bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of boardroom internationalisation on online disclosures of S&P 500
Authors: Shehadeh Esam , Aly Doaa , Yousef Ibrahim
Published: February 2021

Purpose

The purpose of this study is to analyse the level of online disclosure of firms in the USA and to evaluate the impact of diversity in terms of director nationality (boardroom internationalisation) on online disclosure.

Design/methodology/approach

The authors apply, for the first time, a new modified scoring system to measure online disclosure levels by securing more detailed information on each of the items in the voluntary disclosure index. Regarding the percentage of foreign board members, unlike in previous research, the authors calculate two additional proxies to more accurately specify the level of international diversity on the board: the Blau Index and the Shannon Index. Moreover, the authors use a cross-sectional model for the sampled non-financial S&P500 firms using both ordinary least squares (OLS) and heteroskedasticity-corrected estimates to analyse the impact of boardroom internationalisation on the level of online disclosure.

Findings

The findings reveal that the average online disclosure level for the sample in question is 64% for the 0–1 index and 57% for the 0–4 index. In addition, the results of the regression analysis confirm the study’s proposed hypothesis, which is that the presence of international board members correlates with an improvement in the level of online disclosure. This can be attributed to the fact that foreign directors bring unique skills and knowledge from their home countries and thus, increase board discussion, creativity and innovation, which has a positive impact on the level of online disclosure.

Research limitations/implications

Financial firms are subject to capital requirement regulations; consequently, disclosure practices can be influenced. Therefore, these firms were excluded from the sample of the study.

Originality/value

This research contributes to the body of literature on nationality diversity of firm boards and corporate online disclosure in several respects. Firstly, the study adds an international dimension to the existing literature. Secondly, this study provides new evidence that foreign diversity on the board can improve firm value, insofar as the corresponding enhancement of online disclosure leading to positive capital market implications. Thirdly, the authors use, for the first time, a new scoring system approach to measure the level of online disclosure. Finally, it contributes to the corporate governance literature by basing its analysis on a multi-theoretical approach.
Private pension fund flow, performance and cost relationship under frequent regulatory change
Authors: Erzurumlu Yaman Omer , Ucardag Idris
Published: February 2021

Purpose

This paper aims to investigate private pension fund investor sentiment against fund performance and cost in an environment of frequent regulatory changes. The analyses are conducted in a low return, high-cost private pension fund market environment, which makes it easier to observe the relationship between investor sentiment to return and cost.

Design/methodology/approach

This paper conducts fixed effect, random effect and random effect within between effect panel data analyses of all Turkish private pension funds from 2011 to 2019. This paper conducts the analyses using aggregate data and subsets based on fund characteristics and pre-post regulation periods.

Findings

When regulations provide compensation and improve market efficiency in a pension fund market, investor focus shifted from performance to cost. Investors allocated assets with respect to return realization when adequately compensated for risk or had favorable cost contract clauses. Consequently, investors in pension funds with lower expected returns and no special fee reduction clauses tended to adopt the strategy of cost minimization.

Research limitations/implications

The overlap of regulatory change periods could complicate the ability to distinguish the impact of any one specific change. The findings therefore cannot be generalized to differently structured markets.

Practical implications

Regulatory changes could lead to a switch of investor objectives. When regulatory changes compensate investors and increase market efficiency, investors objective could switch from performance to cost.

Originality/value

This study investigates investor sentiment in a relatively young private pension fund market, in which the relevant regulatory body ambitiously implements frequent changes in regulation. The selected market is unique in the sense that it has negative real returns and high costs, which make investor focus to return and cost more readily apparent.
Coronavirus disease 2019: the second wave in Italy
Authors: Chirico Francesco , Sacco Angelo , Nucera Gabriella , Magnavita Nicola
Published: February 2021

Purpose

This paper describes how Italy addressed the first Coronavirus disease 2019 (COVID-19) wave and analyzes the possible causes of the current second wave.

Design/methodology/approach

Descriptive analysis of critical points and differences in the containment strategies between the first and the second waves in Italy.

Findings

Italy's strict lockdown has been credited with getting the initial major outbreak under control. Furthermore, the way Italy handled the first wave was considered a lesson for other countries. On the contrary, a decentralized and highly bureaucratic political system with low coordination and political conflicts between government, regions and stakeholders led to a relaxation of individual health behaviors, poor and conflicting communication to the general public, poor management of the public transport and the reopening of schools and companies after the summer, that in turn generated the second wave, which is showing signs of becoming worse than the first.

Originality/value

This is a commentary piece.
The bidirectional complementarity between market orientation and launch proficiency affecting new product performance
Authors: Fakhreddin Farbod , Foroudi Pantea , Rasouli Ghahroudi Mehdi
Published: February 2021

Purpose

Based on the resource-based view and dynamic capabilities theory, this study aims to examine the complementarity between market orientations and launch proficiency as a driver of new product performance.

Design/methodology/approach

In this research, an on-site survey of Iranian, research and development- intensive, manufacturing firms was carried out to examine the proposed hypotheses. Based on the 179 workable survey responses, a covariance-based structural equation modeling was applied to verify the proposed theoretical model.

