bluuebunny/crossref_metadata_2025 huggingface dataset:
A big data approach to map the service quality of short-stay accommodation sharing
Authors: Ranjbari Meisam , Shams Esfandabadi Zahra , Scagnelli Simone Domenico
Published: June 2020

Purpose

The purpose of this paper is to map the service quality (SQ) of Airbnb, to provide additional insight for such top player of short-stay accommodation in the sharing economy context.

Design/methodology/approach

A mixed-method approach is used in two phases. In the qualitative phase, 112,138 online review comments of Airbnb guests were analyzed to generate the service attributes. In the quantitative phase, an online survey (n = 814) was conducted to calculate the performance and importance values of extracted attributes to plot them in an Importance-Performance Analysis (IPA) matrix.

Findings

A holistic image of the Airbnb extracted service attributes was presented through the IPA plot. Four types of SQ strategies were proposed, considering the actions priority. “Price reasonability” was the most important service attribute of Airbnb for guests, whereas “Check-in flexibility” was the best performed one.

Practical implications

The results shed light on the most relevant SQ attributes of Airbnb and proposed suitable strategies that can prioritize relevant stakeholders’ actions and decisions. The study significantly contributes to all decision makers involved in the short-stay accommodation sharing industry to further understand and develop SQ.

Originality/value

This research, using a comprehensive hybrid method, opens a lens to see more clearly the positioning of different attributes of Airbnb service from importance and performance viewpoints. As a contribution, the SQ of Airbnb was mapped by conducting an IPA for the first time in the literature.
Modelling the enablers of industry 4.0 in the Indian manufacturing industry
Authors: Jain Vineet , Ajmera Puneeta
Published: June 2020

Purpose

The vision of Industry 4.0 concept is to create smart factories that will change the current processes of production and manufacturing system using smart machines to produce smart and intelligent products. The main aim of this research is to explore the enablers with regard to Industry 4.0 application in manufacturing industry in India as the available literature shows that manufacturing sector is still doubtful about the implementation of Industry 4.0.

Design/methodology/approach

Seventeen enablers that can affect the adoption of Industry 4.0 in the manufacturing industry in India have been explored through an extensive review of available literature and viewpoints of industry and academic experts. Total Interpretive Structural Modelling methodology (TISM) has been used to evaluate the interrelationships among these factors. A TISM model has been developed to extract the key enablers influencing Industry 4.0 adoption.

Findings

The result shows that Internet facility from government at reduced price, financial support and continued specialized skills training are the major enablers as they have strong driving power.

Practical implications

Proper understanding of these enablers will help the managers and policymakers to explore the impact of each enabler on other enablers as well as the degree of relationships among them and to take concrete steps so that Industry 4.0 can be implemented successfully in the manufacturing sector in India.

Originality/value

This study is pioneer in exploring the enablers Industry 4.0 which is the most advanced concept that has the capability to change the future of Indian manufacturing sector if implemented judiciously and cautiously.
Emergency remote teaching across urban and rural contexts: perspectives on educational equity
Authors: Aguliera Earl , Nightengale-Lee Bianca
Published: June 2020

Purpose

While educational shifts in response to COVID-19 at the state, district and school-level may have been grounded in the best of intentions, these decisions may not fully respond to the everyday realities of teachers, parents, caregivers and students living within historically marginalized communities. In addition to evidence-based and pragmatic approaches to emergency remote teaching (ERT), there is also a need to understand the experiences of students and families living in urban and rural contexts, who in light of existing educational inequities, are being further exposed to inequitable access due to school closures and the abrupt shift to ERT. This paper aims to use a reflexive dialogic approach to explore these issues.

Design/methodology/approach

Drawing from a larger phenomenological study highlighting the lived experiences of families being impacted by emergency shifts in educational policy and practice, this paper presents a dialogue between two teacher-educators of color working directly with teachers and administrators in the K-12 system across urban and rural contexts. This dialogue acknowledges and interrogates inequitable educational practices exacerbated by the pandemic for marginalized communities, and the shared responsibility of supporting the most vulnerable students as they transition to ERT.

Findings

Reflecting across their local contexts, the authors highlight the importance of educational decision-making that centers the perspectives of families in local communities; develop both pedagogical and structural approaches to address educational inequities; and purposefully approach ERT to disrupt such inequities and move toward a vision of educational justice.

Social implications

Broader implications of this discussion speak to the ever-widening divide between marginalized and dominant communities, which undergirds the and educational inequities that continue to threaten the academic achievement of all students.

Originality/value

As educational decision-makers imagine new pathways in the days ahead, this dialogue highlights the importance of keeping complex issues of educational inequity at the center of the conversation.
Supporting making online: the role of artifact, teacher and peer interactions in crafting electronic textiles
Authors: Jayathirtha Gayithri , Fields Deborah , Kafai Yasmin B. , Chipps Joseph
Published: June 2020

Purpose

The purpose of this paper is to report changes when a classroom-based makerspace moved from face-to-face to an online setting.

