results showed that the four dimensions of the viewer's customer experience (cognitive, affective, sensory and social) predicted his/her social identification with players/teams. In turn, social identification positively influenced purchase intentions for the sponsoring brand. The cognitive, affective and social dimensions of the experience indirectly influenced purchase intentions for the sponsoring brand, through social identification.

Originality/value

This study improves the understanding of esports viewers’ experiences and their impact on purchase intentions toward the sponsoring brand, and the key role of the viewer’s social identification with players/teams.
3D printed microfluidic devices produced by material extrusion: effect of ironing parameters on mixing efficiency and gradient generation
Authors: Pricci Alessio , Percoco Gianluca
Published: December 2024

Purpose

This study aims to describe the effect of ironing process parameters on mixing efficiency and gradient generation in Y-micromixers and microfluidic gradient generators (MGGs), respectively.

Design/methodology/approach

Material extrusion (MEX) enables the production of miniaturized devices with the advantage of lower manufacturing costs and higher design freedom. However, surface finishing is the most important drawback when it comes to microfluidic applications where flow splitting is not required. First, the effect of ironing line spacing (LS) and speed (IS) on mixing efficiency in Y-micromixers was experimentally investigated. Then, the best ironing settings were chosen to further study the spatial stability of the normalized concentration gradient in MGGs.

Findings

Lower ironing LS and IS enhance the microchannel surface smoothness. The best combination of ironing parameters (lowest values of LS and IS) leads to an increase in mixing length of 191% at Q = 10 µL/min and 198% at Q = 20 µL/min, with respect to a similar Y-micromixer geometry where ironing was not performed. These findings were applied in the production of a MGG, showing that the normalized concentration gradient in the crosswise flow direction does not depend on the streamwise position when ironing is performed.

Originality/value

To the best of the authors’ knowledge, for the first time, the possibility of optimizing ironing parameters to enhance the surface roughness in MEX microfluidic devices has been investigated. Ironing of the channel bottom surface allows to reduce ridges-induced flow convection, thus delaying mixing in Y-micromixers and achieving stable concentration gradient in MGGs.
Unlocking the potential: Exploring the interplay of humble leadership, self-efficacy, and negative gossip in overcoming knowledge hiding
Authors: Aftab Hira , Islam Talat , Cheema Amna Umer
Published: December 2024

Purpose

Knowledge hiding has become a great challenge for organizations. Therefore, this study aims to understand how humble leadership affects knowledge hiding. Specifically, this study aims to explore the mediating role of self-efficacy between humble leadership and knowledge-hiding and the moderating role of negative workplace gossip between humble leadership and self-efficacy.

Design/methodology/approach

As 63% of Pakistani employees are involved in knowledge-hiding, data were collected from 329 employees working in various organizations on a convenience basis using a questionnaire-based survey. Considering the potential problem of common method bias, the data were collected on two separate occasions. This study applied structural equation modeling for the analysis using AMOS software.

Findings

This study noted that when working with humble leaders, employees are less inclined to conceal their knowledge, and this relationship is mediated by self-efficacy. In addition, this study noted that individuals high in perceived negative gossip exhibit low self-efficacy even in the presence of humble leadership.

Research limitations/implications

Cross-sectional time-lagged data of the study may restrict causality. Nevertheless, the findings contribute to the social learning theory by offering a more intricate comprehension of how knowledge-hiding can be tackled in the workplace. Further, this study suggests that humble leadership can be an effective strategy to overcome negative workplace behaviors.

Originality/value

Extending the existing literature on knowledge-hiding and drawing upon social learning theory, this study highlighted the role of humble leadership. The study not only reveals self-efficacy as a mediating mechanism between humble leadership and knowledge-hiding but also explores how negative gossip serves as a boundary condition to harm self-efficacy in the presence of humble leadership.
From collaboration to convergence: Nativist attitudes among non‐radical right supporters
Authors: SANTOSO LIE PHILIP
Published: December 2024