Findings

The empirical findings reveal that the effects of market orientation or launch proficiency alone are not significant while the complementarity between them significantly influences new product performance. These research outcomes suggest that this complementarity leads to a bidirectional co-specialization relationship in firms, promoting both market intelligence generation processes and product-launch capabilities, and therefore resulting in superior new product performance.

Originality/value

The current characterization of the resource-based theory signifies that strategic resources merely have potential value and actualizing this value needs complementary organizational capabilities. Furthermore, the literature notably lacks empirical findings supporting these complementarities. Therefore, the findings concerning the bidirectional co-specialization between market orientation and launch proficiency not only provide empirical support for the dynamic capabilities theory but also address recent research calls to identify and calibrate the importance of dynamic capabilities for leveraging market orientation on new product performance.
We’re more alike than different: comparing Western and mainland Chinese women’s journeys to the C-Suite and the emotional components of their successes
Authors: Brock Sabra E. , Ma Chunhui
Published: February 2021

Purpose

This study aims to document the emotions experienced by women achieving high levels of organizational success and investigate what differences, if any, existed between C-Suite women in the West* and China** in this regard.

Design/methodology/approach

In total, 105 senior female leaders in Mainland China and the West participated in an in-depth electronic survey about their leadership journeys.

Findings

The emotional associations with the pathway to high-level positions were generally positive with gratitude, hope, excitement and pride standing out, but Western female leaders were significantly more likely to express fear and feeling overwhelmed than their counterparts, whereas significantly more Chinese female leaders reported feeling inadequate than the Western women. The Chinese sample reported directionally more positive emotions than Western ones. The Chinese women cited curiosity, joy and relief, but Western female leaders made no mention of these emotions in their leadership journeys.

Originality/value

Little has been published on the emotions that women experience on their way to very high-level positions. Many of these studies used other people’s perceptions of female leaders to understand their reactions to the biases and challenges facing them. This study elicited direct responses from female organizational leaders. Research comparing the journeys of Western and Chinese C-Suite women is limited. These results can be useful for educators and human resource professionals in supporting female career advancement in Mainland China and the West.
Fault-tolerant content list management for media servers in the smart robot domain
Authors: Chen Chi-Chun , Wang Jian-Hong , Wang Hsing-Wen , Zhang Jie
Published: February 2021

Purpose

This research proposes an innovative fault-tolerant media content list management technology applied to the smart robot domain.

Design/methodology/approach

A fault tolerant Content List Management Unit (CLMU) for real-time streaming systems focusing on smart robot claw machines is proposed to synchronize and manage the hyperlink stored on media servers. The fault-tolerant mechanism is realized by the self-healing method. A media server allows exchanging the hyperlink within the network through the CLMU mechanism.

Findings

Internet users can access the current multimedia information, and the multimedia information list can be rearranged appropriately. Furthermore, the service of the proposed multimedia system should be uninterrupted even when the master media server fails. Therefore, one of the slave media servers enables the Content List Service (CLS) of the proposed CLMU and replaces the defunct master media server.

Originality/value

The recovery time is less than 1.5 seconds. The multimedia transmission is not interrupted while any one of the media servers keeps functioning. The proposed method can serve to stabilize the system of media servers in a smart robot domain.
Bridging employee advocacy in anonymous social media and internal corporate social responsibility (CSR)
Authors: Lee Yeunjae
Published: February 2021

Purpose

This study explores the link between internal corporate social responsibility (CSR) and employee advocacy intention in the anonymous online environment, viewing the positive behavior of employees in anonymous social media as discretionary and altruistic efforts for their organization. Guided by social exchange theory (SET) and relationship management theory, the role of a communal relationship and organizational citizenship behavior (OCB) is likewise explored.

Design/methodology/approach

An online survey was conducted with 405 full-time employees in the US.

Findings

Results showed that internal CSR positively influences the organization–employee communal relationship as well as OCB. Results further show that the employee-oriented communal relationship plays an important role in increasing OCB, which in turn enhances employee advocacy intention in anonymous social media.

Originality/value

This study is one of the first attempts to conceptualize employees' advocative behaviors in anonymous websites (e.g. Glassdoor) and to explore the antecedents of advocative behaviors, drawing insights from human resources management and internal relations.
Development and characterisation of multifunctional composite coatings using bio-based additives
Authors: Ong Gerard , Shafaamri Ammar , Wonnie Ma Iling Aema , Kasi Ramesh , Subramaniam Ramesh
Published: February 2021

Purpose

The purpose of this paper is to develop the bio-composite organic coatings by adding the bio-based additives that are extracted from banana peels and henna leaves as the organic corrosion inhibitors.

Design/methodology/approach

Bioactive constituents with inhibition properties are extracted from banana peels and henna leaves by using ethanol to form the ethanolic extract. The inhibiting efficiency of these bioactive constituents on mild steel corrosion in 3.5% sodium hydroxide (NaCl) solution is investigated. The investigation is performed using electrochemical impedance studies for 30 days. The optical and adhesive properties of the bio-composite coating systems have also been studied.