Design/methodology/approach

To better understand changes in teaching maker activities, as they move from face-to-face to online contexts, the authors analyzed video and interview data from six weeks of an introductory computer science high school classroom (38 youth) that was implementing an electronic textiles unit, shifting to asynchronous online teaching and learning during the March 2020 state-wide school closure because of the pandemic. The authors analyzed field notes and videos of face-to-face and online interactions between the teacher and his students in learning to craft and code their electronic textiles projects.

Findings

The analysis revealed changes in the role of physical and code artifacts, in improvising teaching, and channels for communication between the teacher and students.

Research limitations/implications

This study discusses the implications for future pedagogical design and research efforts, as the authors continue to engage youth and work toward designing equitable learning opportunities with maker activities online.

Originality/value

In maker activities such as electronic textiles, youth design, sew and program circuits to make personalized three-dimensional, textile artifacts. However, nearly all research on supporting and teaching making has been conducted in face-to-face settings.
A rapid response to COVID-19: one district’s pivot from technology integration to distance learning
Authors: Peterson Lana , Scharber Cassie , Thuesen Amy , Baskin Katie
Published: June 2020

Purpose

In March of 2020, Minnesota schools were mandated to transition to distance learning to slow the spread of COVID-19. The charge of providing equitable and appropriate remote learning to all students gave administrators, educators and non-academic staff a few weeks to completely redesign education. This paper aims to describe one district’s experience in planning and offering distance education and build precedent other educational leaders may use in future designs.

Design/methodology/approach

This case study documents how one rural K12 district leveraged their strong foundation of technology integration and created crisis remote learning solutions for its most marginalized student populations including special education students, English learners and financially disadvantaged students.

Findings

This study shares examples of how this district prioritized relationships and the well-being of students and staff and outlines practical strategies for equitable distance learning that should be considered during and beyond emergency remote teaching.

Originality/value

This paper provides just-in-time practical advice for K12 administrators and educators on navigating crisis distance learning.
Agricultural loan efficiency in centralized bank supply chains with fairness concern: a DEA-based analysis
Authors: Zhuo Jianguo , Hu Yuwei , Kang Min
Published: June 2020

Purpose

Due to the rapid development and innovation in the Internet-based technology, conventional banks are under pressure and have to compete with Internet-based finance. This has made banks adopt measures to improve operational efficiency and reduce input and increase output.

Design/methodology/approach

The authors had proposed a two-stage fairness concern efficiency model based on the classical theory of data envelopment analysis (DEA) and performed an empirical study to measure agricultural loan efficiency in the 20 major Chinese banks.

Findings

The findings of the empirical analysis are as follows: (1) peer-induced fairness concern has no impact on deposit efficiency in a centralized bank supply chain; (2) The China Merchants Bank (CMB) has the third lowest deposit efficiency; (3) monotonicity of loan efficiency with input allocation depends on a bank's ownership structure; (4) efficiency ranks are strongly affected by the fairness concern; (5) most Chinese banks show a low agricultural loan efficiency.

Originality/value

This paper contributes to the literature in several ways. First, to the best of the authors’ knowledge, this is the first attempt to analyze agricultural loan efficiency for a bank supply chain system with the fairness concern. This work reveals the hidden factor that restricts loan efficiency of Chinese banks. Second, the proposed fairness concern two-stage DEA model has shown good ability for full ranking. It can provide a new perspective to the classical DEA literature for ranking decision-making units (DMUs). Third, the authors have demonstrated empirical bank efficiency for the 20 major Chinese banks.
Can innovative knowledge management platforms lead to corporate innovation? Evidence from academician workstations in China
Authors: Quan Xiaofeng , Xiao Hongjun , Ji Qiong , Zhang Jinkang
Published: June 2020

Purpose

This paper aims to analyse the role of government-led innovative knowledge management platforms in innovation knowledge management, social network effects and innovative resource clusters in the context of academician workstations in China. Specifically, this paper empirically studies the impact of academician workstations on corporate innovation capabilities and the mechanisms behind this impact.

Design/methodology/approach

This study uses the propensity matching score method and difference-in-differences method to test the relationship between academician workstations and corporate innovation capabilities. Baron and Kenny’s (1986) mediation method is used to test two potential mechanisms.

Findings

Academician workstations significantly improve corporate innovation capabilities because of their contribution to knowledge and innovation management. The facilitation effects are stronger in non-state-owned firms, high-tech firms and firms in industries with low levels of competition. Further, academician workstations enhance corporate innovation capabilities through their funding effect.

Practical implications

This paper encourages policymakers to create a better market environment and stable support policies to facilitate sustainable scientific and technological innovation.