This study examines the impact of cooperation between radical right parties (RRPs) and non‐RRPs on the policy attitudes of non‐RRP supporters. As RRPs have gained prominence in recent years, particularly for their nativist and anti‐immigration positions, this research investigates whether non‐RRP partisans adopt similar views when their preferred parties collaborate with RRPs. Drawing on original survey data from Denmark, Germany and the United Kingdom in 2019, the findings reveal a notable association: non‐RRP supporters are more likely to express stronger nativist attitudes when they perceive their parties as having cooperative relationship with RRPs. These results suggest the potential for ideological diffusion, where voters adjust their beliefs in response to perceived alignment with allied parties. Ultimately, this paper seeks to enhance our understanding of how party cooperation affects voter attitudes, suggesting that alliances with RRPs may normalize exclusionary policies and exacerbate societal divisions.
Measuring systemic risk: A financial statement–based approach for insurance firms and banks
Authors: Peddireddy Venkat , Rajgopal Shiva
Published: December 2024

We introduce CRISK, a financial statement–based measure, to assess the systemic risk contribution of a financial firm. CRISK measures the capital shortfall of a financial firm conditional on severe distress in the entire system. Our measure complements the market‐based measure, SRISK, introduced by Acharya et al. (2012, American Economic Review, 102(3), 59–64) and Brownlees and Engle (2017, Review of Financial Studies, 30(1), 48–79), in identifying systemically risky financial firms. While SRISK provides a timelier assessment using real‐time stock market data, CRISK offers a more nuanced approach using accounting information and is tailored to the distinct characteristics of insurance firms and commercial banks. Our empirical analysis shows that (1) compared to CRISK, SRISK tends to overestimate capital shortfalls for insurance firms and for banks that hold a substantial portion of Federal Deposit Insurance Corporation–insured deposits while underestimating capital shortfalls for banks heavily reliant on uninsured deposits; (2) CRISK estimates of capital shortfall closely align with the actual capital injections received by financial firms during the financial crisis of 2007–2009; and (3) CRISK exhibits a significant positive correlation with short interest. Based on our findings, we recommend using SRISK as an initial screening tool to identify potential systemically risky financial firms, followed by refining the list and validating the expected capital shortfall using CRISK.
Factors and outcomes associated with under‐ and overdiagnosis of sepsis in the first hour of emergency department care
Authors: Pandey Shivansh R. , Knack Sarah K. S. , Driver Brian E. , Prekker Matthew E. , Scott Nathaniel , Ringstrom Sarah J. , Maruggi Ellen , Kaus Olivia , Tordsen Walker , Puskarich Michael A.
Published: December 2024

Background

Sepsis remains the leading cause of in‐hospital death and one of the costliest inpatient conditions in the United States, while treatment delays worsen outcomes. We sought to determine factors and outcomes associated with a missed emergency physician (EP) diagnosis of sepsis.

Methods

We conducted a secondary analysis of a prospective single‐center observational cohort of undifferentiated, critically ill medical patients (September 2020–May 2022). EP gestalt of suspicion for sepsis was measured using a visual analog scale (VAS; 0%–100%) at 15 and 60 min post–patient arrival. The primary outcome was an explicit hospital discharge diagnosis of sepsis that was present on arrival. We calculated test characteristics for clinically relevant subgroups and examined factors associated with initial and persistent missed diagnoses. Associations with process (antibiotics) and clinical (mortality) outcomes were assessed after adjusting for severity.

Results

Among 2484 eligible patients, 275 (11%) met the primary outcome. A VAS score of ≥50 (more likely than not of being septic) at 15 min demonstrated sensitivity 0.83 (95% confidence interval [CI] 0.78–0.87) and specificity 0.85 (95% CI 0.83–0.86). Older age, hypoxia, hypotension, renal insufficiency, leukocytosis, and both high and low temperature were significantly associated with lower accuracy due to reduced specificity, but maintained sensitivity. Of 48 (17%) and 23 (8%) missed cases at 15 and 60 min, elevated lactate, leukocytosis, bandemia, and positive urinalysis were more common in the missed sepsis compared to nonsepsis cases. Missed diagnoses were associated with median (interquartile range) delay of 48 (27–64) min in antibiotic administration but were not independently associated with inpatient mortality as risk ratios remained close to 1 across VAS scores.