Findings

The best protection is obtained as the loading ratio of the banana peels ethanolic extract (BPEE) and henna leaves ethanolic extract (HLEE) are 10 Wt.% and 30 Wt.%, respectively. Overall, the results obtained show that the BPEE and HLEE not only enhance the optical properties but also can serve as an effective inhibitor for corrosion without affecting the adhesiveness of the neat acrylic properties.

Originality/value

Banana peels and henna leaves consist of bioactive constituents that have anti-corrosion properties which could inhibit corrosion.
Imag(in)ing Colombian post-conflict in corporate sustainability reports
Authors: Cabrera-Narváez Andrés , Quinche-Martín Fabián Leonardo
Published: February 2021

Purpose

This paper aims to study the use of photos in corporate sustainability reports (CSRs) as a means to gain legitimacy concerning Colombian post-conflict representations.

Design/methodology/approach

From a critical perspective based on legitimacy theory and political economy theory, and using visual semiotics and critical discourse analysis, this paper examines the use of photographs in sustainability reports as a mechanism to account for corporate actions regarding peace in Colombia. This paper relies on 121 pictures from 30 CSRs.

Findings

The analysis shows that companies are gaining legitimacy by referring to post-conflict through visual forms. Nonetheless, the structural conditions that caused the Colombian conflict are still present. Sustainability reporting that includes peace action representations becomes a control and subordination mechanism to reproduce existing power relations in the Colombian social order. Indeed, the generation of opportunities for civilians and ex-combatants, victims reparation, security and reconciliation remains unresolved structural issues. Hence, the use of corporate economic resources and their strategic visual representation in reports is just one business way of representing firms as aligned with government initiatives to obtain tax incentives.

Research limitations/implications

This study is centered on Colombian CSRs for the period 2016-2017; however, 2017 reports by some companies have not yet been published. This study also explored the messages contained in the images that include people. Images that do not depict persons were not examined.

Originality/value

This study provides evidence on visual representations of corporate peace actions aimed at gaining corporate legitimacy. Furthermore, this research examines a unique scenario that promoted more significant corporate social participation, following the signing of the peace agreements between the Colombian government and the Revolutionary Armed Forces of Colombia (Fuerzas Armadas Revolucionarias de Colombia, Ejército del Pueblo).
Organizational learning and unlearning capabilities for resilience during COVID-19
Authors: Orth Daniel , Schuldis Philipa Maria
Published: February 2021

Purpose

The purpose of this paper is to empirically validate the positive effect of learning on organizational resilience and, within this relationship, understand the role of unlearning in the COVID-19 crisis context and progress the current knowledge about these concepts.

Design/methodology/approach

This paper uses online survey data from German and Austrian organizations’ employees to test hypotheses derived from frameworks by Duchek (2019), Stephenson (2010) and Fiol and O’Connor (2017). The used questionnaire is built out of three pre-tested questionnaires to increase reliability. Conceptually, this paper takes a capability approach and a process perspective.

Findings

The results support the positive effect of organizational learning on resilience, while rejecting the hypothesized moderating effect of unlearning on this relationship. Organizational learning showed to have a particularly strong positive effect on the adaptive capacity of resilience, compared to organizational resilience overall.

Practical implications

To build a learning capability for organizational resilience, managers should foster an open system culture in their organization, which aims to be generally open to learn and adapt to be able to withstand adversity. During an organizational crisis, managers have the chance to rebuild organizational structures for better information flow, e.g. implementing formal knowledge management structures.

Originality/value

To the best of the authors’ knowledge, this paper is the first to empirically test the causal connection between organizational learning and resilience in the Central European context during the COVID-19 crisis. The inclusion of unlearning enriches the discourse about its conceptualizations and fosters future research.
Kicking Off the Corporate Governance Lifecycle: Seed Funding, Venture Capital and the Nascent Board
Authors: Lang Nils K. , Wirtz Peter
Published: February 2021

Studying the creation of venture boards in a hand‐collected sample of 296 VC investment rounds in 132 German high‐tech ventures, we find that risk exposure and investor syndication are strong predictors of whether a formal board is created or not. Our setup allows to study the creation of the nascent board in a legal context where its existence is voluntary and at the same time imposes a strong cost on its members through personal liability. We find that the probability of board creation strongly increases with the amount invested and with conflicting interests among multiple investors. The need for a formalized corporate governance in form of a board is most amplified in seed rounds with three or more syndicating investors, in follow‐on rounds with the entrance of any additional institutional investor, and in the presence of pre‐planned exit. Hence, a venture board is most required when the stakes are high and when the divergence of interests among principals is amplified.
Increasing Medicaid enrollment among formerly incarcerated adults
Authors: Burns Marguerite E. , Cook Steven T. , Brown Lars , Tyska Steve , Westergaard Ryan P.
Published: February 2021

Objective

To estimate the incremental associations between the implementation of expanded Medicaid eligibility and prerelease Medicaid enrollment assistance on Medicaid enrollment for recently incarcerated adults.

Data Sources/Study Setting

Data include person‐level merged, longitudinal data from the Wisconsin Department of Corrections and the Wisconsin Medicaid program from 2013 to 2015.