Originality/value

To the best of authors’ knowledge, this study is among the first to empirically analyse the impacts of innovative knowledge management platforms on corporate innovation. It enriches the theoretical perspective of innovation platforms and provides an excellent research perspective for effectively analysing the impacts of innovation platforms. This study also contributes to the literature on the determinants of innovation.
Crime control in Nigeria: how relevant is remittance inflow?
Authors: Ajide Folorunsho M.
Published: June 2020

Purpose

This paper aims to draw on extant literature to ascertain the relevance of remittance receipts in improving the level of crime control in Nigeria.

Design/methodology/approach

The study uses time series data spanning for a period of 1986–2017. It adopts dynamic ordinary least square (DOLS), vector auto regression impulse response function, variance decomposition and Toda and Yamamoto causality approach to analyse the data.

Findings

The following findings are established: DOLS shows that remittance receipt has negative and significant impact on crime rate in Nigeria. The impulse response function indicates that a positive shock to the remittance inflows reduces the level of crime in Nigeria. Moreover, a positive shock to the crime rate decreases the remittance. This implies that both variables respond to each other. Toda and Yamamoto causality approach shows that there is unidirectional causality moving from remittance inflow to criminal activities in Nigeria. These results persist after considering other institutional variables. These findings support the previous evidences on remittances-crime nexus and as well support the opportunity cost theory of crime.

Originality/value

Apart from being the first study in African region that evaluates the relevance of remittances in crime control, it also analyses the dynamics between crime rate and remittance receipts using time series econometrics which makes the study to be unique. The study shows that remittances can be used as part of toolkits for controlling criminal activities in Nigeria.
Agree to disagree: Examining the psychometrics of cybervetting
Authors: Schroeder Amber N. , Odd Kaleena R. , Whitaker Julia H.
Published: June 2020

Purpose

Due to the paucity of research on web-based job applicant screening (i.e. cybervetting), the purpose of the current study was to examine the psychometric properties of cybervetting, including an examination of the impact of adding structure to the rating process.

Design/methodology/approach

Using a mixed-factorial design, 122 supervisors conducted cybervetting evaluations of applicant personality, cognitive ability, written communication skills, professionalism, and overall suitability. Cross-method agreement (i.e. the degree of similarity between cybervetting ratings and other assessment methods), as well as interrater reliability and agreement were examined, and unstructured versus structured cybervetting rating formats were compared.

Findings

Cybervetting assessments demonstrated high interrater reliability and interrater agreement, but only limited evidence of cross-method agreement was provided. In addition, adding structure to the cybervetting process did not enhance the psychometric properties of this assessment technique.

Practical implications

This study highlighted that whereas cybervetting raters demonstrated a high degree of consensus in cybervetting-based attributions, there may be concerns regarding assessment accuracy, as cybervetting-based ratings generally differed from applicant test scores and self-assessment ratings. Thus, employers should use caution when utilizing this pre-employment screening technique.

Originality/value

Whereas previous research has suggested that cybervetting ratings demonstrate convergence with other traditional assessments (albeit with relatively small effects), these correlational links do not provide information regarding cross-method agreement or method interchangeability. Thus, this study bridges a crucial gap in the literature by examining cross-method agreement for a variety of job-relevant constructs, as well as empirically testing the impact of adding structure to the cybervetting rating process.
A dog doesn’t smile: effects of a dog’s facial expressions and gaze on pet product evaluation
Authors: Park Jihye , Kim Arim
Published: June 2020

Purpose

This study aims to examine the following issues: whether consumers use a dog’s facial expressions and gaze on a product’s packaging to interpret the emotions of a dog and evaluate product quality and how owner identification with the dog moderates the effect of a dog’s facial expressions on product evaluations.

Design/methodology/approach

A field study and three lab experiments were conducted to examine the moderating roles of a dog’s gaze on the product package (Study 1) and owner–dog identification (Study 2) in the effect of facial expressions of a dog on product evaluations.

Findings

Results showed that the facial expressions of a dog presented on the product package influenced the perceived mood of a dog and product quality evaluation. The effects of the facial expressions were strengthened when the dog looked at the front. Furthermore, those who were more likely to identify with their dog tended to be more responsive to the dog with a smiling face and evaluated the product quality more positively than those who were less likely to identify with their dog.

Practical implications

Marketing practitioners in the pet industry can use the findings of this study to select and place an appropriate pet image on the product package. Happy facial expressions and the direct gaze of a pet can influence positive evaluations of a product and, as a result, increase the purchase intention. Product managers also can place words, phrases or images on the product package that highlight a dog as an inseparable part of the owner’s everyday life and as a representation of his/her identity. Emphasizing the owner’s dog as an extension of him/herself or a part of his/her identities can encourage the active processing of a dog’s facial expressions on the product package and the positive evaluation of a product.