Conclusions

This prospective single–academic center study identified patient subgroups at risk of impaired diagnostic accuracy of sepsis, with clinicians often overdiagnosing rather than underdiagnosing these groups. Prompt abnormal laboratory test results can “rescue” initial missed diagnoses, serving as potential clinician‐ and systems‐level intervention points to reduce missed diagnoses. Missed diagnoses delayed antibiotics, but not mortality after controlling for severity of illness.
Institutional investor distraction and stock price synchronicity
Authors: Zhou Taiyun , Yao Gang
Published: December 2024

This article examines the relation between institutional investor distraction and stock price synchronicity using extreme industry returns as an exogenous shock to investor attention. We find that institutional investor distraction is negatively associated with the quantity of firm‐specific information incorporated into stock prices. Underlying mechanisms that lead to our results are the decremental disclosure of valuable information and reduced efficiency of information dissemination. Further analyses imply that the negative impact of institutional investor distraction is more pronounced for firms with weaker internal control and lower market competition. This stock price synchronicity significantly increases financial constraints and weakens investment horizons.
Don't take me for a free‐ride: Chinese Agricultural Geographical Indications and firms' export quality
Authors: Mao Haiou , Görg Holger
Published: December 2024

Geographical Indication (GI) is a rising policy in developing countries, which has been relatively neglected in the existing literature. This article studies Chinese agricultural GIs and its impact on firms’ exports. By relating newly authorized GIs with firm‐product‐location‐destination level customs trade data according to GIs’ geographical coverage and product type, we estimate the impact of these new GIs on firm's exports. Importantly, we can distinguish GIs with and without quality supervision. For the latter we find negative impacts on export quality, which is not the case for GIs with quality supervision. We interpret this in the context of our theoretical framework as evidence for quality free‐riding, where individual firms have an incentive to lower the quality of the export product. We show that this negative effect is less, the more concentrated an industry is or the more GIs there are for a particular product. Furthermore, our results suggest that the China‐EU agreement on Geographical Indications may play the role of quality supervision and prevent the possibility of free‐riding.
Challenges of Dementia Care in a Regional Australian Hospital: Exploring Interventions to Minimise Length of Stay for Dementia Patients
Authors: Reelh Sandeep , Suri Rahul , Hiskens Matthew , Tan Clement , Rana Alok
Published: December 2024

Objective

There are significant difficulties associated with the management of dementia patients in hospitals, leading to adverse patient outcomes, prolonged length of stay (LOS), strain on resources and high readmission rates. This study aimed to investigate these factors in the context of a regional hospital.

Design

This study retrospectively reviewed all dementia admissions in a publicly funded Australian regional hospital from January 2022 to December 2022.

Methods

All admissions including an ICD‐10 coded dementia diagnosis were assessed, and data extracted using the integrated electronic medical record.

Setting

Overall, 257 bed Australian regional hospital in an area with a Modified Monash Model rating of 2.

Participants

There were 105 dementia patients admitted within the study period.

Main Outcomes Measures

Dementia severity, LOS, consultation liaison (CL) psychiatry involvement, readmission rates, and discharge destinations.

Results

The LOS in patients with dementia was 23.3 (± 35.2) days compared to age‐matched patients without dementia admitted in the same period with a LOS of 8.2 (± 4.7) days. Dementia patients who died in hospital had the longest acute LOS at 14.4 (± 8.8) days. Dementia patients who were admitted from their usual residential aged care facility had the longest maintenance LOS at 69 (± 83.3) days.

Conclusions

This research contributes information to the current knowledge gap of dementia care in regional hospitals. Data from this study may help to inform the development of strategies for effective hospital‐based dementia care and interventions.
Exhaled Nitric Oxide and Sputum Eosinophils Are Complementary Tools for Diagnosing Occupational Asthma
Authors: Doyen Virginie , Migueres Nicolas , van Kampen Vera , Suojalehto Hille , Mason Paola , Munoz Xavier , Sastre Joaquin , Quirce Santiago , Svanes Cecilie , Walters Gareth , Moore Vicky , Jacobsen Iben Brock , Folletti Ilenia , Preisser Alexandra M. , Walusiak‐Skorupa Jolanta , Rifflart Catherine , de Blay Frédéric , Vandenplas Olivier ,   the European network for the PHenotyping of OCcupational ASthma (E‐PHOCAS)
Published: December 2024

Background

Exposure‐related changes in exhaled nitric oxide (FeNO) and sputum eosinophils have not been thoroughly compared in the investigation of occupational asthma.