Study Design

We use an interrupted time series design to estimate the association between each of two natural experiments and Medicaid enrollment for recently incarcerated adults. First, in April 2014 the Wisconsin Medicaid program expanded eligibility to include all adults with income at or below 100% of the federal poverty level. Second, in January 2015, the Wisconsin Department of Corrections implemented prerelease Medicaid enrollment assistance at all state correctional facilities.

Data Collection/Extraction Methods

We collected Medicaid enrollment, and state prison administrative and risk assessment data for all nonelderly adults incarcerated by the state who were released between January 2013 and December 2015. The full sample includes 24 235 individuals. Adults with a history of substance use comprise our secondary sample. This sample includes 12 877 individuals. The primary study outcome is Medicaid enrollment within the month of release.

Principal Findings

Medicaid enrollment in the month of release from state prison grew from 8 percent of adults at baseline to 36 percent after the eligibility expansion (P‐value < .01) and to 61 percent (P‐value < .01) after the introduction of enrollment assistance. Results were similar for adults with a history of substance use. Black adults were 3.5 percentage points more likely to be enrolled in Medicaid in the month of release than White adults (P‐value < .01).

Conclusions

Medicaid eligibility and prerelease enrollment assistance are associated with increased Medicaid enrollment upon release from prison. States should consider these two policies as potential tools for improving access to timely health care as individuals transition from prison to community.
Telehealth practice in surgery: Ethical and medico‐legal considerations
Authors: Lee Danny W. H. , Tong Kar‐Wai , Lai Paul B.S.
Published: February 2021

There was rapid growth of telehealth practice during the COVID‐19 outbreak in 2020. In surgery, there were beneficial effects in terms of saving time and avoiding physical contact between healthcare professionals and patients when using telehealth in the delivery of perioperative care. As telehealth is gaining momentum, the evolving ethical and medico‐legal challenges arising from this alternative mode of doctor–patient interaction cannot be underestimated. With reference to the “Ethical Guidelines on Practice of Telemedicine” issued by the Medical Council of Hong Kong and some published court and disciplinary cases from other common law jurisdictions, this article discusses relevant ethical and medico‐legal issues in telehealth practice with emphasis on the following areas: duty of care; communication and contingency; patient‐centred care and informed consent; limitations and standard of care; keeping medical records, privacy, and confidentiality; and cross‐territory practice. Whilst existing ethical and legal obligations of practicing medicine are not changed when telehealth is used as opposed to in‐person care, telehealth practitioners are advised to familiarize themselves with the ethical guidelines, to keep abreast of the medico‐legal developments in this area, and to observe the licensure requirements and regulatory regimes of both the jurisdiction where they practice and where their patients are located.
Purification, identification, and computational analysis of xanthine oxidase inhibitory peptides from kidney bean
Authors: Wu Yuqun , He Hui , Hou Tao
Published: February 2021

Hyperuricemia is related to plenty of diseases, seriously damaging human health. Current clinical drugs used to treat hyperuricemia have many adverse effects. In this study, kidney bean hydrolysate (KBH) was found to exert high xanthine oxidase inhibitory (XOI) activity. Compared to KBH (50.31 ± 2.73%), XOI activities of three fractions (Mw <5 kDa, Mw<3 kDa, Mw < 1 kDa) by ultrafiltration were higher and increased to 58.58 ± 3.57%, 59.34 ± 1.78%, and 55.05 ± 5.00%, respectively (P < 0.05). A total of 69 peptides were identified by HPLC‐ESI‐MS/MS and analyzed binding affinities with XO with the help of molecular docking. AVDSLVPIGR, DWYDIK, LDNLLR, ISPIPVLK, ISSLEMTR showed well binding affinities with XO and DWYDIK presented the highest XOI activity (68.63 ± 5.07%) among five synthetic peptides (P < 0.05). Additionally, visual analysis results indicated that DWYDIK was pushed into the hydrophobic channel and formed hydrogen bonds with pivotal amino acids of xanthine oxidase. Overall, KBH could be a promising candidate as anti‐ hyperuricemia functional food.

Practical Application

This research initially revealed that kidney bean peptides could significantly inhibit the activity of xanthine oxidase, indicating kidney bean peptides could be a treatment for hyperuricemia. Kidney bean peptides may have commercial potentials as a safer alternative with few side effects to drugs.
Resistance mechanisms of epidermal growth factor receptor tyrosine kinase inhibitors in non‐small cell lung cancer patients: A meta‐analysis
Authors: Kobayashi Nobuaki , Katakura Seigo , Kamimaki Chisato , Somekawa Kohei , Fukuda Nobuhiko , Tanaka Katsushi , Watanabe Keisuke , Horita Nobuyuki , Hara Yu , Piao Hongmei , Kaneko Takeshi
Published: February 2021

Background

Differences in the resistance mechanisms of epidermal growth factor receptor tyrosine kinase inhibitors in patients with non‐small cell lung cancer (NSCLC) harboring epidermal growth factor receptor mutations are unknown. This meta‐analysis aimed to clarify the differences in resistance mechanisms after treatment with various epidermal growth factor receptor tyrosine kinase inhibitors.