Originality/value

The present work adds valuable empirical findings to the limited marketing literature for the pet-related industry. The results of the experiments showed how consumers process the facial expressions and gaze of a dog and use them to infer the quality of a product. Furthermore, the findings extend prior literature reporting that dog owners with a greater identification are more likely to humanize their pet dogs and develop empathetic abilities.
The impact of self-congruity and virtual interactivity on online celebrity brand equity and fans’ purchase intention
Authors: Liu Chengchen , Zhang Ya , Zhang Jing
Published: June 2020

Purpose

There is growing interest among marketers in advertising and promoting their brands by adopting an online celebrity endorsement strategy. However, how online celebrities build their own brand equity and how online celebrity brand equity impacts fans’ purchase behavior have not been extensively researched in the extant literature. This paper aims to explore the factors that contribute to online celebrity branding and improving fans’ purchase intentions.

Design/methodology/approach

A survey and an experiment were conducted among consumers from the mainland of China. A total of 12 hypotheses were proposed to exam how self-congruity and virtual interactivity impact online celebrity branding and to explore the moderating role of perceived quality and product type.

Findings

This paper reveals that customers’ perceived self-congruity with online celebrities’ image and virtual interactivity positively impact the brand equity of online celebrities. Additionally, compared with virtual interactivity, the effect of customer perceived self-congruity on a brand is more significant. The brand equity of online celebrities thereby drives followers’ purchase intentions and the perceived quality of products positively moderates this relationship.

Originality/value

The research conclusions provide managerial implications for marketing practitioners for how to use human brands on social media platforms in the web 2.0 era and ultimately enhance consumer purchase intentions.
The Covid-19 pandemic and the dissolution of the university campus: implications for student support practice
Authors: Raaper Rille , Brown Chris
Published: June 2020

Purpose

This paper problematises student support in higher education during the Covid-19 crisis and proposes an original approach of social network analysis for developing effective support for students from different socio-economic backgrounds.

Design/methodology/approach

In this forward-thinking essay, the authors draw on theoretical ideas from Hannah Arendt in conceptualising the destructive and productive nature of societal crises such as the Covid-19 pandemic. We also draw on literature on social network analysis in exploring student support.

Findings

The authors propose a number of recommendations for university staff to consider when developing effective student support, ranging from nurturing their own professional capital to mapping student support networks and the role of faculty within these.

Originality/value

This paper emphasises the importance of developing effective student support that works for students from different socio-economic backgrounds. This is essential to avoid regression in widening participation policies and practices, and to promote inclusive university environments.
Investigating the role of HRM practices on service innovation: empirical evidence from UAE government agencies
Authors: Alosani Mohammed Saleh , Al-Dhaafri Hassan Saleh , Awadh Abdulla Abdulla
Published: June 2020

Purpose

Government agencies are trying to develop strategies to improve their innovative activities. However, due to many challenges and obstacles, employees are reluctant to perform innovatively in such agencies. Human resource management (HRM) practises and an appropriate culture can help to improve service innovation. However, empirical evidence to prove this relationship is insufficient particularly in the government sector. Thus, this study aims to empirically analyses the effect of HRM practises and innovation culture on service innovation of the United Arab Emirates (UAE)’s Government agencies.

Design/methodology/approach

The data were collected from government entities in the UAE. Structural equation modelling through partial least squares modelling was used to test the proposed hypotheses. SPSS was also used to conduct preliminary analysis.

Findings

Statistical results provide strong evidence that HRM practises and innovation culture positively affected service innovation of UAE’s Government agencies.

Research limitations/implications

Further details and valuable implications are discussed throughout the study. Results have many practical and theoretical implications. Results can help government agencies develop their services innovation by tailoring HRM practises and establishing proper innovation culture in their agencies.

Originality/value

Although several contributions indicated that culture is a key determinant of innovation and a mediator in the link between HRM practises and service innovation, the literature lacks empirical studies investigating this link. Accordingly, this study seeks to bridge this gap and delivers evidence supporting them. In addition, this study is one of the unique studies that use these variables in government agencies in the UAE.
Global pattern and drivers of nitrogen saturation threshold of grassland productivity
Authors: Peng Yunfeng , Chen Han Y. H. , Yang Yuanhe
Published: June 2020

Ecosystem productivity usually exhibits first increase and then saturated response to increasing nitrogen (N) additions, yet the broad‐scale pattern and potential drivers of the N saturation threshold are little investigated.

By synthesizing N addition experiments with at least four N‐input levels from the global grasslands, we applied the quadratic‐plus‐plateau model to fit the above‐ground net primary productivity (ANPP)–N rate relationship, and estimated the saturation threshold for N rate (critical N rate, NCR) and ANPP (maximum ANPP, ANPPmax) from the inflection point where ANPP no longer statistically increased with N rate for individual experiments. Based on these estimations, we investigated the spatial pattern and driving factors of NCR and ANPPmax.

The mean NCR and ANPPmax were 15.0 and 477.0 g m−2 year−1, respectively, but varied substantially among single‐site experiments. Management strategies (e.g. biomass harvest, different N forms and addition frequencies) minimally influenced both parameters. Structural equation models demonstrated that the spatial differences in NCR and ANPPmax were mainly explained by aridity index, and soil carbon (C)/N ratio also predicted the variation in NCR.