Objective

This study aimed at comparing the accuracies of the changes in FeNO concentrations and sputum eosinophil counts in identifying asthmatic reactions induced by occupational agents during specific inhalation challenges (SICs).

Methods

This retrospective multicenter study included 321 subjects who completed an assessment of FeNO and sputum eosinophils before and 24 h after SICs with various occupational agents, of whom 156 showed a positive result.

Results

Post‐challenge changes in FeNO and sputum eosinophils showed similar accuracies, with areas under the receiver operating characteristics curve of 0.78 (95% confidence interval [95% CI], 0.72–0.83) and 0.81 (95% CI, 0.76–0.86), respectively. Increases in FeNO level ≥ 13 ppb and sputum eosinophils ≥ 1.25% were identified as the optimal threshold values for differentiating positive from negative SICs. Using these thresholds, the changes in FeNO and sputum eosinophils each achieved a ≥ 95% specificity but a low sensitivity (55% and 62%, respectively). FeNO and sputum eosinophils showed discordant increases in 38% of subjects with a positive SIC. Combining either a rise in FeNO ≥ 13 ppb or an increase in sputum eosinophils ≥ 1.25% increased the sensitivity to 77%.

Conclusions

Increases in FeNO concentration and/or sputum eosinophils after exposure to occupational agents strongly support a diagnosis of occupational asthma. The assessment of both markers of airway inflammation should be regarded as a reliable complementary tool to spirometry for identifying bronchial responses to occupational agents.
A homozygous loss‐of‐function mutation in CEP250 is associated with acephalic spermatozoa syndrome in humans
Authors: Xiang Mingfei , Wang Yu , Jiao Yuying , Guo Rui , Zheng Na , Yu Kexin , Zhu Xiaoya , Hu Pengcheng , Zhang Jingjing , Zha Xiaomin , Duan Zongliu , Wang Fengsong , Cao Yunxia , Zhu Fuxi
Published: December 2024

Background

The presence of predominantly headless sperm in semen is a hallmark of acephalic spermatozoa syndrome, which is primarily caused by gene mutations in humans.

Purpose

To identify genetic causes for acephalic spermatozoa syndrome.

Methods

Polymerase chain reaction and Sanger sequencing were performed to define mutations in SUN5 and PMFBP1. Whole‐exome sequencing was performed on the patients to identify pathogenic mutations for infertility. Western blotting and immunofluorescence analysis detected the expression level and localization of CEP250. Co‐immunoprecipitation detected the protein‐protein interactions. Cep250‐KI mice were generated by the CRISPR‐Cas9 system.

Results

Here, 10 patients diagnosed with acephalic spermatozoa syndrome were recruited, and a homozygous loss‐of‐function mutation in CEP250 (NM_007186: c. 4710_4723del: p. E1570fs*39) was identified from a consanguineous Han Chinese family. Immunofluorescence experiments revealed a decreased CEP250 signal in the neck region of the patient's sperm compared with the normal. Co‐immunoprecipitation results indicated reduced interaction between SUN5/PMFBP1 and mutant CEP250 compared with the wild‐type, possibly due to the absence of complete 2272–2442 amino acids. Besides, the patient can be effectively treated with intracytoplasmic sperm injections. Nevertheless, Cep250‐KI male mice exhibit non‐obstructive azoospermia, which indicates the different functions in CEP250 between human and mouse spermatogenesis.

Conclusion

Collectively, CEP250 may represent a novel pathogenic gene for acephalic spermatozoa syndrome in humans, and we provide precise genetic diagnosis and treatment strategies for the patient.
Experience of Venoarterial Extracorporeal Life Support‐Assisted Brain Death Donation With Severe Hemodynamic Instability
Authors: An Yuling , Lu Pinglan , Liu Jianrong , Huang Shuai , Yi Xiaomeng , Li Ziyu , Yi Huimin
Published: December 2024

Objective

To explore the experience of extracorporeal life support (ECLS)‐assisted maintenance of brain death donors with extremely unstable hemodynamics.