Methods

We systematically searched PubMed, Cochrane, and Web of Science on July 29, 2020, for relevant studies on acquired resistance mechanisms against epidermal growth factor receptor tyrosine kinase inhibitors. The primary outcome measure was differences in the resistance mechanism between individual or generations of epidermal growth factor receptor tyrosine kinase inhibitors.

Results

In total, 33 trials involving 2418 individuals were included and analyzed. T790M was significantly less frequent after afatinib treatment (40.2%, 95% confidence interval [CI]: 31.7%–48.7%) than after gefitinib and erlotinib treatments (52.5%, 95% CI: 48.7%–56.3%, p = 0.005). There were no significant differences between Asian and non‐Asian patients in the incidence of T790M after gefitinib, erlotinib, and afatinib treatments. Regarding epidermal growth factor receptor pathway‐independent resistant mechanisms, the incidences of small cell lung cancer transformation (osimertinib: 7.9%, 95% CI: 3.6%–12.2%, others: 2.3%, 95% CI: 0.8%–3.8%) and Kirsten rat sarcoma (KRAS) viral oncogene homolog mutation (osimertinib: 4.6%, 95% CI: 1.5%–7.7%, others: 0.2%, 95% CI: 0.0%–1.7%) were significantly higher following osimertinib treatment than with others.

Conclusions

Significant differences in the incidence of resistance mechanisms among epidermal growth factor receptor tyrosine kinase inhibitors exist, which should be taken into consideration when choosing the treatment strategy.
Trade of legal and illegal marine wildlife products in markets: integrating shopping list and survival analysis approaches
Authors: Pheasey H. , Matechou E. , Griffiths R. A. , Roberts D. L.
Published: February 2021

Wildlife is an important source of nutrition and income for rural communities. The International wildlife trade of endangered species is regulated by CITES, but domestic wildlife markets are rarely subjected to this degree of scrutiny. Market surveys provide important domestic trade data but suffer limitations. Occupancy modelling, using search effort, can be applied to market surveys. To compare the availability of marine consumables from species threatened with extinction, we undertook market surveys using a ‘shopping list’ of threatened species. Items included turtle eggs and shark products. Turtle eggs from the Ostional Egg Project are sold under a certification scheme, but non‐certified eggs are readily available. The surveyors were local residents employed to complete the market survey. The search effort for each item was compared using an adaptation of survival analysis. Time to find each item indicated availability. We tested whether demographics and shopping habits affected surveyors’ ability to find the items. Shark products were found fastest and were, therefore, the most readily available item. Non‐certified eggs were found as easily as Ostional certified eggs, implying there are few deterrents to the open sale of non‐certified eggs. The shopping habits of surveyors had no effect on their ability to find eggs. Integrating the shopping list with survival analysis can reveal valuable information on demand and supply, which would otherwise be difficult to obtain using traditional surveys.
The extent of polypharmacy and use of ‘fall risk increasing drugs’ in the oldest old admitted to a regional New South Wales hospital
Authors: Bemand Timothy John , Thomas Sarah , Finucane Paul
Published: February 2021

Objective(s)

Polypharmacy is associated with significant morbidity including cognitive decline and falls. We sought to quantify the extent of polypharmacy and use of medications associated with fall risk in the very old admitted to a regional NSW hospital.

Methods

Cross‐sectional study of patients aged over 80 years admitted to a regional NSW hospital from September to October 2019. Demographic data and medication usage on admission were collected. Polypharmacy was defined as regular use of five or more medications.

Results

A total of 401 patients were included: mean age was 87.2 (±4.6) years and 56.9% were female. Of the participations, 82.9% experienced polypharmacy, and the mean number of medications was 8.2 (±4.2). Of the patients, 91.6% utilised medications associated with risk of falls. There was no association between age and number of preadmission regular medications.

Conclusion

Polypharmacy is extremely common prior to acute hospitalisation for regional older individuals. This highlights the importance of medication rationalisation to reduce medication‐related harm.
The Tasmanian electronic falls ascertainment tool—A pilot study
Authors: Balogun Saliu A. , Sharman James E. , Callisaya Michele L.
Published: February 2021

Objective

This study aimed to develop and test the feasibility of using an electronic tool to ascertain falls and their circumstances (TASeFALL) in people aged over 60 years.

Methods

Forty participants (mean age: 69.3 ± 5.4 years, 55% women) were randomised to receive a monthly paper‐based questionnaire (control group n = 19), compared with the same questionnaire sent via email with LimeSurvey software (TASeFALL n = 21). Falls and their circumstances were recorded prospectively over 12 months in all participants. The main outcomes were feasibility of enrolment, number of falls, adherence to completion of questionnaires and cost.

Results

The incidence, number of falls and adherence to the completion of the questionnaire over the 12‐month follow‐up were similar in both the TASeFALL and control groups. However, the monthly paper‐based questionnaire approach was 45% more expensive.