Given that grasslands are important not only for the trend and variability of the land C sink but also for the maintenance of pasture yield, the pattern and controls of NCR and ANPPmax, as revealed by the current study, are crucial for constructing robust predictions of C sink capacity and improving N fertilizer management in grasslands.
Age‐dependent plasticity in reproductive investment, regeneration capacity and survival in a partially clonal animal (Hydra oligactis)
Authors: Sebestyén Flóra , Miklós Máté , Iván Katalin , Tökölyi Jácint
Published: June 2020

Asexual reproduction diversifies life‐history priorities and is associated with unusual reproduction and somatic maintenance patterns, such as constant fertility with age, extensive regeneration ability and negligible senescence. While age‐dependent plasticity in relative allocation to sexual versus asexual reproductive modes is relatively well studied, the modulation of somatic maintenance traits in parallel with age‐dependent reproduction is much less well understood in clonal or partially clonal animals.

Here, we asked how age‐dependent investment into sexual and asexual reproduction co‐varies with somatic maintenance such as regeneration in a partially clonal freshwater cnidarian Hydra oligactis, a species with remarkable regeneration abilities and experimentally inducible sex.

We induced gametogenesis by lowering temperature at two ages, 1 or 4 weeks after detachment from an asexual parent, in animals of a male and a female clone. Then we measured phenotypically asexual and sexual reproductive traits (budding rate, start day and number of sexual organs) together with head regeneration rate, survival and the cellular background of these traits (number of reproductive and interstitial stem cells) for 2 or 5 months.

Younger animals had higher asexual reproduction while individuals in the older group had more intensive gametogenesis and reproductive cell production. In parallel with these age‐dependent reproductive differences, somatic maintenance of older individuals was also impacted: head regeneration, survival and interstitial stem cell numbers were reduced compared to younger polyps. Some of the traits investigated showed an ontogenetic effect, suggesting that age‐dependent plasticity and a fixed ontogenetic response might both contribute to differences between age groups.

We show that in H. oligactis asexual reproduction coupled with higher somatic maintenance is prioritized earlier in life, while sexual reproduction with higher maintenance costs occurs later if sex is induced. These findings confirm general life‐history theory predictions on resource allocation between somatic maintenance and sexual reproduction applying in a partially clonal species. At the same time, our study also highlights the age‐dependent integration of these resource allocation decisions with sexual/asexual strategies. Accounting for age‐related differences might enhance repeatability of research done with clonal individuals derived from mass cultures.
Japanese‐brand auto sales in China under the shadow of oppositional sentiments
Authors: Chen Zhao , Du Julan , Yang Hongli
Published: June 2020

This study uses the interstate political conflict in 2010 to study the impacts of oppositional sentiment on product sales of Japanese‐brand automobiles in China. By using the nationwide automobile registration data in China, we conduct difference‐in‐differences analysis and find direct evidence on Chinese consumers’ boycott of Japanese‐brand autos. It is individual buyers rather than business or government entity buyers that boycotted Japanese cars significantly. War memory, nationalist education, and protests contributed to the intensity of boycott activities, and the boycott effect was long‐lasting. Older‐generation buyers boycotted Japanese cars more significantly, but younger‐generation buyers living in cities with historical war experience or patriotic education bases boycotted Japanese cars more actively than their counterparts in other cities.
Fatigue and associated factors in a multi‐ethnic cohort of rheumatoid arthritis patients
Authors: Lee Hwai Jien , Pok Lydia Say Lee , Ng Choung Min , Yahya Fariz , Sockalingam Sargunan , Tee Ying Chew , Raja Jasmin
Published: June 2020

Introduction

Fatigue is an important yet infrequently evaluated component in patients with rheumatoid arthritis (RA) and may have a major impact on quality of life.

Objectives

To evaluate fatigue, identify factors associated with fatigue and assess the effect of fatigue on health‐related quality of life (HRQoL) in a multi‐ethnic cohort of RA patients.

Methods

A cross‐sectional study was performed in patients who fulfilled European League Against Rheumatism/ American College of Rheumatology 2010 criteria for RA. Functional Assessment of Chronic Illness Therapy ‐ Fatigue (FACIT‐F) questionnaire was used to assess fatigue. Potential factors for fatigue were categorized into RA‐related (gender, seropositivity [rheumatoid factor and/or anti‐citrullinated protein antibody], disease duration, visual analog scale pain score, Disease Activity Score of 28 joints – erythrocyte sedimentation rate [DAS28‐ESR], ESR, hemoglobin level, functional disability [Health Assessment Questionnaire ‐ Disability Index, HAQ‐DI score], EQ‐5D‐3L, concomitant prednisolone use and number of conventional synthetic disease‐modifying anti‐rheumatic drugs [csDMARDs] used) and non‐RA‐related (age, body mass index, ethnicity and number of co‐morbidities).