Methods

We retrospectively analyzed the clinical data of 12 brain‐dead donors who received ECLS in our hospital from May 2015 to May 2022 due to extremely unstable hemodynamics. The organ acquisition status was analyzed. The transplant outcome of the livers and kidneys procured from these donors on ECLS was also evaluated, who are currently considered as having extended criteria.

Results

After ECLS, the hemodynamics of these 12 patients quickly stabilized and all completed apnea testing and reached the criteria for brain death. The 12 donors on ECLS contributed 36 organs: 1 heart, 2 lungs, 11 livers, and 22 kidneys. All liver and kidney transplant recipients survived within 1 year after transplantation. The 12‐month graft survival rate for these 22 ECLS transplanted kidneys was 95%. Four (18.2%) kidney transplant recipients developed DGF. The average creatinine at discharge was 2.01 ± 0.70 mg/dL (1.14–3.67 mg/dL), which showed a downward trend in the first year after operation. The 12‐month graft survival rate for these 11 ECLS transplanted livers was 100%. There was no incidence of primary nonfunction. The transaminase and bilirubin in the liver transplantation recipient group showed a downward trend, with an average total bilirubin of 2.23 ± 0.17 mg/dL (1.93–2.46 mg/dL) and an average alanine aminotransferase level of 46.55 ± 17.45 (33–89 units/L) at the time of discharge.

Conclusions

ECLS can maintain the organ function of potential brain death donors with extremely unstable circulation and does not affect the functional recovery of the graft.
Vitamin D supplements reduce risk of viral upper respiratory infections in children with lower concentrations
Authors: Devulapalli Chandra Sekhar
Published: December 2024

Aim

Vitamin D is crucial for the immune system, as it enhances pathogen‐fighting cells and reduces inflammation. We reviewed serum 25‐hydroxyvitamin D (25(OH)D) concentrations in children with viral upper respiratory tract infections (URTIs) and the impact of vitamin D supplements on those infections.

Methods

A mini literature review was conducted from 1 January 2000 to 30 April 2024. It used PubMed, Google Scholar, Cochrane and Scopus and focused on children aged 0–18 years.

Results

The review comprised 12 studies: seven randomised controlled trials, two prospective studies, two case–control studies and one cross‐sectional study. The findings included lower 25(OH)D concentrations in children more susceptible to URTIs and significantly lower levels in those with recurrent infections. One study found reduced 25(OH)D concentrations and immunoglobulin G levels in children with URTIs. Of the nine studies that examined vitamin D supplements, five reported benefits for children with URTIs, one only showed short‐term effects and three found no significant reductions. Two reported that taking 2000 IU a day did not reduce URTIs any more than 400 IU and high‐dose supplements may be unnecessary.

Conclusion

Children with viral URTIs often had lower vitamin D concentrations and supplements frequently helped to reduce the risk of these infections.
Gender differences in effects of learning self‐efficacy on learning burnout among higher vocational college students in China
Authors: Yang Dong , Tu Chia Ching
Published: December 2024

Background

In Chinese higher vocational colleges, students often underperform academically and experience burnout from studying. Developing learning self‐efficacy may directly and indirectly address these challenges, and differences in learning self‐efficacy between male and female students may have varying effects on their burnout.

Aims

We examined the mediating relationships between learning self‐efficacy, learned helplessness and learning burnout among Chinese higher vocational college students, as well as the gender‐related differences in these relationships.

Sample

An online survey collected 1045 valid responses. The sample comprised 513 male students and 532 female students, with an age range of 18–21 years.

Methods

A measurement model and multiple structural models for learning self‐efficacy, learned helplessness and learning burnout were established through structural equation modelling to evaluate measurement validity and identify the mediating effects among these variables.

Results

The findings revealed that learned helplessness partially mediated the relationship between learning self‐efficacy and learning burnout among higher vocational college students. Learning self‐efficacy directly influenced learning burnout in male higher vocational college students, whereas learned helplessness partially mediated the relationship between learning self‐efficacy and learning burnout in female higher vocational college students.

Conclusions

The findings indicate that fostering learning self‐efficacy can help mitigate the impact of learned helplessness on learning burnout in female students. However, this protective effect was not observed in male students. Teachers in Chinese higher vocational colleges should implement targeted strategies, such as promoting attainable goal‐setting techniques, to prevent learned helplessness from contributing to learning burnout in male students.