Conclusions

The TASeFALL is a feasible and cost‐effective method of falls ascertainment for older people with email access that could have a wide research uptake.
Efficacy and safety of carboplatin and pemetrexed followed by maintenance with pemetrexed for elderly patients with advanced non‐squamous non‐small cell lung cancer: A single‐arm, open‐label, multicenter, phase II study
Authors: Shinoda Masahiro , Shinkai Masaharu , Hara Yu , Tomaru Kouji , Manabe Saki , Murakami Syuji , Saito Haruhiro , Kobayashi Nobuaki , Miyazawa Naoki , Nishikawa Masanori , Kaneko Takeshi
Published: February 2021

Purpose

Carboplatin plus pemetrexed followed by maintenance pemetrexed is expected to be well‐tolerated by the elderly. This multicenter, prospective study examined the efficacy and tolerability of the regimen in elderly patients with previously untreated advanced non‐squamous non‐small cell lung cancer.

Methods

The primary endpoint was the 1‐year survival rate, with secondary endpoints of response rate (RR), disease control rate (DCR), progression‐free survival (PFS), overall survival (OS), and adverse event rate. Efficacy was compared between patients with performance status (PS) 0 and 1.

Results

Forty‐one patients were enrolled between March 2011 and April 2016. Median age was 76.0 years. The 1‐year survival rate was 73% (95% confidence interval (CI), 56‐84%). RR was 44%, DCR was 81%, median PFS was 7.2 months (95%CI, 3.98‐9.20 months), and median OS was 17.4 months (95%CI, 13.60‐22.83 months). Twenty‐one patients (51%) transitioned to maintenance therapy. Toxicities of grade ≥ 3 during the induction phase included anemia (37%), thrombocytopenia (29%), neutropenia (22%), appetite loss (15%), nausea (10%), bacterial pneumonia (7%), febrile neutropenia (5%), and interstitial pneumonia (2%). Treatment was discontinued in two patients with interstitial pneumonia, but no deaths were encountered. During the maintenance phase, one patient needed dose reductions due to phlegmon. No significant difference in efficacy was seen between PS 0 and PS 1.

Conclusion

Carboplatin and pemetrexed followed by maintenance pemetrexed for non‐squamous non‐small cell lung cancer in elderly patients appear effective and tolerable.
The IHC4+C score: an affordable and reproducible non‐molecular decision‐aid in hormone receptor‐positive breast cancer. Does it still hold value for patients in 2020?
Authors: Harel Nadav , Cheema Steven , Williams David , Ireland‐Jenkin Kerryn , Fancourt Tineke , Dodson Andrew , Yeo Belinda
Published: February 2021

Aim

The majority of women diagnosed with early breast cancer have hormone‐receptor positive (HR+)/HER2‐negative disease. Adjuvant endocrine therapy provides substantial risk reduction benefits in virtually all patients. The role of adjuvant chemotherapy in certain subsets of patients is equivocal. This paper sought to evaluate the role of the IHC4+C score to aid this clinical decision in addition to providing an overview of the current molecular and non‐ molecular tools available in the adjuvant setting.

Methods

This prospective study included 53 post‐operative HR+/HER2‐ negative early breast cancer patients selected from the multidiscipliniary team meeting between August 2017 and January 2020. IHC4+C testing was requested by clinicians for patients in whom the availability of the score may have impacted adjuvant decision‐making. Adjuvant treatment decisions were recorded at three time points (prior and post IHC4+C scoring as well as the patient's final decision). The primary goal was the proportion of patients who were spared chemotherapy following the availability of IHC4+C scores to impact on clinicians’ recommendations for adjuvant systemic therapy.

Results

A total of 34 patients (64%) were initially recommended to undergo chemotherapy or to consider chemotherapy. With the availability of the IHC4+C score, only 17 patients (32%) underwent chemotherapy, demonstrating a substantial reduction in the frequency of chemotherapy prescribing.

Conclusion

This study demonstrates that when utilized appropriately in a multidisciplinary setting, the IHC4+C algorithm is an alternative, reproducible and affordable tool with a proven capacity to stratify risk and to spare a large proportion of patients from undergoing chemotherapy.
Duodenal gastrointestinal stromal tumors: A retrospective study based on a 13 years experience of a single center in China
Authors: Huang Cheng , Li Cheng‐Guo , Zhang Peng , Yang Wen‐Chang , Lin Yao , Shuai Xiao‐Ming , Gao Jin‐Bo , Cai Ming , Tao Kai‐Xiong
Published: February 2021

Aim

Duodenal gastrointestinal stromal tumors (GISTs) constitute a small rare subset. This study aims to analyze the prognostic differences between duodenal and jejunoileal GISTs and evaluate the clinical treatment and prognostic characteristics of patients with duodenal GISTs.

Methods

Data of patients with primary duodenal or jejunoileal GISTs were collected. Patients were matched through propensity score matching (PSM). Perioperative and long‐term outcomes of patients with duodenal GISTs were compared based on surgical approach.