Results

A total of 214 patients (86.9% female) were included; the median age was 62 (25‐91) years and 67.3% were seropositive. Seventy‐six (33.5%) patients had moderate disease activity, 12 (5.6%) had high disease activity and 152 (71%) patients had mild difficulties to moderate disability HAQ‐DI scores. Median of total FACIT‐F score was 113.2 (36.3‐160.0). Joint factors of younger age, longer disease duration, higher HAQ score (increased functional disability), and lower EQ‐5D (poorer HRQoL) were significantly associated with higher levels of fatigue (all P < .02).

Conclusion

Fatigue was associated with functional disability and has a significant impact on HRQoL in RA. Fatigue assessment should be considered in routine clinical practice for RA patients.
Automated Retrospective Calculation of the EDACS and HEART Scores in a Multicenter Prospective Cohort of Emergency Department Chest Pain Patients
Authors: Mark Dustin G. , Huang Jie , Kene Mamata V. , Sax Dana R. , Cotton Dale M. , Lin James S. , Bouvet Sean C. , Chettipally Uli K. , Anderson Megan L. , McLachlan Ian D. , Simon Laura E. , Shan Judy , Rauchwerger Adina S. , Vinson David R. , Ballard Dustin W. , Reed Mary E. ,   for the Kaiser Permanente CREST Network Investigators
Published: June 2020

Objectives

Coronary risk scores are commonly applied to emergency department patients with undifferentiated chest pain. Two prominent risk score–based protocols are the Emergency Department Assessment of Chest pain Score Accelerated Diagnostic Protocol (EDACS‐ADP) and the History, ECG, Age, Risk factors, and Troponin (HEART) pathway. Since prospective documentation of these risk determinations can be challenging to obtain, quality improvement projects could benefit from automated retrospective risk score classification methodologies.

Methods

EDACS‐ADP and HEART pathway data elements were prospectively collected using a Web‐based electronic clinical decision support (eCDS) tool over a 24‐month period (2018–2019) among patients presenting with chest pain to 13 EDs within an integrated health system. Data elements were also extracted and processed electronically (retrospectively) from the electronic health record (EHR) for the same patients. The primary outcome was agreement between the prospective/eCDS and retrospective/EHR data sets on dichotomous risk protocol classification, as assessed by kappa statistics (ĸ).

Results

There were 12,110 eligible eCDS uses during the study period, of which 66 and 47% were low‐risk encounters by EDACS‐ADP and HEART pathway, respectively. Agreement on low‐risk status was acceptable for EDACS‐ADP (ĸ = 0.73, 95% confidence interval [CI] = 0.72 to 0.75) and HEART pathway (ĸ = 0.69, 95% CI = 0.68 to 0.70) and for the continuous scores (interclass correlation coefficients = 0.87 and 0.84 for EDACS and HEART, respectively).

Conclusions

Automated retrospective determination of low risk status by either the EDACS‐ADP or the HEART pathway provides acceptable agreement compared to prospective score calculations, providing a feasible risk adjustment option for use in large data set analyses.
What makes community‐based physical activity programs for culturally and linguistically diverse older adults effective? A systematic review
Authors: Montayre Jed , Neville Stephen , Dunn Ihaka , Shrestha‐Ranjit Jagamaya , Wright‐St. Clair Valerie
Published: June 2020

Objective

This integrative review aimed to determine the features of effective physical activity programs for culturally and linguistically diverse (CALD) older adults.

Methods

We searched for relevant articles in MEDLINE, PubMed, Google Scholar, Scopus and CINAHL. Articles were selected for evaluation if they included CALD older adults and implemented physical activity programs with culturally specific design features. Consistent with the Whittemore and Knafl integrative review methodology, we used the Downs and Black Checklist, Mixed Methods Appraisal Tool and the McMaster University appraisal tool for quantitative studies to assess the quality of included articles.

Results

Seven articles were included in this review. Effective community‐based exercise or physical activity programs for CALD populations commonly featured close‐to‐home delivery, native language instruction and adaptations of culturally familiar activities.

Conclusion

The provision of culturally appropriate community‐based physical activity programs appears to support and encourage engagement among CALD older adults.
Juvenile gangrenous vasculitis of the scrotum: A rare cause of genital ulcer
Authors: Marcos‐Pinto Ana , Lemos Almeida João , Soares‐de‐Almeida Luís , Filipe Paulo
Published: June 2020

Juvenile gangrenous vasculitis of the scrotum is a rare entity of unknown aetiology which should be considered in the differential diagnosis of genital ulcers, mainly with those caused by sexually transmitted infections. The authors report a case of a 23‐year‐old patient who presented a single painful scrotal ulcer developing shortly after an episode of pharyngotonsillitis. The ulcer was treated with oral corticosteroids with total healing and no relapse in over two years of follow‐up.
Labor Unions and White Racial Politics
Authors: Frymer Paul , Grumbach Jacob M.
Published: June 2020

Scholars and political observers point to declining labor unions, on the one hand, and rising white identity politics, on the other, as profound changes in American politics. However, there has been little attention given to the potential feedback between these forces. In this article, we investigate the role of union membership in shaping white racial attitudes. We draw upon research in history and American political development to generate a theory of interracial labor politics, in which union membership reduces racial resentment. Cross‐sectional analyses consistently show that white union members have lower racial resentment and greater support for policies that benefit African Americans. More importantly, our panel analysis suggests that gaining union membership between 2010 and 2016 reduced racial resentment among white workers. The findings highlight the important role of labor unions in mass politics and, more broadly, the importance of organizational membership for political attitudes and behavior.
Clinical assessment for high‐risk patients with non‐alcoholic fatty liver disease in primary care and diabetology practices
Authors: Younossi Zobair M. , Corey Kathleen E. , Alkhouri Naim , Noureddin Mazen , Jacobson Ira , Lam Brian , Clement Stephen , Basu Rita , Gordon Stuart C. , Ravendhra Natarajan , Puri Puneet , Rinella Mary , Scudera Peter , Singal Ashwani K. , Henry Linda ,   the US Members of the Global Nash Council
Published: June 2020

Background

Primary care practitioners (PCPs) and diabetologists are at the frontline of potentially encountering patients with NASH. Identification of those at high risk for adverse outcomes is important.

Aim

To provide practical guidance to providers on how to identify these patients and link them to specialty care.

Methods

US members of the Global Council on NASH evaluated the evidence about NASH and non‐invasive tests and developed a simple algorithm to identify high‐risk NASH patients for diabetologists and primary care providers. These tools can assist frontline providers in decision‐making and referral to gastroenterology/hepatology practices for additional assessments.

Results

The presence of NASH‐related advanced fibrosis is an independent predictor of adverse outcomes. These patients with NASH are considered high risk and referral to specialists is warranted. Given that staging of fibrosis requires a liver biopsy, non‐invasive tests for fibrosis would be preferred. Consensus recommendation from the group is to risk‐stratify patients based on metabolic risk factors using the FIB‐4 as the initial non‐invasive test due to its simplicity and ease of use. A FIB‐4 score ≥1.3 can be used for further assessment and linkage to specialty care where additional technology to assess liver stiffness or serum fibrosis test will be available.

Conclusion

Due to the growing burden of NAFLD and NASH, PCPs and diabetologists are faced with increased patient encounters in their clinical practices necessitating referral decisions. To assist in identifying high‐risk NASH patients requiring specialty care, we provide a simple and easy to use algorithm.
Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma
Authors: Rich Nicole E. , Murphy Caitlin C. , Yopp Adam C. , Tiro Jasmin , Marrero Jorge A. , Singal Amit G.
Published: June 2020

Background

Although sex disparities in hepatocellular carcinoma (HCC) incidence have been well described, there are limited data examining sex disparities in HCC prognosis.

Aim

To characterise sex differences in HCC presentation and prognosis.

Methods

We performed a retrospective study of consecutive patients (n = 1110, 23.5% women) diagnosed with HCC between 2008 and 2017 at two US health systems. We used Cox proportional hazard and multivariable logistic regression models to identify factors associated with overall survival, early tumour detection and response to HCC treatment (per the modified Response Evaluation Criteria in Solid Tumors [mRECIST] criteria).

Results

Women were older at HCC diagnosis (mean 62.5 vs 59.2 years, P < 0.001) and had a higher proportion of early‐stage tumours (53.1% vs 43.7% Barcelona Clinic Liver Cancer [BCLC] stage 0/A, P = 0.04), but similar liver function compared to men (49.2% vs 47.1% Child Pugh A, P = 0.27). In univariable analysis, women had significantly better overall survival than men (median 17.1 vs 12.0 months, P = 0.02). When stratified by age, younger (<65 years) women had better overall survival than men (18.3 vs 11.2 months, P = 0.02); however, older (≥65 years) women and men had similar overall survival (15.5 vs 15.7 months, P = 0.45). In multivariable analysis, female sex was independently associated with lower mortality after adjusting for age, race/ethnicity, alpha‐fetoprotein, BCLC stage, Albumin‐Bilirubin grade and Child Pugh score (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.68‐0.98). In secondary analyses, female sex was independently associated with early tumour detection (odds ratio [OR] 1.46, 95% CI 1.05‐2.02) and response to first HCC treatment (OR 1.72, 95% CI 1.18‐2.53) after adjusting for the same covariates.

Conclusion

In a large cohort of patients with HCC, women had significantly better prognosis than men.
Candidates registered for reasonable adjustments underperform compared to other candidates in the national undergraduate Prescribing Safety Assessment: Retrospective cohort analysis (2014–2018)
Authors: Hutchinson Kate , Ricketts William M. , Maxwell Simon , Ng Fu Liang
Published: June 2020

Aims

Candidates with disabilities are eligible for reasonable adjustments (RA) while undertaking the national Prescribing Safety Assessment (PSA). The PSA is a novel open‐book, time‐constrained, multiformat assessment that may pose challenges to candidates with dyslexia and other disabilities.