Results

Altogether, 101 duodenal and 219 jejunoileal GISTs were identified. In patients with duodenal GISTs, 79 (78%) underwent local resection (LR) and 22 (22%) underwent pancreaticoduodenectomy (PD). Patients undergoing PD had a longer postoperation stay (18.5 vs 13 days, P = 0.001) and more complications (Clavien–Dindo I‐II complications for PD vs LR, 31.8 vs 15.2%; Clavien–Dindo III‐V complications for PD vs LR, 22.7 vs. 2.5%; P < 0.001). There was no difference in recurrence‐free survival (RFS) (P = 0.8) or overall survival (OS) (P = 0.9) when comparing patients who underwent LR versus PD. Multivariable analysis showed that tumor size >5 cm was the only independent predictor of shorter RFS (P = 0.004) and OS (P = 0.012). After matching, there was no significant difference in RFS and OS between patients with duodenal versus jejunoileal GISTs (both P > 0.05).

Conclusion

The prognosis of duodenal and jejunoileal GISTs are similar. Recurrence and OS of duodenal GISTs primarily depend on tumor size. For duodenal GISTs, LR is associated with comparable long‐term survival when compared to PD, but with superior short‐term outcomes.
Rural emergency departments: A systematic review to develop a resource typology relevant to developed countries
Authors: Kerr Lachlan , Kealy Benjamin , Lim David , Walters Lucie
Published: February 2021

Objective

Despite low patient numbers, rural emergency departments have a similar diversity of case presentations as urban tertiary hospitals, with the need to manage high‐acuity cases with limited resources. There are no consistent descriptions of the resources available to rural emergency departments internationally, limiting the capacity to compare clinical protocols and standards of care across similarly resourced units. This review aimed to describe the range of human, physical and specialist resources described in rural emergency departments in developed countries and propose a typology for use internationally.

Design and setting

A systematic literature search was performed for journal articles between 2000 and 2019 describing the staffing, access to radiology and laboratory investigations, and hospital inpatient specialists.

Results

Considerable diversity in defining rurality and in resource access was found within and between Australia, New Zealand, Canada and USA.

Discussion

A typology was developed to account for (a) emergency department staff on‐floor, (b) emergency department staff on‐call, (c) physical resources and (d) access to a specialist surgical service. This provides a valuable tool for relevant stakeholders to effectively communicate rural emergency department resources within a country and internationally.

Conclusion

The proposed five‐tiered typology draws together international literature regarding rural emergency department services. Although further research is required to test this tool, the formation of this common language allows a base for effective communication between governments, training providers and policy‐makers who are seeking to improve health systems and health outcomes.
Long‐term follow‐up of chronic central serous chorioretinopathy after successful treatment with photodynamic therapy or micropulse laser
Authors: van Rijssen Thomas J. , van Dijk Elon H. C. , Scholz Paula , Breukink Myrte B. , Dijkman Greet , Peters Petrus J. H. , Tsonaka Roula , Keunen Jan E. E. , MacLaren Robert E. , Hoyng Carel B. , Downes Susan M. , Fauser Sascha , Boon Camiel J. F.
Published: February 2021

Purpose

To describe the treatment outcomes and recurrence risk of chronic central serous chorioretinopathy (cCSC) in patients who had complete resolution of subretinal fluid (SRF) after either primary half‐dose photodynamic therapy (PDT) or high‐density subthreshold micropulse laser (HSML) in the PLACE trial.

Methods

This multicentre prospective follow‐up study evaluated cCSC patients at 1 year after completion of the PLACE trial. Outcomes included: complete resolution of SRF on OCT, best‐corrected visual acuity (BCVA) in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, retinal sensitivity on microperimetry and a visual function questionnaire (NEI‐VFQ25).

Results

Twenty‐nine out of 37 patients who received half‐dose PDT and 15 out of 17 patients who received HSML could be evaluated at final visit. At final visit, 93% of the patients treated with half‐dose PDT had complete resolution of SRF, compared with 53% of HSML‐treated patients (p = 0.006). At final visit, the mean estimate increase in the PDT group compared with the HSML group was + 2.1 ETDRS letters, +0.15 dB for the retinal sensitivity and + 5.1 NEI‐VFQ25 points (p = 0.103, p = 0.784 and p = 0.071, respectively). The mean estimated central retinal thickness in the half‐dose PDT group was −7.0 µm compared with the HSML group (p = 0.566). The mean estimated subfoveal choroidal thickness in the half‐dose PDT group was −16.6 µm compared with the HSML group (p = 0.359).

Conclusion

At 20 months after treatment, cCSC patients successfully treated with half‐dose PDT are less likely to have recurrences of SRF compared with those successfully treated with HSML. However, functional outcomes did not differ.
Trade, technology, and the labour market: impacts on wage inequality within countries
Authors: Wang Wenxiao , Findlay Christopher , Thangavelu Shandre
Published: February 2021

This paper focuses on the widening wage inequality between skilled and unskilled workers within countries and discusses whether trade and technology have contributed to this trend. The paper develops an analytical framework for wage inequality that traces the determinants and their relative roles in wage inequality in different stages of the development of trade theory, especially those considering new evidence after 2011. We find that technology plays a key role in the rise of wage inequality in most countries, while trade plays an increasingly crucial and more complex role in recent years. Skill supply institutions, such as education systems supplying skilled labour or unions participating in wage‐setting processes, suppress the rise of wage inequality in some countries. The paper further outlines the mechanisms through which trade affects wage inequality, including offshoring, firm heterogeneity, labour market frictions and global value chains. We find that trade has indirect effects on technology, which further enlarges the wage inequality among skills. The paper also discusses the policy implications of the impacts of trade and technology on wage inequality.
Urinary malate dehydrogenase 2 is a new biomarker for early detection of non‐small‐cell lung cancer
Authors: Ma Yu‐Chen , Tian Peng‐Fei , Chen Zhi‐Peng , Yue Dong‐Sheng , Liu Cui‐Cui , Li Chen‐Guang , Chen Chen , Zhang Hua , Liu Hai‐Lin , Zhang Zhen‐Fa , Chen Liang , Zhang Bin , Wang Chang‐Li
Published: February 2021

Reliable and noninvasive biomarkers for the early diagnosis of non‐small‐cell lung cancer (NSCLC) are an unmet need. This study aimed to screen and validate potential urinary biomarkers for the early diagnosis of NSCLC. Using protein mass spectrometry, urinary MDH2 was found to be abundant both in patients with lung cancer and lung cancer model mice compared with controls. Urine samples obtained as retrospective and prospective cohorts including 1091 NSCLC patients and 736 healthy controls were measured using ELISA. Patients with stage I NSCLC had higher urinary MDH2 compared with healthy controls. The area under the receiver‐operating characteristic curve (AUC) for the urinary MDH2 was 0.7679 and 0.7234 in retrospective and prospective cohorts to distinguish stage I cases from controls. Urinary MDH2 levels correlated with gender and smoking history. MDH2 expression levels were elevated in lung cancer tissues. MDH2 knockdown using shRNA inhibited the proliferation of lung cancer cells. Our study demonstrated that urinary MDH2 concentration was higher in early‐stage NSCLC patients compared with that in controls and that MDH2 could serve as a potential biomarker for early detection of NSCLC.
Three‐year survival from diagnosis in surgically treated patients in designated and nondesignated cancer care hospitals in Japan
Authors: Okawa Sumiyo , Tabuchi Takahiro , Nakata Kayo , Morishima Toshitaka , Koyama Shihoko , Odani Satomi , Miyashiro Isao
Published: February 2021

The Japanese national and prefectural governments have accredited high‐capacity, high‐experience cancer care hospitals as “designated cancer care hospitals” to standardize cancer care, centralize patients, and improve clinical outcomes, but the performance of these designated hospitals has not been evaluated. We retrospectively compared 3‐year patient survival in national, prefectural, and nondesignated cancer care hospitals in 2010‐2012 in Osaka using registry‐based data of 86 456 surgically treated cancer patients aged 15 years or older. Hazard ratios and 3‐year survival probabilities were compared among national, prefectural, and nondesignated hospitals using a Cox proportional hazard regression model. Subgroup analyses for six cancers (stomach, colorectum, lung, breast, uterus, and prostate) and other cancers were carried out. In 2010‐2012, 36 634 (42.4%), 38 048 (44.0%), and 11 774 (13.6%) patients were treated at national, prefectural, and nondesignated hospitals, respectively. The mortality hazard for all‐site cancer was significantly lower in national and prefectural designated hospitals (adjusted hazard ratio 0.60 [95% confidence interval, 0.53‐0.68] and 0.72 [0.66‐0.80], respectively) than in nondesignated hospitals. The adjusted 3‐year survival probabilities for all‐site cancer were 86.6%, 84.2%, and 78.8% in national, prefectural, and nondesignated hospitals, respectively. Site‐specific subgroup analyses revealed significantly lower hazard ratios in national and prefectural hospitals than in nondesignated hospitals for stomach, colorectal, lung, breast, and other cancers. To conclude, the majority of cancer patients underwent surgeries at designated hospitals and had higher 3‐year survival probabilities than those treated at nondesignated hospitals. Further centralization of patients from nondesignated to designated hospitals could improve population‐level survival.
Bioelectrical impedance analysis for assessment of body composition in infants and young children‐A systematic literature review
Authors: Lyons‐Reid Jaz , Derraik José G. B. , Ward Leigh C. , Tint Mya‐Thway , Kenealy Timothy , Cutfield Wayne S.
Published: February 2021

Bioelectrical impedance analysis (BIA) is an easy to use, portable tool, but the accuracy of the technique in infants and young children (<24 months) remains unclear. A systematic literature review was conducted to identify studies that have developed and validated BIA equations in this age group. MEDLINE, Scopus, EMBASE, and CENTRAL were searched for relevant literature published up until June 30, 2020, using terms related to bioelectrical impedance, body composition, and paediatrics. Two reviewers independently screened studies for eligibility, resulting in 15 studies that had developed and/or validated equations. Forty‐six equations were developed and 34 validations were conducted. Most equations were developed in young infants (≤6 months), whereas only seven were developed among older infants and children (6‐24 months). Most studies were identified as having a high risk of bias, and only a few included predominantly healthy children born at term. Using the best available evidence, BIA appears to predict body composition at least as well as other body composition tools; however, among younger infants BIA may provide little benefit over anthropometry‐based prediction equations. Currently, none of the available equations can be recommended for use in research or in clinical practice.