Methods

Retrospective cohort analysis of 36 140 UK candidates undertaking first‐sitting of the PSA (2014–2018).

Results

Of the 36 140 candidates, 9.1% (3284) were registered for RA. The RA group had lower pass rates (absolute difference 1.94%, 95% confidence interval 1.01–2.87%; P < .001) and assessment scores (1.16 percentage marks, 95% confidence interval 0.83–1.48; P < .001) compared with the non‐RA group. This absolute difference is small relative to overall variability. This difference persists after adjusting for confounding factors (medical school and paper), and was present for all 8 different question types. The attainment gap within each medical school is negatively correlated with the school's overall performance, both in terms of pass rate (P < .001) and scores (P = .01). The RA group were also less likely to perceive the PSA as an appropriate test, having easy to follow layout/presentation or clear/unambiguous questions, even after adjusting for candidate performance.

Conclusion

This analysis identifies slight differences in academic performance of candidates requiring RA in a national undergraduate assessment. The study is limited by the unavailability of data on ethnicity, sex, age, diagnosis and time of diagnosis. While further research is required to determine the cause of the attainment gap, this study emphasises the need to maintain a careful review on the fairness and validity of all aspects of the assessment.
The role of novel minimally invasive treatments for lower urinary tract symptoms associated with benign prostatic hyperplasia
Authors: Madersbacher Stephan , Roehrborn Claus G. , Oelke Matthias
Published: June 2020

Objectives

To provide an update on novel minimally invasive lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) treatments in a non‐systematic review. To define potential target populations for the various new minimally invasive treatments.

Methods

Recent literature, meta‐analyses and guideline recommendations for aquablation (AquaBeam®; PROCEPT BioRobotics, Redwood City, CA, USA), water vapour thermal therapy (Rezūm®; Boston Scientific, Natick, MA, USA), prostate artery embolisation (PAE), prostatic urethral lift (UroLift®; NeoTract‐Teleflex, Pleasanton, CA, USA) and the temporary implantable nitinol device [i‐TIND® (nitinol butterfly‐like stent ); Medi‐Tate Ltd., Or‐Akiva, Israel] were reviewed.

Results

Procedures that can be performed on an outpatient basis (Rezūm, PAE, UroLift and i‐TIND) are not an alternative for the standard patient requiring BPH surgery. Their effect on urinary flow, post‐void residual urine volume or bladder outlet obstruction is less pronounced than that of transurethral resection of the prostate (TURP). Yet, these options appear to be valuable for those patients unfit for surgery, men who want to avoid medical therapy in general, or those who want to avoid sexual side‐effects associated with medical therapy or standard BPH surgery (e.g. TURP). Aquablation is the first successfully operationalised robotic resection system, especially for patients with prostates >50 g. Nevertheless, long‐term data are necessary for all novel, minimally invasive treatments.

Conclusions

Better designed clinical trials, a clearer definition of target populations and a more realistic marketing allow a better characterisation of novel minimally invasive therapies for LUTS/BPH. It is hoped that some of these novel devices will stand the test of time, in contrast to the vast majority of their predecessors.
Ethnic and socio‐economic disparities in prostate cancer screening: lessons from New Zealand
Authors: Matti Bashar , Lyndon Mataroria , Zargar‐Shoshtari Kamran
Published: June 2020

Objectives

To investigate the presence of ethnic and socio‐economic disparities in prostate cancer (PCa) screening and identify its impact on cancer outcomes.

Materials and Methods

From January 2008 to December 2017, all men in the Northern region of New Zealand who had a prostate‐specific antigen (PSA) test performed in the community were identified from the electronic laboratory reports database. Asymptomatic men, with no known diagnosis of PCa, were included. Variables collected were age, ethnicity, social deprivation, medical therapy, PSA test information and cancer data. Disparities were investigated by comparing the frequency of PSA testing, proportions of men screened, and rates of cancer detection, between Māori (indigenous) and non‐Māori ethnic groups.

Results

The study cohort included 248 491 men, who each received approximately 3.45 PSA tests over the 10‐year study period. Māori men were less likely to be tested compared to non‐Māori men (25.4% vs 46.1% of the total aged‐matched region population; P < 0.001). Moreover, they received less frequent PSA testing irrespective of their deprivation status (mean difference of 0.97 PSA tests per person; P < 0.001). The higher testing frequency in non‐Māori men was associated with increased PCa diagnosis rates. Nevertheless, cancers detected in Māori men were 73% more likely to be of high grade (Gleason 8 or above), compared to those in non‐Māori men.

Conclusion

There were significant ethnic disparities in PCa screening rates in the Northern region of New Zealand. Māori men, regardless of other demographic factors, were disproportionately affected. The difference in the rates of screening by ethnicity had influenced the incidence and clinical significance of the diagnosed cancers.